Wednesday, November 18, 2009

Paper Tigers

Hayat Sindi is an unlikely social problem-solver. The oldest of eight siblings, Sindi left her home in Mecca at the age of 17 and, not speaking a word of English, went to Britain to receive a medical education that she was unable to get in Saudi Arabia. “I wanted to be a scientist,” she says, but “girls didn’t get scholarships.” Even in Britain, there were some who told Sindi that if she insisted on wearing her traditional hijab Muslim head coverings, that she’d fail in the West. But these types of challenges only motivated Sindi, who went on to graduate with honors from Kings College and win a scholarship to get a PhD in biotechnology from Cambridge. Three years ago, Sindi came to Harvard as a visiting Saudi scholar to work with Harvard chemistry professor George Whiteside in his social problems lab.

It was there that Sindi and Whiteside created Diagnostics For All, a nonprofit built on their technology innovation enabling people to use tiny, disposable bits of paper to test bodily fluids for signs of illnesses like HIV, malaria, and tuberculosis. It’s a technology that Sindi believes will help tackle the severe shortage of health workers and medical equipment in developing countries. DFA’s invention enables point-of-care diagnosis using microfabricated paper—tiny square cards that will ease the need for expensive medical labs and personnel who know how to use that equipment. Sindi’s paper solution is accurate, costs practically nothing to make, and can be used to test for a range of different diseases. Use it to screen a drop of blood or urine, sweat or saliva for liver troubles or other ailments, and people can adjust their own medications or more quickly be able to help those in need, Sindi says. “This will help save people’s lives,” she says. Doctors can use these paper devices as well as others with minimal training.

How does it work? A drop of bodily fluid wicks up into tiny wells embedded into the paper and reacts with chemicals in those wells, changing color to signal, for example, the presence of protein or glucose. “Millions of people are dying around the world because they can’t afford access to diagnostic tools to monitor their health,” Sindi told people attending the PopTech 2009 social innovation conference last month in Camden, Maine. “People in the developed world have been sending lab equipment to developing countries to manage their health but [much of this equipment] is old and bulky and [lab] conditions are unsanitary. This approach doesn’t work. Diagnostics For All … can put the power of an entire diagnostic lab at the patient’s fingertips.” Additionally, multiple fluid samples can be tested on the same paper card because there are many wells per card that don’t overlap, connect, or leak.

The first application of the paper test devices is a liver function test. “There are huge numbers of patients who are taking medication for HIV and TB who suffer from liver damage as a side affect of these drugs,” Sindi says. “Here, in the West, doctors do constant blood tests to monitor patients but what is happening in the developing world? It doesn’t happen.” In the United States, some 5 percent of patients being treat with medication for HIV develop liver failure. In the developing world, that figure is 25 percent. “That means that 700,000 will die eventually” if they are not treated or monitored, Sindi says. “And that’s only for HIV. If you add TB to the mix, that number jumps to 2.3 million people who would die – not because of the disease but because of the drugs meant to save them.” She says better diagnostics can solve this problem “head-on” and enable people to screen entire villages in the time it would usually take doctors, in the past, to examine a few patients.

Sindi and her team also are developing a suite of paper diagnostic tools to test for kidney disease and other illnesses. And down the road? Sindi and team want to get involved in applying their invention to the fledgling field of telemedicine. It’s about empowering the voiceless and the powerless, she says, by putting health care tools in the hands of the patient. “Society and science can work hand-in-hand,” she says. “The power is us doing it together.”

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