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Innovators aim to save lives during childbirth

A nurse in a remote Andes community performs a prenatal ultrasound using a remote-presence device invented by Ivar Mendez.

International donors are banking on innovation to save millions of mothers and children who die annually during or within the first 48 hours of childbirth.

Two Canadian researchers are among 65 front runners for funding in the Saving Lives at Birth challenge, sparked by the Bill & Melinda Gates Foundation, Grand Challenges Canada, and the governments of the United States, the United Kingdom and Norway.

At stake are as many as 30 grants for ideas to improve childbirth outcomes in poor, hard-to-reach communities. The winners will be announced on Saturday evening in Seattle.

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Christy Gombay and Ivar Mendez told The Globe about their work.

The problem: Mothers in poor, rural communities cannot access doctors or prenatal care.

Prenatal assessments are crucial for discovering health issues that can complicate pregnancies. In many communities, midwives lack information about their patients, often as basic as whether mothers are carrying more than one child.

"About a thousand mothers die every day from totally preventable causes and 100 per cent of these mothers are in the developing world," Dr. Mendez said.

The innovation: Deliver doctors to patients via remote presence technology.

Dr. Mendez has led development work on a solar-powered device that enables obstetricians to see patients via audio and video conferencing. It allows doctor to guide local health workers as they feed stethoscope and ultrasound readings into the device.

"An obstetrician in Canada, for example, can be listening to the heart of a baby in the middle of the Bolivian Andes," Dr. Mendez said.

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The technology relies on cell signals, but Dr. Mendez said they are common even in rural communities that lack electricity, running water, nurses or doctors

"We'll be able, for the first time, to provide these women with access to something that is taken for granted in the developed world," he said.

Dr. Mendez said his true innovation is pairing the technology to the expertise of midwives.

"It is actually leveraging their skills to allow them to save lives using a device," he said.

"The true innovation is the marrying of this technology with the local expertise - with the local midwifes," said Dr. Mendez. "It is actually leveraging their skills to allow them to save lives using a device."

The problem: Local health workers need help with complicated deliveries.

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Over the past decade, Dr. Gombay and the Tula Foundation have trained 1,000 indigenous youth in rural Guatemala as part-time health workers. Most split their time between farm work and health care, and they typically work without assistance, even during difficult pregnancies.

"They are the doctors in their communities," said Dr. Gombay. "That's just the reality."

The innovation: Mobile phones to improve maternal and infant care.

Dr. Gombay helped develop a project that put Nokia cellphones with medical monitoring programs into the hands of rural health workers to log information about patients.

"It sets up a tracking system for people that they visit so that we can know if there are people in those communities who are really in trouble or not - who need to be monitored more closely," Dr. Gombay said.

The idea came during one of the foundation's three-day training sessions.

"(Students) were all coming out of classes and flipping out their cell phones," said Dr. Gombay. "We though maybe we should try and support them when they're actually in their communities."

Dr. Gombay is seeking funding to help extend the pilot project, which began in 2007, to more Guatemalan provinces.

"Our litmus test for innovation is: If it works and people in communities there are using it ... we keep on going," he said.

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