A life-saving warmth

Four graduates from Stanford University tackle infant mortality head-on by offering a cheaper alternative to the standard incubator

They did not know it then, but when Infosys founder NR Narayana Murthy won The Economist's Innovation Award in 2007 for being a pioneer of the IT industry in India, the seeds for the next winner from India were being planted far away in a classroom in Stanford by four students who had never met before.

Rahul Panicker, Jane Chen, Naganand Murty and Linus Liang - founders of Embrace, which has developed a low-cost infant warmer for premature and low birth-weight babies, and this year's award winners - came from diverse backgrounds. Panicker, for example, was an IIT-Madras alumnus, doing his doctorate in the interface of artificial intelligence and optics, while Chen was a student at Stanford's business school.
 
What brought them together was the Stanford University class titled Entrepreneurial Design for Extreme Affordability, which focused on design solutions for the developing world. One of the partner organisations was working in the neonatal space and wanted a low-cost version of the traditional glass-box incubator.

"When we started working on it, we realised it was possible to make cheaper versions but that would not make much of a difference because most of the babies were dying in semi-urban and rural areas, whereas these incubators sit in city hospitals. And a cheaper version would still need uninterrupted electricity, trained personnel to operate it and maintenance," says Panicker, the company's president, at his office in Bangalore.

All of which would be a challenge in a rural setting. "So we went back and asked them if the real need was for cheaper incubators or to save babies." According to WHO, 20 million premature and low-birth-weight babies are born every year, out of which four million die in the first month.

The device they came up with resembles a baby sleeping bag, into which a phase change material with special chemicals is inserted, after it has been warmed in a warm pack with electricity. The chemical allows the heat to be retained for up to six hours. While the cost of a hospital incubator typically runs into lakhs, Embrace's device costs Rs 15,000. A pilot is being done for an even cheaper version that can be used at home, without electricity.

Bafflingly, when the prototype had been developed, the partner organisation was not interested in it, preferring instead a low-cost version of the traditional incubator. "That's when we figured that if we didn't take it forward, nobody would. And somewhere along the way, we also realised that we were on to something that could have a lot of impact," says Panicker, now 33. He says while they all had easier options before them, something about that did not make sense. "Reducing infant mortality is supposed to be a Millennium Development Goal, so are we saying that some of the world's most important problems should be left to people with nothing better to do? And if I really believed that logic to be absurd, I should be willing to walk the talk."

So they did, shifting base to Bangalore in 2009, because they wanted India to be the launch market. The seed capital was raised in the intervening years after graduation, primarily a $90,000 fellowship from Echoing Green Ventures and another $35,000 for winning the Stanford business plan competition. Investors and supporters include Vinod Khosla's Khosla Impact Fund and Jeff Skoll's Capricorn Investment Group, as well as Ranjan Pai of the Manipal Group and Biocon chairperson Kiran Mazumdar Shaw. "The Embrace infant warmer is just the kind of innovation India needs in this battle to reduce infant mortality," says Shaw, about her decision to invest. Wipro chairman Azim Premji's daughter-in-law, Aditi Premji, is working on Embrace Innovation's business development.

The challenges they had to overcome include the assumption, even by some doctors, that premature or low-birth-weight babies in tropical countries like India would not need infant warmers. "Even we could not understand it at first but a low-birth weight baby has absolutely no feeling other than of being cold, it does not matter what the outside temperature is," says Embrace Innovations CEO Sanjiv Verma.

Over 40,000 newborns in India and in 14 other countries, including Afghanistan and Uganda, have benefitted from the Embrace infant warmer since it was launched in 2011, according to the company.  Two of the founders have since returned to the US to pursue other avenues, while Chen recently shifted to the US to help with the company's international expansion. Panicker says Embrace is also looking at developing other products in the maternal and infant health space.

In tackling a problem of such magnitude, Panicker acknowledges that there have been moments of frustration. "But there have also been times of exhilaration." And net-net, the latter has made up for the former.