An asthma spacer made out of a single, folded sheet of paper.



The Challenge

Millions of children all over the world suffer from asthma. For poor children in Mexico, a severe asthma attack can mean an emergency bus ride in the middle of the night to a hospital hundreds of miles away—all while struggling to breathe. Even more sadly, many Mexican doctors don’t have the necessary equipment to get life-saving medication into the child’s lungs. For such children, a new technology is needed to help deliver the medication they need and eliminate the need for long trips to the hospital in the middle of the night.

The Insight

The Extreme Affordability team addressing this problem learned that the standard asthma inhaler cannot be used on young children because they can’t coordinate their breathing with the puff of aerosolized medicine. In developed countries, spacers exist that attach to an inhaler and capture the aerosolized medicine in a valved chamber until the child’s next breath. These devices allow young children to be treated at home, but are not common in most of the world because they are relatively expensive—in the range of $40. Many health care systems cannot absorb this cost for every asthmatic child they treat. But if this spacer could be made much cheaper—almost free—then even resource-stretched health care systems could give children the tools to be treated at home.

The Product

After three months of class work, the team came up with an elegant solution: an asthma spacer made out of a single, folded sheet of paper. The design had the basic functionality of more expensive spacers for a tiny fraction of the cost. Because paper stacks flat, these spacers can be transported to even the most remote hospitals and clinics, and sent home with any asthma patient.

What’s happening now?

Although Eric Green is a physician at Harvard and Santiago Ocejo works for a microfinance NGO in Bolivia, they have championed the idea since the class ended in June 2007. Together, with Barry Wohl, a mechanical engineer at Medtronic and Extreme Affordability classmate, they founded Respira. The Respira spacer has been further refined and its efficacy has been proven through laboratory trials. The team is currently incorporating Respira as a registered 501(c)(3) non-profit organization, preparing for clinical trials, and seeking funding to implement the idea on a large scale in Mexico and the myriad other places in the world where such technology would meet the needs of children with asthma.

Find out more about Respira at




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