Turning Obstacles into Assets

Seeking to improve global health access? Learn to leverage limits and constraints as springboards for innovation

There is a famous scene in the Tom Hanks movie Apollo 13, accurately recreating the real-life crisis where three astronauts are attempting to return to Earth from an aborted Moon mission.

The astronauts are flying in a damaged Command Module with a still-attached Lunar Lander. To keep these astronauts alive with clean air to breathe during this dangerous voyage, the engineering team on the ground in Houston is forced to solve an enormous problem.

They must figure out how to adapt the Command Module’s cube-shaped air filters so they could be inserted into the Lunar Lander’s cylinder-shaped air filter receptacles.

In other words, the engineers and astronauts almost literally had to plug a square peg into a round hole.  

Using nothing but a few odds and ends known to be aboard the craft, the engineers cleverly taped together a few hoses, plastic bags, spacesuit fans, batteries, etc.

In this way, they created a simple workaround to capture unhealthy air from the Lander, channel it through the Command Module filter system, and return clean air to the Lander for the astronauts to breathe.

In space, the crew of Apollo 13 duplicated this feat by building an identical workaround system out of the same materials, following step-by-step instructions over the radio from the engineers.

Result: the astronauts returned home safely. (You can view this 1-minute scene here.)

This true historical incident provides a textbook example of turning obstacles into assets -- or as some people express it, turning stumbling-blocks into stepping-stones.

Transforming obstacles into assets is a useful skill for anyone trying to radically expand access to healthcare services and technology in the resource-challenged parts of the world.

That is a major goal for us at the ApiJect Global Initiative, and I thought I’d share a quick slice of my own “stumbling-blocks to stepping-stones” story with you here.

Back in 2008, my team and I decided to create an affordable, portable baby incubator that could save lives of infants in remote locations, far from hospitals and clinics. At first we didn’t completely realize what huge challenge we were taking on.

Yes, we knew that 15 million pre-term and underweight babies are born each year, and we knew 3 million of them die in the first 28 days of life.

We also knew that state-of-the-art incubators, meaning the standard incubators designed for typical Western-style hospitals, cost over $20,000 per unit, a price far out of reach in places where the average person may be getting by on less than US$2.50 a day.

However, it wasn’t until we did research on the ground in places like India (where 40% of the world’s premature babies are born) that we truly began to understand the obstacles we were facing. We realized that many mothers of these endangered “preemies” were too impoverished to travel from a rural village to a city for healthcare, and too poor to afford that care if they could reach it.

In addition, we discovered in many places where premature infants die so tragically soon, there is a lack of stable electricity to run a typical Western-technology incubator consistently.

We decided these seeming obstacles or “constraints” were not a set of insurmountable burdens. They were a set of conditions that were far outside of our own personal experiences or cultural expectations – but for that very reason, they were factors that motivated us to think outside the box, and to come up with creative new approaches and solutions.

By the way, our original team had no experience in medicine or in designing health devices. We had an aerospace engineer, computer science engineer, electrical engineer, and I had some background in public health.

But in a very real sense, our lack of “relevant” experience was also an asset. Looking at the challenges with different sets of eyes and mindsets allowed us to see problems from a fresh perspective, and made it natural for us to ask the “why not?” questions that seem so obvious to an outsider and so irrelevant to many professionals and specialists.

We performed years of in-depth field research, talking to everyone from rural mothers who had lost their babies, to doctors, midwives, community health workers, and more.

Eventually, we came up with a new kind of low-tech incubator that we call the Embrace Portable Incubator.

It looks like a tiny sleeping bag for an underweight or premature baby, with a small hood and a clear plastic “window” in front so the mother or health worker can see the baby’s breathing and color.

The most important feature: it doesn’t require stable electricity. The heat source for this incubator is a phase-change-material, a wax-like substance, which when melted, can maintain a constant temperature of 98 degrees for up to eight hours at a stretch. 

This wax pouch slips into a pouch in the back of the incubator. This creates a micro-environment inside the sleeping bag that regulates the baby’s body temperature. The wax pouch can be reheated and reused thousands of times. A simple graphic indicator lights to indicate when the temperature is right to use, and when it needs to be reheated.

No written instructions are necessary for the Embrace Portable Incubator; each product comes with a set of graphic instructions. We intentionally made it so easy to use that someone who is illiterate can learn how to use it.

The product features and ease-of-use mean our incubator can be used in remote settings -- and in situations where there is a lack of stable electricity or trained medical staff.

We recently sent hundreds of incubators to Ukraine, where they are now being used in bomb shelters. Given the attacks on hospitals, this is where many babies are being born throughout the country. A neonatologist in Ukraine noted, “we can now transport a child to the bomb shelter in warm and safe conditions. And we don’t have to worry that the child will freeze.”

There was no single “aha!” moment of blinding insight or inspiration that allowed us to leap from the initial “unsolvable” problem to a successful solution. We worked through years of development, endless iterations, countless consultations, round after round of trial and error, and outright failures and disappointments.

But with each experience, we kept learning – using each new obstacle to help us discover innovative, yet practical solutions.

Based on all this, I think it’s fair to say that our team became apprentices in the art of turning obstacles into assets. “And that (as Robert Frost famously wrote) has made all the difference.”

Along the way, we learned several other lessons that we believe can help expand and maximize access to health services and technology to millions more patients and families anywhere in the world. I will be sharing these takeaways soon, in future posts in this space.

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Editor’s note: Jane Chen, Director of Innovation Strategy for ApiLabs, is also the founder of a nonprofit organization called Embrace Global that works to save premature infants worldwide with its ground-breaking portable baby incubator. To date, Embrace has saved nearly 350,000 babies around the world.