ASOGUA Ostomy Care

In developing countries like Guatemala, where most people lack a health insurance, an ostomy can be a life-saving procedure that fails in the long-term due to scarce resources, poor access to information and difficulties obtaining the required ostomy bags. Furthermore, the lack of specialised physicians, capable of performing the right surgery to different populations (from newborns, to older people) exacerbates the dangers that such medical procedures imply. 

It is estimated that worldwide up to 1 in 500 people undergo ostomy surgery. In Guatemala, there are no real statistics about the problematic, but for the past 8 years ASOGUA (The Guatemalan Asociaction for Ostomized People - in spanish) led by Alejandro de la Riva has been helping people of scarce resources after an ostomy procedure. We have observed how people come out of the hospital with a poorly performed stoma and without the proper indications as to how to care for their stoma. Additionally, they are only given one or two kits for placing their stoma bag and they have no real idea as to where this devices can be acquired. These people are left to their own luck, without any real knowledge on how to take care for their stoma, nor a clear idea of who to ask for help when they are in need. In addition to the physical burden a poorly performed stoma and its care represents, we have observed that most people are faced with tremendous mental health problems and require assistance to know they are not on their own in this new stage of their life. 

For years ASOGUA has been searching for donations of stoma bags and the required accessories to help people of low resources. ASOGUA has been going to every remote place in Guatemala trying to educate and bring help to people living with a stoma in the rural communities. It is remarkable how with a little information and the right equipment people who are bed-ridden due to infections and pain are capable of bouncing back to a functional and happy life. It is the goal of ASOGUA to find sustainable solutions to facilitate the access to information, adequate medical care and cost-effective medical devices to the ostomized population.

We intend to approach the problem in three different ways by 1) creating a digital platform (App), 2) developing cost-efficient ostomy bags and 3) organising visits from expert surgeons to educate local physicians in the best ostomy procedures. 

1) We are creating an App (Android/iOS) where people can be made aware of the existence of ASOUGA and be informed of all the work we do and help we can provide. The app will have several functions ranging from information to community services including, but not limited to:

• Information/Education - the user will find informative videos and tutorials to familiarize themselves with their stoma and its adequate care. The videos will be created under the advise of healthcare professionals and experts in stoma care. 
• News - relevant news regarding the work performed by ASOGUA, new donations, future projects, visiting doctors, and special events will be posted here to keep users informed of the work we are doing.
• Stoma Journal - the app will remind users daily of taking a picture of their stoma to facilitate tracking of progress over time. All images will be uploaded to a secure server following strict data protection guidelines (e.g., EU GDPR). The images will be initially analized by experts to ensure progress is being made with stoma care or to detect any unwanted infection. A machine learning algorithm will be developed to facilitate a fast detection of unwanted changes in the stoma and skin around it.
• Community - users will be able to post to forums and have 1-on-1 chats with experts answering their questions related to their stoma. All chats will be encrypted.

2) Cost-efficient ostomy bags will be developed to reduce all costs associated with stoma care in developing countries. Furthermore, we will develop technologies based on 3D scanning, and 3D moulding to facilitate the positioning of ostomy bags in stomas that have not been adequatly performed. For the adhesion of the ostomy bag to the skin, special hydrocolloids will be developed based on chitin and chitosan extracted from shrimp shells, adding to the sustainability of this products. Rapid prototyping technics such as 3D printing and laser cutting will be used to accelerate production of other relevant parts like the adapters for the bag itself. Several polymeric materials will be tested for their adequacy to retain fecal matter for the development of the bags. This materials will be locally sourced and if possible come from recycled sources. All materials employed will be verified for their biocompatibility and stability through carefully performed pre-clinical testing following ISO10993

3) Expert physicians in colostomy surgeries will be contacted throughout the project and will be invited to impart seminars and talks with local surgeons to improve the outcomes of surgeries. The first doctors will be approached through current collaborations with the United Ostomy Association of America and the Karolinska Institute in Stockholm. 

Our solution will help all people that undergo an ostomy procedure and lack the resources to obtain adequate care and the required medical devices for  it. 17 Million people live in guatemala, of those 8 Million (47%) live in poverty. Assuming 1 in 500 will require an ostomy, we are talking of approximaetly 16 Thousand people that will need our help in the future. Additionally, the technologies developed here can be leveraged in other developing countries.

ASOGUA has already helped over 300 individuals that had suffered due to bad ostomy surgery, non-existent advice and difficulty in obtaining the adequate medical equipment to care for their stoma. All of these persons that have been helped live in precarious conditions with low incomes and bad sanitary environments. Two thirds (2/3) of these persons still require specially designed ostomy bags, as their stoma is atypical due to poor medical training. 

For 8 years, ASOGUA has been the only organization in Guatemala taking care of ostomized people. No government program or support exists for these people and the bad medical infrastructure in the country has only exacerbated the problem. In this time we have created a name for ourselves in Guatemala and amongst the ostomized community, providing them with the required help and devices that we are able to gather thorough donations. 

This year we have started a collaboration with the department for Biomedical Engineering at Universidad del Valle (UVG) and they are leading the technological revolution that we want to achieve with ASOGUA. 

The combination of all the community work that has been previously done by ASOGUA and the technical expertise and resources provided by UVG, the leading private university in Guatemala and Central America, ensure the acceptance of the provided solutions by the ostomized community and reduce the risk associated with developing such technologies.

So far ASOGUA has established itself as the only organization serving and helping the ostomized community in Guatemala. We have reached and helped over 300 people, but our current resources have not allowed us to help further. This year we have started a collaboration between ASOGUA and UVG giving us the right tools and people in place to increase our outreach and bring new technological solutions to the people who need them the most.

We want to gain access to an innovation and entrepreneurship network where we can find partners willing to collaborate and advise us on our journey. Developing medical technology is always accompanied by large costs, therefore, we are also looking to be mentored on how to secure additional funding for our project. Finally we would like to gain visibility and increase awareness of the problems that ostomized communities face in developing countries.

The innovation of our solution lies in the use of already established technologies like smartphone apps and social media to reach an already established user base and facilitate the care of a critical medical condition. Through the "gamification" of healthcare we envision people being more compliant and constant with the care and supervision of their stomas. We further see a positive impact on the mental health of ostomized people through the easy access to a community of people going throuhg the same hardships. 

Additionally we are recycling biological waste that typically results in large costs and contamination, to create a low-cost alternative for already established biomedical devices. The use of pre-established processes and materials will provide an unique advantage to all of the people suffering from stomas, not only in Guatemala, but probably across all developing countries. 

We envision that by using our app ostomized people will be reminded that they are not alone in the world with their stoma, and that a dedicated group of experts and voluntaries that care are there for them. With the information we provide we expect ostomized people to be able to be educated and make informed decisions on the care of their stoma. Through the ability to easily detect progress or worsening of the stomas with simple images we aim at improving the use of resources by focusing on the most problematic cases first and encouraging the improvement of people through self care. Finally, the community aspect will provide people with an ostomy with a sense of belonging and encourage them to share their journey with other people that are about to be operated.

On the other hand we see the production and use of low-cost ostomy bags as a life-saver for people in low-income communities. By being able to obtain adequate medical devices, their quality of life and their mental health can improve, encouraging them to continue with an active lifestyle as part of the working community, with more time for them and their families. 

1. All of ASOGUA's current patients download the App and complete the learning module. 

2. All of ASOGUA's patients record the progress of their stoma through the app providing enough data to start training of the machine learning algorithms.

3. ASOGUA's social media accounts reach 10,000 followers increasing awareness on the problem and encouraging more people to volunteer or donate to the cause

4. The production of hydrocolloids is established (from raw material processing to material formation) and the material is evaluated for biocompatibility. 

5. The first "ostomy day" is celebrated in Guatemala with at least 3 invited physicians from other countries providing crucial training to local surgeons.

6. ASOGUA's app reaches 1000 downloads and active users 

Through gamification of healthcare with an app, using notifications, badges and apparent rewards we envision an increase in the compliance of patients to use the app, inform themselves and learn the proper care of their stomas. Furthermore, we will leverage the advancements in digital photography, enabled through smartphones, and the capacity to elaborate powerful, yet fast machine learning algorithms for image detection. This will allow for fast and safe remote monitoring of users' stomas, reducing the human work needed in countries where physicians are already overwhelmed. 

The development of low-cost ostomy bags made with novel materials like chitin/chitosan hydrocolloids leverages new technologies that have proven to be biocompatible and antimicrobial with sustainable fabrication steps. Taking advantage of the large shellfish industry in Guatemala and the large amount of waste produced by them, we envision lowering the costs of the raw materials required to produce the hydrocolloids. The procedure to convert the raw material into useable reagents has already been successfully implemented in Guatemala and we are going beyond the originally proposed applications by leveraging this into a medical product. Combining the ability to obtain the required materials with novel 3D scanning and 3D printing methods further ensures the compatibility of the ostomy bags with the poorly operated stomas. This shall improve patient's comfort and healing ability, while ensuring compliance of the patient with the correct use of the ostomy bags.  

We are currently 18 people working on this solution:

1 full-time person, director and single worker of ASOGUA for the past 8 years.

6 part-time persons:

• 1 lead of technology development
• 3 business developers
• 1 biotechnology expert
• 1 graphic designer

12 volunteers - students of biomedical engineering and entrepreneurship

Less than 1 year.

We have an interdisciplinary team consisting of engineers, business administrators, biologists, graphic designers, and experts in ostomy care. 70% of our team are women and we abide to a gender equality plan. We are currently expanding our team to include further disciplines from data scientists and programmers to clinicians and nurses. 

Our team is new, but we are compromised with the following criteria to ensure a diverse team: 

1. Diverse Hiring Practices: actively seek out candidates from a variety of backgrounds, including different ethnicities, genders, ages, and abilities. This ensures that our team reflects the diversity of the community we serve.

2. Training and Education: provide regular training sessions on diversity, equity, and inclusion (DEI) topics to all team members. This includes workshops on unconscious bias, cultural competence, and creating an inclusive workplace.

3. Open Communication: encourage open and honest communication within the team. This includes creating opportunities for team members to share their experiences, concerns, and suggestions related to diversity and inclusion.

Empowering Lives Through Social Innovation

In our world, health is a fundamental right that everyone deserves. In our commitment to social responsibility and innovation, we are proud to present ASOGUA Ostomy Care a unique solution that transcends the boundaries of conventional healthcare: Affordable Ostomy Bags and a comprehensive ecosystem of services.

1. Low-Cost Ostomy Bags:

Our mission is to make ostomy bags accessible for all. We are dedicated to manufacturing high-quality products at affordable prices, without compromising integrity or comfort. 

2. Education and Medical Support:

We understand that the journey to adapting to an ostomy can be challenging. That's why we offer personalized educational and medical support services. Our team of trained professionals is here to provide guidance, emotional support, and practical resources to help every individual feel empowered and confident on their journey towards recovery and well-being.

3. Community and Mutual Support:

The strength of community is unmatched. We believe in the importance of connecting patients with others who share similar experiences. Through our platform, we create safe and welcoming spaces where patients can share stories, find inspiration, and receive mutual support. 

Business model: One for One direct to consumer

Our commitment to equity goes beyond the quality and price of our products. For every ostomy bag we sell, we donate another to a person in need in disadvantaged communities. We believe in the power of doing good while doing business, and we are committed to creating a positive and sustainable impact in the world around us.

Customer Segments:

1. Ostomy Patients with Resources:

This segment would include individuals who have the resources to purchase ostomy products at full price. Their participation in the "One for One" model could significantly contribute to the social impact of our venture, as their purchases would help finance the provision of free products to those unable to afford them.

2. Patients with Ostomy from Economically Disadvantaged Backgrounds:

This segment would include individuals who have undergone ostomy surgeries but face economic challenges in acquiring quality products. Our focus on offering affordable ostomy bags would provide them with an accessible and dignified solution.

3. National Hospitals and Government:

National hospitals and the government would also be significant players in our model. We will become providers and establish partnerships with these entities to provide healthcare and ostomy products through public health programs and government funding. 

4. Healthcare Professionals and Medical Organizations:

Physicians, nurses, and other healthcare professionals working with ostomy patients would also be a key segment. We would provide educational resources and training materials to help them provide better support to their patients.

5. Non-Profit Organizations and Humanitarian Aid Agencies:

Given our commitment to the "One for One" model, non-profit organizations and humanitarian aid agencies could be important strategic partners. Our ability to provide donated ostomy bags to underserved communities would complement their healthcare efforts.

6. Medical Communities and Private Healthcare Centers:

Hospitals, clinics, and healthcare centers would be another relevant segment. We could collaborate with these establishments to provide access to our ostomy bags and complementary services to their patients.

The distribution channels of ASOGUA Ostomy Care focuses on reaching the end customer directly, ensuring accessibility and sustainability. We will utilize a combination of online sales platforms and physical distribution points strategically located in areas where ostomy patients gather. These distribution points will serve as hubs, ensuring a steady supply of our products to meet the fixed demand from our target market. Depending on specific sectors and logistical needs, distribution may be managed in-house or outsourced to trusted partners. This approach ensures efficient delivery of our ostomy bags and complementary services to those who need them most.

Revenue Streams:

Our revenue generation strategy encompasses multiple avenues tailored to the diverse needs of our stakeholders:

1. Direct-to-Consumer Sales for Patients with Resources: Through our online platform and physical distribution points, we will offer a range of ostomy bags and complementary services to meet the diverse needs of this customer segment. 

2. Business-to-Business (B2B) Partnerships with Private Hospitals and Government Institutions: We will collaborate with these entities to provide our products and services to ostomy patients within their facilities.
3. Grant Proposals in Collaboration with Non-Governmental Organizations (NGOs):By partnering with organizations focused on healthcare access and social impact, we can develop grant proposals aimed at addressing the needs of underserved ostomy patients.

Key Resources:

1. Local Laboratory for Product Development and Production: This laboratory will serve as the hub for research, development, and manufacturing of our low-cost ostomy bags. Having a dedicated space equipped with the necessary facilities and equipment is essential for ensuring the quality and efficiency of our product development process. 

2. Software Development: We require robust software solutions for various aspects of our operations, including inventory management, order processing, customer relationship management (CRM), and e-commerce platforms. Developing and maintaining custom software tailored to our specific needs will optimize our internal processes and enhance the overall efficiency of our business operations.
   
   

Key Activities:

1. Ostomy Bags Production: Manufacturing bags with top-notch quality in the local laboratory.
2. Active Partnerships: Engaging with insurance companies, hospitals, medical centers, and NGOs for distribution, coverage, and outreach programs.

Competitive Advantages:

1. Low-Cost Production: Offering quality ostomy bags at competitive prices.
2. Customization: Developing bags in various sizes and specs for diverse patient needs.
3. Added Value: Providing comprehensive information and medical support beyond products.

Growth Plan:

1. Increasing Number of Patients:  Our primary objective for growth is to expand our reach and serve a larger number of ostomy patients. By increasing our visibility and accessibility, we aim to capture a larger share of the ostomy care market, reaching patients in both urban and rural areas.

   2. Maximizing Long-Term Client Value: Beyond acquiring new patients, we recognize the importance of nurturing lasting relationships with our existing clients. The number of patients in need of lifetime provision of ostomy bags is as high as 70% in developing economies. Based on this fact our clients will be in need of the product and care. Our strategy needs to focus on maximizing our long-term client value through a communication and care provision of support.