Frugal Ecosystem in Nepal: Lesson for Least Developed Countries

Authors: Sweekrity Kanodia, Sudarshan GC

Nepal is a developing nation faced with poor healthcare infrastructure due to geographical, economic and socio-cultural constraints.  The average wage is $2.64 per day per person making healthcare services, hygiene, nutrition and sanitation inaccessible and unaffordable. The way forward for Nepal and similar developing nations is frugal healthcare.

Frugal means “economical – not only in terms of money but also sustainability, accessibility and applicability. It is a whole new way of thinking, converting adversities and problems into opportunities to create more value at low cost for more people. Use of local resources to provide cheaper, more accessible care would bring the impact that is required and would cater to the needs of masses in every socio-economic strata. Hence, Nepal like many other countries is gradually switching to frugal innovations to bridge the gap in healthcare.

Some distinguished contributors

A very simple example of frugal innovation in the context of Nepal is the solution offered by ‘Possible’ to improve primary care by creating a network of providers and community health workers connected to secondary care facilities [1]. A name that comes to mind when talking about frugal innovations in Nepal is Dr. Sanduk Ruit – pioneer of low cost cataract surgeries, which cost an average of $115 compared to $3000 in the west. His lab also produces intraocular lenses for $4 compared to $100 for imported counterparts [2].

Sometimes modern technologies or their cheaper versions may not give the desired result. Frugality also inculcates the need and adaptability of local communities to provide personalized, effective solutions. Non-profit organization “Sochai – Social Changemakers and Innovators” created an innovative Nutribeads and Redcycle bracelet with a set of colorful beads which was made by local artisans to remind rural mothers what to feed their babies to tackle child deaths leading to malnutrition. Bonita Sharma, founder of Sochai was awarded with honor of “BBC  100 Women 2019” [3].

With the advent of the current pandemic, the National Innovation Centre led by Ramon Magsaysay Award winner Mahabir Pun came into the limelight for frugal innovations to fight the crisis locally. They developed an aerosol box, low cost PPE and a model emergency ventilator to reduce the risk of infections to medical professionals.

Frugal and open innovations in PPEs, ventilators, transformation of space to create more room for patients etc during this pandemic have highlighted the importance of Open Science – freely sharing of knowledge, efficient and smart use of available resources and of course improving the healthcare system. The National Innovation Centre formed collaborations with various international universities like Prakash Lab at Stanford University to work on several Covid response and relief interventions like ventilators, fabric producing machines for masks, UVC disinfection chamber etc [4].

Nyano Nani, by Nepal Innovation Center – infant warmer is a great example of technological innovation, designed and built all in Nepal, with the intent to provide required warmth to an infant right after birth. Such technological advancements developed within Nepal can hugely impact the economy and make us self reliant. It also excites the youth by creating opportunities for them[5].

In 2006, Nepal’s “READ – Rural Education and Development” bagged “Access to Learning Award” by Bell and Melinda Gates foundation for their pioneering approach to providing free public access to computers and internet to residents and for its commitment to promoting information and literacy.  They also established rural community libraries throughout the country. They sustain via support from community businesses. Solutions such as this motivates every individual to take responsibility while nurturing the rural communities [6].

Kathmandu Institute of Applied Sciences has developed a breakthrough low cost, easy to implement smartphone microscopic method for detection of (oo)cysts in vegetables and water samples which has the potential to contribute to the minimization of food and water borne illness [7]. This smartphone microscopic They are currently working on paper microfluidics as an alternative tool for determining a wide range of target analytes including protein, that combines paper analytical platform with a do-it-yourself desktop spectrometer [8,9].

The way forward

Open Science Communities and makerspaces could contribute towards creating frugal innovation ecosystems. Media Lab Nepal, founded by Sudarshan GC (one of the authors) is leading in frugal innovation in biotechnology in Nepal. Projects and initiatives by Media Lab Nepal like recycling of cigarette butts, or affordable braille readers, have not only motivated but also provided a platform to young students to participate in frugal innovation to reshape biotechnology and medical sciences in Nepal. Media Lab Nepal has been organizing virtual seminars even during this pandemic to feed the young, inquisitive brains in Nepal, our future [10].

Growing interest in frugal, open source, wearable technology can also greatly impact the healthcare sector. Wearables are taking the burden off of the hospitals in regards to long term monitoring of patients. Also, with the geographical limitations to large populations living in remote areas, wearables serve as alternative solutions. As they are easily scalable, are multi-functional, produce large quantities of high quality data, and can be made easily accessible everywhere, they are potentially the future of healthcare. Low cost heart rate sensors can provide effective means to control cardio-vascular diseases, one of the leading causes of death in the world [11]. Growing research and innovations in wearable technology combined with AI will eventually translate into highly reliable smartphone based diagnostics like hand held echography tools]. Wearable bra systems are another example of which has the potential to aid in early diagnosis of cancer and improve standard of living [12].

Food for thought

With easy access to the internet, and open source knowledge, each of us has the power to make an impact, to change lives, for ourselves and others for the better. Today, an “Idea is all we need” are not just words but new beginnings. There are lots of investors, organizations waiting for a good idea to spend money on. These success stories send forth an important message to all the under-developed and developing countries – “Think frugal, think smart, money will pour in.

A apt conclusion that accurately captures the essence of our writing – ‘Necessity is the mother of all invention, but inventions are best when suited for those that need it”, by Plato (but a little twisted by us :P).

References :

1. M. McClellan, K. Udayakumar, A. Thoumi et al., “Improving Care and Lowering Costs: Evidence and Lessons from a Global Analysis of Accountable Care Reforms,” Health Affairs, Nov. 2017 36(11)1920–27.
2. Velagapudi, R., 2016. How Frugal Innovation Is Revolutionizing Medical Technology. [online] Cyient.com.
3. UNESCO. 2019. Bonita, A Young Change-Maker Inspires Girls And Women In Nepal Through Education. [online]
4. Shrestha, B., 2020. National Innovation Centre Develops Aerosol Box For Protection Of Health Workers. [online] GorakhaPatra.
5. Thapa, J., 2020. Nyano Nani. [online] NIC Nepal.
6. Gatesfoundation.org. Press Release. Nepal Organization Receives International Award For Development Of Rural Community Library System Providing Free Access To Information Technology. [online]
7. Shrestha, R., Duwal, R., Wagle, S., Pokhrel, S., Giri, B., & Neupane, B. B. (2020). A smartphone microscope method for simultaneous detection of (oo) cyst of Cryptosporodium and Giardia. bioRxiv
8. Pokhrel, P., Jha, S., & Giri, B. (2020). Selection of appropriate protein assay method for a paper microfluidics platform. Practical Laboratory Medicine, e00166
9. Fuyal, M., & Giri, B. (2020). A Combined System of Paper Device and Portable Spectrometer for the Detection of Pesticide Residues. FOOD ANALYTICAL METHODS.
10. http://medialabnepal.com/innovations.php