"Growth has helped millions to avoid malnutrition but it still threatens to hold back a generation of rural Chinese."

A recent article in The Economist about malnutrition in rural China cites REAP's research on anemia.

“The propaganda message, scrawled in white paint on the side of a wood-frame house, could hardly be more blunt: ‘Cure stupidity, cure poverty’. The cure for both, in one of China’s poorest counties, seems to be a daily nutritional supplement for children. At a pre-school centre in Songjia, as in more than 600 other poor villages across China, children aged three to six gather to get the stuff with their lunch. If China is to narrow its urban-rural divide, thousands more villages will need to do this much, or more....

"'Babies are probably 50% malnourished' in poor rural areas, says Scott Rozelle, co-director of the Rural Education Action Programme (REAP), a research outfit at Stanford University which has done extensive tests on anaemia in rural China. 'But almost no mums are malnourished.' Mr Rozelle says that in one of his surveys rural mothers showed a better understanding of how to feed pigs than babies: 71% said pigs need micronutrients, whereas only 20% said babies need them."

Read more here.

REAP's Gansu eyeglasses project was featured on CNN's Global Public Square, a program that invites international thinkers and leading journalists to discuss global issues .

When asked about his theory to "think small," Stephen Dubner, the co-author of "Think Like a Freak," said, "We write about these economists who wanted to help education like a lot of people do, and they were in China doing some research and they noticed something very small, which was that if you look at a class picture of these kids in Gang Su province in China, which is rural and poor generally, none of the kids were wearing glasses. And they thought well, that's either because they need them and they don't have them or there, you know, there's no myopia here. And so they did some tests and they found there was plenty of myopia, plenty of kids needed them, but they didn't have them.

"So, they thought let's run an experiment. Just take something as simple as providing free glasses. Half the kids they gave them to, the other half they left as a control group, they left them as is. And after one year, the kids who got the glasses were basically a full grade ahead. Does that solve the education problem? Of course not. But it's an example of how whoever is out there hearing this, whatever realm they're working on, if you peel off a small piece where you can actually get data, figure out what's going on, you can make some progress. I would rather have 100 smart people working on small versions of one big problem than 100 people shouting at each other about the big problem and getting nowhere."

Watch the full clip here.

Robert Chang, Assistant Professor of Ophthalmology at Stanford University Medical Center and SCPKU Faculty Fellow, gave a public talk at the center earlier this month focused on mobile healthcare innovation and the growing adoption of smartphones as medical devices.

Life expectancy worldwide made huge gains in the last century alone which has created an increasingly heavier burden on our health systems.  The world has seen a rise in age-related chronic illnesses, unique challenges for less developed nations, an increased need for specialized health care workers, and alarming health care cost increases.  These challenges have created opportunities which have spurred innovation in mobile healthcare solutions and the use of smartphones as medical devices to improve the delivery and cost of healthcare.

Chang highlighted Apple’s plans to penetrate the mobile healthcare market including rumors that the company will be releasing a new “iWatch” in October.  At its Worldwide Developer Conference in early June, the company also announced a new iOS 8-based health app and HealthKit framework for tracking personal health and fitness data.  Chang believes these represent important steps in digital health, signaling strong interest in major high-tech players to develop digital healthcare “hubs” and solutions for effective disease monitoring and management.

The current trend within the healthcare technology space is the general population’s use of smartphone sensors to self-track health and fitness data including heart rate, sleeping patterns, activity level and calorie consumption.  Over time, Chang sees the industry moving towards more wearable devices that are more fashionable, invisible and intuitive. 

Within the field of ophthalmology, eye disease diagnoses have typically been done with expensive, bulky equipment.  This limits the ability to deliver effective and efficient eye care in remote patient situations and/or where eye specialists aren’t readily available.  Ophthalmology is well-suited for telehealth and the use of mobile devices to facilitate remote triage. As mobile medical devices, smartphones are ideal given their broad market adoption and processing power and the ubiquity of the Internet.  Currently,  however, cost-effective adapters are needed to accompany a smartphone solution as the smartphone alone is insufficient to capture enough detail inside the eye for effective diagnoses.  As an ophthalmologist with a special interest in healthcare startups, Chang is working with a Stanford-based team to develop the EyeGo, a custom iPhone attachment and adapter coupled with a HIPAA-secure app to facilitate taking pictures of both the front and back of the eye to support remote triage and more efficient physician to physician communication.  While his initial platform is iPhone-based due to the phone’s ubiquity in the Silicon Valley, he eventually plans to port his solution to an open systems platform.

Chang closed his talk by re-emphasizing his point about wearable mobile healthcare becoming more invisible and intuitive.  “The lines are blurring between man and machine,” he said. He cited the “Turing Test,” an experiment developed by famed mathematician Alan Turing to create an artificial intelligence (AI) design standard for the tech industry.  “Can you design an AI where the AI can talk to a person but you can’t tell the difference between the computer and the human?” he challenged.  In order to pass the test, one must fool at least 33% of the judgment panel into thinking the AI is the real person.  Chang believes that mobile health technology can be successfully integrated into the medical field and that we will get to the point where people are completely comfortable interacting with the technology   “This is the next level in the wearable healthcare revolution  -- it will be like you’re talking to your doctor and you won’t be able to tell the difference,” he said.

Chang is a clinician-scientist with an active surgical practice and an interest in early stage medical device development and healthcare IT startups. He has received numerous grants and fellowships In recognition of his focus on patient care, physician innovation, biodesign, and design thinking.  Chang’s clinical research revolves around understanding the association between myopia and glaucoma.