Neonatal incubator made of car parts

Stuff breaks.

Replace, send for repairs, or try to fix it yourself? In the developing world, choice 3 is often the only option. Unfortunately, even if you’re game to try fixing a broken machine, the parts are often all but unobtainable. And even if the parts are obtainable, modern technology has made many machines opaque.

So here's a brilliant idea: medical machinery that can be repaired anyplace where there are car parts and mechanics. The NeoNurture was invented by Design That Matters, an American NGO that creates products and services to help the poor in developing countries. This nifty incubator is made of auto components and should be transparent to anyone who understands cars. That means it can be used in remote areas (since presumably there are cars just about everywhere these days), and when it breaks or needs to be altered, it doesn't become a useless piece of junk. God knows we're glad to have our ultrasound machine and X-ray out here in our rural Indonesian clinic, but we haven't any special parts or expertise to fix them once they fail. What do we do with them then? Burn them? To borrow a quote from the New York Times, which blogged about the incubator last November:

“Every rural clinic in the developing world has a shack full of broken donated medical equipment,” said Timothy Prestero, chief executive of the Cambridge, Mass., design consultancy. 

You get it, DTM! Thank you. Can't wait to see these in production.

Check out the other ideas this firm is developing: a phototherapy device, a microfilm projector, and an IV flow controller. Their past projects sound great, too. I'd like to know more about which ones have been most successful and which ones remained at the prototype stage.

Review: Fabulous little EKG machine

Greetings, faithful readers, from the aftermath of a long Internet outage. I want to review a nifty portable EKG machine that our clinic recently received from a generous donor.

Sold on eBay by a Chinese company called Medeshop for $239.00 plus $29.00 shipping (American dollars), this electrocardiogram machine fits in one's palm and weighs 800 grams. It arrived promptly (to a US address, after which it was hand-carried to Indonesia) and came with detailed instructions in somewhat fractured but quite understandable English. And I couldn't be more pleased with it.

For one thing, it's a snap to use. We borrowed one of our male nurses and had it on him within minutes, using its handy suction-cup and clamp attachments. After five or ten minutes' spent studying the instructions, we'd mastered all the buttons and options, each of which was close to intuitive.

For another thing, it's all but self-contained. For one thing, the suction cups and clamps mean no disposable stickers--not only are those stickers expensive and hard to obtain in remote areas, but they also generate trash. And here in rural Indonesia as everywhere in the world, trash is a big problem. The only thing this machine does need is paper for printouts--unless you decide to hook it up to your PC and view the EKGs digitally. Our clinic is Mac-based and we're not able to choose this option, but one could conceivably go completely paperless and trashless with this EKG. In a low-resource environment, all things being equal, equipment that doesn't require disposable parts and that behaves in a near self-sufficient matter should be given greater weight in purchase decisions than equipment that relies on parts that must be continually bought and replenished. Even if one has a steady supply of parts, they can go missing or be hard to store or keep track of in a small clinic.

Finally, one can operate without power--its battery lasts at least half an hour after being fully charged. That is absolutely key in an environment where the power often goes out. And you can opt for backlighting.

This machine allows the user to toggle through each lead on a standard 12-lead EKG; one can then opt to print it out. The printout isn't like a full-sized machine that prints a series of heartbeats from the simultaneous point of view of each of the leads--on this little machine, each lead is measured for three seconds sequentially. So you have to bear in mind that you're not comparing individual heartbeats across leads.

It offers various paper speeds and filters, too. I'm delighted with this thing and hope our clinic will eventually be able to obtain a few more. But if we never do, it's so light and portable that we can carry it from bedside to bedside and use it as we would any other portable equipment.

Verdict: great product.