Low Cost Nepali Incubator: The LIFE RAFTSecond Design Review

Low Cost Nepali Incubator: The LIFE RAFTSecond Design Review

Prepared for: Entrepreneurial Design for Extreme AffordabilityMay 9, 2007

2

Team StacksI need to build

something. Now![e.Nag]

I need to build something. Now!

[e.Nag]

How do we build empathy and

connect to the right people? [b.Leslie]

How do we build empathy and

connect to the right people? [b.Leslie]I just built

something sweet![e.Eric]

I just built something sweet!

[e.Eric]

I can’t stop thinking like a consultant…

[b.Yuval]

I can’t stop thinking like a consultant…

[b.Yuval]

3

The project is a series of realizations

Nepali nurses need our help

We must define our niche (aka, Klaus was right)

Van Hemel was onto something

Prototype, prototype, prototype

Nepal is small, India isn’t

Measuring success is all about the babies

We are strengthened by our partners Time is short; prioritizing is key

4

Understanding Nepal

28M people

Infant mortality of 6.5% is among worst in world (8x US rate)

~45% lives below the poverty line, income per capita of $220– Ranked 153 out of 175 countries in human development

1 doctor per 20,000 people (in parts, 1 for every 100,000)

Only 18% of deliveries have a trained health worker in attendance (for the poorest parts, <5%)

“>99% of Nepal’s hospital have no formal NICU that can ventilate sick premature babies”

5

Nepali nurses need our help

The “junior” nurse in public Nepali

hospital…

..an intuitive, trustworthy, intelligent

helper that keeps premature babies alive and ensures long-term health

needs

6

$1

$10

$100

$1,000

$10,000

GAP

Features & Capabilities (from a Nepal perspective)

Cost

Free

Basic Average Best-in-class

Indian

Static Incubators Available in Nepal

“Almost Giraffe”

Atom

Home-made

Maintenance & Repair

“It breaks to easily..We don’t trust it”

Shortage

Finding our niche (aka, Klaus was right)

7

The original idea

Dr. Van Hemel was onto something

First built in Uganda 1968, revised in 1983

Simple as possible - low cost and ease of maintenance. – Many incubators with 15+ yrs of service still

functioning, even with no serious maintenance

Now 1000+ VH incubators “in almost all developing countries”

– Approx 25 incubators purchased each year for >270 euros

The Van Hemel Incubator

Trustworthy (reliable, safe)

Intuitive (easy to use, feels modern)

Intelligent (customized to local users and market, alarm)

THE LIFE RAFT (The Van Hemel 2.0)

The BIG idea

8

Prototyping priorities

We’re going to tackle only the most critical

features

and nail them!

9

Prototype, prototype, prototype

15

20

25

30

35

40

0 5 10 15 20 25 30 35

LIFE RAFT

Ohmeda

Minutes

Ce

lsiu

s

Canopy: Reduces volume, improves

access, better visibility

Performance: Comparable rate of

heatingHeat: Potential combo

of convection and radiation

Repairable: Simplified (no fan);

locally available parts

Humidity: Mechanical control of humidity; heated water kills bacteria

10

Nepal is small. India isn’t.

0

20

40

60

80

100

120

Sloan projection Hospital-based UK comp

Nepal

PRELIMINARY ESTIMATES: Annual Total Demand for Static Incubators

Note: All annualized numbers assume a lifespan of 8 years. “Sloan projection” based on scaling of MIT team’s estimate of India for Nepali population. “Hospital based” assumes 74 District hospitals, 180 PHCs, 3187 sub-health posts respectively demanding 2, 1, 0.1 incubators/hospital. “Bottom up” is based on Nepali birth rates and health of babies. Demand does not take into account price elasticity.

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

Sloan projection Hospital-based UK Comp

NepalIndia

Units

Approach for estimation

11

Measuring Success: It’s all about the babies

20,000

22,000

24,000

26,000

28,000

30,000

32,000

34,000

2006 With VH2.0

2,000-3,000 infants saved annually by

increased access to incubators

Total Annual Neonatal Deaths in Nepal*

* Conservative estimate of premature babies who would benefit from an incubators

Note: estimates based on Nepali birth, neonatal mortality, and premature/LBW rate, current and projected access to incubators, and medical estimates of survival improvements resulting from access to temperature regulation.

12

We are strengthened by our partners

Michele Avila-Emerson, NICU/PICU nurse

Akira Nagai, Manager of Export Dept.

Dr. Benitz, Chief of Neonatology

“On the ground”Dr. Mark ZimmermanDr. Sangita Basnet KoiralaThakur Lamsal

Dr. Geetha Rana, Reproductive Health Coordinator

Fidel Rodriguez

Otho Boone, President and CEO (and former Ohmeda incubator designer; “advisor” to Team Stacks

Tim Prestero, CEOMatt Eckelman DtM Fellow

Ray Avery, Founder CEO

Fred Shepardson, Exec. Dir.+ 5 more of Fred’s colleagues

Additional relationships being cultivated with the WHO in Nepal, local doctors, and anyone who can lend a

useful hand!

13

Time is short! Prioritizing is key.

Week 6 Week 7 Week 8 Week 9 Week 10

Business-side

Engineering-side Heat & HumidityAccess (shell, portals, and frame)

Electronics feasibility study

Refinements

Surveying / demand estimation

Org design & partners

Tying together

Costing (mfg + dstr)

2 3

Finalized prototype

14

Engineering: – What’s the most reliable, lowest cost heating solution for Nepal?

Demand-side: – How do you compete with free, a.k.a. “What’s the right price?”

Distribution: – Current path of the donated incubators – Who our big partners are going to be (WHO, UNICEF)?

Safety:– How the heck do we get FDA approval?

Remaining questions