My route to starting my own technology company began over five years ago in a design school course at Stanford. My team was challenged to design a baby incubator that would cost 1% of the US$ 20,000 cost of the incubators you’d see in a modern hospital – a sum far beyond the means of many healthcare facilities in developing countries. In setting out to solve this problem, we came upon an insight that has fundamentally changed the way I think about technology.
Our research began in Nepal and India. It turned out that some hospitals in even small towns had traditional equipment like incubators and radiant warmers – sometimes procured, sometimes donated by well-meaning foreigners. But they’d often be lying idle, given the lack of constant electricity to power them, not to mention the lack of training for the healthcare workers to operate them. Furthermore, the vast majority of premature babies were dying miles away from these hospitals, in villages.
In these settings, we saw local solutions such as light bulbs or space heaters to warm babies, which are extremely unsafe and ineffective. We also learned of Kangaroo Mother Care (KMC), the practice of placing a baby against a mother’s bare chest. While this is an incredibly effective form of temperature regulation that provides numerous benefits to the infant, we found it was difficult for mothers to provide this continuously throughout the day.
Through our research, we began to meet dozens of women who had lost their babies, like Sujatha, who is from a village in southern India. Sujatha lost all three of her babies. She described to us her desperate attempts to seek care for each of them, but her efforts were futile. In each case, she was simply not able to access a healthcare facility or the medical equipment that was needed.
Based on these insights, my team and I quickly came to realize that what was needed was not just a lower cost incubator. What was needed was a solution that could work without a constant supply of electricity, something that was extremely intuitive to use, so mothers like Sujatha could use the product.
We came up with the Embrace infant warmer, a sleeping bag design that incorporates a “phase change” material – a substance a little like wax which changes state when warmed. When melted, this can maintain a constant temperature of 98ºF (37ºC) for hours at a stretch.
Once we graduated, we moved to India to further develop the product. As we continued our research, it began to sink in that the populations we were working with were largely uneducated and illiterate. We were anxious about sending a medical device home with them – what if something went wrong and they were unable to read an instruction manual?
So we created a version of the product that could be used in hospital settings by doctors. We created a sleeping bag that was compatible with IV lines. Given that many hospitals have intermittent access to electricity, we developed an electric heater to melt the wax pouch that would only require 30 minutes of power for every 4-6 hours of heat. We launched the product towards the end of 2011.
However, this product was still only able to serve those who could get to clinics, and pay the fees necessary to receive care. What we ultimately wanted to do was to create a product that could be used at home. So we continued to develop the version of our product that could be used directly by mothers.
While clinics tend to have intermittent electricity, homes often do not – so we adapted the product to be heated by hot water instead. We made a version of the wax pouch that would retain its heat for up to eight hours, so mothers could sleep through the night. We developed a sleeping bag that allowed for even easier access to the baby, so mothers could easily breastfeed and provide KMC. And we developed instructions that were entirely pictorial, given that many of the women we wanted to serve couldn’t read.
At the end of 2012, we began to pilot this version of the product. We trained mothers, nurses and doctors how to use it, following which mothers took it home with them. A few weeks later, we went back and tested everyone whom we had trained to assess how well they retained the information.
Guess who performed the best on these training assessments?
It wasn’t the health workers – it was the mothers. In retrospect, this makes perfect sense. In countries like India, the doctor patient ratio is 1:2,000 – doctors and nurses are severely overstretched and simply don’t have time to pay attention to every patient or new technology. A mother, however, will go to any length to save her baby. Technology will ultimately be powered by this love, as technology can only serve to magnify intent. Our mistake had been to value the training of the professionals over the motivation of the mothers.
The Embrace infant warmers have now helped 40,000 babies across 10 countries, and we hope to help many more babies through other disruptive innovations that tackle additional causes of infant mortality, such as pneumonia and sepsis. Our goal is to develop solutions that can be used by healthcare workers as well as caregivers who are ultimately most motivated to save their infants.
Through my work over the last five years, I’ve witnessed many things that could easily make you become jaded – from the infant deaths I’ve learned first-hand about, to the extreme poverty and broken healthcare systems that result in these deaths, to the endless challenges we’ve faced in taking this new technology from a concept in a classroom to the hands of those whom desperately need it. And yet through this all, I have maintained my optimism through witnessing the most beautiful thing in this world: the pure, selfless love of the mothers.
Technology alone can’t solve massive global problems like infant mortality. However, technology powered by love can. Whatever our next product turns out to be, it will capture this simple insight: create solutions for the people who care the most about solving the problem.
Listen to Nissima's Story and get to know the wonderful Embrace Nest.