Buildable Emergency Ventilators

Indigenous communities are too often talent rich but resource poor (the problem). We are demonstrating a Hawaiian-led project to design a purely mechanical emergency ventilator that can be built by indigenous communities worldwide (the solution). These ventilators can directly help with respiratory emergencies and also demonstrate open source engineering and production models that could be needed in indigenous communities. The mechanical nature of the emergency ventilator makes it easier to build and does not rely on complex software, microprocessors, and gearing found in other open-source projects. Most importantly this project will comprehensively document the process for developing buildlable solutions and teams from other indigenous communities in Rapa Nui, Russia, Micronesia, and Chile have expressed great interest in also building these ventilators (positive worldwide change). A website is up at http://www.Kahanu.org with all project files open sourced.

Photo of Kahanu being tested at an ICU room at a hospital in Hawaii.

COVID-19 has exposed significant structural challenges in worldwide health care systems, especially in low resourced indigenous communities. The Navajo Nation for instance is the hardest hit reservation in the country, with a higher per capita rate of infection than any U.S. state. The Navajo Nation is one of more than 500 federally recognized tribes facing disproportionate rates of COVID-19 infection and death as a result of an insufficient Indian Health Service (IHS) budget, delays in federal relief funds, and social determinants of health that put American Indian and Alaska Natives (AI/AN) at an elevated risk.

This project demonstrates that we indigenous innovators can create solutions that can work for us, starting with an emergency ventilator. We are also demonstrating that 100% of the development pathways can be given freely as open source including detailed engineering notes, materials lists, alternative parts, and step by step videos. We are also demonstrating solutions that are pragmatic for indigenous communities, in this case a mechanical ventilator versus a computer driven one. Finally we are demonstrating economic models where funds can be obtained through market mechanisms to pay for development and distribution.

Photo of Kahanu volunteer Dr. Brodsky verifying tidal volume and pressure characteristics.

Led by a Native Hawaiian innovator, the current project is called Kahanu which in Hawaiian means “The breath.” Our solution benefits every single indigenous community in need of emergency ventilators. Our solution is not a complex microprocessor/software driven emergency ventilator but one that can be built in almost any community with commonly found materials and a few easily obtained electro-mechanical parts. With a mechanical design, not only is it cheaper and easier to build requiring less specialized experts like software engineers, reliability is based on a motor and a simple belt driven system versus one tied to software, gearing, and controllers.

Completed units being tested. Kahanu volunteer in the background helped with assembly of these units.

Many of our indigenous communities are resource poor, but innovation rich. Our project lead, Olin Lagon, has worked with over a dozen indigenous communities directly across the United States including Hawaiian, American Indian, Alaska Native, Micronesian, and Samoan communities. He was a past executive of the Intertribal Information Technology Alliance LLC which had 13 members (1 Hawaiian, 2 Alaska Native Village Corporations, 10 American Indian Tribes). The group grew to tens of millions in revenue with hundreds of indigenous staff that worked in digitization. Although the project is only two months old, Olin has already been in contact with communities in Micronesia and Rapa Nui to transfer technology for their local development, all done with no exchange of funds in a purely voluntary model. More contact will happen after FDA approval of the design has been obtained. This solution will address emergency ventilator shortages by providing detailed production notes to self produce necessary supply, if other options are not available. 

Photo of Olin giving part of the Keynote Address at Microsoft's Annual Developer's Conference in Toronto.

Project lead Olin is a lifetime advocate for Hawaiian economic self determination. He is Petra Fellow at Community Change. He was an executive at one of the few LLCs wholly owned by only American Indian, Alaska Native, and Hawaiian tribal organizations. Olin was also one of the youngest fellows accepted as an East West Center Fellow.

Our health care capacity is constrained by limited ventilator inventory. This project shows a pathway for us to solve this problem. It also models a project that highlights indigenous talent and community resilience.

Kahanu ventilators can be made with easy to find raw materials.

We have created a WhatsApp channel and invited all 40 open source ventilator projects being developed around the world. The WhatsApp channel is at http://j.mp/C19diycommunity. The Google Sheet with links to all 40 projects are up at http://j.mp/C19diyProjects. Instead of viewing the other teams as competition, Kahanu invited members from every group to collaborate. As a result daily technical conversations happen in the WhatsApp channel. This has accelerated Kahanu's progress as well as the progress of other groups. For example, we got help with our breathing circuit that cut three weeks off of development!

The key thing that makes our solution innovative is the move away from software/microprocessor/complex gearing to a system that can deliver a similar range of respiratory care with mechanical changes that are geometry based. Also the system is designed to be rugged enough to run for weeks and be dropped from a hospital bed and still operate. The system is also designed to be disinfected easily using extremely caustic chemicals. Other designs can also be great for communities but may require skill sets and components that are not as easily resourced.

Kahanu ventilators can be made with relatively easy to source raw materials and components

Please see our website at http://www.Kahanu.org for detailed CAD and other engineering notes that show our technology. It is 100% open source. While we are not done with design, enough has been released to get a solid sense of the technology. Two of the engineers on the Kahanu team are MIT graduates (mechanical engineering) and project lead Olin Lagon has completed one project at MIT's Digital Media Lab (jrsummit bought software he developed).

The core technology is a cam driven system that compresses an Ambu bag to provide respiratory care where the tidal volume of air delivered, max/min air pressures, inspiratory to expiratory ratios, and respiratory rate can all be changed through geometric changes (sled change, cam change, motor speed change). This sled design is unique and not yet replicated on any project known.

Members of the Kahanu team have worked at companies like Google, Apple, and Tesla and responsible for core designs on projects including the PowerWall and Pixel.

The first prototypes were hand built proof of concepts

Here Blair is putting the cover on the first completed Kahanu working prototype

Please see http://www.kahanu.org to download detailed CAD and Bill of Materials. The system has been tested by doctors and operated in an actual ICU hospital room for testing. Please visit our Facebook page at https://www.facebook.com/kahanuosv for dozens of photos and videos of the unit operating, being tested by doctors, being characterized in an ICU room in a hospital, and being produced.

Parts to make 200 units have already been machined.

Three test units undergoing FDA approval characterization, here at 26 breaths per minute.

The theory of change that got Kahanu to this stage is based on kanaka maoli (Hawaiian) integration into STEM education. Kahanu leader Olin Lagon is the Co-Founder of the Hawaii-based Purple Mai‘a Foundation. The theory of change is core to Purple Mai‘a’s operations which are 1) statewide STEM education rooted in Hawaiian knowledge, 2) job creation for kanaka maoli makers that reinforce self worth, and 3) funding indigenous tech via the PurplePrize.com arm. Rooted in these activities is the theory that indigenous knowledge can add significant value to education, projects, and companies.

Please visit http://purplemaia.org for more information

For example the curriculum to teach motherboards first involves taking students to Hawaiian lo‘i (taro patches) where taro is farmed using centuries old wetland technology. Students learn about the source of water and how water flows between fields, stored, sped up, slowed down, redirected, switched on/off etc. Then the motherboard analogies are introduced but instead of water electrons are being moved from batteries through resistors, conductors, capacitors, and other circuits.

Please visit http://www.purpleprize.com for more information

Rooted in the management of Kahanu are these values. All of the founders of Kahanu have been working seven days a week for two months 100% unpaid to design and produce emergency ventilators to provide this resource across the islands for every community. Kahanu has also gotten a dozen volunteers to also work alongside our team, volunteers with shared values of community. And sharing out the work as 100% open source is also inline with these indigenous values.

This year it will serve the population of Hawaii, 1.3 million residents, with up to 200 emergency ventilators placed at as many hospitals and health care facilities statewide as possible. Over the next five years, Kahanu is confident it will have one of the most documented and easiest to build emergency ventilators that will easily serve 50 million potential residents with emergency ventilator capacity.

The next year we intend to build a multitude of variants of Kahanu to create alternative builds for communities that may not have access to the raw materials and components we recommend. For example, if there are no aluminum sheets, various plastics can work. We will develop guidelines for alternative builds that include limitations that may come as a result of the change of design as well as engineering notes necessary to use alternative components. For example, notes on how to re-wire car windshield wiper motors to spin in only one direction.

With the next five years, Kahanu will set up an online community to reinforce the open source nature of the ventilator to connect builders from around the world who will be able to continuously add value such as local language versions of all videos and documentation.

We are only two months old. We are also new to Open Source models so we have a ton to learn and the risks that come with new business models being adopted. We have not yet figured out how to properly get liability insurance for example. We have not figured out all of the legal steps necessary to successfully assist communities worldwide with deploying life saving equipment. We are hopeful this MIT grant and most importantly the access to world leading innovators and communities will help us figure out these and many more challenges. We have the experience and aptitude to tackle huge challenges.

We will continue to increase our outreach. For example in the first two weeks of operations, we reached out to every group on earth designing emergency ventilators. We have reached out to State of Hawaii leadership and getting support. We have reached out to volunteer attorneys, accountants, engineers, and doctors and have gotten support. We are reaching out to MIT via this grant. We will continue to find the support necessary to scale our project into a national and then international model with broad impact and community changing potential.

We are an LLC. We were advised by attorneys to select LLC to reduce liability as well as position our group to obtain insurance. Despite the LLC, we are a volunteer driven and the principals are unpaid.

We have six people in our LLC.

Kai Matthes, M.D., Ph.D. is a Harvard-trained pediatric anesthesiologist. He was an Associate Professor at Harvard Medical School.

Jeffrey Hayashida leads core teams at Google, past lead at Apple. Mechanical engineering at MIT.

Peter How is currently in the autonomous vehicle space. He is a former Tesla battery engineer. Bachelor’s and Master’s mechanical engineering from MIT.

Olin Kealoha Lagon is a native Hawaiian serial social entrepreneur and software engineer.

Blair Stultz is a master machinist and founder of Bear Machinery.

Ryan Kawailani Ozawa is a native Hawaiian civic tech advocate and community organizer.

We have a Harvard trained doctor, three engineers, one world class machinist, and one community organizer. We have collectively innovated solutions for dozens of Global 1000 companies around the world such as Disney, Mercedes, and Nike. We have worked and led core projects at Apple, Google, and Tesla leading for instance both versions of the PowerWall. We have scaled our startups like starting the first crowdfunding company on earth, ChipIn, which funded over $100 million to causes worldwide. We have the perfect innovation team and are looking at this project to help fill in strategic gaps and help elevate the team's mission. Two of our core six team members including the Managing Director are native Hawaiian.

Olin is comfortable with public speaking to advocate as needed for the project. He has spoken at conferences worldwide such as part of the Keynote at a Microsoft Annual Developers Conference.

As described earlier, we reached out to 40 open source ventilator projects worldwide and invited every single team into a WhatsApp channel to quickly share technical information. You can join our group http://j.mp/C19diycommunity and see our open source summary of the talent here http://j.mp/C19diyProjects. We are only 2 months old but took this leadership step to unite the teams worldwide. Kahanu's Managing Directory and the lead on this application is one of the administrators of this community.

Kahanu LLC got $250,000 in funding to design and deploy up to 200 ventilators across Hawaii. To be honest, we could use some help in this section. While we are funded to produce up to 200 ventilators, we are not yet funded to complete all 200 with FDA approval. The $10,000 prize money will go directly to support FDA approval. Kahanu will need to evaluate models though at this point the Open Source model is our current preference.

Kahanu has received funding for up to 200 ventilators. The $10,000 would be necessary for the group to complete FDA Emergency Use Approval. When Kahanu started the project, little was known about FDA approval. Since then a host of additional requirements have made the project not feasible with the original budget. For example medical grade alarms that track static pressure were added as well as battery backup systems. The $10,000 will go directly to components and testing necessary to complete the FDA application. 100% of the labor will still be voluntary. We are also applying as two engineers are graduates of MIT and this project will absolutely help lift of the status of the project, which is necessary in the open source model preferred.

We are engineers. We would love to get some big picture support and help to scale our solution to worldwide open source status and help develop models that can accelerate development across other communities, with a particular emphasis in indigenous communities.

MIT already has an open source ventilator but based on different principals. We would love support from the mechanical and electrical engineering departments to help us iterate alternative solutions on the core model as well as help with any design enhancements that could be part of the next build. We would also love help reaching out to indigenous innovators already identified by MIT to start conversations about expanding the model.