TMC PULSE

t m c » p u l s e | o c t o b e r 2 0 1 8 17 An entire toolkit One of the first inventions Richards- Kortum and her team created for newborns in sub-Saharan Africa was a continuous positive airway pres- sure machine, known as a CPAP, an essential tool in any neonatal intensive care unit (NICU) for help- ing newborns who have problems breathing. The students managed to keep production costs around $350 per machine, whereas a typical CPAP runs upwards of $6,000. Initially prototyped using a Nalgene water bottle and a shoe box, the sim- ple design requires minimal mainte- nance, with flow coming from an air pump and pressure provided by a newer, mass-produced version of the original plastic bottle. After intro- ducing the machine to one hospital in Malawi, the newborn mortality rate there dropped dramatically. "I think, somewhat naively, we thought that once we scaled the CPAP, that would be good work done and that would really be the end of what we intended to do," Richards-Kortum said. But after disseminating their CPAPs to district hospitals, Richards-Kortum and her team learned that creating one machine that solved one problem simply wasn't enough. In order to deliver quality, comprehensive newborn care, they needed an entire toolkit. "Just because a baby has breath- ing problems, if you treat that alone, if they're cold or they're hypoglyce- mic or they're jaundiced, they don't do well. We saw that babies weren't doing as well as they could and we met so many clinicians who were very frustrated. They didn't have the tools they needed to do their jobs," Richards-Kortum said. And so, Richards-Kortum and her team have set out to assemble this toolkit. Dubbed NEST360°, the suite of 17 technologies will save an estimated 500,000 newborns every year—half the current mortality rate for newborns in sub-Saharan Africa. In addition to the CPAP, the toolkit includes tailor-made devices like a radiant warmer and incubator to help infants maintain their body temperature; diagnostic tools for glucose monitoring, sepsis and infections; a spectrometer that can provide quantitative measure- ments for bilirubin, PH levels and hemoglobin in the blood within approximately 30 seconds; monitors for breathing, oxygen levels and temperature; a low-cost and low- power syringe pump to help supply medicine, fluid or formula; and a unique phototherapy machine that helps treat jaundice. If left untreated, jaundice can cause brain damage or death, and NEST360°'s diagnostic tool can detect the condition at the bedside in less than two minutes, with one drop of blood. Each test costs only five cents. The full toolkit is estimated to cost 10 times less than the tools and machines used in high-resource settings, including NICUs across the U.S. "What was both amazing and exciting to me was when you cost out how much it would be to deliver that suite of technology, it turns out to be $1.50 per each baby born at the hospital," Richards-Kortum said. "It's just crazy that for that small amount, these tools are not avail- able. I think it could be as cost-effec- tive and as lifesaving as vaccines." Kortum offered his analysis of his wife's work and impact. "She started to see that there was this whole realm of global health where she could attack the heart of some problems,'' he said. "It's kind of interesting because when you see the end devices, a lot of people say, 'Well, gosh, it's so simple, anybody could have thought of that.' And then the question is, well then, why didn't anybody, and why do devices in the United States cost 10, 20, 30 times more and not work as well? Because it is hard. It's super hard." It was, in fact, the hardest thing she could do. Sacred time Richards-Kortum's work takes her to Africa about four times a year, and she is gone for her fair share of domestic travel, too. She tries not to be away from family for more than 10 days at a time, but with 30-plus hours of travel from Houston to Malawi, it's not always easy. So she wrings every second out of every day. (continued) Foot Notes p r e s e n t e d b y LEPOW FOOT & ANKLE SPECIALISTS Walking shouldn't be a pain. We offer a wide range of conservative, surgical, and rehabilitative treatment plans, combining state of the art technology with personal care and attention. Prompt and accurate diagnosis coupled with early intervention is essential to the proper care and treatment of: l e p o w f o o t . c o m • Achilles Tendonitis • Ankle Injuries • Bunions • Diabetic Neuropathy • Gout • Hammertoes • Heel Pain/Spurs • Metatarsal Stress Fracture • Neuroma • Plantar Fasciitis • Toe Problems • Wound Care 4 0 + y e a r s o f e x p e r i e n c e B o a rd Ce r t i f i e d, A m e r i c a n B o a rd o f F o o t a n d A n k l e S u rg e r y 7 1 3 . 7 9 0 . 0 5 3 0 Texas Medical Center 7 1 3 . 9 5 1 . 5 0 0 0 Downtown

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