Two women researchers on MIT’s India TR35 list for their work in Bangalore

Two women researchers -- Aishwarya Lakshmi Ratan and Alefia Merchant – are part of Massachusetts Institute of Technology’s (MIT) prestigious ‘ India Technology Review 35’ list for 2011 for their innovative work in Bangalore.

Bangalore-based Microsoft Researcher Aishwarya Lakshmi Ratan came up with a low-cost digital system which lets the users have the convenience of using a normal pen and a plain paper to record data and instantly store it in the digital form.

Alefia Merchant developed a novel method of screening for eye disease in children under the age of five is the second women on this year’s list. The wide ranging benefits Alefia’s work in prevention of blindness among young children in the developing countries made the MIT’s Technology Review brought out in India in association with CyberMedia to name her the Humanitarian of the year.

Merchant’s method exploits existing, low-cost, and readily-available digital camera technology to photograph a child’s eye for signs of vision-threatening disease as an alternative to standard medical technology in current use.

Merchant, 32, developed the method during 2009-2010 as part of her community pediatric ophthalmology project at the Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bangalore. Merchant was the co-investigator of the project along with Ashwin Mallipatna, a consultant pediatric eye surgeon at Narayana Nethralaya.

Aishwarya and Merchant are among the 18 young innovators, all under age 35, who have been chosen by a Technology Review India as part of the TR35.

“These award-winning young innovators exemplify innovation in business and technology. Each year, the editors of Technology Review honour the TR35, a set of young innovators whose inventions and research they find most exciting Their work—spanning medicine, computing, communications, electronics, nanotechnology, and more—is changing our world,” says Narayanan Suresh, Editor of Technology Review india who led the TR35 initiative in India for the second year in a row.

The India TR 35 honorees will describe their revolutionary and inspiring work at the 3^rd emerging technologies conference—EmTech India—to be held at Bangalore on March 22 and 23. The EmTech conference will feature eminent professors and researchers from Massachusetts Institute of Technology and Harvard Medical School and several scientists from India.

Aishwarya’s solution has been piloted with self help groups (SHGs) who microfinance and maintain records of each person’s savings and loans. Conventionally, the data was recorded at a site on papers and it was later converted into digital data.

Aishwarya’s team built a financial record management application, on top of the device, that follows the structure of the paper accounting system used by the SHGs. An account writer would have to simply make entries in a smaller version of the ledger book placed on the digital slate. He would then simultaneously open the digital application on the slate, progressing from one module to the next using the back of the pen as a stylus. As entries are made, they are automatically stored in their respective fields in the database. At the end, a voice-over in the local language is played back to validate the data. Once the errors are reconciled, the data gets validated and saved.

Immediate digitization of data allows for easy aggregation, storage, and manipulation and digital devices allow real-time prompts and checks to ensure that data entered is accurate and complete. However, technologies that exist today either require users to use a digital pen and a digital slate, which are not very user-friendly, or they require users to digress totally from pen and paper to a personal digital assistant or a computer-based interaction.

All of these technologies are expensive as compared to a pen and paper medium. And therefore, such technologies have not taken off in countries like India where the masses are still comfortable using pen and paper to write in their regional languages.

An estimated 1.4 million children in the world are blind and 90 percent of them are found in developing countries. In India, these children often face a lifetime of disability. Poor vision affects every aspect of their lives—economic, social, and psychological. Ultimately, it undermines their function and acceptability in their families and in society. If children with visual disabilities were detected sufficiently early, approximately 40 per cent of such cases could be prevented or treated and the remaining could be rehabilitated to minimize the child’s handicap, says Technology Review India about Alefia’s project.

In India, there are many hurdles in detecting, diagnosing, and treating such children. There is no organized screening program focused on identifying children under the age of five for sight-threatening eye conditions. The World Health Organization reports the lack of adequate community-based, primary-care screening programs as an important barrier to improvements in current morbidity and mortality rates due to eye-related diseases.

A red-reflex examination works on the principle that light entering the eye is reflected off the back of the eye (the retina). This reflected light (or red reflex) is visible to the examiner when a specialized instrument called a direct ophthalmoscope is used. However, the standard red-reflex test requires expertise and equipment which is not commonly available in India.

To obtain a red reflex, all layers of the eye through which light passes must be transparent and the surface of the retina must be normal. “Any significant change in the structure of the eye changes the optics of the reflected light and can alter the reflex seen in the photograph. A symmetrical, red reflex is considered normal. The loss of a reflex, a white reflex, or an asymmetry in the size or quality of the reflexes could all indicate the presence of an eye abnormality,” says Merchant.

Merhcant’s method, which she calls as Photo-Red protocol, uses a digital camera to elicit red reflexes. “The Photo-Red protocol allows one to consistently elicit a standard, clinically-relevant red reflex in children and adults using a compact digital camera. The amount of reflected light captured by the camera is controlled by two important factors: the size of the pupil and the angle at which the light enters the eye. The larger the pupil, the more light enters the eye.

Similarly, the smaller the angle of reflection, the more light reaches the camera lens. We found that photographs taken in a dark room (maximizing pupil size) at a distance of 4 meters (such that the angle of reflection is sufficiently small) reliably produced a red reflex in each photograph,” she explains.

The Photo-Red protocol can be performed by rural health workers or other laypersons in a community with little initial training. Merchant now intends to pilot and implement the new technology into programs that cater to very young children, such as immunization clinics, Anganwadi services, and other community health services.