Such concern is unnecessary when an autoclave is used to sterilize medical tools with high temperature and pressure. Two recent MIT graduates, Greg Tao '10, SM '12 and Hallie Sue Cho '10, SM '12, are working on developing low-cost autoclaves for use in low-income nations. They have spent the last year piloting the use of their prototype in rural communities in Nepal as a step to decrease post-surgical infections.
According to the World Health Organization, the rate of surgical site infections in hospitals in developing nations is up to nine times greater than in hospitals in developed nations. This large gap is due in part to the procedures for sterilizing equipment in developing nations, especially in rural health clinics. Many health clinics boil their instruments for up to 15 minutes as a sterilization practice, but about 5 percent of microbes may remain on the equipment and lead to later infection. In Nepal's district-level hospitals, which serve the nation's rural population of about 20 million, post-surgical infections are common.
OttoClave, a two-time winner of the MIT IDEAS Global Challenge, retrofits commonplace pressure cookers as autoclaves. Currently available autoclave models are expensive, technologically complex and dependent on electricity. In contrast, the OttoClave team has developed a portable autoclave that costs only about $100 to manufacture. The device has a simple user interface, instructs users in their native language on proper usage procedure and can operate on a variety of energy sources, including wood, kerosene and solar power. The autoclaves are equipped with a remote SMS monitoring system that can track the autoclaves in real time, providing the OttoClave team with valuable data.
After an internship at a medical supplies manufacturer, Tao realized that many technology manufacturers are not incentivized to innovate for hospitals and clinics in the developing world. Instead, manufacturers often cater to hospitals in the developed world, which can afford to buy expensive technology.
Noticing that few companies produce medical technologies that rural hospitals and clinics can access and afford, Tao was inspired to take action.
"It's never only about technology, but the ability of technology to benefit people in the world in a tangible way," says Tao, explaining his personal motivation.
Tao worked on the autoclave in conjunction with his master's thesis in the Department of Mechanical Engineering. There he connected with Cho, who would work on the business development of their autoclave while completing her own master's thesis about the sustainability of international development projects.
As the idea gained traction, Tao and Cho entered the 2011 MIT IDEAS Global Challenge and won funding to pilot 15 of their autoclaves in rural clinics in Nepal.
The team's goal for this first trip to Nepal was to determine if there were demand for the autoclave in the clinics for which it was designed. The team delivered all 15 of its prototypes to remote health clinics, and those that used the prototypes saw immediate results. Before using the OttoClave, one hospital reported that two patients from its eight weekly vasectomies would become infected. After six months with the OttoClave at the clinic, the weekly infection rate for vasectomies dropped to zero.
During this trip to Nepal, the team realized that their data collection process of self-reported paper surveys was inefficient, so upon return to the United States, they developed a new tracking module. Completed in January, the new OttoClave integrates a simple antenna into the system, which gives the team the ability to track the usage of its autoclaves. The new data-gathering module, which eliminates the need for paper surveys, utilizes SMS messaging to report on equipment use in the field; it was the feature of OttoClave's winning entry in the 2012 MIT IDEAS Global Challenge. The SMS monitoring system has dramatically improved OttoClave's ability to monitor equipment in the field.
The OttoClave team has now grown to include two programmers, two medical students, a director of public relations and communications and a partner on the ground in India to coordinate the business.
This summer, the OttoClave team has focused on developing their business partnerships and securing further funding. OttoClave was recently one of 127 start-ups selected from around the world to participate in Start-Up Chile, a small business incubator funded by the Chilean government. Start-Up Chile attracts world-class early stage entrepreneurs to start their businesses in Chile.
While at MIT, OttoClave received support through the MIT Public Service Center, International Development Initiative, the Singapore University of Technology and Design and the MISTI India Innovation Foundation.
One of OttoClave's primary goals for the future is to establish direct business connections to the ministries of health in developing nations. OttoClave hopes to use these connections to form valuable partnerships with state and local governments in the communities that need help most. Additionally, OttoClave hopes to partner directly with a pressure cooker manufacturer, with the ultimate goal being the transfer of the OttoClave brand to this manufacturer.
"The experiences we gained while at MIT and through working with outside partners helped us to benefit people in a measurable way," Tao says. "That's the greatest value of education."