How Third-World Ideas Can Change First-World Lives
WHY YOU SHOULD CARE
Because Kolko’s idea is big: New York has as much or more to learn from Nairobi or Bogotá as the other way around.
By April Joyner
For Beth Kolko, it’s not just cool when innovation comes from Azerbaijan or Uganda. It’s a must.
The English major turned engineering professor who now runs a medical device company called Shift Labs has been studying up for more than two decades, researching the use of technology in not-so-silicon-drenched places. Over that time, Kolko has seen hacks that could rival anything coming out of Silicon Valley’s startups: from a DIY phone booth developed by a Tajikistan resident to a device for assisted childbirth invented by an Argentine auto mechanic.
Which has given her an eye on the big, groundbreaking picture: Third-world ideas can bubble up to the first world — not just the other way around.
Over 80 % of devices in developing countries are donated, but only a small fraction are used because of spotty electricity or staffing shortages.
Shift’s first product, which hit the market this summer, is DripAssist, an infusion pump that tracks the delivery of IV fluids. Without such a device, clinicians have to count out IV drips, which is laborious and can cause errors. And DripAssist costs only $195, a price reached by simplifying its components: The compact device has just four buttons and uses a standard AA battery.
Next in the pipeline are an oxygen monitor, a cooling system for vaccines and a device to pasteurize breast milk.
The medical device industry is tough territory these days due to onerous regulations driving up the cost of getting products to market. And funding for startups in the field has dried up. There is, however, an open space: hospitals and clinics in developing countries. According to the World Bank, more than 80 percent of medical devices in those regions are donated, but absurdly, only a small fraction are ever used. Why? Because they aren’t designed for spotty electricity or staffing shortages.
Shift Labs, founded by Kolko in 2012, tailors its products to those conditions, with a focus on private facilities in developing countries, many of which are so cash-strapped they struggle to procure basic equipment. Yet they make up a huge market: Collectively, they take in half the dollars spent globally on health care.
U.S. hospitals have since come calling, eager to use Shift’s technology to prepare for disasters.
But the self-funded company, with just three full-time employees, has a long road ahead. It needs to bring in cash quickly to stay afloat, and gaining regulatory approval in the U.S. and abroad can take years. To raise funds for the DripAssist, Kolko launched a campaign on the crowdfunding site Indiegogo. Turns out the FDA restricts such activity to prevent companies from making unvetted product claims. So Kolko backed off, and in the meantime is pitching the product to the veterinary market, which doesn’t require FDA approval.
Sketchy? More like scrappy. An engineering professor at the University of Washington since 2000, Kolko has the get-it-done attitude that comes from collaborating with physicians, hackers, crafters and tinkerers to devise workable, low-cost technologies.
Plus, she’s gotten big-time validation from technologists like Bre Pettis, the CEO of MakerBot, and Ethan Zuckerman, director of MIT’s Center for Civic Media, both of whom are advisers to Shift. “The notion that you might not need the sexiest and the newest is surprisingly hard for people to wrap their heads around,” says Zuckerman. “Beth has critical insights about what makes products useful.”
Insights gained, perhaps, from not diving into STEM but instead devouring books, majoring in English and traveling extensively. She went to Brazil as a high school exchange student and later lived in Japan with her family. Kolko considered a career in journalism but opted instead for academia.
In 2000, on a Fulbright grant, tech came calling. Kolko traveled to Uzbekistan to study residents’ use of technology and returned repeatedly over 10 years. She noticed similarities between the burgeoning Maker Movement in the U.S. and the informal hacks she encountered abroad. The parallel convinced Kolko that people from diverse backgrounds could become fluent in tech without formal training. “Narrow disciplinarity makes me sad,” she says. “I wouldn’t solve problems the way I do if I didn’t have a background in the humanities.”
Narrow disciplinarity makes me sad. I wouldn’t solve problems the way I do if I didn’t have a background in the humanities.
— Beth Kolko
The impetus for Shift came after Kolko worked on a project with students to develop a simplified ultrasound, using a netbook and a USB wand, for midwives in Uganda. Their work won a grant from the Gates Foundation, and Kolko took the research to medical device companies in hopes that they would develop a similar system.
None of them bit. “The VP of one company told me, ‘We could make cheaper technology, but it would not support the cost of our sales force, so we don’t have the motivation to do so,’” she recalls. “That’s the moment I knew I had to start up this company.”
The hacker-and-maker approach clearly doesn’t sit comfortably with health care — but there’s another reason the medical device industry hasn’t aggressively pursued emerging markets. “It’s hard to build a sales team in small rural villages across Africa, so you don’t see companies trying to do that,” says Ryan Pierce, an entrepreneur-in-residence at the health-tech accelerator Rock Health.
With a background combining intensive academic research and a journalist’s eye for cultural context — not to mention a geek’s fascination for how people use and respond to technology — Kolko may have precisely what it takes to export innovative and possibly life-saving ideas for use throughout the world: first, third and everywhere in between.