Technology is neither good nor bad; nor is it neutral Melvin Kranzberg, The Six Laws of Technology
In Austin, Texas today law student Cody Wilson is printing guns. Well, technically, he prints parts of guns. And these are not just any guns; Cody Wilson prints semiautomatic weapons. In seven hours, Mr. Wilson’s Defense Distributed Company prints a key component of firearms (the AR-15 lower receivers), the exact component that (not coincidentally) happens to be tracked by the U.S. government.
What’s the significance of Mr. Wilson’s actions, actions that are seemingly so far outside of our interest in improving maternal and child health here at Maternova? Why discuss such fear-inducing actions, actions of a dubious ethical and legal nature? The answer is the technology. To quote Michael Weinberg’s white paper on the revolutionary nature of 3-D Printing, “It will be awesome, if they don’t screw it up.”
*** Bits to Atoms to Saving Lives
3-D Printing, also known as “additive manufacturing” has been all over the news lately. By 2017, it’s expected to be a $6 billion industry, and has been called the “next Industrial Revolution.” MIT has a class solely devoted to “digital fabrication.” Retail stores for MakerBot, one of the largest 3-D printer manufacturers, have opened on Newbury Street in Boston crowded with wonder-struck crowds. But what exactly is this exalted technique and burgeoning industry?
While Michelangelo sculpted David by whittling away from rock, 3-D printing instead sculpts by building up; from horizontal slices of a digital design file (many available on the Web), 3-D printers lay down layer by layer of starch or gypsum powder, encapsulating them in “binder solution”. Other methods of additive manufacturing have used UV light to instantly harden the plastic resin.
The revolution, in the words of Foreign Policy magazine, is “the ability to turn data into things and things into data.”
Chuck Hull, the father of 3-D printing, initially sought a better (and faster) way to manufacture small parts when prototyping for furniture. The uses, however, have expanded far beyond those initial internal R&D uses of rapid prototyping, or even hobbyists who have the cash to buy their own 3-D printers. 3-D Printing is changing every field with its novel feature of local manufacturing, including health.
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Take the example of Garrett Peterson, a 16-month old with a debilitating condition called tracheomalacia that rendered him unable to breathe due to a weak trachea. A 3-D printed shell has allowed the windpipe to regain structural integrity. Or 3-D printed ortho-prosthetics in Sudan, 3-D printed skin cells and kidney cells, facial reconstruction and skull reconstruction. All of healthcare has the potential to be transformed by 3-D printing. This potential is even greater in nations with lower healthcare and health device access.
3D-printing is distinct from normal manufacturing in several ways: it’s individualized, it’s at reduced cost (if the cost of the printer itself can be lowered), and it can be functionally integrated with precision for complex geometries. Many organizations across the globe, including our partners, are using these features to tackle problems of maternal and child health. GE Global Research is working on using additive manufacturing to build portable/ultraportable transducers for ultrasound machines. In Haiti, A. Dara Dotz is working with Field Ready to train Haitians to use MakerBot printers and software to print essential umbilical cord clamps for a fraction of the cost of import/purchase ($0.36 vs $2.69). Dotz is working to partner with clinics and birthing centers to spread the impact of the umbilical cord clamps across Haiti and even further.
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These projects are only the very beginning of 3-D printing’s uses for maternal and child health across the globe; this technology has the potential to save many more lives in the future if we choose to use it for the ultimate good. In areas of incredible need, 3-D printers may provide the ability to develop cheap, effective tools from the operating room to daily use. By training locals in country and keen recognition of the areas in which 3-D printed applications could be useful, this dream can become a reality. And that, in contrast to Mr. Wilson’s use in Texas, would be truly awesome.
The BiliDx is a novel system for diagnosing jaundice. The device uniquely meets the Target Product Profile (TPP) developed as part of the NEST 360 initiative in that it allows blood-based testing at the bedside. This initiative is part of an emerging global consensus in the Every Newborn Action Plan that countries need functional WHO level-2 inpatient units to care for "small and sick newborns."
Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device.
Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, theMaternaWellTraywas conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.