Placed on a hospital cupboard about two meters from the ground, the little box glows with a brilliant blue light, beautiful in the dark. Unlike the normal incubator used in Paediatric Intensive Care Units (PICU), the box measures approximately about 1m x 0.5m x1m (3ft x 2ft x 2ft) and weighs a little above 5 kilograms (11 pounds) . This box has saved the lives of many babies since a young mother and her team first produced it, three years ago.
Originally conceived, designed, tested and launched in Yenagoa, Bayelsa State, the box now sits in the paediatric units of various hospitals in the Federal Capital Territory (FCT), including Maitama, Wuse and Asokoro District Hospitals.
Named Crib A’Glow, it is a low-cost phototherapy solution to treat newborn babies with neonatal jaundice. It was developed by a young mum and professional graphic designer, Virtue Oboro, after her son’s experience with jaundice. With a group of medical professionals and biomedical engineers, she built a prototype, but it took four failed attempts and several trials before the product worked and she started her company, Tiny Hearts Technologies.
Addressing a Silent Child Killer
Data from the World Health Organization’s Global Health Observatory shows that in 2017, newborn deaths accounted for 47% of deaths among children under five, and in 2016, 1 million children died as a result of complications arising from premature births. While jaundice occurs in about 50% of babies reaching full term, it occurs in 80% of preterm babies. A paediatric specialist at the Asokoro District Hospital in the FCT estimates that 8 out of every 10 premature births in their unit have the condition.
Image credit: Nigeria Health Watch
Jaundice is usually caused by an excessive build-up of bilirubin, a substance made when the body routinely breaks down red blood cells. However, a newborn’s still-developing liver often cannot remove bilirubin quickly enough, causing an excess. Another predisposing factor is Rhesus (Rh) incompatibility between a mother and her baby. Although a small number of babies have different rhesus blood types from their mothers, these mismatches can lead to jaundice. Occurring in the first few days of life, the most notable symptom is a yellow colouration of the skin, which with time, is also observed in the whites of the eyes. While many mild cases do not require treatment, the common treatment for severe jaundice is phototherapy which involves placing the baby under a special type of light that helps break down the excess bilirubin.
A harrowing experience with jaundice
If the bilirubin isn’t broken down quickly enough, it can lead to death or severe disability. Early detection is therefore very important because the symptoms can be missed by new mothers. In the case of Oboro, she thought her son, Tonbra, “just had a fair complexion.” Oboro was discharged from the hospital about 48 hours after delivery, and it wasn’t until her mum, a nurse, came visiting that she realised the yellowish colour was unusual. Once they returned to the hospital, little Tonbra was diagnosed with jaundice. Oboro described the experience that followed the diagnosis as “harrowing“, as the excitement of the birth of her first son was replaced with fear and uncertainty, especially when she learned of the possibility of brain damage if the diagnosis was not properly handled.
With all phototherapy treatment units in use at the PICU of the hospital where Tonbra was admitted, a mother whose baby had almost recovered asked that her baby be discharged to give baby Tonbra a chance. Almost immediately, he was placed inside the phototherapy unit, but then, there was a power outage and other alternative sources of power in the hospital failed. The doctors performed an emergency blood transfusion which sustained him until he was able to access a phototherapy unit. After about a week, Oboro returned home with her baby but the experience was not to leave her for weeks.
Nurses at Wuse General Hospital search for space to place the Crib A’Glow phototherapy unit. Photo source: Tiny Hearts
Necessity usually leads to invention but for Oboro, it was a combination of the near-death experience of her son, curiosity, a passion for problem-solving and empathy for other babies who might face similar situations, that led to the development of Crib A’Glow.
Once she and her son had recovered from the experience, she set out to learn more about jaundice and possible ways for other parents and healthcare providers to overcome the challenges they had faced. The main problems turned out to be lack of quick access to treatment and unstable power supply.
After extensive research, Oboro and her team came up with Crib A’Glow, a simple solar-powered phototherapy system that can be easily moved around to locations where it is needed.
Powered by the sun, the unit solves the problem of unreliable power supply. It also improves ease of access as the equipment can be easily disassembled and moved from one location to another where it is needed urgently.
As a social enterprise, the company is sustained by selling and hiring out the Crib A’Glow phototherapy units. A unit sells for N150,000 and can be rented at the rate of N3000 for 24 hours. Tiny Hearts Technologies also produces disposable phototherapy blindfolds, conducts training programs and recently launched a sensitisation initiative called Yellow Alert to help raise awareness about neonatal jaundice among pregnant women.
Medical staff at the neonatal and pediatric unit in Asokoro District Hospital watch a demonstration of the Crib A’Glow phototherapy unit. Photo source: Tiny Hearts
Beyond Bayelsa: Scaling up a home-made solution
Since the inception of Tiny Heart Technologies in 2016, over 1250 babies have benefitted from their initiative, says Oboro. For her, the task of pitching their services to hospitals is a difficult process because most times, they are met with scepticism. “They usually prefer big equipment from big companies outside Nigeria and usually don’t want to try homemade solutions,” Oboro said. However, they continue inventing strategies to win them over. She recounted how such efforts saved a baby’s life and led to bringing the Crib A’Glow unit to three hospitals in the FCT.
In February 2018, Oboro walked into the paediatric intensive care unit of the Niger Delta University Teaching Hospital (NDUTH) in Yenagoa, Bayelsa state capital. Her mission was to retrieve the phototherapy unit she had rented to the hospital for use. An attending paediatrician told her that a baby was to start treatment with the unit, but the parents were unable to afford it. After hearing the story and with a plea from the doctor to assist, she decided to see the baby.
Medical staff at Wuse General Hospital receive a free unit of the Crib A’Glow phototherapy equipment from Tiny hearts technologies. Photo source: Tiny Hearts
Baby Ndukwe, as he was called, had jaundice but presented at the hospital when complications had set in. His parents had turned to herbal remedies when they first noticed he was sick. On seeing the state of the baby, Oboro decided to assist by starting a fundraiser for him even though it was out of their line of business. She got consent from the parents, took baby Ndukwe’s picture and asked for financial help through her WhatsApp network. Within 24 hours, over N70,000 was raised. This helped offset his medical bills, rent the phototherapy unit for the duration of his treatment and even covered the next baby in need of treatment.
Someone who donated to the fundraiser for baby Ndukwe bought three units of the phototherapy unit and anonymously donated them to three hospitals in Abuja. Oboro said the donor’s motivation was simple. “She said since the Crib A’Glow helped save the life of one baby, she wanted to extend that opportunity to other babies who might need it,” she said.
Twin babies placed inside a Crib A’Glow phototherapy unit in a private hospital in Bayelsa. Photo source: Tiny Hearts
Can Nigeria sustain innovative homegrown start ups?
The challenges with the Crib A’Glow solution are not different from other Nigerian start-ups and largely revolve around the cost of running a business, hiring and retaining talent, government support and regulations. But as a Nigerian medical equipment and device start-up, Tiny Hearts Technologies has its unique set of challenges too, one of which is the inherent preference for imported products. Oboro said this is one of their biggest challenges because it’s difficult to convince hospital executives to adopt their solution.
The cost of using the equipment is another challenge. Hospitals that rent the units need to make profit because they are running a business. This is likely to increase the cost for patients’ relatives and introduce a barrier to access. This can be overcome if there is an effective health insurance system that covers citizens in the formal and informal sectors.
The Crib A’Glow phototherapy unit was donated to Maitama District hospital by an anonymous donor after it saved a baby’s life in Bayelsa. Photo source: Tiny Hearts
A challenge which raises an important question is the issue of patents and protecting intellectual properties. How well are these innovations protected especially in a highly competitive market like Nigeria? Oboro says she has a patent right which offers protection for her design. The legal framework for patents is enshrined in the Patents and Designs Act of 1971. In place for nearly five decades now, is the Act still in tune with current realities, and able to protect young inventors?
Globally, there is a need for affordable technologies to tackle neonatal jaundice. The Crib A’Glow is one of such but for it to thrive, we must develop a culture of adopting and supporting Nigerian-made solutions once they are proven to be effective. The team has plans of expanding to other African countries but charity, they say, begins at home. Let us adopt and use our own, so that other babies like Tonbra and Ndukwe can be given a fighting chance.
By Chibuike Alagboso (Lead Writer)
Dream Becoming A Reality
The residents of Kyukuni Village, Voo Kyamatu Ward, Kitui County had challenges in accessing water before the intervention of the Amref Health Africa Kitui WASH Project. Residents would trek for over 15km in search of water, a situation that not only affected the time women spent doing other economic activities, but also affected school enrolment and attendance among school going children.
According to the Project Officer George Wambua, there were shallow aquifers which were an alternative source of water, but the residents believed that water from this source would only be enough for household use and nothing else. This was a long standing belief that they held, and changing it was an uphill task.
During a baseline survey that was carried out in 1998, water was ranked first on the priority list of needs among communities. For the residents of Kyukuni Village, water was a priority but they did not realize how it could help to change their economic status. “Changing their mind-set to make them see how water could improve their lives economically was a challenging task. However, with continued follow-ups and interactions with the community, we were able to change the community’s way of doing things,”said Mr Wambua.
In trying to make a case for using water to improve the community’s economic status, the project started by developing a small farm around the Miembeni giant well situated in Zombe/ Mwitika Ward. The well serves a group of 12 families who decided to change their traditional way of doing things. They decided to extend water use from domestic to other economic activities including horticulture farming and poultry keeping.
According to Mr Mutua, one of the beneficiaries of the project, a number of giant wells were commissioned along the Thua River through the support of Amref, but only a few of the groups seriously engaged in intensive farming.
“You would find a group of 15 households doing small scale farming that was not enough to support the whole group, but yet the well had sufficient recharge of about 10m3.
This means they only utilised 30% of the water in the well leaving 70% not utilised”, said Mr Mutua. He added that when his group realized that they were sleeping on gold about two years ago, they started serious farming activities around their water points. The group now owns a two-acre piece of land that can be utilized freely by the group.
Kitui East has been hard hit by the regular occurrence of drought due to erratic rainfall. For the last 10 years, the rainfall pattern has been unpredictable. The rainfall onset has been delayed every year, and when it has rained, rainfall has also not been adequate. The only remaining option is to use water from the well to grow crops that can feed their families and have some left overs to sell for economic sustainability. This is what Mr Mutua the chairperson, encouraged his group to do.
“We started our farming in a small way by cultivating very basic crops just enough to feed our families. Little did we know it was our turning point as a group,” said Mr Mutua.
Mr Mutua added that they upgraded their activities by growing cash crops like tomatoes, onions, water melons and carrots. The first group was successful and made good profit. On sharing the profit among the 15 households’ after all necessary deductions, each was able to get Kshs 5,000. This enabled members have cash to do other things like paying school fees and other bills. The community members had longed for.
“God is great, our dream has come true,” said one of the group members.
Additional activities carried out using water from the well include poultry farming. This is another project that has had multiple benefits to the family. The groups now have eggs that they use to feed their children, thus preventing diseases associated with poor feeding. They also sell the birds to make good money for the household use.
The project though funding from Amref Italy has built 50 giant wells to support 20,500 people with agricultural activities and 218,940 people with access to safe water and sanitation. The project is committed to make safe and affordable drinking water, hygiene and sanitation a reality for the people of Kitui County.
This CSIR Female Researcher Is One Of Few Stem Cell Reprogramming Experts In South Africa
Dimakatso Gumede, CSIR Researcher.
Only a handful of people in South Africa have mastered Stem Cell reprogramming and Dimakatso Gumede (34) is one of them. As the CSIR’s candidate researcher of the Bioengineering and Integrated Genomics Research Group, she works on creating disease models of the innate immune system to study unique African gene variants that lead to elite controllers that naturally control viral load levels without antiretroviral therapy.
By using induced pluripotent stem cell technology, the CSIR research group also creates“mini liver”models in order to determine the adverse drug affects in the South African population.
“The African population is known for its genetic variation, which often affects the way in which an individual responds to particular medication. For example, while an aspirin may work effectively for 70% of the population, it is possible that the remaining 30% may experience adverse effects. Therefore, as part of CSIR’s Bioengineering and Integrated Genomics group, we are looking to create effective and personalised medication for those who do not respond positively to the drugs that have been distributed for the general population,” says Gumede.
Gumede, who is a PhD scholar of the University of Cape Town (UCT), recently submitted her doctoral thesis. She studied the role of a gene mutation that causes skin and lung fibrosis, using a scientific method called induced pluri-potent stem cells. This approach produces any cell type in the body, such as skin or lung cells, which, in this case, provides insight into how an inherited dermatological condition is associated with lung fibrosis – a condition caused by uncontrolled scar formation that affects the organ and air sacks.
However, this was not Gumede’s original project. Initially, her PhD project was on cardio genetics, and she was working with the late Prof. Bongani Mayosi and Dr. Gasnat Shabooden at the UCT Hatter Institute for Cardiovascular Research in Africa.
“While I was busy with my initial research project, the late Prof. Mayosi suggested that I shift the focus of my project to the study of a rare genetic condition that is associated with lung, skin and muscle fibrosis. I was excited because not only was it a ground-breaking research project that would serve as a massive breakthrough for the South African medical science sector, but it would also provide me with the opportunity to apply my cell biology expertise,” says Gumede.
With the assistance of Prof. Susan Kidson and Dr Robea Ballo, Gumede focused mainly on the cell biology of the rare skin condition in question. She learnt a great deal about reprogramming skin cells into pluripotent cells to understand what causes this gene mutation, how this rare skin condition develops at cellular level and how or why it affects organs such as the lungs and muscles and prevents them from functioning properly.
“I discovered that the gene mutation that causes this condition accelerates cell division, which contributes to fibrosis in the affected individuals and is also associated with cancer progression,” says Gumede.
Further, according to Gumede’s Principal Investigator at the CSIR – Dr Janine Scholefield, her ability to not only master but, explain highly technical and advanced science in isiZulu and Sesotho is what makes her so highly prized at the CSIR.
“She has mastered the craft of communicating her work fluently in isiZulu, Sesotho and English which is so important. With science and technology shaping our lives daily, it ought to be accessible to all, especially young people wanting to pursue a career in science. Having a young black woman who is at the top of her game and is able to make the work we do relatable is what will continue to inspire young girls entering the science field. It also makes her even more invaluable to the CSIR and the scientific community at large” added Dr Scholefield.
With the skills that she has gained, she aims to use her PhD to further establish the stem cell platform for precision medicine, drug screening and, possibly, commercialisation in the CSIR. She also intends to use the stem cell and genome engineering platforms to find new approaches to eliminate HIV reservoirs in infected persons and, hopefully, also contribute in finding key therapeutic strategies that resolve excessive scar formation in heart and lung conditions, which are a great burden of disease worldwide.
The African Union Appoints Amref Health Africa Global CEO to Board of Africa Centre’s for Disease Control and Prevention (Africa CDC)
NAIROBI, 8 August 2019: Amref Health Africa Global CEO and Co-Chair of UHC 2030 steering committee, Dr Githinji Gitahi has been appointed as a member of the Governing Board of the Africa Centre’s for Disease Control and prevention (Africa CDC).
Dr Gitahi will join the Governing Board of the Africa CDC pursuant to article 10 of the statute of the Africa CDC. Dr Gitahi was appointed by the Commissioner for Social Affairs, Her Excellency Mrs. Aminra Elfadil of the African Union Commission.
The Africa CDC supports all African countries to improve surveillance, emergency response, and prevention of infectious diseases. This includes addressing outbreaks, man-made and natural disasters and public health events of regional and international concern. It further seeks to build the capacity to reduce disease burden on the continent.
“I would like to extend my gratitude to the African Union and specifically to H.E Mrs Elfadil for this appointment. I am honoured to be nominated to this position that is geared towards strengthening and transforming the health in Africa. I look forward to sharing my expertise and skills as we work towards achieving Universal Health Coverage and achieving health security in Africa,” said Dr Gitahi.
The Africa CDC is also a specialized technical institution of the African Union that serves as a platform for Member States to share knowledge, exchange lessons learnt and build capacity.
This appointment comes after his nomination as the co-chair of the UHC2030 Steering Committee in December 2017. UHC2030 is a World Bank and World Health Organization (WHO) forum for achievement of universal health coverage (UHC) by 2030 and has membership across countries, private sector and civil society organisations.
About Amref Health Africa
Amref Health Africa, headquartered in Kenya, is the largest Africa based international non-governmental organisation (NGO) currently running programs in over 35 countries in Africa with lessons learnt over 60 years of engagement with governments, communities and partners to increase sustainable health access in Africa. Amref Health Africa also incorporates programme development, fundraising, partnership, advocacy, monitoring and evaluation, and has offices in Europe and North America as well as subsidiaries; Amref Flying Doctors, Amref Enterprises and the Amref International University.
Credit: Amref Health Africa
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