New Hearing Technology Brings Sound to a Little Girl
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Bavishi's auditory brainstem implant is helping her hear some sounds for the first time.","publishDate":1433180653,"status":"inherit","parent":3739,"modified":1433181104,"caption":"Jiya Bavishi's auditory brainstem implant is helping her hear some sounds for the first time.","credit":"Lauren 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The technology is considered one of the greatest medical achievements of the past 30 years, but it doesn't work for all patients. Now an experimental \u003cspan class=\"s1\">auditory brainstem implant may offer new hope for some.]\u003c/span>\u003c/em>\u003c/p>\n\u003cp>Jiya Bavishi \u003ca href=\"#_msocom_1\" name=\"_msoanchor_1\">\u003c/a>was born deaf. For five years, she couldn't hear and she couldn't speak at all. But when I first meet her, all she wants to do is say hello. The 6-year-old is bouncing around the room at her speech therapy session in Dallas\u003ca href=\"#_msocom_2\" name=\"_msoanchor_2\">\u003c/a>. She's wearing a bright pink top; her tiny gold earrings flash as she waves her arms.\u003c/p>\n\u003cp>\"Hi,\" she says, and then uses sign language to ask who I am and talk about the ice cream her father bought for her.\u003c/p>\n\u003cp>Jiya is taking part in a clinical trial testing a new hearing technology. At 12 months, she was given a \u003ca href=\"http://www.nidcd.nih.gov/health/hearing/pages/coch.aspx\">cochlear implant\u003c/a>. These surgically implanted devices send signals directly to the nerves used to hear. But cochlear implants don't work for everyone, and they didn't work for Jiya.\u003c/p>\n\u003cp>\"The physician was able to get all of the electrodes into her cochlea,\" says Linda Daniel, a certified auditory-verbal therapist and rehabilitative audiologist with \u003ca href=\"http://hearindallas.com/\" target=\"_blank\">HEAR\u003c/a>, a rehabilitation clinic in Dallas. Daniel has been working with Jiya since she was a baby. \"However, you have to have a sufficient or healthy auditory nerve to connect the cochlea and the electrodes up to the brainstem.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Jiya's connection between the cochlea and the brainstem was too thin. There was no way for sounds to make that final leg of the journey and reach her brain.\u003c/p>\n\u003cp>Usually, the story would end here. If cochlear implants don't work, you turn to sign language. And the Bavishis did -- for years they communicated with their daughter through sign language. But then they heard about an experimental procedure called an auditory brainstem implant.\u003c/p>\n\u003cp>It is a very rare procedure, according to \u003ca href=\"http://www.masseyeandear.org/find-a-physician/details?physician_id=945050\" target=\"_blank\">Dr. Daniel Lee\u003c/a>, director of the pediatric ear, hearing and balance center at Harvard Medical School. \"There have been less than 200 of these implanted worldwide in children,\" he says. In the U.S., auditory brainstem implants are\u003ca href=\"http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm089750.htm\"> approved by the Food and Drug Administration\u003c/a> for adults and teenagers who have lost their hearing due to nerve damage, but they have not been approved for use in younger children.\u003c/p>\n\u003cp>Surgeons in Europe have pioneered the use of the auditory brainstem implant in children who are born deaf and can't receive a cochlear implant, Lee says. \"And those data look pretty encouraging.\"\u003c/p>\n\u003cp>So in 2013, the FDA approved the first \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT01904448?term=auditory+brainstem+implant&rank=6\">clinical trial\u003c/a> in the U.S. for young children. The Bavishis decided to apply for Jiya. It wasn't an easy decision. It would involve surgery to place a tiny microchip into Jiya's brainstem.\u003c/p>\n\u003cp>\"The family was at a crossroads,\" Daniel says. Did they want to take a chance on a risky, experimental procedure to give their daughter a chance to hear? They decided to try the procedure and traveled from their home in Frisco, Texas, to Chapel Hill, N.C., for the eight-hour surgery. The University of North Carolina is one of four institutions investigating the implant.\u003c/p>\n\u003cp>Jiya's mom, Jigna Bavishi, pulls back her daughter's purple headband to reveal two of the three parts of the device.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Even though she’s doing so good right now, we have to still be careful where we set our expectations.\"\u003cbr>\n\u003ccite>Jigna Bavishi, Jiya's Mom\u003c/cite>\u003c/aside>\n\u003cp>There's the piece that sits on her ear, which works like a microphone to pick up sounds. That microphone is attached to a small black magnet that rests on her head. What you can't see is what the magnet is connected to. And this is what makes it different from a cochlear implant. Below the skin, there's a receiver, and down in the brain stem is the microchip\u003ca href=\"#_msocom_3\" name=\"_msoanchor_3\">\u003c/a>. The idea is that the sounds picked up from the microphone on her ear end up in the implant in the brainstem.\u003c/p>\n\u003cp>\"It's a rectangular shaped element,\" says rehabilitative audiologist Linda Daniel. \"It has two rows of electrodes and each electrode is responsible for a band of frequencies.\" The electrodes transmit signals directly into the brain.\u003c/p>\n\u003cp>Daniel says we don't know exactly what Jiya hears.\u003c/p>\n\u003cp>\"I think we could assume that it doesn't sound crisp, distinct, clearly interpretable,\" she says. \"It would take longer to learn to interpret the sound.\"\u003c/p>\n\u003cp>Doctors told the Bavishis not to expect any changes for a year or two. But Jiya didn't take that long to start recognizing and mimicking sounds. On the day I visit, Jiya is playing with a yellow toy car. \"Beep, beep,\" she says.\u003c/p>\n\u003cp>\"They actually had to tell us, even though she's doing so good right now, we have to still be careful where we set our expectations,\" says Jigna.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doctors will monitor Jiya, and four other children taking part in the study, for the next few years. They'll be studying how their brains develop and incorporate sounds and speech. There are two other clinical trials investigating auditory brainstem implants in children: one at \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02102256?term=auditory+brainstem+implant&rank=5\">Children's Hospital\u003c/a> in Los Angeles, and the other at the New York \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02310399?term=auditory+brainstem+implant&rank=3\">University School of Medicine\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 KERA Unlimited. To see more, visit \u003ca href=\"http://www.kera.org/\">http://www.kera.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=New+Hearing+Technology+Brings+Sound+To+A+Little+Girl&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n","blocks":[],"excerpt":"Jiya Bavishi is one of a handful of children in the United States testing an experimental hearing device, a tiny implant in her brainstem. Jiya is now able to hear and repeat some sounds.","status":"publish","parent":0,"modified":1434047748,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":907},"headData":{"title":"New Hearing Technology Brings Sound to a Little Girl | KQED","description":"Jiya Bavishi is one of a handful of children in the United States testing an experimental hearing device, a tiny implant in her brainstem. Jiya is now able to hear and repeat some sounds.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"New Hearing Technology Brings Sound to a Little Girl","datePublished":"2015-06-01T18:03:08.000Z","dateModified":"2015-06-11T18:35:48.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"3739 http://ww2.kqed.org/futureofyou/?p=3739","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/06/01/new-hearing-technology-brings-sound-to-a-little-girl/","disqusTitle":"New Hearing Technology Brings Sound to a Little Girl","nprByline":"Lauren Silverman","nprStoryId":"410065053","nprApiLink":"http://api.npr.org/query?id=410065053&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/06/01/410065053/new-hearing-technology-brings-sound-to-a-litte-girl?ft=nprml&f=410065053","nprRetrievedStory":"1","nprPubDate":"Mon, 01 Jun 2015 12:34:00 -0400","nprStoryDate":"Mon, 01 Jun 2015 03:35:00 -0400","nprLastModifiedDate":"Mon, 01 Jun 2015 12:34:30 -0400","nprAudio":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/06/20150601_me_auditory_brainstem_implant.mp3?orgId=77&topicId=1066&d=326&p=3&story=410065053&t=progseg&e=410487719&seg=7&ft=nprml&f=410065053","nprAudioM3u":"http://api.npr.org/m3u/1410488015-5f38a0.m3u?orgId=77&topicId=1066&d=326&p=3&story=410065053&t=progseg&e=410487719&seg=7&ft=nprml&f=410065053","path":"/futureofyou/3739/new-hearing-technology-brings-sound-to-a-little-girl","audioUrl":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/06/20150601_me_auditory_brainstem_implant.mp3?orgId=77&topicId=1066&d=326&p=3&story=410065053&t=progseg&e=410487719&seg=7&ft=nprml&f=410065053","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>[Editors' note: \u003ca href=\"http://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=83\">The first cochlear implant was approved\u003c/a> by federal regulators in 1984. The technology is considered one of the greatest medical achievements of the past 30 years, but it doesn't work for all patients. Now an experimental \u003cspan class=\"s1\">auditory brainstem implant may offer new hope for some.]\u003c/span>\u003c/em>\u003c/p>\n\u003cp>Jiya Bavishi \u003ca href=\"#_msocom_1\" name=\"_msoanchor_1\">\u003c/a>was born deaf. For five years, she couldn't hear and she couldn't speak at all. But when I first meet her, all she wants to do is say hello. The 6-year-old is bouncing around the room at her speech therapy session in Dallas\u003ca href=\"#_msocom_2\" name=\"_msoanchor_2\">\u003c/a>. She's wearing a bright pink top; her tiny gold earrings flash as she waves her arms.\u003c/p>\n\u003cp>\"Hi,\" she says, and then uses sign language to ask who I am and talk about the ice cream her father bought for her.\u003c/p>\n\u003cp>Jiya is taking part in a clinical trial testing a new hearing technology. At 12 months, she was given a \u003ca href=\"http://www.nidcd.nih.gov/health/hearing/pages/coch.aspx\">cochlear implant\u003c/a>. These surgically implanted devices send signals directly to the nerves used to hear. But cochlear implants don't work for everyone, and they didn't work for Jiya.\u003c/p>\n\u003cp>\"The physician was able to get all of the electrodes into her cochlea,\" says Linda Daniel, a certified auditory-verbal therapist and rehabilitative audiologist with \u003ca href=\"http://hearindallas.com/\" target=\"_blank\">HEAR\u003c/a>, a rehabilitation clinic in Dallas. Daniel has been working with Jiya since she was a baby. \"However, you have to have a sufficient or healthy auditory nerve to connect the cochlea and the electrodes up to the brainstem.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Jiya's connection between the cochlea and the brainstem was too thin. There was no way for sounds to make that final leg of the journey and reach her brain.\u003c/p>\n\u003cp>Usually, the story would end here. If cochlear implants don't work, you turn to sign language. And the Bavishis did -- for years they communicated with their daughter through sign language. But then they heard about an experimental procedure called an auditory brainstem implant.\u003c/p>\n\u003cp>It is a very rare procedure, according to \u003ca href=\"http://www.masseyeandear.org/find-a-physician/details?physician_id=945050\" target=\"_blank\">Dr. Daniel Lee\u003c/a>, director of the pediatric ear, hearing and balance center at Harvard Medical School. \"There have been less than 200 of these implanted worldwide in children,\" he says. In the U.S., auditory brainstem implants are\u003ca href=\"http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm089750.htm\"> approved by the Food and Drug Administration\u003c/a> for adults and teenagers who have lost their hearing due to nerve damage, but they have not been approved for use in younger children.\u003c/p>\n\u003cp>Surgeons in Europe have pioneered the use of the auditory brainstem implant in children who are born deaf and can't receive a cochlear implant, Lee says. \"And those data look pretty encouraging.\"\u003c/p>\n\u003cp>So in 2013, the FDA approved the first \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT01904448?term=auditory+brainstem+implant&rank=6\">clinical trial\u003c/a> in the U.S. for young children. The Bavishis decided to apply for Jiya. It wasn't an easy decision. It would involve surgery to place a tiny microchip into Jiya's brainstem.\u003c/p>\n\u003cp>\"The family was at a crossroads,\" Daniel says. Did they want to take a chance on a risky, experimental procedure to give their daughter a chance to hear? They decided to try the procedure and traveled from their home in Frisco, Texas, to Chapel Hill, N.C., for the eight-hour surgery. The University of North Carolina is one of four institutions investigating the implant.\u003c/p>\n\u003cp>Jiya's mom, Jigna Bavishi, pulls back her daughter's purple headband to reveal two of the three parts of the device.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Even though she’s doing so good right now, we have to still be careful where we set our expectations.\"\u003cbr>\n\u003ccite>Jigna Bavishi, Jiya's Mom\u003c/cite>\u003c/aside>\n\u003cp>There's the piece that sits on her ear, which works like a microphone to pick up sounds. That microphone is attached to a small black magnet that rests on her head. What you can't see is what the magnet is connected to. And this is what makes it different from a cochlear implant. Below the skin, there's a receiver, and down in the brain stem is the microchip\u003ca href=\"#_msocom_3\" name=\"_msoanchor_3\">\u003c/a>. The idea is that the sounds picked up from the microphone on her ear end up in the implant in the brainstem.\u003c/p>\n\u003cp>\"It's a rectangular shaped element,\" says rehabilitative audiologist Linda Daniel. \"It has two rows of electrodes and each electrode is responsible for a band of frequencies.\" The electrodes transmit signals directly into the brain.\u003c/p>\n\u003cp>Daniel says we don't know exactly what Jiya hears.\u003c/p>\n\u003cp>\"I think we could assume that it doesn't sound crisp, distinct, clearly interpretable,\" she says. \"It would take longer to learn to interpret the sound.\"\u003c/p>\n\u003cp>Doctors told the Bavishis not to expect any changes for a year or two. But Jiya didn't take that long to start recognizing and mimicking sounds. On the day I visit, Jiya is playing with a yellow toy car. \"Beep, beep,\" she says.\u003c/p>\n\u003cp>\"They actually had to tell us, even though she's doing so good right now, we have to still be careful where we set our expectations,\" says Jigna.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doctors will monitor Jiya, and four other children taking part in the study, for the next few years. They'll be studying how their brains develop and incorporate sounds and speech. There are two other clinical trials investigating auditory brainstem implants in children: one at \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02102256?term=auditory+brainstem+implant&rank=5\">Children's Hospital\u003c/a> in Los Angeles, and the other at the New York \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02310399?term=auditory+brainstem+implant&rank=3\">University School of Medicine\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 KERA Unlimited. To see more, visit \u003ca href=\"http://www.kera.org/\">http://www.kera.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=New+Hearing+Technology+Brings+Sound+To+A+Little+Girl&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/3739/new-hearing-technology-brings-sound-to-a-little-girl","authors":["byline_futureofyou_3739"],"categories":["futureofyou_1"],"tags":["futureofyou_491","futureofyou_34","futureofyou_138","futureofyou_398","futureofyou_397","futureofyou_400","futureofyou_80","futureofyou_319","futureofyou_399"],"featImg":"futureofyou_3740","label":"futureofyou"},"futureofyou_2981":{"type":"posts","id":"futureofyou_2981","meta":{"index":"posts_1591205157","site":"futureofyou","id":"2981","score":null,"sort":[1431619203000]},"guestAuthors":[],"slug":"d-rev-ceo-we-build-medical-devices-for-people-who-live-on-less-than-4-a-day","title":"D-Rev CEO: We Build Medical Devices for People who Live on Less than $4 a Day","publishDate":1431619203,"format":"image","headTitle":"Women’s Health | KQED Future of You | KQED Science","labelTerm":{"term":219,"site":"futureofyou"},"content":"\u003cp>Most medical equipment companies don't regularly top \"\u003ca href=\"http://www.fastcompany.com/most-innovative-companies/2013/d-rev\">most innovative\u003c/a>\" lists.\u003c/p>\n\u003cp>But \u003ca href=\"http://d-rev.org/\">D-Rev\u003c/a> isn't your typical medical device maker. The San Francisco-based non-profit wants to help the world's poorest individuals, who subsist on less than a few dollars per day. Its products include an \u003ca href=\"http://d-rev.org/projects/mobility/\">$80 prosthetic knee\u003c/a> and a \u003ca href=\"http://d-rev.org/2010/12/brilliance-is-licensed-to-phoenix-medical/\">phototherapy device\u003c/a> to treat infants with jaundice.\u003c/p>\n\u003cp>[Skip to the bottom of the article to watch a TED talk on the $80 ReMotion knee.]\u003c/p>\n\u003cp>What's unique about D-Rev is its approach to research. The company sends its small team of designers into the field -- whether it's a rural village in India or a remote hospital in Uganda -- to conduct interviews with patients, doctors and nurses.\u003c/p>\n\u003cp>During a recent conversation with a doctor based in rural India, D-Rev employees learned that many babies were dying of jaundice. The treatment devices were too expensive to maintain. The team brainstormed low-cost solutions and came up with \u003ca href=\"http://d-rev.org/projects/newborn-health/\">Brilliance\u003c/a>, a photo-therapy lamp that sells for $400, a fraction of the cost of its mainstream competitors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cem>KQED\u003c/em> sat down with Krista Donaldson, the company's chief executive, to discuss the ongoing challenges of running a medical non-profit and the opportunities for the future. Donaldson shared that D-Rev is considering a move into the U.S. market to help those in need closer to home.\u003c/p>\n\u003cp>This interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>In the past few years, D-Rev seems to have exploded in the media. When did the company get its start?\u003c/strong>\u003c/p>\n\u003cp>It was started in 2008 as a skunk-works of technology for the developing world. I was brought in because a lot of the products were in stages of prototyping and weren't reaching users. I cancelled most of the projects and focused our attention on people who are living on less than $4 a day. Our core mission is to close the gap in quality health care by focusing on delivery and design.\u003c/p>\n\u003cp>\u003cstrong>What was the first product that you released as CEO?\u003c/strong>\u003c/p>\n\u003cp>It was the Brilliance photo-therapy device. We got the idea after a doctor from India approached us at a conference. He said that the global health community, which is very Western-driven, is focused on the 'big ticket items' like preterm births and asphyxia [\u003cspan class=\"st\">a potentially-fatal condition caused by a lack of oxygen in the blood\u003c/span>.] But he told us that at his hospital, many babies were dying of jaundice. We estimate that 6 million babies with severe jaundice are not receiving adequate treatment.\u003c/p>\n\u003cp>My colleague got intrigued about developing a device that would shine an intense, blue light onto the baby's skin as a safe and effective therapy. We had heard that a hospital in Uganda was putting babies in the sun to get treated. This isn't safe, but the doctor did that because it was his only option.\u003c/p>\n\u003cp>[Watch the video below to learn more about D-Rev's solution.]\u003c/p>\n\u003cp>[youtube http://www.youtube.com/watch?v=eOgPT0faICs]\u003c/p>\n\u003cp>\u003cstrong>Many medical device companies will donate surplus equipment to developing nations. So why would health providers buy a product from D-Rev?\u003c/strong>\u003c/p>\n\u003cp>The medical device industry is far behind in terms of design. The approach they often take when thinking about low-income people is to donate the stuff that isn't being used in the West. There are all sorts of problems with that, whether it's different electronic frequencies, plugs and outlets, fluctuating temperature standards, or broader cultural issues.\u003c/p>\n\u003cp>\u003cstrong>How about low-income people in the U.S. who struggle to access cost-effective therapies? Are you planning to build devices for the domestic market?\u003c/strong>\u003c/p>\n\u003cp>Yes. We are in the early exploration phases of looking into low-income amputees in the United States. If we do something, it'll be a version of our prosthetic knee. The problem is that devices are so expensive here that many low-income people we've spoken to say they are ordering stuff from China on eBay. We'll have more information about our next steps later in the year.\u003c/p>\n\u003cp>\u003cstrong>What's your design process like for developing a new medical device?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">“ There were these teeny tiny babies that could fit in the palm of your hand. And they were under these photo-therapy devices that I could tell were ineffective in one glance.\"\u003cbr>\n\u003ccite>Krista Donaldson, CEO of D-Rev \u003c/cite>\u003c/aside>\n\u003cp>We start with a problem identified by a user, oftentimes a doctor at a rural clinic. One example might be a lack of high-quality, affordable prosthetic knees. We would ask questions to potential users like: 'Would you want a prosthetic that will help with your gait? Are you looking for a device that will help you to return to work?'\u003c/p>\n\u003cp>When we were doing the prototype of \u003ca href=\"http://d-rev.org/2014/10/learning-comet-rural-clinics-home-care-arent-ready-phototherapy/\">Comet\u003c/a>, an offshoot of our Brilliance phototherapy device, we drove around India and stopped at 20 different hospitals and clinics of all sizes to talk to the doctors. At this stage, we had four rough prototypes. Once you get more information, you can show the prototypes and get feedback. We also take into account cultural norms.\u003c/p>\n\u003cp>Once the product has been designed, we deal with things like regulation and intellectual property. Regulation is different in every country -- some have no requirements at all.\u003c/p>\n\u003cfigure id=\"attachment_2989\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-2989\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-800x533.jpg\" alt=\"Donaldson interviewing an amputee \" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee.jpg 1025w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Donaldson interviewing an amputee victim \u003ccite>(D-Rev)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Travel to rural parts of the world is expensive. Is it an ongoing challenge to raise funding?\u003c/strong>\u003c/p>\n\u003cp>We are raising money constantly. It is a challenge because we are more like a medical device startup than a typical philanthropic organization. We don't fit neatly into a bucket within the global health community, like\u003ca href=\"http://www.usaid.gov/\"> USAID [the government agency responsible for administering foreign aid.] \u003c/a>Their typical idea of global health innovation tends to be very labs-based.\u003c/p>\n\u003cp>But we have had a lot of success with foundations and individuals. Some companies help us out too, like \u003ca href=\"http://autodesk.com\">Autodesk\u003c/a>, which provides free software.\u003c/p>\n\u003cp>One big frustration I have is that big funders want to see data about improving mortality rates. They are less inclined to fund devices that prevent brain damage, rather than just save lives. We have to make sure that people can live healthy lives.\u003c/p>\n\u003cp>\u003cstrong>Aside from funding, what are some of the biggest hurdles that the company faces?\u003c/strong>\u003c/p>\n\u003cp>A lot of our users have low-trust in medical devices in general, in large part due to poor quality of some of the less expensive ones. Doctors often say to us: 'Why is your product so cheap? What's wrong with it?'\u003c/p>\n\u003cp>Another lesson learned is that in many low-income countries the government will purchase large batches of medical devices for state hospitals. They put out a tender with specifications that companies need to meet. I expected there to be less corruption in that process. But I'm hoping that things will improve over time with greater transparency.\u003c/p>\n\u003cp>\u003cstrong>What is the core demographic for D-Rev's devices?\u003c/strong>\u003c/p>\n\u003cp>We don't have any good data yet. But we are starting to do some preliminary research on gender. We have learned that boy babies are brought in for jaundice far more frequently than the girls -- it's about two to one. But boys and girl babies are equally likely to suffer from jaundice.\u003c/p>\n\u003cfigure id=\"attachment_2993\" class=\"wp-caption alignright\" style=\"max-width: 326px\">\u003cimg class=\" wp-image-2993\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Bangladesh-Photo-450x600.jpg\" alt=\"A snap of some data compiled by a hospital in Bangladesh\" width=\"326\" height=\"435\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo-450x600.jpg 450w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo-400x533.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo.jpg 843w\" sizes=\"(max-width: 326px) 100vw, 326px\">\u003cfigcaption class=\"wp-caption-text\">A snap of some data compiled by a hospital in Bangladesh \u003ccite>(D-Rev)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>We had heard that stat anecdotally for a long time, but it wasn't really apparent until we were in a hospital in Bangladesh last year and spotted a board filled with the data. It clearly showed more male babies.\u003c/p>\n\u003cp>We're spotting similar trends with our research into prosthetics. Female amputees will come into the clinic less frequently than men. We think it may be related to social stigma.\u003c/p>\n\u003cp>\u003cstrong>What have been a few of your high and low points at D-Rev?\u003c/strong>\u003c/p>\n\u003cp>My background is that I worked in Kenya for a number of years designing water pumps for farmers. I don't have as much experience in health.\u003c/p>\n\u003cp>The first time I was in a hospital in India, it was very upsetting. I was a new mother myself. There were these teeny tiny babies that could fit in the palm of your hand. And they were under these photo-therapy devices that I could tell were ineffective in one glance.\u003c/p>\n\u003cp>It was a low point, because I couldn't help but step back and think, 'these are lives that could be damaged permanently, but it's all so easily fixed.' My goal now is for everyone on our team to undertake at least one trip like this a year.\u003c/p>\n\u003cp>A high-point involves meetings with our users. I met a young woman called Poornima, who lost her leg in a car accident. She lost her brother in that accident. Poornima had wanted to be an engineer. Now, she wears one of our prosthetic knees and is filled with renewed energy.\u003c/p>\n\u003cp>\u003cstrong>In SIlicon Valley, almost every company is fighting to hire good designers and engineers. Do you find it difficult to find and retain talent?\u003c/strong>\u003c/p>\n\u003cp>I have this frustration that the nonprofit sector pays very talented people not very much money because they have chosen this field. We try to pay people market salaries, despite the push-back from donors. I think our employees are worth even more than what we're paying them.\u003c/p>\n\u003cp>Overall though, we've done well with recruiting. Where it gets challenging is with more senior staff; people with nonprofit experience and medical device experience.\u003c/p>\n\u003cp>\u003cstrong>Any parting words of wisdom for would-be health entrepreneurs who want to help low-income people?\u003c/strong>\u003c/p>\n\u003cp>Get out there and get experience. Talk to people; learn how to frame questions. Every time I go on vacation for instance, I stop into clinics and hospitals that use our products. Whenever I do field work, I always learn new things.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[ted id=1895]\u003c/p>\n\n","blocks":[],"excerpt":"D-Rev CEO Krista Donaldson on selling medical devices to hospitals and clinics in the world's poorest communities. ","status":"publish","parent":0,"modified":1477282577,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":46,"wordCount":1658},"headData":{"title":"D-Rev CEO: We Build Medical Devices for People who Live on Less than $4 a Day | KQED","description":"D-Rev CEO Krista Donaldson on selling medical devices to hospitals and clinics in the world's poorest communities. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"D-Rev CEO: We Build Medical Devices for People who Live on Less than $4 a Day","datePublished":"2015-05-14T16:00:03.000Z","dateModified":"2016-10-24T04:16:17.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"2981 http://ww2.kqed.org/futureofyou/?p=2981","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/05/14/d-rev-ceo-we-build-medical-devices-for-people-who-live-on-less-than-4-a-day/","disqusTitle":"D-Rev CEO: We Build Medical Devices for People who Live on Less than $4 a Day","path":"/futureofyou/2981/d-rev-ceo-we-build-medical-devices-for-people-who-live-on-less-than-4-a-day","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most medical equipment companies don't regularly top \"\u003ca href=\"http://www.fastcompany.com/most-innovative-companies/2013/d-rev\">most innovative\u003c/a>\" lists.\u003c/p>\n\u003cp>But \u003ca href=\"http://d-rev.org/\">D-Rev\u003c/a> isn't your typical medical device maker. The San Francisco-based non-profit wants to help the world's poorest individuals, who subsist on less than a few dollars per day. Its products include an \u003ca href=\"http://d-rev.org/projects/mobility/\">$80 prosthetic knee\u003c/a> and a \u003ca href=\"http://d-rev.org/2010/12/brilliance-is-licensed-to-phoenix-medical/\">phototherapy device\u003c/a> to treat infants with jaundice.\u003c/p>\n\u003cp>[Skip to the bottom of the article to watch a TED talk on the $80 ReMotion knee.]\u003c/p>\n\u003cp>What's unique about D-Rev is its approach to research. The company sends its small team of designers into the field -- whether it's a rural village in India or a remote hospital in Uganda -- to conduct interviews with patients, doctors and nurses.\u003c/p>\n\u003cp>During a recent conversation with a doctor based in rural India, D-Rev employees learned that many babies were dying of jaundice. The treatment devices were too expensive to maintain. The team brainstormed low-cost solutions and came up with \u003ca href=\"http://d-rev.org/projects/newborn-health/\">Brilliance\u003c/a>, a photo-therapy lamp that sells for $400, a fraction of the cost of its mainstream competitors.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED\u003c/em> sat down with Krista Donaldson, the company's chief executive, to discuss the ongoing challenges of running a medical non-profit and the opportunities for the future. Donaldson shared that D-Rev is considering a move into the U.S. market to help those in need closer to home.\u003c/p>\n\u003cp>This interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>In the past few years, D-Rev seems to have exploded in the media. When did the company get its start?\u003c/strong>\u003c/p>\n\u003cp>It was started in 2008 as a skunk-works of technology for the developing world. I was brought in because a lot of the products were in stages of prototyping and weren't reaching users. I cancelled most of the projects and focused our attention on people who are living on less than $4 a day. Our core mission is to close the gap in quality health care by focusing on delivery and design.\u003c/p>\n\u003cp>\u003cstrong>What was the first product that you released as CEO?\u003c/strong>\u003c/p>\n\u003cp>It was the Brilliance photo-therapy device. We got the idea after a doctor from India approached us at a conference. He said that the global health community, which is very Western-driven, is focused on the 'big ticket items' like preterm births and asphyxia [\u003cspan class=\"st\">a potentially-fatal condition caused by a lack of oxygen in the blood\u003c/span>.] But he told us that at his hospital, many babies were dying of jaundice. We estimate that 6 million babies with severe jaundice are not receiving adequate treatment.\u003c/p>\n\u003cp>My colleague got intrigued about developing a device that would shine an intense, blue light onto the baby's skin as a safe and effective therapy. We had heard that a hospital in Uganda was putting babies in the sun to get treated. This isn't safe, but the doctor did that because it was his only option.\u003c/p>\n\u003cp>[Watch the video below to learn more about D-Rev's solution.]\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/eOgPT0faICs'\n title='//www.youtube.com/embed/eOgPT0faICs'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Many medical device companies will donate surplus equipment to developing nations. So why would health providers buy a product from D-Rev?\u003c/strong>\u003c/p>\n\u003cp>The medical device industry is far behind in terms of design. The approach they often take when thinking about low-income people is to donate the stuff that isn't being used in the West. There are all sorts of problems with that, whether it's different electronic frequencies, plugs and outlets, fluctuating temperature standards, or broader cultural issues.\u003c/p>\n\u003cp>\u003cstrong>How about low-income people in the U.S. who struggle to access cost-effective therapies? Are you planning to build devices for the domestic market?\u003c/strong>\u003c/p>\n\u003cp>Yes. We are in the early exploration phases of looking into low-income amputees in the United States. If we do something, it'll be a version of our prosthetic knee. The problem is that devices are so expensive here that many low-income people we've spoken to say they are ordering stuff from China on eBay. We'll have more information about our next steps later in the year.\u003c/p>\n\u003cp>\u003cstrong>What's your design process like for developing a new medical device?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">“ There were these teeny tiny babies that could fit in the palm of your hand. And they were under these photo-therapy devices that I could tell were ineffective in one glance.\"\u003cbr>\n\u003ccite>Krista Donaldson, CEO of D-Rev \u003c/cite>\u003c/aside>\n\u003cp>We start with a problem identified by a user, oftentimes a doctor at a rural clinic. One example might be a lack of high-quality, affordable prosthetic knees. We would ask questions to potential users like: 'Would you want a prosthetic that will help with your gait? Are you looking for a device that will help you to return to work?'\u003c/p>\n\u003cp>When we were doing the prototype of \u003ca href=\"http://d-rev.org/2014/10/learning-comet-rural-clinics-home-care-arent-ready-phototherapy/\">Comet\u003c/a>, an offshoot of our Brilliance phototherapy device, we drove around India and stopped at 20 different hospitals and clinics of all sizes to talk to the doctors. At this stage, we had four rough prototypes. Once you get more information, you can show the prototypes and get feedback. We also take into account cultural norms.\u003c/p>\n\u003cp>Once the product has been designed, we deal with things like regulation and intellectual property. Regulation is different in every country -- some have no requirements at all.\u003c/p>\n\u003cfigure id=\"attachment_2989\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-2989\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-800x533.jpg\" alt=\"Donaldson interviewing an amputee \" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee.jpg 1025w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Donaldson interviewing an amputee victim \u003ccite>(D-Rev)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Travel to rural parts of the world is expensive. Is it an ongoing challenge to raise funding?\u003c/strong>\u003c/p>\n\u003cp>We are raising money constantly. It is a challenge because we are more like a medical device startup than a typical philanthropic organization. We don't fit neatly into a bucket within the global health community, like\u003ca href=\"http://www.usaid.gov/\"> USAID [the government agency responsible for administering foreign aid.] \u003c/a>Their typical idea of global health innovation tends to be very labs-based.\u003c/p>\n\u003cp>But we have had a lot of success with foundations and individuals. Some companies help us out too, like \u003ca href=\"http://autodesk.com\">Autodesk\u003c/a>, which provides free software.\u003c/p>\n\u003cp>One big frustration I have is that big funders want to see data about improving mortality rates. They are less inclined to fund devices that prevent brain damage, rather than just save lives. We have to make sure that people can live healthy lives.\u003c/p>\n\u003cp>\u003cstrong>Aside from funding, what are some of the biggest hurdles that the company faces?\u003c/strong>\u003c/p>\n\u003cp>A lot of our users have low-trust in medical devices in general, in large part due to poor quality of some of the less expensive ones. Doctors often say to us: 'Why is your product so cheap? What's wrong with it?'\u003c/p>\n\u003cp>Another lesson learned is that in many low-income countries the government will purchase large batches of medical devices for state hospitals. They put out a tender with specifications that companies need to meet. I expected there to be less corruption in that process. But I'm hoping that things will improve over time with greater transparency.\u003c/p>\n\u003cp>\u003cstrong>What is the core demographic for D-Rev's devices?\u003c/strong>\u003c/p>\n\u003cp>We don't have any good data yet. But we are starting to do some preliminary research on gender. We have learned that boy babies are brought in for jaundice far more frequently than the girls -- it's about two to one. But boys and girl babies are equally likely to suffer from jaundice.\u003c/p>\n\u003cfigure id=\"attachment_2993\" class=\"wp-caption alignright\" style=\"max-width: 326px\">\u003cimg class=\" wp-image-2993\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Bangladesh-Photo-450x600.jpg\" alt=\"A snap of some data compiled by a hospital in Bangladesh\" width=\"326\" height=\"435\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo-450x600.jpg 450w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo-400x533.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo.jpg 843w\" sizes=\"(max-width: 326px) 100vw, 326px\">\u003cfigcaption class=\"wp-caption-text\">A snap of some data compiled by a hospital in Bangladesh \u003ccite>(D-Rev)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>We had heard that stat anecdotally for a long time, but it wasn't really apparent until we were in a hospital in Bangladesh last year and spotted a board filled with the data. It clearly showed more male babies.\u003c/p>\n\u003cp>We're spotting similar trends with our research into prosthetics. Female amputees will come into the clinic less frequently than men. We think it may be related to social stigma.\u003c/p>\n\u003cp>\u003cstrong>What have been a few of your high and low points at D-Rev?\u003c/strong>\u003c/p>\n\u003cp>My background is that I worked in Kenya for a number of years designing water pumps for farmers. I don't have as much experience in health.\u003c/p>\n\u003cp>The first time I was in a hospital in India, it was very upsetting. I was a new mother myself. There were these teeny tiny babies that could fit in the palm of your hand. And they were under these photo-therapy devices that I could tell were ineffective in one glance.\u003c/p>\n\u003cp>It was a low point, because I couldn't help but step back and think, 'these are lives that could be damaged permanently, but it's all so easily fixed.' My goal now is for everyone on our team to undertake at least one trip like this a year.\u003c/p>\n\u003cp>A high-point involves meetings with our users. I met a young woman called Poornima, who lost her leg in a car accident. She lost her brother in that accident. Poornima had wanted to be an engineer. Now, she wears one of our prosthetic knees and is filled with renewed energy.\u003c/p>\n\u003cp>\u003cstrong>In SIlicon Valley, almost every company is fighting to hire good designers and engineers. Do you find it difficult to find and retain talent?\u003c/strong>\u003c/p>\n\u003cp>I have this frustration that the nonprofit sector pays very talented people not very much money because they have chosen this field. We try to pay people market salaries, despite the push-back from donors. I think our employees are worth even more than what we're paying them.\u003c/p>\n\u003cp>Overall though, we've done well with recruiting. Where it gets challenging is with more senior staff; people with nonprofit experience and medical device experience.\u003c/p>\n\u003cp>\u003cstrong>Any parting words of wisdom for would-be health entrepreneurs who want to help low-income people?\u003c/strong>\u003c/p>\n\u003cp>Get out there and get experience. Talk to people; learn how to frame questions. Every time I go on vacation for instance, I stop into clinics and hospitals that use our products. Whenever I do field work, I always learn new things.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>[ted id=1895]\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/2981/d-rev-ceo-we-build-medical-devices-for-people-who-live-on-less-than-4-a-day","authors":["3252"],"series":["futureofyou_135","futureofyou_219"],"categories":["futureofyou_1062"],"tags":["futureofyou_316","futureofyou_320","futureofyou_322","futureofyou_80","futureofyou_317","futureofyou_321","futureofyou_319","futureofyou_323","futureofyou_318"],"featImg":"futureofyou_2987","label":"futureofyou_219"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. 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