What is a MedTech: How MedTech can Truly Democratize Health Access8 min read

Ian Mathews’s talk “What is a medtech

What is a MedTech?

Full text of Ian Mathews’s talk “What is a medtech: How MedTech can truly democratize health access” at TEDx NTU Conference

TRANSCRIPT:

Ian Mathews- Medicine Physician, National University Health System (NUHS)

So, I have a confession to make, I don’t know how to ride a bicycle. I mean, I just don’t get the whole balance thing. You know, in my high school years, when I wanted to learn to fly a plane through a school youth flying program, my mother said, no, you don’t know how to ride a bicycle. You won’t be able to fly a plane. It’s all about balance.

A few years later, as a late teen, I wanted to learn to ride a motorbike. And my mother’s response again was no, you don’t know how to ride a bicycle. You can’t ride a motorbike. I injured my knees, snowboarding ones. And her response is because you don’t know how to ride a bicycle. Now I got tired of people telling me what I could and could not do. So I thought I’m going to challenge myself and prove to everybody that I can indeed do whatever I set out to do. 

So I finally decided just two months ago to learn wakeboarding. Now I know what all of you are thinking. I don’t know how to ride a bicycle. I won’t be able to wake board, but I was determined to prove that it could be done.

So as I strapped my boots onto my feet on the board and got into the water, I thought to myself, this is it. There’s no turning back. The first few times as the boat started to move, I would fall flat on my face in the water. But by the sixth time, I was determined. And as the boat started to move, as the rope started to pull me as the board was being lifted by the waves from underneath, I thought to myself finally, but before I could think any further, my feet and board caught a wave and flew in one direction while my body flailed in another direction, the result was a fractured ankle and I was taken to hospital that same day. 

Of course, when my mother visited me in hospital, the first thing she said was it’s because you don’t know how to ride a bicycle, but I had a surgical fixation the next day and was discharged the morning after that I was in and out of hospital in under 48 hours, because I was fortunate to have excellent access to healthcare.

But as I lay in hospital bed, recovering post broken ankle, I couldn’t help. But think that others around the world were not so fortunate that something else in this world was truly broken. Something that has bothered me often enough.

I thought back to December 26, 2004, when many people around the world were recovering from their Christmas festivities, when a massive 9.1 magnitude earthquake hit the Indian ocean floor resulting in a devastating tsunami that killed nearly a quarter of a million people in a single day in the countries and islands surrounding the Indian ocean, the boxing day tsunami, it was shocking. And an utter tragedy.

The world responded rapidly with an outpouring of financial donations, relief, supplies, and equipment. There were those two who volunteered much needed relief services in the immediate aftermath, but the tragedy didn’t end in that one day, nor in the weeks to months after the event, the tragedy continued to affect lives…Many years. 

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The world stopped caring, Even though the tsunami had shed lights on communities of people that already before the event we’re living in dire conditions without proper access to basic health care, the Tsunami made this exponentially worse and tipped many more under the poverty line. And years later, there was still hardly access to healthcare for many communities. But by then the interest of most people around the world was focused on newer events to the suffers of the tsunami. 

It was as if the world just watched five years after the tsunami, I joined the team to provide medical relief to villages in Padang Indonesia who are still suffering the effects of a post tsunami world. I witnessed firsthand the continual struggle of people living day by day, without proper access to healthcare for even their basic needs. In stark contrast, we volunteers had come from countries that had many clinics, every few kilometers. We had set up clinic near an isolated village.

And on the last day, one of the patients were hobbled to us with a makeshift walking stick and a deformed lower leg was a 58 year old  who had slipped in his field a few days prior,  Not sought medical treatment because the nearest hospital was many, many kilometers away. And he did not have the financial means for the journey, even without an x-ray. It was apparent that his lower leg was broken and would require surgery.

I advised him he needed to go to a hospital immediately to avoid the risk of permanent disability. He adamantly refused. He was just not going. He was afraid. 

The cost of the journey and hospitalization would be too much for him to bear with the limited resources that we had. I could only treat him with a splint and painkillers his non-surgical treatment, which was not uncommon in such low resource settings would possibly lead to lifelong disability. In plain contrast. After my broken ankle, I was walking near normal in six weeks. We left that same night. There was little more that I could do for him. I felt completely helpless.

The 2010 earthquake in Haiti was no different. And again, I went with a team to provide medical relief. And again, the inequity was stark. A one-year-old baby was brought to us with a bout of severe diarrheal disease. Sunken eyes are dry lips and tongue and was lethargic. Her veins were so tiny from her severe dehydration that we struggle to put an intravenous drip for her and start her on fluids.

We finally managed to on a neck vein, started her on fluids and transferred her to the nearby us Navy Floating hospital. She was fortunate….Thousands others were not…because healthcare just couldn’t reach them.

Once again, I felt completely helpless with lack of resources. 

Once again, people started losing interest.

And once again, The world just watched 

Now in many low and middle income countries, the continuing tragedy is that the poorest and most vulnerable have got inadequate access to quality health care. People are dying unnecessarily of diseases that can and should have been treated easily.

This is not about inequality. This is about inequity. Justice is broken. These tragedies expose these inequities for the whole world to see, but we did little about it, perhaps because we just did not know how, as I continued lying in bed, thinking about broken ankles and broken justice, I recalled how I had developed an interest in medical technology or med tech using innovative technological or engineering solutions to solve all sorts of traditional medical problems.

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 A few years ago, I had come across a company that claim to be able to perform an array of blood tests rapidly with just a single drop of blood. Imagine the number of lives this technology could improve, and this could extend to low resources things. It unfortunately turned out to be fraudulent. 

And I had realized the potential of its impact. I had seen the power that MedTech truly could have could medical technology offer a solution to the problems I had seen. Now it would seem somewhat intuitive that our recent era of rapid innovation of medical technology could do so 

With The potential for cheaper, better, faster diagnostics and treatments of with robotics, 3d printed organs, AI, and precision medicine devices, gene editing technology, our own lives to have improved with the advent of wearable technologies, giving us real time feedback, Status…

But who are these solutions truly made for? Who are those that can afford these solutions?

Without careful purpose, solutions can actually widen the gap, the same gap that all these tragedies had exposed the same gap that many people were closing their eyes to because it just didn’t affect them. The gap of health inequity. 

Fast forward, December, 2019, a new virus had spread across the globe to nearly every single country, severe acute respiratory syndrome coronavirus too, or coronavirus. As we know it had spread well, virally we in Singapore were lucky early in the course of the disease.

 I went to work every day with the fear of bringing back and infection to my loved ones. But knowing that with proper and available personal protective equipment and rigorous protocols, the risk of infection was decreased. My fears diminished.

However, many people around the world were not so lucky economies were toppled. Healthcare systems are challenged people, even healthcare workers and politicians and leaders of countries were being infected by a tiny virus that knew no boundaries, no social economic class, no creed, no color. 

And now the world sets up. We could no longer just watch because COVID 19 is affecting nearly every single one of us yet, even here, the inequities are becoming ever clearer. Richer countries are focusing on their own survival while the gap with the smaller countries and poor countries of the developing world are continuing to widen much of the progress that some of these countries had made in terms of health access was set back years in just a matter of weeks to months by a tiny particle, not even visible to the naked eye. 

Yes, this is a global battle, but although we are all in the same fight, the harsh reality is that some are armed with tanks and artillery while others with simple bows and arrows. In our modern world medic, well, technology has the ability to level this battlefield to really improve health access and to truly democratize healthcare, if done purposefully.

This means the intentional design of technologies and solutions aimed at lower resource settings.

This means evaluating the social implications and consequences of our technological solutions.

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This means a rethink of the entire concept of MedTech, and instead of aiming to be the next biggest exit focusing, instead on how many lives can be saved or improved 

Moved, but how do we do this? How do we innovate with purpose?

Let me leave you with three piece problem thing:

First of the problems specific to a low resource setting 

Person, When you have identified the problem in a low resource setting, think of the unique challenges that a person with this problem 

Face, passion, No need to be a doctor or an engineer. You just need to have a passion to innovate with purpose. Let me give you a few examples. 

There are over 20 million people around the world with limb amputations, as a result of trauma from natural disasters, accidents and war, a limb processes costs anywhere from 6,000 to a hundred thousand us dollars, depending on the level of sophistication, a team from Stanford delve deep into this problem and created an innovative knee joint that address the unique needs of developing world amputees who needed a highly durable, strong performance, yet simple light and affordable Prosthesis.

Their products costs 40 us dollars. I had identified a need in a low resource setting and understood the unique challenges that developing world amputees would face moving over to India.  A school Out who had become an odd job. Laborer had realized his wife was collecting old rags and newspapers to use during her menstrual cycle, as conventional sanitary pads were too expensive. 

He developed a low cost Sanitary pad making machine, despite being ridiculed for dealing with such a taboo subject, but by understanding the unique challenges that women face in such situations, not only that the affordable sanitary pads allow many women to continue earning their livelihood during their menstrual cycles, the machines to create a job. So many women…

These are just some examples of how med tech can improve health access and truly democratize healthcare. And anyone can realize this value, whether you’re a Stanford team or a school dropout.

Anyone with the passion and heart to solve problems of health inequity can do so, but innovate, purposefully, innovate, intentionally innovate for social Impact in a world. Re-imagined our world.

We can no longer just watch. We urgently need to heal the fractures of our world’s broken health delivery system and to do so. You don’t need to know how to ride a bicycle.  

– Ian Mathews

So, this was the Ian Mathews’s talk “What is a medtech: How MedTech can truly democratize health access” organized by TEDx NTU Conference.

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Ian Mathews’s talk “What is a medtech: How MedTech can truly democratize health access” at TEDx NTU Conference