Placed on a hospital cupboard about two meters from the ground, the little box glows with a brilliant blue light, beautiful in the dark. Unlike the normal incubator used in Paediatric Intensive Care Units (PICU), the box measures approximately about 1m x 0.5m x1m (3ft x 2ft x 2ft) and weighs a little above 5 kilograms (11 pounds) . This box has saved the lives of many babies since a young mother and her team first produced it, three years ago.
Originally conceived, designed, tested and launched in Yenagoa, Bayelsa State, the box now sits in the paediatric units of various hospitals in the Federal Capital Territory (FCT), including Maitama, Wuse and Asokoro District Hospitals.
Named Crib A’Glow, it is a low-cost phototherapy solution to treat newborn babies with neonatal jaundice. It was developed by a young mum and professional graphic designer, Virtue Oboro, after her son’s experience with jaundice. With a group of medical professionals and biomedical engineers, she built a prototype, but it took four failed attempts and several trials before the product worked and she started her company, Tiny Hearts Technologies.
Addressing a Silent Child Killer
Data from the World Health Organization’s Global Health Observatory shows that in 2017, newborn deaths accounted for 47% of deaths among children under five, and in 2016, 1 million children died as a result of complications arising from premature births. While jaundice occurs in about 50% of babies reaching full term, it occurs in 80% of preterm babies. A paediatric specialist at the Asokoro District Hospital in the FCT estimates that 8 out of every 10 premature births in their unit have the condition.
Jaundice is usually caused by an excessive build-up of bilirubin, a substance made when the body routinely breaks down red blood cells. However, a newborn’s still-developing liver often cannot remove bilirubin quickly enough, causing an excess. Another predisposing factor is Rhesus (Rh) incompatibility between a mother and her baby. Although a small number of babies have different rhesus blood types from their mothers, these mismatches can lead to jaundice. Occurring in the first few days of life, the most notable symptom is a yellow colouration of the skin, which with time, is also observed in the whites of the eyes. While many mild cases do not require treatment, the common treatment for severe jaundice is phototherapy which involves placing the baby under a special type of light that helps break down the excess bilirubin.
A harrowing experience with jaundice
If the bilirubin isn’t broken down quickly enough, it can lead to death or severe disability. Early detection is therefore very important because the symptoms can be missed by new mothers. In the case of Oboro, she thought her son, Tonbra, “just had a fair complexion.” Oboro was discharged from the hospital about 48 hours after delivery, and it wasn’t until her mum, a nurse, came visiting that she realised the yellowish colour was unusual. Once they returned to the hospital, little Tonbra was diagnosed with jaundice. Oboro described the experience that followed the diagnosis as “harrowing”, as the excitement of the birth of her first son was replaced with fear and uncertainty, especially when she learned of the possibility of brain damage if the diagnosis was not properly handled.
With all phototherapy treatment units in use at the PICU of the hospital where Tonbra was admitted, a mother whose baby had almost recovered asked that her baby be discharged to give baby Tonbra a chance. Almost immediately, he was placed inside the phototherapy unit, but then, there was a power outage and other alternative sources of power in the hospital failed. The doctors performed an emergency blood transfusion which sustained him until he was able to access a phototherapy unit. After about a week, Oboro returned home with her baby but the experience was not to leave her for weeks.
Necessity usually leads to invention but for Oboro, it was a combination of the near-death experience of her son, curiosity, a passion for problem-solving and empathy for other babies who might face similar situations, that led to the development of Crib A’Glow.
Once she and her son had recovered from the experience, she set out to learn more about jaundice and possible ways for other parents and healthcare providers to overcome the challenges they had faced. The main problems turned out to be lack of quick access to treatment and unstable power supply.
After extensive research, Oboro and her team came up with Crib A’Glow, a simple solar-powered phototherapy system that can be easily moved around to locations where it is needed.
Powered by the sun, the unit solves the problem of unreliable power supply. It also improves ease of access as the equipment can be easily disassembled and moved from one location to another where it is needed urgently.
As a social enterprise, the company is sustained by selling and hiring out the Crib A’Glow phototherapy units. A unit sells for N150,000 and can be rented at the rate of N3000 for 24 hours. Tiny Hearts Technologies also produces disposable phototherapy blindfolds, conducts training programs and recently launched a sensitisation initiative called Yellow Alert to help raise awareness about neonatal jaundice among pregnant women.
Beyond Bayelsa: Scaling up a home-made solution
Since the inception of Tiny Heart Technologies in 2016, over 1250 babies have benefitted from their initiative, says Oboro. For her, the task of pitching their services to hospitals is a difficult process because most times, they are met with scepticism. “They usually prefer big equipment from big companies outside Nigeria and usually don’t want to try homemade solutions,” Oboro said. However, they continue inventing strategies to win them over. She recounted how such efforts saved a baby’s life and led to bringing the Crib A’Glow unit to three hospitals in the FCT.
In February 2018, Oboro walked into the paediatric intensive care unit of the Niger Delta University Teaching Hospital (NDUTH) in Yenagoa, Bayelsa state capital. Her mission was to retrieve the phototherapy unit she had rented to the hospital for use. An attending paediatrician told her that a baby was to start treatment with the unit, but the parents were unable to afford it. After hearing the story and with a plea from the doctor to assist, she decided to see the baby.
Baby Ndukwe, as he was called, had jaundice but presented at the hospital when complications had set in. His parents had turned to herbal remedies when they first noticed he was sick. On seeing the state of the baby, Oboro decided to assist by starting a fundraiser for him even though it was out of their line of business. She got consent from the parents, took baby Ndukwe’s picture and asked for financial help through her WhatsApp network. Within 24 hours, over N70,000 was raised. This helped offset his medical bills, rent the phototherapy unit for the duration of his treatment and even covered the next baby in need of treatment.
Someone who donated to the fundraiser for baby Ndukwe bought three units of the phototherapy unit and anonymously donated them to three hospitals in Abuja. Oboro said the donor’s motivation was simple. “She said since the Crib A’Glow helped save the life of one baby, she wanted to extend that opportunity to other babies who might need it,” she said.
Can Nigeria sustain innovative homegrown start ups?
The challenges with the Crib A’Glow solution are not different from other Nigerian start-ups and largely revolve around the cost of running a business, hiring and retaining talent, government support and regulations. But as a Nigerian medical equipment and device start-up, Tiny Hearts Technologies has its unique set of challenges too, one of which is the inherent preference for imported products. Oboro said this is one of their biggest challenges because it’s difficult to convince hospital executives to adopt their solution.
The cost of using the equipment is another challenge. Hospitals that rent the units need to make profit because they are running a business. This is likely to increase the cost for patients’ relatives and introduce a barrier to access. This can be overcome if there is an effective health insurance system that covers citizens in the formal and informal sectors.
A challenge which raises an important question is the issue of patents and protecting intellectual properties. How well are these innovations protected especially in a highly competitive market like Nigeria? Oboro says she has a patent right which offers protection for her design. The legal framework for patents is enshrined in the Patents and Designs Act of 1971. In place for nearly five decades now, is the Act still in tune with current realities, and able to protect young inventors?
Globally, there is a need for affordable technologies to tackle neonatal jaundice. The Crib A’Glow is one of such but for it to thrive, we must develop a culture of adopting and supporting Nigerian-made solutions once they are proven to be effective. The team has plans of expanding to other African countries but charity, they say, begins at home. Let us adopt and use our own, so that other babies like Tonbra and Ndukwe can be given a fighting chance.
Are you aware of other technology solutions tackling neonatal jaundice in Nigeria? What are your thoughts about Crib A’Glow and other similar solutions? Please share in the comment section below. We would love to hear from you.