ICoRD'13 pp 679-690 | Cite as

Participatory Design for Surgical Innovation in the Developing World

  • Florin Gheorghe
  • H. F. Machiel Van der Loos
Conference paper
Part of the Lecture Notes in Mechanical Engineering book series (LNME)


The field of surgery is very much a technology-mediated practice. Unfortunately, locally appropriate medical equipment is largely unavailable, or in the case of Western donated devices, is non-functional in much of the developing world. This paper presents two critical challenges that face medical device manufacturers and designers looking to innovate in international surgery, and proposes a methodology to address these concerns. First, designers approach the process with a set of embedded assumptions and biases that are rooted in their experience of traditional markets, thus delimiting the solution space too narrowly. Second, designers working cross-culturally with expert users face numerous difficulties in understanding the problem space. Through a reflective process within both a Canadian and Ugandan context, this study proposes that the assumptions Western designers hold can be challenged to co-create and uncover innovative technology solutions in international surgery.


Medical device Design Emerging markets International surgery 



The authors would like to thank the Engineers in Scrubs program, as well as the Branch for International Surgery at the University of British Columbia for their generous support of this study.


  1. 1.
    Mock CN, Jurkovich GJ, nii-Amon-Kotei D et al (1998) Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma 44(5):804–814CrossRefGoogle Scholar
  2. 2.
    World Health Organization (2004) The global burden of disease: 2004 updateGoogle Scholar
  3. 3.
    Mathers CD, Loncar D (2006) Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3(11):e442CrossRefGoogle Scholar
  4. 4.
    Malkin RA (2007) Design of health care technologies for the developing world. Annu Rev Biomed Eng 9:567–87Google Scholar
  5. 5.
    World Health Organization (2010) Medical devices: managing the mismatchGoogle Scholar
  6. 6.
    Prahalad CK (2003) The fortune at the bottom of the pyramid: eradicating poverty through profit. Wharton School Publishing, Upper Saddle RiverGoogle Scholar
  7. 7.
    Holtzman Y (2012) The U.S. medical device industry in 2012: challenges at home and abroad. Med Device Diagn Ind 17,
  8. 8.
    Das R (2012) Asia pacific healthcare outlook 2012–2015. Frost & Sullivan, USAGoogle Scholar
  9. 9.
    CIA, CIA World Factbook (2012)
  10. 10.
    GE Healthymagination (2010) 2010 Annual report,
  11. 11.
    Johnson & Johnson (2011) 2011 Annual report,
  12. 12.
    Covidien (2012) Covidien opens US$45 million R&D facility in China,
  13. 13.
    Deloitte (2012) Securing the next level of growth: second tier emerging markets,
  14. 14.
    Duflo E, Banerjee AV (2011) Poor economics: a radical rethinking of the way to fight global poverty. Public Affairs, New YorkGoogle Scholar
  15. 15.
    Zenios S, Makower J, Yock P (2009) Biodesign: the process of innovating medical technologies. Cambridge University Press, CambridgeGoogle Scholar
  16. 16.
    Pietzsch JB (2009) Stage-gate process for the development of medical devices. J Med Devices 3:021004CrossRefGoogle Scholar
  17. 17.
    Von Hippel E (2005) Democratizing innovation. MIT Press, MassachusettsGoogle Scholar
  18. 18.
    Suri JF (2005) Thoughtless acts?. Chronicle Books, San FranciscoGoogle Scholar
  19. 19.
    Brown DS, Motte S (1998) Device design methodology for trauma applications. Proc Comput Hum Inter (CHI), pp 590–594Google Scholar
  20. 20.
    Dudley E (1993) The critical villager: beyond community participation. Routledge, LondonCrossRefGoogle Scholar
  21. 21.
    Adams JL (2001) Conceptual blockbusting: a guide to better ideas. Perseus Publishing, CambridgeGoogle Scholar
  22. 22.
    Stefik M, Stefik B (2005) The prepared mind versus the beginner’s mind. Design Management Review, Winter, pp 10–16Google Scholar
  23. 23.
    Sehgal V, Dehoff K, Panneer G (2010) The importance of frugal engineering. Strategy + Business 59Google Scholar
  24. 24.
    Glaser BG, Strauss AL (1967) The discovery of grounded theory: strategies for qualitative research. Transaction Publishers, New JerseyGoogle Scholar
  25. 25.
    Gaver B, Dunne T, Pacenti E (1999) Design: cultural probes. Interactions 6(1):21–29CrossRefGoogle Scholar
  26. 26.
    Currano RM, Steinert M, Leifer L (2011) Characterizing reflective practice in design: what about those ideas you get in the shower. Int Conf Eng Des (ICED11)Google Scholar
  27. 27.
    Ulwick AW (2002) Turn customer input into innovation. Harvard Business Rev 80(1):91–97Google Scholar
  28. 28.
    Sekimpi P, Okike K, Zirkle L, Jawa A (2011) Femoral fracture fixation in developing countries: an evaluation of the SIGN intramedullary nail. J Bone Joint Surg 93(19):1811–1818CrossRefGoogle Scholar

Copyright information

© Springer India 2013

Authors and Affiliations

  • Florin Gheorghe
    • 1
  • H. F. Machiel Van der Loos
    • 1
  1. 1.Department of Mechanical EngineeringUniversity of British ColumbiaVancouverCanada

Personalised recommendations