Chronic respiratory disease is a serious and growing threat to global health. The WHO estimates that 300 million people worldwide have asthma or chronic obstructive pulmonary disease, already one of the top killers.
Having worked in clinical settings in low and lower-middle income countries, I’ve always been struck by the absence of basic equipment like spirometers and pulse oximeters. One physician after another in India complained about the very high cost of spirometers, if he or she could even get one at all.
Part of the problem with efforts to improve global respiratory health is their limited focus on clinical practice guidelines, which take for granted that asthma medications and tools like spirometers are available and affordable. When they’re not, we develop separate algorithms for these settings that use simple, readily available indicators, such as symptoms or basic clinical signs. But without basic tools, practitioners are flying blind, making important decisions about treatment and medications without essential information. The consequences are unnecessary morbidity and mortality.
There are tens of thousands of private physicians in places like India who run small private fee-for-service clinics that want and need basic medical technology. But since they can’t pass on the high costs to their patients, who are often poor, they don’t purchase it. Nevertheless, these practitioners realize that spirometers or oximeters would mean much better outcomes for their patients (and that would help them compete with the many other practitioners).
After some discussions with Julian Crane last year, I’ve decided to organize a group to design, develop and test a low-cost, open-source spirometer. I’m also hoping to simplify and improve the quality of measurement by delivering coaching through standardized audiovisual materials.
As of January, development is underway. A team of four undergraduate engineering students here in Madison has decided to work on the project for their applied design course. We’ve set up a basic website with a forum and wiki, where we’re putting all of our notes, drawings, background research, and everything else we generate.
This is a challenging – if exciting – undertaking, and we really need your help. We hope and intend to grow an online community for the project, and want to interact with other interested designers, engineers, respiratory physicians, and scientists around the world. Please visit and explore the site, spread the word, and contribute your skills and knowledge.
