The HEBI Incubator

The HEmel Baby Incubator (HEBI) was developed by Dutch gynecologist Dr. Oscar van Hemel while working in Africa.  The first HEBI incubator was built in Uganda in 1986.  The HEBI Foundation, a project of Kiwanis Club Rotterdam, now builds and ships HEBI incubators throughout the developing world.  It is estimated that there are currently over 1,400 HEBI incubators now in use.  This incubator is inexpensive, easy to assemble, easy to repair, and effective in third world settings.

BKIF Incubator Specs

The BKIF Incubator Project is basically a 30” x 14” x 20“ box of ¾” constructed of polyurethane and Plexiglas.  The lower compartment houses a heater of three 75 watt light bulbs.  The (upper) infant chamber contains a thermometer and thermostat, and has a top and front of ¼“ clear plastic with two access hand-holes in the front panel.  Heat from the lamps flows up into the infant chamber and exits from the top rear, where the thermostat is located for temperature control.

Inspiration Behind the BKIF Project

Inspired by the HEBI and by the need for more incubators, the Baltimore Kiwanis Incubator Foundation (BKIF) was formed to produce incubators for the Caribbean basin, and Central and South America.  While Haiti has been a prime example of need since the 2010 earthquake, many other islands and the continent have regions of severe poverty where infants are not receiving basic care needed for survival.  The initial rational for the project was that the need is far greater than HEBI could possibly fill; thus, Baltimore-based units would cost less to deliver in the western hemisphere.  This was enhanced by the recognition that an American-made polyurethane composite, developed for the marine industry, offered numerous advantages over the HEBI units constructed of plywood.  These improvements include mold, moisture, and fire resistance, as well as no formaldehyde out-gassing.  Another major advantage of this material is that it is over 60% lighter than the plywood used in the HEBI units, thus allowing lower delivery cost and increased convenience.  Additional improvements include an UV lamp to treat jaundice, as well as initial kidney treatment for all infants.  The team identified an inexpensive LED array “grow-lamp” which has adequate intensity blue-green light with a wavelength in the range of 460-490 nm, the most effective range for phototherapy.  Initial life testing extended for more than a year with 100,000 on/off cycles, far exceeding normal UV lamp usage.

Inasmuch as shipping material to Europe for manufacture and then returning completed incubators back to the Western Hemisphere is needlessly expensive and cumbersome at best, BKIF determined that the units could be manufactured locally to be sent to the Caribbean and Central and South America.

Our NICU adviser, Fernando V. Mena, MD FAAP, Chief of Neonatology at MedStar Franklin Square Medical Center in Baltimore, recommended eliminating the HEBI humidity control, permitting a major design change and other improvements, including an anti-jaundice LED lamp, while retaining cost goals.  BKIF has completed pilot production and now has incubators available for field evaluation.  The BKIF is currently funded, having received a very generous donation to continue fabricating and distributing a low-cost infant incubator designed for premature infants in third world countries.

Azadeh Farzin, MD MHS, a neonatologist at Johns Hopkins, has also provided very helpful advice and suggestions, and worked with us to develop a pilot program for field testing these units in Sylhet, Bangladesh.  However, the BKIF Board determined that field testing in Bangladesh would not be cost effective, and instead wishes to concentrate primarily on areas in the Caribbean and Central and South America.


Summary

  1. HEBI incubators are fabricated and shipped from Rotterdam/Amsterdam They are shipped without lamps, sockets, wiring, fasteners, and varnish, which are to be found & installed/applied locally.  An optional UV lamp is available
  2. Complete BKIF incubators cost $325, plus shipping. Due to lighter weight & more compact size, they may be taken aboard aircraft as airline baggage. An optional UV lamp to treat jaundice is an additional $50.  A 500 watt inverter for battery operation is about $50.  Purchase and delivery of a complete BKIF incubator, with UV lamp and inverter, is approximately $550.  Purchase and delivery of a HEBI incubator with UV lamp could cost upwards of $800-$900.  Additional materials for the HEBI unit would still need to be obtained locally.
  3. BKIF Incubator enhancements include polyurethane composite, mold, moisture, & fire resistance, no formaldehyde out-gassing, and lower delivery cost.  The units are designed to incorporate a bubble CPAP if needed.
  4. BKIF units use incandescent light bulbs.  BKIF has inventory of 240 long life (5000 hour) bulbs, enough to supply 60 incubators, each with spare, & BKIF is able to obtain more.  However, energy efficient light bulbs are now being manufactured which produce same light intensity as 100 watt bulb while drawing only 74 watts.  These are now widely sold throughout the USA & satisfy new regulations.
  5. BKIF has ample funding to continue fabricating & distributing low-cost infant incubators for use in 3rd world countries.
  6. BKIF needs assistance in identifying specific areas in need throughout the Caribbean & Central & South America, and to identify partners who are able help facilitate delivery of these incubators to those areas.
  7. BKIF currently investigating the possibility of working with international shipping concerns (e.g. DHL, FedEx, etc) to further minimize shipping costs.
  8. BKIF seeks guidance on whether complete incubators used outside of the USA would be subject to review & certification as medical equipment, and, if so, how to obtain such certification.