The idea to use toys to produce medical devices grew out of simple necessity. When a supply store frequented by Jose Gomez-Marquez, a medical device designer at MIT, and his students was closed on a Saturday afternoon, the group found themselves at Target. There they mined toy helicopters and cartons of Legos for parts for their medical device prototypes.
Years later, Gomez-Marquez is using those ideas to develop kits that could allow doctors and nurses -- and even patients -- to build their own affordable medical devices. Gomez-Marquez, whose work was featured by Dr. Sanjay Gupta on CNN, was named a TEDGlobal Fellow for his work in developing countries and one of Technology Review's Innovators Under 35.
I spoke with Gomez-Marquez about turning toy helicopter parts into inhalers, why we need affordable medical devices and how his MEDIKit could transform hospital care. Below are excerpts from our interview.
How did you become a medical device designer specializing in affordable devices?
My background originally was in mechanical engineering, but then I switched over to science. My formal training was unconventional. When I moved to Massachusetts to switch careers, I did a lot of work in research projects at MIT. I joined a team that had come up with an aerosol vaccine device. It was there that I started to hone, through a process of forming and directing teams, this approach to [affordable] design. It was rooted in the notion of DIY prototyping. Most people will do it to renew their deck or something like that. We were doing it to make a prototype. The prototype did very well. It ended up winning a major competition at MIT and other awards. Then we jumped to a diagnostics platform. In the end, MIT [hired me].
Six years ago, I would have described myself as a developing country-global health specialist for medical technology. That expertise was partly from my own upbringing in Honduras and further travels. [Those travels focused] on partners in the field who would tell us their conditions and we’d co-design with them. I had many conversations with people asking us how to use the technologies here. We started looking into how these technologies can trickle back up. The banner we prefer to fly under now, at least in the last two years, is affordable healthcare technologies with the vehicle of DIY as a mechanism for empowering people.
You turn toy helicopter parts into inhalers. Why do toys make great medical devices?
We have supply chains around the world. Some are very efficient and some are very inefficient. Healthcare technology supply chains are very inefficient. Things take forever to get anywhere and they aren’t widely distributed. Things like consumer electronics and toys turn out to be really efficient supply chains. How do we take the very efficient supply chains, mine the stuff that’s coming out of them and create methods to make healthcare technology? The idea of toys grew out of necessity. It was afternoon and the supply store we get supplies from was closed. We needed a specific motor. We’d ask our students, ‘Where can we get a motor?’ We began doing that in a more systematic way.
The toy helicopter came about when we were brainstorming designs for an inhaler. We noticed one of them used a mechanism to beat powder into a small cloud the same way you beat dust out of a rug with a stick. What else produces a motion that we can use to flap a small vessel to create a cloud? We were in Target, saw the toy helicopter and put two and two together. Now we use lots of different toys -- whether it’s Legos or remote-controlled cars -- to look at the available mechanisms that have become really cheap. The toys we get today, you’re getting an engineered item. There’s a remarkable level of engineering they go through. There’s also a level of safety.
What are some other examples?
Just last night, my students were using Legos to make a syringe pump. A syringe pump is a highly accurate device that pushes liquid at a very constant rate. They’re usually about $500. In Nicaragua, $500 is a lot of money. How do I get somebody in Nicaragua to have the same thing I have access to at MIT? We were building a syringe pump to deposit proteins used to detect things like the ebola virus.
We’ve also been able to hack the optics of toy cameras to make microscopes that will magnify at a certain rate.
Talk about another one of your projects: the MEDIKit.
I taught the first affordable medical technology class at MIT. I needed to teach my students, in one semester, a survey of a bunch of different medical technology. I didn’t want to just invite a bunch of experts to give talks because the students wouldn’t learn how to make the stuff. They’d just learn how other people do it. How do I get them to learn how I learned? I bought a bunch of medical devices in different sectors and put them in Tupperware boxes. In lab No. 1 you would play with a bunch of different devices. In lab No. 2, you’d play with different devices. That became almost our original teaching kit. Ten months later, we had a grant to teach the same notion to Nicaraguan nurses and doctors. That’s how the MEDIKit was born. We looked into how we could create a kit for health that is intuitive as far as how you can use it to make a pregnancy test or a bicycle-powered nebulizer.
The MEDIKit is a set of construction blocks. When you put them together, in a non-linear fashion, you make medical devices. You have all these elements in place. We constantly evolve it. We’ve spun off aspects of it so people can access it from around the world. We’re proud of it. It keeps us on our toes trying to come up with new parts. Our biggest driver is to understand what healthcare providers want to construct, not just what we think they want. We’re going to do a big push to embed it in some American hospitals.
Why would hospitals in the U.S. need the MEDIKit?
It’s not just about supplying things that are non-existent. The MEDIKit isn’t to supplant the healthcare system. You can’t assume that if the healthcare system exists you don’t need more technology. The concept is using democratized medical fabrication. How do you get anybody who will encounter medical technology to have a say in what that technology will look like and how it will function? That’s not just limited to developing countries. In developing countries, a lot of the ingenuity isn’t from people like me who go there as technology heroes. The ingenuity is happening by doctors and nurses who have to get by every day. When technology fails, they reinvent it locally.
The same thing happens in America for different reasons. It has different semantics. In the nursing community, you hear about "workarounds" where nurses make small [solutions] just to treat their patients. Both in developing countries and America, they largely end up prototyping this using rubber bands, office supplies, whatever they can get ahold of in their work area. There’s nothing out there that is one set of materials that can let them do what they’re already doing in a much more efficient way.
There’s also the patient. There’s tremendous interest from patients who want to fix and create their own technologies for health. There are pill bottles out there that will send you a text message or light up when you need to take your pills. These technologies are about $200. An inner city patient who doesn’t have a lot of means could never afford that. But that’s exactly the person you want to have that technology.
Democratizing access to those basic technologies is the approach. Are we going to put biomedical engineers out of work anytime soon in America? Absolutely not. But we want more people to participate in the process of telling them what they should design. It’s a bottom-up approach.