Creating health-tech entrepreneurs

Depending on developed countries for supply of healthcare products has rendered majority of the global population vulnerable, exposed more by the recent Covid19 pandemic. A severe lack of expertise exists in low and medium income countries (LMIC) like Bangladesh in design, development and commercialization of modern electro-medical technology, although capability exists in related science and engineering. Bi-BEAT will train and nurture graduates in relevant Science & Engineering subjects to turn them into successful SME entrepreneurs in healthcare technology so that they can manufacture and supply such equipment to local hospitals and clinics and can create jobs for many others. This training will target creating essential scientific background, hands-on fabrication expertise, commercial manufacture and aspects of entrepreneurship, followed by nurtured entrepreneurship in real life. This programme will provide essential capability and self-confidence, which when scaled globally in the LMICs, will bring a huge change in the lives of the common people.

Hospitals and clinics in small towns and sub-urban areas of Bangladesh, home to over 170 million people, do not have adequate working medical devices needed for diagnosis and therapy, not even the basic ones like ECG and X-ray machines, invented one century back. The main reason is that such equipment are all imported, cost of procurement is high and repair is almost impossible because of a huge technology gap with countries of manufacture. History of the industrially developed countries indicate that when technology innovators became entrepreneurs, the products succeed in the commercial marketplace. However, this concept is totally absent in LMICs, where it is held that if someone innovates a technology it has to be given to large business groups for commercial manufacture. Unfortunately, all large and medium industries in these countries are established by moneyed people, purchasing fully foreign technology on turn-key basis. These establishments do not have the capability of taking a new technology based product to the market. On the other hand science & engineering graduates, many of whom are unemployed, have a serious lack of expertise in designing technology for commercial manufacture and in entrepreneurship although capability exists in related basic science and engineering.

With decades of experience in design, development and entrepreneurship in electro-medical technology, Bi-BEAT produced a team of experts who can now give a leadership in the country. Bi-BEAT now plans to expand this manpower base so that a critical mass needed to bring about appropriate changes in the country may be achieved soon. With this aim, Bi-BEAT plans to set up a training facility for bio-electrical systems, analogue and digital electronics, computer interfacing, embedded systems, IOT and entrepreneurship in the area of health and well-being. During this project period about 15 science & engineering graduates with background in electronics will be trained in all aspects of a 12 lead computerised ECG machine which Bi-BEAT is manufacturing for some years with success. The product has all the above technological aspects and will allow the trainees to take up design challenges in almost any other healthcare technology with further experience. Bi-BEAT and its associated groups have a philosophy of not patenting their innovations in view of the technology deprivation of a global majority in the LMICs. The trainees will also be nurtured to become successful entrepreneurs manufacturing the ECG machine first using kits from Bi-BEAT, allowing them to be independent later.

During this project period about 15 science & engineering graduates will be trained thoroughly and followed up in a bid to turn them into successful healthcare-technology entrepreneurs, and innovators. Although this number may seem low, but they will impact the lives of hundreds of thousands others through providing healthcare devices at low cost with long workable life at all hospitals and clinics in the country. Furthermore, since the technology is locally developed this will create a network of small entrepreneurs manufacturing and supplying various parts and components needed to make these devices. None of the imported medical devices have created this local network so far which is essential for the enhancement of the quality of life of the common people in any country.

As mentioned before, our science and engineering graduates are taught to understand how different technologies work so that they can install and maintain readymade technical devices, but they are not taught how to design a technology based device from scratch, which needs a small twist. Through this project we will bring this twist into the educational curriculum and later will try to influence the established education system to adopt these.

‘Giving a fish to a man feeds him for a day, but teaching him how to fish feeds him for a lifetime’ is an ancient saying and Bi-BEAT’s plan to proactively teach and train qualified engineers in design, development, manufacture and entrepreneurship is going to make a huge impact in Bangladesh. They can also create jobs for many others. More such science and engineering graduates will follow seeing the success, either taking direct support of Bi-BEAT or by themselves. Later, this example may be disseminated to LMICs all over the globe, contributing to a huge impact. 

In Bangladesh and in most LMICs, publication in journals are considered the only target of university research. Science and engineering graduates are taught only to understand how different technologies work so that they can install and maintain readymade devices. Therefore, they are usually scared and keep away from the challenges of designing technology based devices from scratch. That technology innovators need to become entrepreneurs is absent as a concept in the LMICs. Therefore, most LMICs like Bangladesh have failed to create an environment of innovative technology based entrepreneurship that are essential to solve local problems and enhance the quality of life of the common people in a country. Favourable national policies are also absent, naturally. Therefore, through this project Bi-BEAT aims to fill up a vacuum existing in Bangladesh through training science and engineering graduates so that they can design, develop and manufacture technology based products and can establish SMEs.

Although Bi-BEAT will provide initial training in medical devices, the outcome will have implications in all areas of technology. Bi-BEAT will also keep on nurturing the trainees so that they can overcome obstacles relatively easily, using its own experience. Even after this project period is over, Bi-BEAT will continue this training programme. Besides, it is expected that this endeavour will create such an environment in the country that conventional educational institutions will also integrate entrepreneurship into their curriculums. This example will then be used to disseminate similar activities in other LMICs in the near future.

Bi-BEAT’s training programme to turn science and engineering graduates in Bangladesh, to be followed in other LMICs, uses bio-electrical systems, analogue and digital electronics, computer interfacing, embedded systems, IOT and entrepreneurship in the area of health and well-being. 

Importance of ECG machine in diagnosing cardiac problems has kept this device in great demand over the last century and the technology has seen continuous innovations whenever new technologies became available. The latest technologies of microcontrollers and computer interfacing has also been exploited by many groups across the world. However, these products are not appropriate to the conditions of LMICs like Bangladesh having warm and humid atmosphere and extreme abnormalities of power line voltages. Since these use technologies that are very latest, and not readily available in the LMICs, once an imported device breaks down, repair is very rarely cost effective, contributing to a stoppage of service, waste of scarce resources and increase in e-waste. Therefore, Bi-BEAT’s ECG machine was developed by its members (while at the University of Dhaka) with the following conditions:

• The design was based on widely available electronic components and ICs, not on special ICs of a particular manufacturer which makes these spares difficult and expensive to source.
• In order that the device can be reproduced easily in the LMICs, the design used a single sided printed circuit board (PCB), which also made it easy for repairs using a hand soldering iron.
• The housing of the device was made of aluminium sheets, using manual crafting, not requiring expensive dies, and can be easily made in the LMICs.

The following links have some information of Bi-BEAT’s ECG machine.

 https://bibeat.com/product/12-lead-ecg/

https://www.banglajol.info/index.php/BJMP/article/view/14701

Our theory of change addresses the following deficiencies of the existing situations in the LMICs as follows.

• LMICs look towards a few industrially developed countries of the world for technology based products, which is particularly true in the healthcare sector. Almost nothing available in the market is innovated, designed and made locally that could have suited the local people and the environment better. This has led to mass deprivation in the use of technology based products required for good living and health.
• Covid19 has also made us realise that if the remotest and the poorest of the persons in the world is not protected, none else in the world are.
• Education curriculums in Science and Technology in LMICs are oriented towards understanding and using readymade technology based products or processes only. These are not geared to the design of new technology based product or process, so science and engineering graduates are not ready to design products based on the needs of the local people.
• A wrong concept exists in the LMICs that innovators of technology based products should not start a business to commercialise the products. It is commonly held that the innovators should leave it at the hands of the existing business infrastructure. However, no one realises that industrial revolution that happened in Europe never happened in the LMICs. All existing industries in LMICs are based on fully foreign technology, on turn-key basis; they do not have the capability to take a technology based innovation to a viable industrial product for commercialisation. LMICs are still waiting for the first generation of technology entrepreneurs to establish such infrastructure. 

Bi-BEAT’s training programme to create and nurture technology entrepreneurs out of science and engineering graduates is aimed at changing the above scenario, at least in the health sector to begin with. With continuation of the training programme beyond the project period, Bi-BEAT will cover other essential areas of technology. Simultaneously, Bi-BEAT will try to spread the concept among other LMICs of the world, expecting a revolutionary change affecting more than two thirds of the global population.

In the current year we will be training up about 15 science and engineering graduates and nurture them to become successful entrepreneurs.

In five years we expect this number to rise to about a hundred in Bangladesh and a few hundred in other countries in Africa and South East Asia.

The first 15 trainees will start entrepreneurial ventures after the first year. Each of them will be given a seed money as a start-up, to establish their office, factory, etc. If each of them makes and sell 50 to 100 ECG machines in the second year, together with our own sales, this will be about 1500 machines in so many hospitals and clinics. If each of these serve 2000 patients per year, that will be 3 million people served in one year. These trainees will also bring out other products by themselves, which are going to serve millions more. More graduates will be trained in subsequent years, both in Bangladesh and a few other countries, and the outcome will provide benefit to about 50 million people in the next five years.

The barriers are mainly financial.

We registered our company as a ‘Company limited by Guarantee’ where there are no shareholders. The subscribers have limited guarantees in case the company breaks down. Therefore, no local banks, or the recently established local venture capital firms are willing to give loans to BiBEAT Limited. We deliberately registered the company this way looking over the horizon in space and time, and would wait till we can make a breakthrough, either through philanthropic support, or through our slow but steady marketing efforts.

We have the necessary technological and entrepreneurial expertise. However, due to financial constraints we could not appoint separate manpower for marketing and also could not advertise in the media adequately. The premises that we have now is adequate for the current sale volume. However, for expanding the business we need to move to a larger premises and open up a few shopfronts in Bangladesh, again fund shortage is the barrier.

Firstly, we will need to attract trainees to the programme. For this we will need to make adequate publicity in the media. The trainees are all graduates and will need to be given monthly allowances. The trainers and supporting staff will need to be compensated. Bi-BEAT will also set up a training facility with adequate equipment, workshop facility and tools which will continue even beyond this proposed project period. Next challenge will involve establishing the trainees as successful entrepreneurs. They will need to be paid initial seed funds. All the above will require funds and this is the major barrier before us, for which this application is being made.

Bi-BEAT has already an infrastructure for manufacture and sale of medical products based on own technology. The ECG machine in question already has Government approval. Therefore, the trainees will not face trouble in selling these devices. They can register their own companies eventually, but if needed, they may use Bi-BEAT’s platform up to a certain time.

For going beyond Bangladesh, we have contacts with an innovative engineer in Cameroon, and through him we can get in contact with several others in Africa. Similarly we have contacts in Nepal, Pakistan and Sri Lanka where our products may be sold (we already sold a few items to Pakistan and Sri Lanka). We may ask the support of Solve community to support extension of this training programmes to these countries later.

Management Team - 1 

Support staff - 3 

Trainers - 6 

Lab Assistant - 2 

Contractor -1 

Sub Contractors- 4

Bi-BEAT’s founder President, Professor Siddique-e Rabbani obtained a PhD in Microelectronics from University of Southampton, UK in 1978. There he realised that without indigenous technology solutions, the quality of life of the common people in Bangladesh will not improve, they will remain ever deprived. In spite of lucrative job offers abroad he came back home straight. Becoming a teacher at Dhaka University, the premier university in the country, he realised that all research outputs would rot within the laboratories unless these are commercialised. So he started efforts in entrepreneurship, starting with virtually ‘zero’ capital. In these efforts he faced many ups and downs as the national policies and the business environment were not favourable. He lobbied with policymakers, organised stakeholder groups; a few changes came, but some obstacles still remain. Through these efforts he found out how to bend around these obstacles to achieve desired targets, keeping a low profile for the time being. Increasing the number of similar minded people through the proposed training programmes, he expects reaching a critical mass when the obstacles can be removed. Through links with foreign universities, he developed expertise for himself and for many energetic youths in modern technologies involved. About a dozen of them remained together to form the backbone of Bi-BEAT. So BiBEAT essentially has more than four decades of experience in technology development and entrepreneurship, working in a difficult environment, which none other in Bangladesh or other LMICs have. Therefore, Bi-BEAT is uniquely positioned to provide the solution stated.

At Dhaka University Professor Rabbani founded the postgraduate Department of Biomedical Physics & Technology (BMPT) in 2008, solely targeting application oriented research. Thus teachers and students of this department were imbibed with his philosophies and together with some of them he founded BiBEAT Ltd., in 2013. Prior to that, in 1996, he also founded ‘Relevant Science & Technology Society, Bangladesh (RSTS)’ taking along groups of colleagues and students. ‘Relevant Science & Technology Institute (RSTI)’ is an institute which they formed recently under RSTS. The purpose of RSTI is to take up innovations from BMPT and turn them into disseminable products, either commercially or non-commercially, and also take up the dissemination process for the latter. Thus BMPT, RSTI and BiBEAT form a triangular eco-system which would be a model for any LMIC. Professor Rabbani realised long back that unless all the three parts of this eco system is under the same technology group, it would be difficult proceed in an environment existing in the LMICs at present. Research organisations, solely established to support industrial research in Bangladesh by the Government, also became like universities, giving priority to publications only since the researchers were not allowed to initiate enterprises based on the outcome of their research. The eco-system established by Professor Rabbani’s team has achieved successes which dwarf many others employing many more scientists and spending many times the expenses. Later, when this culture spreads and national policies are made favourable, models currently followed in the developed countries may be tried.

Bi-BEAT is registered as a ‘Company Limited by Guarantee’ under the company law. This does not have any shareholders, the initiators are called subscribers. The company can operate and run as any other public limited company except that here liability of the subscribers are limited by Guarantee to a small amount and the paid up capital is zero. Nobody can take any share of the profit earned by the company. Profits made can be reinvested for the company’s expansion or given to charity, to other organisations doing R&D, etc. Bi-BEAT’s current products are:

• Computerised ECG, 12 lead, for stand-alone use or for telemedicine
• Computerised Dynamic Pedograph Equipment
• Muscle & Nerve stimulator for physiotherapy
• Iontophoresis equipment for treatment of excessive sweating (hyperhidrosis)
• PEMF therapy device for relief of musculo-skeletal pain
• Telemedicine system including software and some online diagnostic devices
• Educational equipment for biomedical engineering courses.

Items iv and v are mostly procured by patients for home treatment. Item vii is for universities and all others are for hospitals and clinics. Continuous in-house R&D and that at partner organisations (BMPT and RSTI) are adding newer products into the range.

Bi-BEAT sells the devices directly to the customers in addition to intermediate dealers. People need these devices for health benefits.

Bi-BEAT is already earning enough to sustain itself and its income is increasing. After the recent Covic19 situation, Bi-BEAT is developing several essential devices for hospitals which will bring in more revenues in the foreseeable future, producing surplus amounts. As nobody takes the profits of Bi-BEAT, parts of these surplus amounts will be used to promote the mission that this project targets.  BMPT at the university gets a good monetary support from the International Science Programme (ISP) of Uppsala University, Sweden, continuing since 2011, which helps in paying salaries to many researchers who also contribute part time to RSTI and Bi-BEAT. BMPT also gets a regular support from the University for its academic and research activities. BMPT also has a Telemedicine programme which generates its own income through patient fees and donations. Side by side, RSTS has also received some project grants and challenge funds from Government.

After the training is over, a seed funding will be provided to each of the trainees to start their enterprises, under continued guidance of Bi-BEAT. Bi-BEAT will provide them with kits of ECG machines that they can assemble and sell to begin with. For continuing such training programme in the future, it may be possible to provide the training in lieu of fees charged to trainees, which will cover the basic costs, the rest being supplemented by BiBEAT’s earnings. For extending such training programme to other LMICs grants from international donors will be sought.

The barriers mentioned before includes setting up a standard training facility at a separate premises with adequate equipment, workshop facility and tools, attracting trainees, giving them monthly allowances, compensating the trainers and supporting and paying the trainees initial seed funds to begin their start-ups under guidance of Bi-BEAT. All the above will require funds and this is the major barrier before us, for which this application is being made to MIT Solve.

For going beyond Bangladesh, we have contacts with an innovative engineer in Cameroon, and through him we can get in contact with several others in Africa. Similarly we have contacts in Nepal, Pakistan and Sri Lanka where our products may be sold (we already sold a few items to Pakistan and Sri Lanka). We may ask the support of Solve community to support extension of this training programmes to these countries later.

In Bangladesh, Department of Biomedical Physics & Technology of the University of Dhaka, Relevant Science and Technology Institute are the two organisations which are established partners for most activities of Bi-BEAT. In subsequent years it will seek partnership with Cameroon through Dr. Youssoufa Mohammadou, a teacher at the University of Ngaoundere, Cameroon and through him with establishments in a few other African countries. Anyone from MIT Solve who can support in this extension phase of the programme would be included, but we have no one in our connection at present.