Why you should care
Because small lives matter too.
Here are two essentially different types of suffering: Americans who eat too much, and babies who die of hypothermia. You know which is supposed to strike your soul more, not that you necessarily do anything about it. Ratul Narain, on the other hand, decided to stopper his bleeding heart three years ago by choosing the babies over the obese Americans.
His is a story shared by an increasing number of corporate-bred Indian-Americans: The 30-year-old Stanford-educated medical engineer spent almost seven years climbing the professional ladder at Johnson & Johnson, but then he grew restless, heading to the motherland for something new. He had tired of “working on incremental improvements for medical devices for Americans who had eaten too many hamburgers,” and remembered trips as a child, seeing kids his age “naked in the streets or running up to the car and begging.” He settled on a small piece of technology, a tiny wristband, designed for newborn babies at risk of hypothermia, a surprisingly dangerous condition for infants in the developing world.
The startup he founded in India, called Bempu, boasts funding from the Gates Foundation and has built a monitoring system to correlate a baby’s wrist temperature with her overall body temp, sounding an alarm if it dips too low. That allows parents to quickly warm up their infant and call in medical help before hypothermia translates to bigger issues like bacterial infection. In fact, UNICEF estimates that preventing and effectively responding to hypothermia could save 18 to 42 percent of newborns who die each year in developing countries in their first month of life. That’s anywhere from between 600,000 and 1.4 million babies. And that doesn’t even account for those who survive a drop in temperature, but have developmental problems because they struggle to gain weight and fight off infection when they become too cold.
In theory, keeping a baby warm is as simple as making sure it’s bundled up. “The big challenge for newborn health globally is: We know what the problems are, we know what to do about it and it’s not happening,” says Karsten Lunze, a doctor and expert in newborn hypothermia at Boston University. If Bempu, which is still in prototype and will likely get to market by the end of 2015, succeeds, “it would be a miraculous catalyzer that everyone has been looking for over a decade,” he says. It’s testing well so far: A prototype, used on 25 newborns this year, detected a temperature drop a full 24 hours before hospital workers noticed. And it cost just a fraction of a day’s expense in the neonatal intensive care unit, which typically starts at $76 in India (unaffordable for many).
Bempu, of course, is far from a one-shot solution and has a long way to go. The band needs a “smart distribution strategy” — the eternal problem that dogs public health in the developing world and first world alike — to ensure it gets to the caregiver at the time of birth and that they know how to use it, says Lunze. Doctors have to climb on board, and health care can be a notoriously plodding field. And scariest of all: The neediest hospitals are government-run, which means India’s large bureaucracy would have to foot the bill. Narain estimates (perhaps optimistically) that it will take two to three years to navigate that behemoth.
Narain — warm, approachable, with a neatly sculpted head of hair and a slightly awkward smile — has long been aware of the discrepancy between his life and the developing world, thanks in part to his dad’s gig as an operations officer at the World Bank; he grew up in Washington D.C., but traveled everywhere from Kenya to Lebanon, watching his dad work on improving farming in Africa and delivering emergency aid to refugees. But family trips to India made the biggest impression. As a boy, Narain played pickup football on vacations in Delhi with his neighbor, the son of the local ironing man. At the end of the match, Narain would return to his grandmother’s comfortable apartment, the boy to his family’s shack next door.
Bempu was born after Narain followed his nose to the global south at 27, where he worked as an engineering fellow at Embrace, a nonprofit that makes a cheap, portable and rechargeable incubator for newborns. He noticed something clear: No one was really watching closely. Nurses lacked thermometers; some couldn’t even read them and mothers didn’t know the difference between Celsius and Fahrenheit. “Kangaroo care,” a proven way for mothers to effectively keep babies warm by holding their newborns close, using skin-to-skin contact to warm them up, hadn’t been widely adopted. Some mothers were too busy to do it because they had to get back to work. Too often, doctors and nurses themselves didn’t tell new mothers about how effective kangaroo care can be, either because they didn’t have time or they didn’t know themselves.
Which all goes to show that here, the tiny things matter. A flutter of a fan just after birth can cool a baby too much. A few moments without a mom’s heat against their bodies. A little wrist with a little bracelet.