What’s the best way to bring cutting-edge healthcare to the world’s poorest places? It can be tempting to export money and equipment to solve the problem. But when bioengineer Rebecca Richards-Kortum visits hospitals in places such as Malawi and El Salvador, she sees the unintended consequence of that charitable impulse.

“Ironically, if you walk down the hall or into the basement of a hospital, there’s always a big room that is just for broken, donated equipment,” she says. The equipment works just fine in the United States, but in places plagued by lack of air conditioning, power outages, and challenges like dust and dirt, what would be a high-tech lifesaver in the U.S. is just another hunk of junk. Given the amount of time, energy, space and money that can go into figuring out how to use the equipment and repairing it when it breaks, says Richards-Kortum, “it can hurt more than it helps.”

Could there be a better way? Richards-Kortum thinks so — and her efforts to bring affordable, adaptable technology to the world’s poorest places earned her a spot in this year’s class of MacArthur fellows. Richards-Kortum, who heads up Rice University’s Institute for Global Health, uses the latest advances in nanotechnology, fabrication and molecular imaging to help invent equipment that’s rugged enough to stand up to the most challenging clinical conditions and cheap enough to make sense for communities that usually lack access to health care.

“Cheaper can certainly be as effective,” says Richards-Kortum. “In some cases it can be better in the sense that it improves access.” Take her high-resolution microscopic endoscope, which her team developed in conditions in countries that have high rates of cervical cancer but low access to things like labs that process pap smears or biopsies. Rather than collect tissue that is then analyzed in a laboratory, the portable endoscope lets technicians view cervical tissue, diagnosing cancer in real time and for less money. And by using new fluorescent dyes developed by Richards-Kortum and her team, doctors can spot oral cancers without spending as much money or time as they would using traditional diagnostics.

Resource constraints don’t intimidate Richards-Kortum — they inspire her. “They force you to make really tough decisions,” she says. “I think you often end up with a better product.” She passes on that philosophy to students in Beyond Traditional Borders, a program she developed that teaches undergraduates how to translate classroom ideas into global health solutions. Students focus their efforts not on hypothetical situations, but on real-world problems, developing technologies that fill health needs.

For example, a group of her students recently invented an inexpensive bubble CPAP machine for newborns who can’t breathe due to respiratory infections. Developed in conjunction with practitioners in Malawi, the technology decreased mortality rates in one neonatal ward by 46 percent. And patients in developing countries aren’t the only ones who benefit from the program. Students who participate in real-world projects in the program, she says, graduate at higher rates than STEM majors who don’t — especially women and underrepresented minority students.

“If your inventions don’t ever leave the lab, you’re not doing your job,” she says. Similarly, she says, inventions that are designed in a vacuum are useless. Rather, she teaches her students to collaborate with end users, clinicians, and patients in the countries they seek to serve. That collaborative process can lead to even more inventive solutions, like a rapid prototyping facility Richards-Kortum helped develop at the University of Malawi. “They came up with a way to locally repair oxygen concentrators,” she says, instead of relying on a pricier, more complex fix.

Though Richards-Kortum focuses the majority of her work on finding inexpensive ways to bring healthcare to the developing world, her inventions work the other way, too. She’s currently working to figure out ways to bring her cervical cancer detection system, which is currently being deployed on vans throughout rural Brazil, to under-served places in the United States, like the Rio Grande Valley in Texas.

All that penny-pinching has earned Richards-Kortum an honor with a massive $625,000 stipend to use as she pleases. (“I was sure it was a telemarketer, but it turned out to not be a telemarketer,” she jokes of receiving the call from the foundation a few weeks ago.) She isn’t sure yet how she’ll use the money, but she’s committed to using it to improve health for babies and pregnant women in Malawi.

“At the current rate of progress, it’s going to be 150 years before a baby who’s born in Africa has the same chance of survival as a baby in North America,” says Richard-Kortum. “I don’t want to live in that world.”

Erin Blakemore (@heroinebook) is a freelance journalist from Boulder, Colo. She is the author of "The Heroine’s Bookshelf" (Harper). 

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