Solar Ear

Globally,60% of the 34 million infants with a hearing loss is from preventable causes,75% of them live in low/middle-income countries (LMIC) Contributing to this problem is the lack of audiologists and cost of hearing testing equipment for newborns, plus the lack of education for expectant mothers. We will invent the first hearing test using proven medical protocols on newborns using the Android phone. The  Big Data will be a free bi-product which we will share with Ministries of Health with the goal of making newborns screening part of public policy as there are no statistics of hearing loss in LMIC's. We will have a language-neutral free carton app for mothers showing the 5 main ways to prevent hearing loss with their baby. An infant with a hearing loss if helped before the age of 3 can then develop speech and the opportunity to go to a public school.   

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An estimated 718,000 newborns each year have detectable hearing loss and the WHO expects this to grow by 33% in the next 20 years. Neonatal Screening is an initial process of evaluation that allows early detection of possible auditory problems. Infants diagnosed with this deficiency are referred to interventions where they can receive appropriate treatment. It is important that hearing impairments be diagnosed as early as the first days of life to minimize possible risks on the child's cognitive psychosocial development. We aim to mitigate the effects of early hearing loss by offering both mobile healthcare workers and those in clinics and hospitals a diagnostic device, their own Android phone. In developed countries, there is 1 audiologist for every 20,000 people, in LMIC's 1 professional for every 2 to 6 million people. The cost of the equipment starts at $10,000. There is virtually no professionals nor equipment outside of any capital city

Eighty (80) percent of hearing loss occurs after birth but 60% can be prevented through a maternal hearing education prevention program, (a free app) which includes educating mother's on the proper ways  to breastfeed, the importance of  vaccinations, the effects of ototoxic drugs and proper home ventilation.

The Evoked Otoacoustic Emissions Test  (OAE) consists of a simple, painless and non-invasive examination that consists of the positioning of a probe (microphone plus phone) that can send and receive biological signals in the child's ear and, with the aid of a specific device, is able to inform whether or not the child has hearing impairments. We will invent the first OAE test for newborns using an Android phone. We aim to mitigate the effects of early hearing impairment on infants by offering both mobile healthcare workers and those in clinics and hospitals a diagnostic device in order to increase the accessibility of screening. OAE screening is the current international standard of care that does not require any newborn response and by using a cell phone is user-friendly. The age, gender location, and type of hearing loss will be collected and shared with local Ministries of Health as no data exists on hearing loss in newborns in LMIC's. We will meet all European and  US, patient privacy regulations.

For the newborn hearing loss prevention app it will be a language neutral game type app and include a free crowdmapping app where  a mother can get more local help and information. 

We have 4 direct and several indirect stakeholders. Our OAE test can be used by secondary healthcare working in LMIC's on newborns. The WHO has promised from the data we have collected to share it with Ministries of Health with the goal of making newborn screening part of public policy. Our Maternal hearing loss prevention program is directed at mother's but also we will joining the resources of the hearing-aid industry, the commercial sector, INGO's, user organizations, donors and other stakeholders.The activities focusing on these target areas can be carried out more effectively than by Solar Ear alone. 

We are working with audiologists in Mexico, Guatemala, Columbia, and Brazil to ensure we meet the needs of their country plus  we will pilot in their country for the OAE test. 

 Print material has been developed  for maternal hearing loss prevention program will come from the National Center for Hearing Assessment and Management and Global Foundation For Children with Hearing Loss. We will work with  engineering student at the University of Sao Paulo to gamify these materials so that even  women who are illiterate will be able to understand the way to prevent hearing loss with their baby

We combined the Theory of Change Model taught at MIT with the frugal innovation model we studied at Santa Clara Univerity, GSBI program. Our focus is on newborns and their mothers in LMIC's in general Latin America and the Caribbean in particular. For the past  18 years, we have been selling solar-powered hearing aids made by people who are deaf to people with hearing loss in this region. Our goal is to lower hearing loss and the burden of hearing loss, not to sell more hearing aids in an affordable, accessible, scalable sustainable  manner  

Given our 18 years experience of selling hearing aids, a mobile holistic hearing health solution, on an Android phone, called mDREET (mobile-Detection, Research, Education, Equipment, and Therapy) program is being developed. Each individual aspect of the DREET program, medical protocols have been successfully implemented and tested at the Solar Ear operation in Brazil 

Our. advantages.

 Focus on LMIC's through affordable and accessible Android platform

Language-agnostic apps that are geared to secondary healthcare workers. 

The only organization with multiple detection apps (Puretone, otoscopy, and OAE)  for different life stages, and 1st to start with babies 

Data collection, a free by-product of mDREET’s detection apps The resulting database will facilitate one of the world’s largest hearing aid studies.

Remotely calibrate user phone ensuring constant reliable professional results with instant feedback using AI and algorithms.

It is a holistic solution with the goal of reducing hearing loss and not selling more hearing aids. We are the only company who can offer a solar-powered rechargeable  hearing aid until our cell phone as a hearing aid app has been developed

Our apps will either be free or cost $1.50 to download. We have 3 competitors, Mimi, Shoebox, and Hearx and they are geared for the professionals. Shoebox ( $1500) and Mimi are iPhone based and have only pure-tone tests. Hearx has purtone and otoscopy ($600). There are a dozen free pure-tone hearing tests one can download  but the test and  results are not  of a professional grade and will give many false-positive results

An examination that has gained great prominence in the world and especially in Brazil is the Evoked Otoacoustic Emissions Test, also known as Ear Test and mandatory to all hospitals and maternity hospitals by law (Federal Law No. 12,303 is in force since August 2010). This test can diagnose how the child is hearing shortly after birth. The Evoked Otoacoustic Emissions Test consists of a simple, painless and non-invasive examination that consists of the positioning of a probe(microphone plus phone) that can send and receive biological signals in the child's ear and, with the aid of a specific device, is able to inform whether or not the child has hearing impairments

Neonatal Auditory Screening is an initial process of evaluation of children's hearing that allows early detection of possible auditory changes, covering all neonates, including those who do not have risk indicators for hearing loss.      Nowadays, the exam is done with the aid of a portable (or not) portable otoacoustic emissions test device to analyze the signals received from the ear of the newborn. OAE equipment is imported to Latin America and starts at a cost of $10,000, plus duty, shipping, and cost of local medical import approvals.

We will develop our own probes ( cost of $73). Our apps can be downloaded via google play and either sold for free as there will be advertising on the app or can be sold at $1.50 no advertising. There is no cost of the probes.

There are hundreds of academic studies proving the importance and reliability of a traditional Evoked Otoacoustic Emissions Test

https://www.sciencedirect.com/topics/medicine-and-dentistry/evoked-otoacoustic-emission

We do not yet have a video of our OAE test as it is in development but we have videos of our simple to use cell phone pure-tone tests.https://www.youtube.com/watch?v=x6Mn6xklDUo

There are many studies showing that a cell phone can perform a professional hearing test. Here are some links to academic studies on our competitor's pure-tone test only.  https://www.hearxgroup.com/research/,https://www.shoebox.md/clinical-validation/

https://mimihearingtechnologies.github.io/SDKDocs-iOS/master/

Input- Diagnostic devicefor early hearing impairment (H.I.) intervention 

Outputs- Clinics and  hospitals purchase device for secondary healthcare         workers to use 

Outcomes- Secondary health workers screen young children and identify H.I.s

                 -Children with H.I.s are on track with education
                 -Avg. age of detected hearing impairment decreases

Impacts- Early intervention as a concept can be prioritized globally

             -Higher socio-econ status
             -People are lifted out of cycles of poverty

Assumptions

Inputs to outputs   

1. Early detection will enable early intervention

2. Distribution channels exist
3. Androids are accessible
4. Smartphones are preferred by clinics
5. Our solution is competitive
6. No governmental barriers to entry

Outputs to Outcomes7. Parents/families havecapacity to care

8. Follow-up testing/treatment is accessible
9. Families with children under 3 will attend regular health checkups where medical professionals can identify hearing issues
10. Next steps are taken for treatment

Outcomes to Impacts

11. Early hearingintervention is correlated with socioeconomic status

12. After the government sees the outcomes - incorporated with
public policy

Through our non-profit hearing aid manufacturing facilities in Brazil, Botswana, and China we have sold 50,000 solar-powered hearing aids, 100,000 solar chargers, and 250,000 rechargeable hearing aid batteries. Our solar charger and batteries can be used with any hearing aid, not just Solar Ear ones During the pilot stage of our Detection apps we will serve 525,000 people. By year 5 we will be testing the hearing of 36 million. Our distribution model includes) 

1  Micro-finance institutions  (MFI)such as BRAC   and Grameen 

There are about 200 micro-finance institutions that sell to and train over 100 million micro-entrepreneurs. Fifteen of the MFI's have an 85% market share. Of the 100 million micro-entrepreneurs, 44% sell non-financial related products, like eye tests, eyeglasses.

2  Medical reps. These are commissioned sales organizations that sell medical equipment to hospitals and clinics

3  Through Solar Ear distributors

4  Through NGOs like  Rotary, Lions for hearing, UNICEF, World Vision, Rotary and Lions test the eyes, teeth hearing of over 8 million children a year. 

5 Pharmacies. In many LMIC's it is the pharmacist who is the local doctor. We will connect with their wholesalers.

6  Telephone orgs like Votacom who have health apps on their new phones

7  We will also private labels for some orgs.. eg Phillips Healthcare in Africa. J &J in Africa and Asia , World Vision, UNICEF, World Wide Hearing

Hearing loss is more common than most people realize, affecting about seven in every 1,000 newborns in LMIC's. Permanent hearing loss in a child should be considered a neurological emergency, not a catch-as-catch-can condition. Auditory deprivation can have an impact on brain development and learning, the cost of inaction is being paid by hundreds of thousands of children every year, as it affects their cognitive, social, emotional, academic and communication development. Universal screening has not been instituted, hospitals tend to only test babies considered at high risk for hearing loss, such as preemies and those who have had serious infections. When hearing loss is not detected at birth, it is often not discovered until around age two, when children start speaking. Sometimes parents notice problems and manage to get help, but it's not easy to do so in LMIC's. Universal screening can make a real difference by preventing disability and helping children reach their full potential for learning and social interaction. Developing the first free newborn hearing test using a cell phone and sharing the data with Ministries of Health with the goal of making newborns screening as part of public policy is our main goal. 

We will also develop a free carton type gamification apps for mothers of ways to educate them and prevent hearing loss. We will also be to connect mothers to local professional stakeholders if their child has a problem. In 5 years we will reduce hearing loss and the burden of hearing loss by 50%  

Actually, it was the financial, and legal problems which lead us to develop our mobile program. Solar Ear being an NGO sells to other NGO's. We realized that even if we would manufacture  2 million hearing aids, becoming the largest manufacture we would not be solving the issue of hearing loss for infants as hearing aids alone are not the solution.  We also did not have the working capital to scale globally. 

Even though we could sell a hearing aid, starting at $99USD, or  80% to 2000% less expensive than our competitors it was still too expensive for many parents. 

Audiologists are another problem. The first one being that there are so few in LMIC's and those that do work there are not interested in testing someone's hearing then fitting them with an aid for such a low price. They prefer selling an aid for $2000 making 40% commission. Hospitals and clinics do not have the professional nor money given the cost of testing equipment to  test the hearing of a newborn, especially outside of the capital city

 When exporting to LMIC's we encountered many roadblocks. Bureaucracy and corruption too often prevent any medical product from entering a country for the first time. Also, getting the local health authority approval is expensive $50 to $20,000 and time-consuming, ranging from 1 month to 3 years. Often import duties were more expensive than the cost of the product.

Lessons learned and mistakes made, and roadblocks encountered lead us to our moble program

Our goal is to make  hearing health affordable and accessible for all with focus on newborns and their mothers.Alexander Graham Bell invented the first telephone with the idea of helping his mother who was deaf. We are marrying his technology, with today's proven medical protocols and  today's cellphone yet maintaining a similar mission except ours will help newborns.

 Given the cost of hearing aids today and equipment to test is only affordable and accessible to 3% of the world's population, therefore to lower the entry price and barrier we will be using the user's Android phone. Given we are selling apps and not hearing aids nor medical equipment,  we will not have to deal with import customs regulation, bureaucracy, cost, and corruption. Given our apps will be free with advertising or $1.50 without, it will now be affordable and accessible via google play and others

There are few professionals to test the hearing therefore we will be using our 7 prong innovative distribution and partnership channel as mentioned earlier. The use of the technology will be simplified to use and geared for secondary healthcare workers and available to other digital health distributors working in LMIC's

Collecting data which is a free bi-product from the OAE test and sharing data with Ministries of Health is critical for a  long term solution. Educating pregnant mothers on how to prevent hearing loss via a free gamification app will enable us to lower hearing loss by 50% in the next 5 years. 

Not applicable

We are 4  people working part-time on this solution as we maintain our jobs on other projects. As part of an Ashoka Global Fellowship were fortunate to have been funded and helped by  4 consultants from McKinsey Consulting. During this consulting period, 4 MIT, MBA students volunteered and together we developed a sustainable business program, cash flow, investor pitch and plan, timeline to develop a holistic solution to lower hearing loss and the burden of hearing loss. 

From a technical standpoint, Olin University -USA and McGill University are developing the alpha models for our newborn screening program.

In 2002, I went to rural Africa and helped start with 10 women who are deaf, the first low-cost solar-powered hearing aid company.  Since then I have been able to help other organizations in Brazil, China, Russia and this year in Canada, with Aboriginal women who are deaf and Israel with Muslim, Christain and Jewish young adults who are deaf replicate our successful hearing aid business. We started with a small grant from the African Development Foundation and then one from the Lemelson Foundation. Today we have sold over 15 million dollars and have helped over 100,000 people, plus created 75 jobs for people who are deaf. All operations are locally owned and operated and we have won over 30 national and international awards, including one at UN as Best Global Social Business, AAA Humanitarian award, Salt Magazine as top 100 Global Compassionate Business Leaders. Our products have been exhibited at the Smithsonian, Gates Discovery  and Alexander Graham Bell Museum

My wife who is co-founder of our new mobile business was a Professor of Audiology at a university in Brazil. She has been a pediatric audiologist in an intensive care unit at an inner-city hospital in Sao Paulo, studied Education at Harvard, sustainable development at the London School of Economics and helped develop the newborn screen policy for the State of Sao Paulo.

We have partnered with McKinsey Consultants, MBA students from MIT and Yale to develop our business plan. I have a technical partnership for our OAE program with Olin and Babson Colleges Affordable Design and Entrepreneurship course. I am also working with The Centre for Interdisciplinary Research in Music Media and Technology  which is a multi-disciplinary research group centered at the  School of Music of McGill University in Canada. They have experience in audiology using cell phones.  I have worked with the Innovation Center at the USP and the Department of Audiology at Santa Casa Hospital both in  Sao Paulo.

For the maternal hearing education and hearing loss prevention program, we have partnered with  the National Center for Hearing Assessment and Management and Global Foundation For Children with Hearing Loss.These 2 organizations have in print format the proven programs to help mothers of newborns. They also have in their network over 150  associations, in 56 countries for people with a hearing loss as well as associations for people who are deaf.

We have also received funding for our mobile program from Phillips Foundation in Holland as well as Johnson and Johnson. They have also expressed an interest in distributing the apps for the maternal hearing loss prevention program as each one has a larger maternal health program on many other subjects. 

The Director of Hearing and Vision at the WHO has agreed to transmit all data and lobby all Ministries of Health to ensure they adopt a newborn screening policy  

Key Resources

                      $1 million USD

                      Technical Institutions

                       Audiologist

                       Distributors  for  Pilot Program

Partners and Stakeholders

                    McGill, Olin University, University of Sao Paulo

                    W.H.O.

                    National Center for Hearing Assessment and Management 

                    Global Foundation For Children with Hearing Loss

Key Activities 

                    Pilot Program in 6 countries

                   Verify, Technology, Price structure, Diffrent types of distributors

Type of Intervention

                       Hearing test on newborns

                       Education hearing loss prevention program for mothers

                       Collection of Big Data

Channels

                      Micro-finance Institutions to micro-entrepreneur

                     Medical Distributors to hospitals and clinics

                     Solar Ear Distributors

                     INGO's- Lions & Rotary Clubs, UNICEF

                     Pharmacies

                     Digital Health organizations

Segments  

                   Newborns and their mothers

                    Minsitries of Health

                   Hospitals and Clinics in LMIC's

                  Micro-entrepreneurs

Value Proposition

                     # of countries who make newborn screening public policy

                     # of newborns hearing screened

                    # of newborns referred for follow-up

                    # of mothers downloading Prevention app

                     A decrease in global hearing loss

Cost Structure

                      50% of our initial cost occur on developing the product

                      20% on overhead

                      30% on salaries

As we scale we reduce the development cost and in year 2

                        25% is on development and refinements

                        30% is overhead

                       25% on salaries

Surplus

                       Deaf empowerment programs

                       Capacity building of secondary healthcare workers

                       Public Policy initiative.

Revenue          90% from the selling of apps

                         5%  Licencing agreements

                         5% Selling Data

Our model makes the hearing testing equipment for newborns and education programs of their mothers, as well as Big Data for the WHO affordable and accessible. We are using an extensive yet innovative method to reach these people based on the value and distribution model of Vision Spring and Peek Vision who do over 10 million eye tests a year. Nobel Laureate Dr. Yunus helped us develop our pricing structure which would ensure that everyone up and down the value chain would have the proper financial incentives and be rewarded to perform the test. According to Dr. Yunus a micro-entrepreneur will do 3 tests a day if they can make $1 a day in revenue. Working backward they will make $0.33 at test, their micro-finance institution who will supply the test, and train them  $0.15, Google play $0.30, the cloud hosting-security privacy firm $0.05 and Solar Ear $0.67 a test. At the same time, we will use commissioned medical representatives who sell other products to hospitals. They will earn $0.15 a test, the hospital $0.68 a test and Solar Ear $0.67. The MBA students at Yale and MIT, plus CEO of Vision spring calculated that by year 5 we will have done over 36 million hearing tests in LMIC's. We can also do these tests at many pharmacies in developed countries charging a higher price.  

We have a liceiencing agreement with a Swiss organization

We will sell the Big Data to pharma companies as there are few hearing loss studies.

I have been successful in my career as I know what I do not know. The reason for applying to Solve is the same reason which motivated me to become an Ashoka Fellow, a Yunus Fellow, and a Lemelson Fellow, i.e. their network. Being a fellow with the above organizations has brought me not only credibility but has enabled me to connect with other Fellows in areas where I needed help. Many Ashoka Fellows have started a micro-finance institution in the health field. They have explained the intricacies and motivation of micro-entrepreneurs in their country. Dr. Mohamad Yunus helped me with our pricing strategy as well as the importance of getting the spouse of the micro-entrepreneur onside. The people at Lemelson helped me develop our business plan as well a different investor pitch presentations, as pitching to a VC is different than pitching to a Social Investor which is different than pitching to a Foundation.

I will need help from the Solve network in terms of possible medical approval in developing countries. Members of the Solve team live in LMIC's, know not only the national regulations but as important often know the key people in their Federal bureaucracy of their country. 

I would also like to expand my Board to include medical doctors, professionals with a disability as well as be more inclusive, i.e. professionals in the LGBTia community.

Many  Solve Fellows have had experience in getting digital health products approved by local authorities as well as can help us better understand local customers, cultures and distribution channels. For example we have found that micro-entrepreneurs would be the best distributors in Guatemala but pharmacies would be the best in Mexico. Mexico has a very stringent medical approval process while Chile's is quite easy. Given all of the countries we plan to distribute, we will need to expand our network of professionals and of knowledge.

A more inclusive Board with experts from medical, technology,  and digital health space is a priority. A Board that reflects the culture and diversity of the countries where we will be operating is imperative. 

I will also be looking for the next CEO of this organization as I am not the right person to lead a digital health/technology business.

I am a social entrepreneur and know that I can benefit from the Solve Fellows and organizations who are also social entrepreneurs with a focus on early childhood development. In particular  Babymigo,  Myanmar Cash Transfers, E-Heza Digital Health Record and Sexperto.co The  Maymay app from Myanmar Cash Transfers and  Babymigo, will facilities the transfer of knowledge with mothers, professionals, NGO's  and government up and down the knowledge chain.

-Heza Digital Health Record  can teach us the best way to collect the data and share it with Ministries of Health yet ensuring patient privacy  

Sexperto.co can teach the best way to connect with mothers who want to either prevent hearing loss with their babies as well as mothers who have found out that their infant has a hearing loss.

There is an old expression that goes," a mother is only as happy as her unhappiest child." Imagine the pain a mother experiences when she finds out that her baby has a hearing loss or is deaf. Imagine the frustration and worry when she does not know what do do next. Imagine the anguish and guilt when she realizes that 80% of the time she could have prevented the hearing loss in her baby. 

Our mobile hearing loss prevention program will explain to the mother in a language-neutral cartoon style free app on her cell phone how to prevent her baby from losing her hearing. Most mothers do not know that improper breastfeeding can cause a hearing loss, nor the importance of vaccines. Many mothers cook on a fire and the smoke can cause a middle ear infection. 50% of hearing loss can be prevented and 80% of the 180 million children with a hearing loss developed it after birth. this number will rise to 250 million in the next 20 years unless we educate mothers.

With the prize money, we will develop a crowd-sourcing app, so that a mother for example in rural Peru  can lick on a map in her state and find out where to get help from an audiologist, an ENT,  an humanitarian organization, an association for people with a hearing loss, a school for the deaf. All of the above orgs can post for free their service and location on our open crowdsourcing app.