Atul Gawande’s recent piece on “Slow Ideas” in the New Yorker has generated much buzz, and deservedly so. Gawande analyzes the differing speeds at which innovations spread, and concludes that technology alone is often not enough to solve complex social and medical problems. Instead, as he concludes, “people talking to people is still how the world’s standards change.”
Gawande’s piece is highly relevant to Embrace, both because he focuses specifically on the context of addressing hypothermia in India, and because his thoughts echo our program-based approach. Although simple, effective solutions for addressing hypothermia exist, getting them to take root is particularly challenging:
“We picture a blue child, suffering right before our eyes. That is not what hypothermia looks like. It is a child who is just a few degrees too cold, too sluggish, too slow to feed. It will be some time before the baby begins to lose weight, stops making urine, develops pneumonia or a bloodstream infection. Long before that happens—usually the morning after the delivery, perhaps the same night—the mother will have hobbled to an auto-rickshaw, propped herself beside her husband, held her new baby tight, and ridden the rutted roads home.”
Introducing any new solution in such a context is ultimately a process of social change. As Gawande observes, history has repeatedly taught us that in embracing a new idea, ”people follow the lead of other people they know and trust when they decide whether to take it up. Every change requires effort, and the decision to make that effort is a social process…human interaction is the key force in overcoming resistance and speeding change.”
At Embrace, we realize that while the infant warmer we have developed provides a powerful new tool for combating hypothermia, the technology alone is not enough. That’s why we set up strong partnerships in every community where we work. We establish a long-term presence and hire local staff to provide intensive, side-by-side training to mothers, caretakers, and health care workers.
A new mother in Karnataka, India holds her baby in an Embrace warmer.
We provide constant education not just on how to use the warmer, but also on other interventions such as Kangaroo Mother Care (skin-to-skin contact), as well as the root causes of neonatal hypothermia.
Addressing hypothermia in severely under-resourced environments is far more complex than simply following a protocol or pushing a button. It takes time, patience, and trust. But when we invest these things, we find that Embrace’s product and programs can serve as powerful catalysts for advancing the social change necessary to decrease neonatal hypothermia.
One such example comes from our successful collaboration with the Teso Safe Motherhood Project in Soroti, Uganda. Our implementing partner, International Midwife Assistance (IMA), noted that after introducing the Embrace warmer and Embrace trainings the clinic staff were more aware of and responsive to hypothermia among the newborns it serves. As Jennifer Braun, Executive Director of IMA stated,
“Really we have found the warmers to be a big help. We had a big problem with hypothermia that we didn’t even know about. The first lesson that we have learned is that awareness of hypothermia here is low and that the Embrace warmers are an excellent tool not only for treating hypothermia, but also for raising awareness of hypothermia.”
Staff are trained on how to use an Embrace warmer at an International Midwife Assistance facility in Soroti, Uganda.
As we continue to expand the reach of Embrace, we remain committed to integrating the infant warmer into local public health programs, so that we can have a deeper and more lasting impact on the communities we serve. The last thing we want is for the warmers to sit on a shelf, forgotten, while overworked staff in under-resourced clinics heroically triage huge volumes of patients– and newborns continue to silently suffer from hypothermia. Gawande reminds us that the only way to do this is by taking the time, cultivating the relationships, and investing the resources necessary to allow “slow ideas” to take root.
Embrace Executive Director