D-Rev marries technology and design to create products for people living on less than $4 a day

“To design and deliver products that improve the health and incomes of the 4.0 billion people living on less than $4 per day”

This mission statement captures the impact that D-Rev, a 10-people non-profit based in San Francisco, wants to create across the world by combining latest cutting-edge technology with design thinking principles. Two of the recent stories that illustrate the impact created by D-Rev in emerging markets are:

The story of Dinesh, a young Indian amputee, who was fitted with D-Rev’s ReMotion Knee in March 2013

The ReMotionKnee or JaipurKnee is a high-performance, low-cost prosthetic knee joint for above-knee amputees. D-Rev designed this product from grounds up to provide an affordable solution to amputees living in developing countries. This product is made with the help from world experts and is designed for high performance, is lightweight and has a life span of 3-5 years. A ‘western’ prosthetic would cost between $5,000 and $20,000 and ICRC (the Red Cross)’s ‘low cost’ knee would cost $150. The ReMotion Knee retails for only $80.

5,122 patients are mobilized with JaipurKnee and 95% of patients report no failures in their JaipurKnee.

Brilliance is an affordable medical device for treating newborns with severe jaundice in urban and rural hospitals and clinics, a low resource setting. Brilliance was also designed from grounds up, and has received raving reviews from experts in the field. Brilliance is designed to provide world-class treatment with minimal maintenance and is energy efficient since it uses low powered LEDs. D-Rev is providing these units in collaboration with Phoenix Medical Systems Ltd, the largest manufacturer and seller of quality neonatal care equipment in India.

10,947 babies have been treated with Brilliance, so far 9230 babies have been treated who otherwise would not have received effective treatment and 224 new born deaths and disabilities were averted.

Krista Donaldson

Krista Donaldson

This amazing organization is led by Krista Donaldson, CEO of D-Rev, who has received numerous awards such as Silicon Valley ‘40 Under 40’ winner, a TEDx and Clinton Global Initiative speaker, and she was recently named as Fast Company’s Co.Design 50 Designers Shaping the Future.

YourStory caught up with Krista Donaldson as she was getting ready for her field trip to India:

What drives you and why did you join D-Rev?

Fundamentally, I believe in the power of technology and design to improve the lives of people. I’m not necessarily someone who went on a trip and then wanted to change the world, I have always been interested in creating an impact through my work. I was focused on product design during my undergrad and while working towards my PhD. I made a choice between staying in academia vs. doing what I am doing now, and decided to join D-Rev because I wanted to be involved in actually creating products, and working with people to create an impact around the world.

How did you start your career in the non-profit field? What lessons did you learn from your early experience?

I went to Vanderbilt for my undergrad and was focused on journalism and engineering. I was always fascinated by people, loved making physical products, and knowing how things worked. As a result, I took many engineering classes while I was at school. I was involved in various communities on campus, and this provided me a perfect opportunity to have an emerging experience. So when I graduated, I wanted to use my love for creating products to help communities and create impact, but at that time there was no Engineers Without Borders or any other institution like that.

I met Martin Fisher from Kickstarter in the early days. It took me one year of persistent effort to convince him that they should take interns and that’s how I started my career with Kickstarter in Kenya. Back in those days, students use to send their resume to the employers via courier services such as DHL and it was a huge expense for any student.

In technology development, you always have ups and downs but I think particularly when you’re working in some of the markets that we work in, we have added challenges. Designers are internal optimists and we think that there is a solution for every problem. You can call it either persistence or optimism, but we try to work around the problems.

We design products, but we also have to figure out supply chains, price points, what products people are currently using and how what we are designing fits into the context. I am lucky that I have the prior experience of working in Kenya with Kickstarter and working in Iraq doing reconstruction work, because I saw how the whole picture and the system is important and not just the product.

What drives and motivates you to lead D-Rev?

What drives me actually is seeing kids getting treated with Brilliance and hearing the stories of some of the amputees who have been remobilized by our JaipurKnee. One such story is of Praneema in India, who is in her teens and was fitted with JaipurKnee. She told my colleague that now she would be able to go back to school and would like to become an engineer. She had dropped out of school earlier. Stories like Praneema that empower people to pursue their dream; these are amazing and make me work harder to design the next product. This hope of creating better future for our current and next generation is what drives me.

What have you learned while leading D-Rev?

D-Rev was founded in 2007 by Paul Polak and Kurt Kuhlman. Paul is very well known for developing technology for social good. Kurt is an incredible technologist in Silicon Valley. When I came, they had created all these incredible technologies that had limited impact. So I took a major decision to refocus our efforts and cancelled most of the pilots. The primary reason was because I really felt that we needed to have fewer good ideas that reached impact as compared to having many great incredible technologies but actually NOT reaching impact. I believe that innovation is great but innovation does not create impact, impact creates impact.

Focus is very important for any non-profit. Most of the non-profits have limited resources and if you want to create a world-class impact backed by a small team like ours, you need to make hard decisions and choose where you can create impact.

What project is your team working on now?

We are focused on neonatal and mobility equipment. The primary reason is because we have built these great networks with world experts in these two areas, who are advising and helping us in building great products. We want to leverage that momentum to ship great products out. At present, we have two products: Brilliance and JaipurKnee.

We don’t know what we don’t know. As we push the projects through a few different phases, from technology development, design, and commercialization to distribution and scale, we learn a lot about doing business in developing countries. For instance, with marketing Brilliance, we are learning a lot of internal structures in trade. This knowledge will help us as we make more products and scale them up.

D-Rev has built domain expertise in neonatal and remobilization devices. What are some of the future projects that you are working on?

One thing that is primarily different about D-Rev is that we are focused on solving the problem and what is required to solve that problem. We constantly ask ourselves whether we are the right people to solve that problem. We also want to eliminate the problem completely.

As a result, we look at adjacent markets. For instance, with treating Jaundice, another area is screening of babies for Jaundice. At present, there are seven million babies per year who need Jaundice treatment. However, there are 52 million babies who need to be screened for Jaundice. So if we really want to solve the problem, we have to think about the whole ecosystem and build a solution for screening babies for Jaundice, rather than just creating one product.

Our strategic thinking is that once we are able to push out a suite of products that can seriously address these two issues, then we will add a third suite of products. I always tell people that we are a product company and not a medical device company. It just happens that two of our initial products are for the medical field.

I am a true believer in a cross pollination – lessons learned in one domain can help in other domains. As a small organization, we have to be very strategic about our resources and not spreading ourselves too thin.

What are the top three challenges you have faced at D-Rev?

I think there are many challenges that we face, primarily because we are a non-profit.

  1. Funding is a big challenge. We hope that our investors or donors would see the impact that we are creating and use that to justify the investments that they make in us.
  2. Figuring out timelines has been another big challenge because it is dependent on funding. We are not sure when the funding would come and that impacts the timeline that we want to work with.
  3. Third challenge is finding the right partners that we want to work with in the local markets. Our model is such that we try to find partners in early stages of our product development such as product design or due diligence. For instance, we licensed Brilliance to Phoenix in Chennai. Phoenix does manufacturing, distribution and sales of the Brilliance. We won’t be able to bring Brilliance to light without Phoenix. A major lesson that we learned on the way is to make sure that our partners have the same goals as us. Otherwise, it is very hard to push our partners to commit to the same deadlines that we want to achieve.

D-Rev is launching the products in very diverse markets such as Africa, India and SE Asia. What differences or similarities have you seen when you introduce the product in the local market – in terms of localization efforts or finding the right partners?

We do have some good surprises along the way. We have two medical devices which are different from a consumer product. In a consumer product, the purchaser and the user of the product are mostly the same or similar. In a medical device such as JaipurKnee, it is not the end user who actually buys the product. A prosthetic clinic would buy a knee and then decide who would be the user of the product. So the user of the product is not the one who makes the purchasing decision.

d-revHowever, prosthetic clinics around the world aren’t that different. They differ in terms of culture and motivations, but have enough similarity that we can scale the similar product across geographies.

Another major difference that we see is in Sub-Saharan Africa, which has much less capital for healthcare expenditure. We see greater foreign aid presence in Africa, which affects the market. We are a market-driven model, but if you have high amount of aid, then it skews the market. We see these parallel markets in East Africa, with private medical device market and device market driven by foreign aid. We don’t see so much foreign aid in India. So we have to make strategic decision whether we want to sell to aid-based agencies or sell it to private sector or can we do both.

Another thing we are learning is about trade policy such as importance of free trade zones and what are the requirements to take the currency outside the country. When we look at scaling, we try to understand where the greatest social needs are, but we also look at marketing conditions so that a small group like us can come in and have an impact leveraging the market.

As a non-profit, funding is a big challenge that you highlighted. Do you have any recommendations for other non-profits on how they should go about product marketing, product development and hiring talent to spend that funding effectively?

As I am running D-Rev I am learning every day. I would always recommend hiring great talent and paying them the market rate for the talent. I have been in discussions where I have to mention that we are not competing against non-profits for talent, we are competing against Medical Device companies. So it is very important for non-profits to understand where to find great talent.

There is always a tension between spending money between product development and marketing. We have not spent enough money so far on marketing. I think since I am an engineer and a designer, I wanted to focus people on developing the product. Being a great storyteller and capturing the emotions in the impact that we are creating is very important for a non-profit like us.

Do you have any message for our readers?

Be who you are. Authenticity is respected in the long haul. Everybody should have a storyteller as part of the team.

If you want to know more D-Rev’s products or donate to D-Rev, click here.


Ashish Aggarwal

Ashish Aggarwal

Ashish is passionate about making impact at a bigger scale using technology and helping people build technology driven businesses. He has been a techie, entrepreneur, and an early stage tech VC. Ashish actively advises startups globally and assist them through innovative strategy, growth planning and cost & complexity reduction. Ashish believes in process + possibility based thinking. Ashish holds MBA from Kellogg School of Management and MEM degree from McCormick School of Engineering at Northwestern University.