Tuesday September 30 2014

Giving babies air at birth

 

By Esther Nakkazi

It was his first time to attend a hackathon. All the way from Mbarara in western Uganda to Boston in Massachusetts, USA, the rules were clear: you pitch a clinical problem and a solution, within 24 hours you team up and come up with a prototype.

He had no idea what he was going to pitch, but as a pediatrician, Dr Data Santorino, had seen babies die at birth and knew he wanted something around that issue. As a national trainer for a project ‘Helping Babies Breathe’ that teaches neonatal resuscitation techniques, he appreciated the gravity of the problem.

Uganda’s neonatal mortality rate is 27 deaths per 1,000 live births. This is Millennium Development Goal number four, one of the statistically unprogressive ones. As he was searching for a solution to pitch, he saw Kristian Olson, a master trainer at Helping Babies Breathe (who later became part of the team) walk into the room with a resuscitator. Finally, Dr Santorino knew what problem and solution he would pitch.

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“The hackathon was our match maker,” Dr Santorino, who is also a lecturer at Mbarara University of Science and Technology (MUST), says on the event that connected him to computer scientists.
A multi-disciplinary team was formed consisting of Dr Santorino, Oslon a clinician and also the Medical Director of CAM Tech at Massachusetts General Hospital (MGH), Craig Mielcarz a software engineer and Kevin Cedrone a mechanical engineering at MIT.

Together, they came up with a prototype of the Augmented Infant Resuscitator (AIR) in 24 hours, which will monitor in real time and capture data on the quality of resuscitation of babies.

“Our technology has the potential to save lives. It’s feasible, has a sustainable, business model, can spread globally and has two markets for clinical use and training,” said Data also the Uganda country manager CAMTech. “In time it will get in the training market faster and in multiple geographical areas.”

Elizabeth Bailey, director Consortium for Affordable Medical Technologies (CAMTech) says a hackathon is usually the spark. The hard work comes afterwards with things like mentoring, keeping teams together and commercialisation of the devices.

Moving forward
The team of four inventors meets online every week to map the way forward and they still have a lot to learn. Oslon says he knew nothing about IP but with the mentoring that comes in a hackathon he has learnt so much.

“The innovation is now under field testing,” says Dr David Bangsberg, a professor at Harvard University and director, Centre for Global Health at Mass General Hospital (MGH).

If it hits the market, the gadget may cost between Shs7500 and Shs12,500 per piece or retail at Shs37,500. Globally, the scientists are confident it will prevent at least 80 per cent deaths of the 1.8 million new born baby deaths and still births of babies who experience oxygen depriving events at birth annually. In Uganda, it is the third leading cause of deaths of newborn babies.

It is a joint invention between MUST and Mass General Hospital’s Global Health Centre, says Bangsberg. It is also a land mark Intellectual Property, shared between two worlds and the first ever for MUST. Its licence recognises the four inventors and has a clear share of revenue between the investors and the two institutions.

Beyond health

“As African innovators we need partnerships

“As African innovators we need partnerships that support our weak areas. There is a lot we can contribute to global health because we understand global health problems better,”
Dr Data Santorino, lecturer at Mbarara university who took part in the hackathon that led to the air prototype


Bailey says the AIR could present an interesting business model especially considering that in the Global health space, making a public health impact is bigger than making money. But concedes, sustainability is also key to the manufacturer.

“As African innovators we need partnerships that support our weak areas. There is a lot we can contribute to global health because we understand global health problems better,” says Dr Santorino.

One of the viable business models for a manufacturer spelt out in the licence could for instance be that they maintain certain prices in the developed world, but keeps them low to enable scaling up in resource limited settings and to have a global health impact.

“If it does not scale up, it will not matter,” says Kristian who attended the second Hack-a-thon at Mbarara University between August 22 and 24. But there is proof that “it will have a high health impact and could have a dual use in the US, Uganda and neighbouring countries markets”.

Dr Santorino also the country manager CAM Tech says the resuscitators on the market around the world are not smart enough and time is of the essence in this game. Immediately, a baby is born and it does not breathe properly, the health worker has just a one minute window to get oxygen into its lungs. Sometimes, it could be the position of the baby, a congested airway, or the seal of the resuscitator not fitted well but it is hard to tell which is the problem.

The AIR is a gadget to be attached to a resuscitator to give instant feedback to a paediatrician on the performance of the face mask seal, rate of breathing; for instance, if it is too slow, it could indicate a baby’s blocked airway due to secretions or bad positioning or poor ventilation.

Taking advantage of hackathons
Firms that manufacture medical devices for the health market can also learn from hackathons.

To date, over 1,000 innovators have participated in CAM Tech hackathons across Uganda, India and the United States and they have spawned many new technologies addressing different health problems.

According to Bangsberg, medical device companies interested in growing the global health sector should know that Africa is the growth market of their business tomorrow while India as a middle income country is seen as the growth market today.

“If you want to innovate, you have to overcome so many problems. One of them is finance,” says Prof Fredrick Kayanja, the Vice Chancellor, Mbarara university.

He also recognises that innovations raise the profile of the university and the country and show that the staff and students are innovative and thinkers, but only partnerships sustain them. Hackathons provide these partnerships.

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