Health Security & Pandemics Challenge

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SMILE - SMart last-mILE cooling system

User-centered last-mile carrier to minimize vaccine wastage

Team Lead

Kitty C. Liao

Solution Overview

Solution Name:

SMILE - SMart last-mILE cooling system

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One-line solution summary:

SMILE, the only user-centered last-mile carrier with air-locking mechanisms to minimise human error and vaccine wastage

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Pitch your solution.

According to the WHO, Pre covid-19,  20 million children worldwide still had no access to basic vaccinations and 2 to 3 million children died each year of a vaccine-preventable disease. Globally, up to 85% of vaccines are spoilt. This equates to at least 1 billion dollars wasted every year. A major reason for this is that during the last few miles of delivery (‘last-mile’) vaccines become damaged by fluctuations in temperature.

However, existing solutions either freeze vaccines or last barely a day when in use.

IDEABATIC’s solution is SMILE: a patented, smart, last-mile cooling system. SMILE is the only vaccine carrier that reduces human error and spoilage. It is low-tech and fool-proof. SMILE can last for 3-6 days without power while monitoring and displaying the remaining cool-life. SMILE will help in last-mile applications for temperature-sensitive products. SMILE will improve efficiency in critical research and in end-to-end cold-chain applications worldwide.

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What specific problem are you solving?

Along with the high spoilage rate and current solutions (i.e. cool boxes) not being adequate, one of the biggest issues we observed in last-mile vaccination is human error. 

Trained health workers often left the lid open throughout the injection session. The cool boxes require 4 ice packs but in the field, it’s common for too few to be used. 

We took 2 cool box models back to the lab and experimented on them and analysed them. 

Results show that with one icepack, the cool box goes down to 17 degrees only for a few hours. With 4 icepacks, vaccines are exposed to freezing risks at the very start. This will spoil certain vaccines. 

We also simulated behaviours when health workers place the correct number of icepacks in the cool boxes and open the lid repeatedly during an injection session. 

A smaller model only survived an hour when in use and a bigger model had exceeded the required maximum temperature after 3 hours. 

In reality, many of these vaccine cool boxes are not able to keep vaccines cold for long enough after the start of use. It is concerning that the door was often left wide open throughout the injection session.

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What is your solution?

Ideabatic’s solution is SMILE: a patented, smart, last-mile cooling system. SMILE is the only vaccine carrier that reduces human error and spoilage.  It is low-tech and fail-proof

To solve the human error problems, our one-icepack design makes it impossible to use the wrong number of icepacks. Once the bespoke SMILE icepack is inserted, SMILE can last for 3 to 6 days without power. 

The self-closing door and vending-machine mechanism mean it’s OK to forget to close the lid and the temperature will still be maintained. 

The temperature is monitored and the remaining cold life is displayed.

SMILE comes with a backpack that helps with organisation. Users turn the dial to the desired chamber to retrieve their vaccines according to their vaccine sheet on the backpack. There is no need to open and look for the right vaccines as they currently do in vaccine cool boxes. Only a minimal number of vaccines are exposed, meaning the rest are kept in cool chambers. SMILE can be operated within the backpack. The backpack has compartments for essentials such as dry goods and patients’ vaccination booklets. Currently, healthworkers carry multiple bags with their cool boxes on their trips.

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Who does your solution serve, and in what ways will the solution impact their lives?

We started in 2014 when we learnt about the issues with last-mile cold-chain and vaccination coverage in remote parts of the world. Therefore our primary target populations were those living in low-resource settings where healthworkers carry cool boxes in extreme weather and over difficult terrain on foot, bike, donkey, canoe or a combination of these. 

We believe that it is important to look at the problem holistically before narrowing down and focusing on the ‘last-mile’ issues. We interviewed healthworkers and cold-chain personnel over several years and went to Nigeria and Madagascar for field research in 2017 and 2019. We traveled with the healthworkers and observed how vaccines were delivered from the state level down to the last-mile injection sessions in remote villages. We went on multiple last-mile trips in 4-wheel drives, walking in mountains, crossing rivers by bare foot for 5 to 12 hours per day. We helped carry what they use during the trips to understand the practicalities. 

We observed errors made by trained health workers in injection sessions. We simulated these behaviours with field vaccine carriers in lab environments and results showed that these errors cause the temperatures to rise above the acceptable limit within a short time. For example, using an insufficient number of icepacks meant the vaccine temperatures were not maintained and the vaccines heated up rapidly.  Moreover, leaving the carrier lid open throughout the session and placing usable vials on the floor risks vaccine potency. The stated cold life among cool boxes is in fact shortened dramatically during injection sessions when the lid is opened repeatedly. These results were presented at the 2018 International Tech4Dev Conference in Switzerland. 

Our aim was to solve the thermal problems and create a system that is fail-safe during transport and injection sessions. Our smart, low tech device considers technology and user adaptability for under-privileged and low-resource settings. SMILE was designed to be intuitive so that SMILE can still function even if an error is made. SMILE has been iterated and tested multiple times. The small model of SMILE can carry over 500 doses and the large one over 700 doses. These are more than sufficient in remote areas and will benefit a wider communities. 

We spent a month conducting user-focused testing in Ikongo, a remote town in Madagascar. We brought the small and big SMILE models and tested them with health representatives from 27 health centres. Each centre serves 50 to 250 people. There were two types of the tests: a practical user blind test and a last-mile field test. The practical tests involve individuals in separate rooms for ‘blind tests’ to figure out how SMILE works without any instructions. The essentials needed on a vaccination trip were laid out on a table. We asked them to prepare for their trip and filmed the process of them figuring out how SMILE works. Each health representative was given a questionnaire and a group feedback session took place at the end of the blind tests. The last-mile field test involves healthworkers carrying SMILE during a real last-mile trip. Feedback interviews were conducted during the trip and after the end of the trip.   

Prior to our trip, we designed questionnaires to minimise biased answers or answers that the users believe we want to hear. During the sessions, the users were encouraged to express their true opinion because we were there to improve the device to help with their work. 

At the end of our trip, we gave the healthworkers feedback and training to improve how they use existing cool boxes. 

  

We used the information we collected and the films we took for analysis and further improved SMILE after our trip. 

Throughout our time, we shared our findings and feedback from the users with policy makers. We encountered opinions from the healthworkers (users) that contradicted those of the policy makers. Usually the users focus on having a better system to improve their work whereas the policy makers prioritise costs. We had to make compromises in our design and development accordingly.

We are now working on an upgrade for SMILE that provides temperature monitoring and cold life prediction. This allows users to make decisions on their trips. For example, with SMILE’s extended cold-life, they are able to visit more than one village per trip instead of having to return to replenish ice packs. 

We are also conducting research with a different group of users who also have issues using existing cool boxes in their missions but are based in mature markets. The aim is to understand their needs, feedback using conventional cool boxes, procurement procedures, how might SMILE help and how we might adopt the design for their specific needs.

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Which dimension of the Challenge does your solution most closely address?

Other
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Explain how the problem you are addressing, the solution you have designed, and the population you are serving align with the Challenge.

Our work primarily tackles the last-mile cold-chain issues in low-resource settings and immunisation coverage issues globally. In particular, we work on minimising human error that leads to spoilage in vaccines and other temperature-sensitive products. Our device is designed to maximise the chance of unspoilt vaccines being received and help health workers complete their work even when they are under stress. Our work also improves efficiency in critical research where traditional cool boxes are used. 

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In what city, town, or region is your solution team headquartered?

Cambridge, UK
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What is your solution’s stage of development?

Pilot: An organization deploying a tested product, service, or business model in at least one community.
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Explain why you selected this stage of development for your solution.

The SMILE has been iterated, lab tested and field tested. It is now close to ready for manufacturing. We did a field trial with the department of primary health in Ikongo District in Madagascar at the end of 2019. This involved 27 health representatives from the District. 

We are now working on an optional add-on element for SMILE which is modular.

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Who is the Team Lead for your solution?

Kitty C. Liao who is the founder and team lead

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More About Your Solution

Which of the following categories best describes your solution?

A new technology
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What makes your solution innovative?

All vaccine carriers used in the field are essentially cool boxes, i.e. a box filled with icepacks. They come in different sizes and colours. All of them require 4 rectangular ice packs to reach the coolness stated by the manufacturers. 

SMILE is not a traditional cool box. A senior scientist has described it as a "Star Trek vaccine machine". SMILE is like a robust, portable vaccine vending machine with a backpack, designed for travel over rugged terrain. There is nothing like SMILE out there — a cooling system that minimises human error, reduces waste and improves efficiency. 

Hexagonal in shape, SMILE contains a cylindrical ice block surrounded by a carousel system to hold vials of vaccine. This eliminates the common error of using too few ice packs. The design also ensures that all vials are kept within the right temperature, preventing variations in temperature which can occur in conventional cool boxes, making them unsuitable for carrying certain vaccines. The carousel system is also an air-locking system. A self-closing door complements the carousel system to minimise heat transfer even when the door is opened repeatedly. 

Existing cool boxes either come with a top handle or a cross-body strap. The bespoke SMILE backpack is shock-proof and comfortable to use. SMILE can be operated within the backpack and altogether it provides an organisation system to help healthworkers vaccinate more efficiently.

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Select the key characteristics of your target population.

  • Women & Girls
  • Pregnant Women
  • LGBTQ+
  • Infants
  • Children & Adolescents
  • Elderly
  • Rural
  • Peri-Urban
  • Urban
  • Poor
  • Low-Income
  • Middle-Income
  • Refugees & Internally Displaced Persons
  • Minorities & Previously Excluded Populations
  • Persons with Disabilities
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Which of the UN Sustainable Development Goals does your solution address?

  • 1. No Poverty
  • 2. Zero Hunger
  • 3. Good Health and Well-being
  • 9. Industry, Innovation and Infrastructure
  • 10. Reduced Inequality
  • 13. Climate Action
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In which countries do you currently operate?

  • Madagascar
  • United Kingdom
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In which countries will you be operating within the next year?

  • Madagascar
  • Uganda
  • United Kingdom
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How many people does your solution currently serve? How many will it serve in one year? In five years?

The number of people we were impacting during our trial in Madagascar was about 1350. After the trial in Madagascar, we have been making more improvements. We are also developing the add-on unit. We will need funding in order to go into production to sell the product or conduct a larger-scale pilot with yet more potential users. When we raise the funding for production, we aim to produce 100 units in the first year to serve communities of 5000 people. We hope to be able to produce 10,000 units in 5 years to serve at least 400,000 people in both the developed and developing world.  

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How are you measuring your progress toward your impact goals?

  • How many organisations or users are using the device?

  • How many users are benefited directly and indirectly from the device?

  • Among these users, what is the percentage that they will recommend our device to others?

  • How many devices are sold?

  • How many people have been reached out by our device?

  • What is the percentage of the vaccines that reached the users unspoilt?

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About Your Team

What type of organization is your solution team?

Hybrid of for-profit and nonprofit

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How many people work on your solution team?

1 full-time staff

5 full-time students

4 contractors

2 volunteers

2 collaborators

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How long have you been working on your solution?

7 years+

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How are you and your team well-positioned to deliver this solution?

The founder Kitty has been working on this since mid 2014. She founded IDEABATIC and built a team around her in 2016. She has a background in electronic engineering, physics and entrepreneurship and has over 10 years of experience in cryogenic systems, project management, innovation, prototyping and design for low-resource settings. We have worked with contractors, design firms, university researchers and students and industrial advisors of various backgrounds over the years to deliver the project milestones. We select and work with talents according to the project’s needs at each stage. This means we have a pool of talent and are able to focus to maximise our achievements. 

Abellona has been with us since 2016 and has a PhD in biomedical research and is pursuing a medical degree at Cambridge University. Her field experience using cool boxes in her research, entrepreneurial background and photography and film-making skills have contributed to our success so far and her passion in helping people has been inspirational. 

 We, IDEABATIC, are known as the super star achiever by our funders and have been invited to apply for more funding. Kitty is the project leader and manager planning for the project and driving the team to deliver results. Her plan is always ambitious but she has a track record of achieving more with less time than previously planned. For example, we received an impact innovation grant of $100,000 from Expo 2020 Dubai and we were later awarded another grant of $300,000 because of our achievements.

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What is your approach to building a diverse, equitable, and inclusive leadership team?

We value an individual's talents and embrace equality. We have managed to attract talented and open-minded people from diverse backgrounds to work in IDEABATIC. We have 14 people from 8 different countries working on the project and we have a 3:4 female-to-male ratio. We also collaborate with organisations and individuals in Madagascar, South Africa, Switzerland, Taiwan, UAE, Uganda and the UK.

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Your Business Model & Partnerships

Do you primarily provide products or services directly to individuals, to other organizations, or to the government?

Organizations (B2B)
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Partnership & Prize Funding Opportunities

Why are you applying to Solve?

We are involved in three impact networks such as the Expo Live Global Innovators, Centre for global equality at Cambridge (UK) and Cambridge Institute for Sustainability Leadership network (UK).  Being in a network of impact entrepreneurs has helped us grow in many ways. We have learnt from impact entrepreneurs and we have helped each other grow our network which is crucial to scale up our impact and help more people. We have also learnt from their field trial experiences and this  has prepared us better for our own field trials. We love to inspire and be inspired in the network. We have previously made videos and conducted workshops to help others in our networks. When we encountered difficulties, there was always someone there who had been through a similar situation and was supportive. At times, it can be very tough working in the impact space but a strong and empathetic network can help create positive steps towards a greater impact. 

The MIT Solve network portfolio has impressive teams who have made great achievements to date. We believe that with our experience and passion to help others, we will be a valuable Solver team in the network. We also hope to brainstorm with the teams to move the barriers in our space. We would like to work with Simprints to minimise waste and strengthen the system and data collection in vaccine delivery. We would also like to work with E-Heza, LifeBank to improve medicine and vaccine distribution and relief.

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In which of the following areas do you most need partners or support?

  • Business model (e.g. product-market fit, strategy & development)
  • Financial (e.g. improving accounting practices, pitching to investors)
  • Public Relations (e.g. branding/marketing strategy, social and global media)
  • Monitoring & Evaluation (e.g. collecting/using data, measuring impact)
  • Product / Service Distribution (e.g. expanding client base)
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Please explain in more detail here.

Business model: We are now exploring a target audience that is different from our initial customer but would like to continue exploring customers based in the developing world where it could be financially viable. 

Financial: So far, our strategies for the developing world were not seen to be financially lucrative enough for traditional investors. Therefore, we would like support to navigate this route and develop a new strategy targeting an audience that could help us secure the manufacturing funding. 

Public Relations: We would like help on market strategy and increase our visibility in solving such an important problem which is also very relevant to the current pandemic. 

Monitoring & Evaluation:  We are keen to work with partners who could conduct case studies and quantify how our system improves their efficiency and accuracy. 

Product / Service Distribution: We would like to partner with logistics hubs and providers to improve their efficiency and reliability.

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What organizations would you like to partner with, and how would you like to partner with them?

Simprint works with organisations who care about improving vaccine deliveries. This is aligned with what we do. Our device, SMILE, helps reduce vaccine waste through efficient cooling and reduction of human error . The add-on element we are working on helps health workers make decisions and plan their vaccinations programs more effectively. Simprint could help us improve our algorithms on remaining cold-life with their data expertise. We could help Simprint’s customers and partners save lives, reduce vaccine wastage and improve data collection throughout the journey.

LifeBank seeks partnerships to expand its product suite to include vaccines and expand outreach to remote areas. We would love to be included in their logistics supply chain and explore products that could be stored within our device and expand the reach to wider communities.  

RevelaGov fights corruption which is unfortunately a common issue in developing countries. We would like to work with them to understand how to navigate and work with the right partners in our target markets. 

We would like to partner with logistics companies such as UPS, Amazon, DHL and Airline cargos to include our solutions in their supply chain. We would also like to work with more university researchers and cool box users in the developed world to understand their problem areas. This will help us reposition our product offering and potentially tweak the current SMILE design for bespoke clients.

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Do you qualify for and would you like to be considered for the Robert Wood Johnson Foundation Prize? If you select Yes, explain how you are qualified for the prize in the additional question that appears.

Yes, I wish to apply for this prize

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Explain how you are qualified for this prize. How will your team use Robert Wood Johnson Foundation Prize to advance your solution?

Our work aims to reduce human error, wastage and increase immunisation coverage globally. Cool boxes are used in outreach missions globally, this include developed nations such as in the US and the UK. 

With this funding, we would like to investigate and help strengthen healthcare systems in communities living in remote parts of the US and provide a more flexible and resilient network by working with local authorities and communities.

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Do you qualify for and would you like to be considered for The Andan Prize for Innovation in Refugee Inclusion? If you select Yes, explain how you are qualified for the prize in the additional question that appears.

Yes, I wish to apply for this prize

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Explain how you are qualified for this prize. How will your team use The Andan Prize for Innovation in Refugee Inclusion to advance your solution?

SMILE is portable and can be used in outbreak and vaccination campaigns in refugee camps. It can also be placed in mobile clinics that serve refugee camps. SMILE is not only useful for vaccines, it can be used to store temperature-sensitive products such as bio-samples and medicine. Volunteers or health workers are able to conduct injections and take bio-samples from patients and store them within SMILE. SMILE will then be taken back to a mobile clinic for samples to be analysed. 

We would like to visit and work with a refugee camp and mobile clinics for initial research, preparation for an initial trial and to secure more funding to conduct large scale pilots. The cost will include travel, personnel, translation and prototyping. 

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Do you qualify for and would you like to be considered for the Innovation for Women Prize? If you select Yes, explain how you are qualified for the prize in the additional question that appears.

Yes, I wish to apply for this prize

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Explain how you are qualified for this prize. How will your team use the Innovation for Women Prize to advance your solution?

Our work aims to reduce human error and vaccine wastage to increase immunisation coverage. SMILE will help everyone to receive life-saving vaccines and critical medicine. This includes women and girls. 

IDEABATIC’s founder is a woman in STEM. We would like to use the Innovation for Women Prize to encourage women in STEM and to develop SMILE further. We will engage women engineers to work on our SMILE electronics add-on project to improve SMILE’s cold-life prediction algorithms and the electronics. The project cost will include travel, personnel, software, testing and prototyping. 

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Do you qualify for and would you like to be considered for The AI for Humanity Prize? If you select Yes, explain how you are qualified for the prize in the additional question that appears.

No, I do not wish to be considered for this prize, even if the prize funder is specifically interested in my solution

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Do you qualify for and would you like to be considered for The Global Fund Prize? If you select Yes, explain how you are qualified for the prize in the additional question that appears.

Yes

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Explain how you are qualified for this prize. How will your team use The Global Fund Prize to advance your solution?

Our product will complement and enhance the performance at the last-mile. Therefore, we would love to work with Solver teams and incorporate SMILE to the supply chain to improve the availability and accessibility at health facilities. SMILE’s organisation system will help healthworkers to clearly record the types and quantities of vaccines before they set out and upon return. During their journey, the healthworkers are able to monitor the temperatures of the vaccines and to record spoilage. This allows them to report and make decisions quickly. 

 

We will work with the Solver team(s) or stakeholders to come up with a solution for a specific area. This might involve tweaking in the design or prototyping in each other’s product or services and planning before we set out for a pilot. We believe this will be a collaboration type project that needs a leader to manage and drive the project and implement to achieve success.

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Solution Team

 
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