Stanford University
IN-4: Innovation 4

Design for Extreme Affordability is a two-quarter course offered at Stanford’s d.school jointly by the Graduate School of Business and the School of Mechanical Engineering. This multidisciplinary project-based experience creates an enabling environment in which students learn to design products and services that will change the lives of the world’s poorest citizens. Students work directly with course partner organizations on real world problems, the culmination of which is actual implementation of solutions and real change. Over the past ten years, student teams have worked with 26 partner organizations in 18 countries on solutions in the areas of agriculture, architecture, energy, food processing, irrigation, lighting, medical devices, nutrition, sanitation, stove technology and water catchment and purification. Partners are often the implementers of these innovations, but sometimes student teams form their own organization to carry an idea forward. The course has two main goals: that every student has a great educational experience and that every partner gets a great outcome. Furthermore, sustainability from a business standpoint is at the core of Extreme's philosophy regarding impact. The course emphasizes the importance of enterprise and entrepreneurship because instructors believe they are the most important factors in a project's long-term success and sustainability.

There are too many positive measurable outcomes to describe all at length in this submission. A few examples are provided below, but the complete list of all projects, outcomes, and current status can be found online (http://extreme.stanford.edu/projects/list). (1) Clubfoot is a congenital birth defect that results in the internal rotation of one or both feet. With a new case occurring in every 750 births and over one million untreated cases worldwide, clubfoot is one of the leading causes of disability in the developing world. Left untreated, clubfoot results in physical deformity and social stigma. The miraclefeet brace is a low-cost (<$20) foot abduction brace designed to treat clubfoot using the non-surgical Ponseti method. With proper compliance, treatment success rates of 95% can be achieved. (2) A third of the world’s population suffers from water scarcity. Without access to affordable water efficient irrigation, small-plot farmers are unable to grow crops during much of the year to support their families. International Development Enterprises Ethiopia (IDE-Ethiopia) challenged the students to make drip irrigation appropriate and accessible and to small-plot farmers. Driptech irrigation systems offer the benefits of traditional commercial drip irrigation with additional features optimized for one acre plots. For instance, these irrigation systems are designed for very low water pressures, with gravity feed from buckets and tanks and are easy to install, maintain, and expand. They cost two to five time less than traditional drip irrigation, and boast visibly higher uniformity of water application than any other low-cost irrigation product. (3) Pneumonia is the number one killer of children under the age of 5 worldwide, yet receives only a fraction of the attention given to HIV/AIDS, malaria, and tuberculosis. Named "The Forgotten Killer of Children" by the World Health Organization, severe pneumonia remains difficult to treat in low-resource settings due to the lack of intensive care technologies. Resourceful doctors in the developing world have developed an effective therapy known as Bubble CPAP to deliver respiratory support to children with severe pneumonia. Existing methods, however, are hampered by a reliance on oxygen tanks, which are expensive, dangerous, and notoriously difficult to transport. One group in the Design For Extreme Affordability course realized that a critical therapeutic aspect of CPAP is the air pressure generated by the device, rather than simply the oxygen itself. They created a product called Inspire, which utilizes pumps to pressurize the ambient air, which is then delivered to the patients to keep their lungs open. The device is capable of running off a car battery for many hours at a time and does not require oxygen tanks to deliver therapeutic continuous positive airway pressure. Inspire was selected as a Social E Lab awardee in Summer 2011. Having begun the project in January 2011, the group returned to Bangladesh, India, and Vietnam to user-test the interface of the device in its practice setting later on. This project has been supported, in part, by a global health innovation grant from the NIH, known as C-IDEA. The project is currently a member of the XSEED laboratories and is working towards obtaining CE mark approval of the device.