Myshkin Ingawale is the CEO and founder of ToucHb, a startup in India that has developed a battery-powered portable device for diagnosing anemia. Anemia is a serious, common problem in India, especially as related to women in pregnancy, where it is believed to cause over 130,000 maternal deaths each year. As the ToucHb website outlines, "Iron deficiency anemia is one of the most prevalent nutritional deficiencies in the world and affects a billion people worldwide. Iron demand in pregnancy and growth is high, so pregnant women and children are most seriously affected by anemia. In India, anemia contributes to around 40% of maternal deaths per year...." This is especially insidious because female children conceived by anemic mothers often end up being anemic themselves, driving a cycle of infection.
As the son of a pediatrician, Myshkin was repeatedly exposed to this problem during his childhood. Later on, as a professional engineer, he realized that proper diagnosis could nip it in the bud, as anemia can be cured with iron tablets when caught early enough.
As a diagnostic tool, ToucHb is an attractive option for Indian women because it is "noninvasive"--it does not even require the prick of a finger. It is also light-weight and can be toted around by a local health worker, who can come right to their home.
How did you first break into this path of citizen engineering?
I could generalize and say engineers love technology and they love to fix problems with technology. At my end, it was no different. I was generally of that mindset. What affected me and pushed me into this career was a second-hand experience of the problem.
My mother is a pediatrician who has been treating both the affluent and not-so-affluent in India. I would sit around the clinic and see all kinds of patients come in and out and how she would handle them. I got to learn about how health care is in India.
I saw friends of mine in India who were doing medical training and the problems they came across and I would say, wait a minute, this is a problem that is easy to fix with technology. It was nothing too grandiose; I wasn't saving the world, but I was identifying problems that were easy enough to fix.
Tell me more about squaring up to this particular problem.
The problem I had seen in the field was that health care workers could not diagnose iron-deficiency anemia. They were using very primitive technologies, like simple visual inspection of a person's eyes to see if they were yellow. It was very subjective and almost useless as a diagnostic tool when no medical personnel were there. And even if there was medical personnel present, it still had low specificity.
The second primitive tool I saw was literally a home chemistry kit, where you put a blood sample in a pipette and sucked it through and acidified it in a test tube with hydrochloric acid. It wasn't convenient, it wasn't precise, and it was this lack of precision in these methods that was causing the problem to persist.
That's how it started for me. Observation of the problem on the ground. Two of my friends who were doctors had also seen this problem. They had done their medical internships in rural parts of West India. They had seen women in childbirth with undiagnosed anemia, with hemoglobin levels that were extremely low-like 6, or 7 even-and they would have a lot of problems and bleeding during childbirth. If they had been diagnosed early enough and monitored over a nine-month period, they would have been saved of either pain or infant mortality. And this could all be traced back to nutrition.
We realized that intervention was possible with a tool we have built called ToucHb. Over the last three years, we have tried to perfect this technology to a level where it is just accurate and usable enough for the end users we have in mind. We had a limited pre-release in March of 2012 and are looking to launch it on a wider scale in late 2012.
How does it work and how does treatment follow if anemia is detected?
It estimates hemoglobin and oxygen in the blood without using needles, working on an optical principle, similar to a pulse oximeter. It shines light of different wavelengths through the tissue and determines the concentration of the molecules in blood via analysis of the transmitted light.
If mild anemia is detected, treatment is administered with iron tablets. If it is more serious, there is a referral to a tertiary health care center, where treatment could involve injection or blood transfusion depending on what the problem is.
At what stage is this project currently, and where do you see it going in the future?
We have tested at ten different locations so far and we are looking to sell one hundred devices. If we can do that, we can do a thousand, and if we can do that, ten thousand. It's a slow ramp-up plan.
The pre-launch is restricted to select clinics, and we shall be partnering with organizations in different geographies for a phased roll-out in 2012. Pre-orders from individual clinics will start later in 2012.
What sustains this work for you?
I am motivated to do this because it is fun. It's fun to develop the technology and see that it can be used, and it is satisfying to see it built and actually be useful to somebody. It's why I do what I do.
To learn more about Myshkin and his work, you can find the TouchB website here.
To watch a video about Myshkin visit the Unreasonable Institute.