Frugal Innovation in Medicine

Bottom-up innovations

Use of novel and low tech approaches to obtain results unattainable before

Stitching wounds with the mandibles of ants or beetles

In case of a cut, press together the margins of the cut with the fingers of the left hand and apply the insect. The mandibles of the insect are widely open for self defense, and as the insect is brought near to the wound they seize upon the raised surface, penetrate the skin on both sides and remain tenaciously fixed while the operator severes the head from the thorax, leaving the mandibles grasping the wound. Published in the JAMA in 1925

References: Miscellany. JAMA. 1925;84(24):1861-1865. doi:10.1001/jama.1925.02660500069048.


Breast Milk HIV shield - Flash heating

Flash heating, as well as pretoria pasteurization (longer duration heating), have been shown to effectively remove HIV from milk. Procedurally, using the flash-heating method, a mother first expresses 75-150 mL of breast milk into a glass jar. The jar is then placed in a pot of water, which is brought to a boil. At this point the milk can be removed, and fed to the baby once it cools to an acceptable temperature. Flash heating utilizes materials that are already found around the home, which could put the mother's upfront cost of the device at virtually zero. Furthermore, daily cooking is done by most families, so that the boiling of the milk might be incorporated into everyday life. However, the flash heating method could require more boiling than is typical for a mother's routine, which might require increased time, effort, and money to acquire the extra fuel. Even if the heating were somehow incorporated entirely into the daily cooking, performing the acts of manually expressing enough milk (often 600mL/day), storing the milk, and finally delivering the milk to the child are simply not practical for many women. Furthermore, by blatantly not breastfeeding a child, a woman is often subject to the stigma of being HIV+, a reality that many women and their families are reluctant to admit.

References: Israel-Ballard K, Chantry C, Dewey K, Lonnerdal B, Sheppard H, Donovan R, et al. Viral, nutritional, and bacterial safety of flash-heated and pretoria-pasteurized breast milk to prevent mother-to-child transmission of HIV in resource-poor countries: a pilot study. J Acquir Immune Defic Syndr. 2005;40(2):175-81.

Filtered sunlight in treatment of jaundice in neonates.

Sunlight, filtered with commercial window-tinting films that remove most UV and significant levels of infrared light and transmit effective levels of therapeutic blue light, is a practical, and inexpensive method of phototherapy (PT) that potentially offers safe and efficacious treatment strategy for management of neonatal jaundice in tropical countries where conventional PT treatment is not available.

References: Slusher TM, Vreman HJ, Olusanya BO, Wong RJ, Brearley AM, Vaucher YE, et al. Safety and efficacy of filtered sunlight in treatment of jaundice in African neonates. Pediatrics. 2014 Jun;133(6):e1568-74.

Blood transfusion when no donors or blood are available

Blood pools into incisions in the woman's abdomen, before a sterilized gallipot or soup ladle scoops it into a basin of anticoagulants. From there it filters through a gauze lined funnel, feeds into a blood bag and drips back into her body.

References: World Health Organization. Emerging economies drive frugal innovation. Bull World Health Organ. 2013 Jan 1;91(1):6-7

Simple sari cloth filtration of water to protect villagers from cholera

Sari filtration was accepted and sustained by the villagers and benefited them, including their neighbors not filtering water, in reducing the incidence of cholera

References: Huq A, Yunus M, Sohel SS, Bhuiya A, Emch M, Luby SP, et al. Simple sari cloth filtration of water is sustainable and continues to protect villagers from cholera in Matlab, Bangladesh. MBio. 2010 Apr;1(1).

Kangaroo mother care

Home care program based on the following principles: - discharge home without regard to weight once the baby's condition is stable and it has adapted to extrauterine life, thereby removing the baby from the disease-ridden hospital - no artificial milk formula to be given, only mother's milk supplemented with guava juice - encouragement of early bonding by nursing the baby next to the mother's body between the breasts - maintenance of the baby in a head-up position

References: Whitelaw A, Sleath K. Myth of the marsupial mother: home care of very low birth weight babies in Bogota, Colombia. Lancet. 1985 May 25;1(8439):1206-8.

Odon's device for vaginal deliveries

The Odón device is a low-cost technological innovation to facilitate operative vaginal delivery and designed to minimize trauma to the mother and baby. These features combined make it a potentially revolutionary development in obstetrics, particularly for improving intrapartum care and reducing maternal and perinatal morbidity and mortality in low resource settings.

References: Schvartzman JA, Krupitzki H, Betran AP, Requejo J, Bergel E, Fiorillo AE, et al. Feasibility and safety study of a new device (Odon device) for assisted vaginal deliveries: study protocol. Reprod Health. 2013;10:33.

Solar disinfection of drinking water

Solar disinfection of water may significantly reduce morbidity in communities with no other means of disinfection of drinking water, because of lack of resources or in the event of a disaster.

References: Conroy RM, Elmore-Meegan M, Joyce T, McGuigan KG, Barnes J. Solar disinfection of drinking water and diarrhoea in Maasai children: a controlled field trial. Lancet. 1996 Dec 21-28;348(9043):1695-7.

Bicycle ambulances

Use of Bicycle ambulances instead of car ambulances

References: Low-tech innovation saves lives in Malawi. Aljazeera, 2014.



"Any problem can be solved with a little ingenuity"
Mc Gyver

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