More than 8 million children in Mexico suffer from asthma. These children and their families travel up to several hours to urban hospitals where they endure long waits to get relief from acute asthma attacks. More troubling still, these families are sent home from the hospital without the means to prevent further attacks. This all but ensures a vicious cycle of frightening and expensive returns to the hospital, and leads to a national asthma fatality rate that is the 8th highest in the world (1.45%).
The physicians in Health Centers, which provide nearby, free primary care to uninsured Mexicans, can recognize asthma and have access to the medication necessary to treat asthma attacks, but they lack effective, affordable devices to deliver that medication. Mexican Health Centers are stocked with asthma inhalers, which inexpensively create aerosol particles of medication, but these devices are not sufficient to deliver the medication to a child's lungs. Successful use of an inhaler requires that a child coordinate a deep breath with discharging the inhaler. This is challenging for a young child, particularly one gasping in the midst of an asthma attack. As a result, medication does not reach the lungs but is instead absorbed in the mouth and throat, where it causes undesirable systemic side effects.
To overcome these problems, inhalers are used in combination with a device commonly called a “spacer.” A spacer is a chamber that attaches to an inhaler, captures the discharged medication and holds it until the patient inhales it. In spite of their effectiveness, these devices are unavailable in Mexican Health Centers due to their cost (~ $50 plus distribution). Using paper and a precise system of cuts and folds, we have designed a spacer that can be produced for approximately 25 cents, a cost reduction of more than 99%. Furthermore, the device can be distributed as a flat sheet to be folded into a usable form on-site, so hundreds can be sent for the cost of a stamp.