It's been done.  But the device is not being widely used...yet.  This little indestructible plastic sticker is a liquid crystal device that cost about $.20 US.  It was invented 10 years ago by John Zeal and David Morley.  Zeal is a third generation temperature specialist and Morley a global child health specialist.  Together they worked to test the device in India and in Malawi.  The plastic sticker attaches to an infant's upper right chest (deep in the armpit) and actually stays on the baby for up to a week--and it is reuseable. The disc pictured here measures core body temperature and turns from green to black if a baby reaches a dangerously low temperature indicating hypothermia.   This fact is extremely important because it means that a mother can take an infant home and even if she is illiterate she can see when the baby is in danger.  The device pairs with the teaching about Kangaroo Care--that a mother should hold a baby to her chest to warm the infant if the baby is too cold.  It is thought to be most effective in settings where there is little supervision of newborns and no presence of trained health workers or home visits. Yet strangely, for such a simple little powerhouse of a device, it is not in as widespread use as we'd expect.  

This is an absolutely fascinating story that begs many questions.  Why is the device not more widely used? Robert Fripp covers the issue in a terrific short piece called 'It's Hard to do Good."  One hypothesis is that it is in fact too inexpensive to warrant aid agencies attention.  Another is that the marketing needs to be further ramped up and to have a champion.  Many of the smaller clinics and networks we've talked to have not heard of the device and are intrigued.

Here is a device that is so simple and so inexpensive.  It's been invented.  It's been tested.  It is cheap for the health system and it costs nothing for the end user.  It is even reusable!!  It weighs nothing.  As Fripp summarizes, 'it has reaped positive comment in The Lancet, Tropical Doctor, The Indian Journal of Pediatrics, and Archives of Disease in Childhood -- Fetal and Neonatal Edition 2006.  'What else needs to be done?  This is a cautionary tale in some ways for new teams coming out of graduate schools with the 'next big thing'-- if only there were just as many teams focused on marketing and increasing use of the things that have already been invented to save the world.

We sent the ThermoSpot to Haiti with Cynthia Siegel from Midwives for Haiti when she went down a week or so after the earthquake.  Cynthia sent the photographs above.  She noted that the baby went from normal (green) to below normal (black) just in the time that she spent adjusting her camera to get the right angle. She said it was a great reminder for even a very well-trained clinician of how quickly a baby become dangerously cold even in the punishing heat.  Cynthia supplied these photos of a baby she delivered in Haiti just after the quake.  John Zeal, inventor of the ThermoSpot advises that an even more optimal placement of the device would be deeper into the armpit or "n the hypochondrium (above liver) on a neonate which is where the body temperature is controlled for about 6 months when the hypothalamus will begin to take over this function." 

We'll continue to follow this story and to dig into the layers of the story surrounding the ThermoSpot.  We might even help distribute it.