BiBEAT Limited - Appropriate Technology for People

Healthcare is dependent on expensive modern technology but is associated with extreme deprivation of a vast majority of global population in low resource countries. The remedy is indigenous design, development and marketing of appropriate technology-based essential healthcare devices. With this mission BiBEAT was established by people involved with Department of Biomedical Physics & Technology (BMPT), Dhaka University. BiBEAT has already marketed, in limited scale, several electro-medical devices, some of which are IT enabled and internet based. These have endured years of field use and now needs scaling up. Hospitals and clinics, particularly those in small towns and sub-urban areas in Bangladesh can procure these devices at low cost allowing the common people access to modern healthcare technology. One product is a telemedicine system package with integrated diagnostic devices, which brings consultation of city based doctors to the rural people over internet, allowing a great leap in the quality of life.

Most hospitals and clinics in small towns and sub-urban areas of Bangladesh do not have adequate working medical devices needed for improved diagnosis and therapy, not even the basic ones like ECG and X-ray machines, invented one century back. Besides, people living in rural areas do not have access to qualified doctors for consultation. About 80% of the global population living in low resource countries (LRC) like Bangladesh suffer due to such inadequacies.
For the former problem, the major contributing factor is that the medical devices are designed, developed and produced only in industrially advanced countries. Past global policies created this situation which also caused a huge technological and economic disparity. Even if procured at very high costs, such medical devices fail frequently under our weather conditions and power line abnormalities. Usually the technologies are kept secret through patenting, and spares are difficult to acquire, so these devices cannot be repaired, contributing to service stoppage, wastage of resources and e-waste.

For the second problem, the major contributing factor is the socio economic disparity within the LRCs where rural areas do not have modern amenities that towns and cities have. So qualified doctors do not want to live in rural areas.

BiBEAT’s solution is going to serve the whole population in Bangladesh, particularly benefitting those in small towns, where the hospitals do not have adequate essential healthcare equipment, and in rural areas, where there are no qualified doctors. With proliferation of our medical devices in most hospitals and clinics, the quality of healthcare will improve manifold. Our telemedicine system will bring the consultation of city dwelling doctors to the rural people. 

BiBEAT’s Founder-President has been involved with R&D in healthcare technology and technology-based entrepreneurship for about four decades in Bangladesh. He has personal experience of visiting rural areas, including community clinics and sub-urban hospitals, had intimate discussions with doctors, and reads information available in newspapers meticulously. The other members of BiBEAT, though much younger in age, went through efforts with similar purposes although for shorter periods, and this brought all of them together, sharing the same philosophy of doing something for the deprived human beings using the knowledge, skill and experience they acquired.

Medical equipment and telemedicine system distributed by BiBEAT are designed to suit local conditions and will give long uninterrupted service to the target people. 

Bi-BEAT is manufacturing and marketing (in a limited scale) some healthcare products at present, which are providing affordable healthcare to people with relevant health problems. These products are: (i) PC based 12 lead diagnostic ECG equipment with real time data transfer to doctors through internet, suitable for both stand-alone use or for telemedicine, (ii) Computerized Dynamic Pedograph and custom-made Shoe-insoles for prevention of foot ulcers and gangrenes in diabetic patients, which otherwise could result in toe or foot amputation, (iii) Electrical Iontophoresis equipment for treatment of excessive sweating of palms, soles and armpits (Hyperhidrosis), (iv) PEMF healing device for musculo-skeletal pain relief , (v) Muscle & Nerve stimulator for physiotherapy and (vi) Web-based Telemedicine system package including software and integrated online diagnostic devices (Stethoscope, ECG, etc.) for providing improved medical tele-consultation to people in rural areas of LRCs where there are no doctors (in Bangladesh 65% people live in rural areas).

BMPT and Bi-BEAT do not take patents on innovations, rather when a product technology matures, they will disseminate the technology to qualified engineers in other low resource countries so that they can make, sell, maintain and repair these devices locally. This will contribute to reduction of global disparity besides effective utilization and long workable life of these devices, reducing pollution and global e-waste. BiBEAT will continuously improve on the designs of devices and bring new devices to the market too, thus giving them a continued leadership, even without a patent.

Electronics and Information technology are at the basis of all the devices that BiBEAT is producing. They deliberately use technology that are amenable to fabrication and repair in LRCs using hand soldering tools, for which reason single layer printed circuit boards (PCB) are used, even though multilayered one are used by most major global manufacturers. BiBEAT’s designs try to incorporate, as much as possible, electronic components that are available as ‘off-the-shelf’ components. This allows easy production and repair throughout the world. BMPT is offering telemedicine services under the name, ‘Dhaka University Telemedicine Programme (DUTP)’ since 2013 and has given more than 26,000 tele-consultations so far. The technology was improved as the project went along, through regular feedback, making it a robust one and that which suits our rural people and culture. All the products are also designed to sustain the weather and power line abnormalities in Bangladesh and countries with similar conditions.

Although products similar to those of BiBEAT are available in the global market, these have serious disadvantages from the perspective of an LRC like Bangladesh. These are very expensive, do not survive long in the warm and humid weather and aberrant power supply conditions. Local repair is difficult, sometimes impossible because of the use of custom-made electronic components that are not available locally and needs procurement from the manufacturer at a great cost. Also modern production techniques involving multi-layered printed circuit boards (PCB) and surface mount ICs make it almost impossible to repair in LRCs. Besides, most technology and embedded programs (in microcontrollers) are kept secret.

BiBEAT addresses the technical problems through appropriate innovative designs that sustain the local weather and power line conditions, use ‘off-the-shelf’ electronic components, as much as possible, allowing easy production and repair in the LRCs. Single layer printed circuit boards (PCB) and dual-in-line packaged ICs are used for the same reason. This allows easy production and repair throughout the world. Besides, BiBEAT’s policy of not patenting and giving out technical details to qualified personnel in other LRCs solves the other problems (opening the full technology for public has the danger of being copied by less qualified technicians, which could be hazardous to the users of medical devices). The telemedicine software was designed and developed keeping in view the attitudes, behaviours, language and culture of the local people in the villages. Therefore, our solutions are innovative.

As mentioned before, medical devices made by BiBEAT are working satisfactorily for many years in Bangladesh and a few neighbouring countries. The cost was low compared to that of the imported ones and the users also got a guarantee of local repair over the full usable life of the devices (some medical devices made be BiBEAT’s senior members are still in use in Bangladesh for almost two decades). For those in the neighbouring countries, we taught their personnel how to repair if something goes wrong. There were no Pedographs in the countries before where BiBEAT installed theirs.

BMPT’s telemedicine service through DUTP, using technology which BiBEAT is going to market, has already given more than 26,000 tele-consultations of doctors to rural patients in Bangladesh over about 7 years. Therefore, we are fairly confident on the success of this technology.

‘Giving a fish to a man feeds him for a day, but teaching him how to fish feeds him for a lifetime’ is an ancient saying and Bi-BEAT’s plan to proactively teach the technology to qualified engineers in low resource countries is going to make a huge impact globally. This will also instill self-confidence, which will open a gateway to unthinkable appropriate innovations. This will create an eco-system and an improvement in the global quality of life which the present-day economic theories and practices of the industrialised countries have failed to achieve. Thus Bi-BEAT’s efforts will help contribute to the achievement of a primary SDG, improved healthcare and well-being for all.

The estimates depend on receiving the grant applied for. Two items (Iontophoresis equipment and PEMF device) are mostly sold directly to individual patients who are the clients. However, some of these will be sold to hospitals and clinics providing benefit to a larger number of people. These and other devices are sold to hospitals, clinics or telemedicine service providers as appropriate who are considered as clients in the following list. In the latter cases, the actual number of people who will benefit from these devices will be huge. Besides, we expect to spread out to other LRCs in the next five years, so the number of people benefited will be even more.

The following estimates are given considering only direct clients who are using devices procured from us. For telemedicine system, users will be service providers from DUTP, NGOs, Govt and Semi-Govt organisations.

1. the current number of clients (since beginning): 3,000

2. the number of clients in next one year: 3,000

3. the number of clients in next five years: 40,000

The following estimates are the number of people who will be benefited from the above devices per year after five years, mostly installed in hospitals and clinics, and the telemedicine system (being used by DUTP, NGOs, Govt and Semi-Govt organisations).

1. the current number of people we are  serving (since beginning): 30,000

2. the number we will be serving in next one year: 100,000 

3. the number we will be serving in the next five years: 50,000,000 

Possible impact of each individual device/system are presented individually below, assuming the proposed grant to be available. Each product sold and installed in a hospital or a clinic will give service to many people. The estimates below are based on this service. 

(arrangement in sequence:  

product name: no of units sold next year; sold within next five years; number of people served per year after five years)

• PC base ECG: 100; 500; 1.5 million
• Dynamic Pedograph: 5; 100; 0.5 million
• Iontophoresis equipment: 500; 10,000; 1 million 
• PEMF healing device: 1500; 25,000; 3 million 
• Muscle & Nerve Stimulator: 150; 3,000; 5 million
• Telemedicine system: 3 packages for 300 rural centres; 30 packages for 3000 rural centres; 10 million

 Within Bangladesh we will make the manufacture and sale of the devices and packages. However, people will get the benefits of the telemedicine system through NGO, Govt & Semi-Govt service providers who will procure the packages from us.  We hope the items will go beyond the boundaries of Bangladesh within the next five years and the services provided may be even greater then.

The barriers are mainly financial.

We registered our company as a ‘Company limited by Guarantee’ where there are no shareholders. The subscribers have limited guarantees in case the company breaks down. Therefore, no local banks, or the recently established local venture capital firms are willing to give loans to BiBEAT Limited. We deliberately registered the company this way looking over the horizon in space and time, and would wait till we can make a breakthrough, either through philanthropic support, or through our slow but steady marketing efforts.

 We have the necessary technological and entrepreneurial expertise. However, due to financial constraints we could not appoint separate manpower for marketing and also could not advertise in the media adequately. The premises that we have now is adequate for the current sale volume. However, for expanding the business we need to move to a larger premises and open up a few shopfronts in Bangladesh, again fund shortage is the barrier.

 Other small barriers are giving a finished outlook to some of the products. At present the sales volume is small, so it is not worth making dies for plastic dies which are very expensive initially, and we do not have the funds. While we have overcome these problems through innovative designing so that even hand crafted casings have a reasonable outer finish, good enough for the current marketing, for some of the items that may sell in large volumes, plastic casings will be better, and will also lower the costs.

It is only availability of funds that can remove all barriers. If we can get the funds proposed through this grant scheme of Tiger-IT, we are confident that we will be able to achieve the targets mentioned above for the next five years. The following discusses the steps specifically, for expansion in Bangladesh.
(i)                Move the manufacturing unit to a larger premises (on monthly rental), recruit and train adequate manpower based on a step by step plan.
(ii)              Set up shopfronts in a few major cities (on monthly rental), recruit and train manpower, decorate and equip these shopfronts.
(iii)             Recruit and train marketing manpower to cover the whole country, in phases. They will cover the aspects of personal marketing.
(iv)             Engage dealers all over the country through advertisements.
(v)              Engage professional advertisement makers to prepare materials for advertisement – all media (print, electronic, social) and give regular advertisements.
(vi)             Recruit more R&D staff as activity grows. Improve the existing products and select new viable products for R&D.
(vii)            Keep on expanding business, purchase property in the company’s name, expanding out to countries in South Asia and Africa having similar socio-economic conditions.

We subcontract most of the manufacturing jobs (making PCBs, metallic or plastic casings, packages, etc.) to other firms in the city, and carry out the final assembly at our premises which include stuffing and hand soldering of electronic components, testing and quality control. This way, we can minimize manpower and thus save a lot of efforts and time. Most of our R&D staff are concurrently working for BiBEAT Ltd., Relevant Science & Technology Institute (RSTI) and BMPT (of Dhaka University). The numbers are:     

Full-time staff:         06

Part-time staff:        06

Full time Factory Worker (technicians): 03

Subcontracted firms: 03

The leader of this project, Dr. K Siddique-e Rabbani with Ph.D. in Electronics, has been working on technological solutions for the common people in Bangladesh since 1978, a major focus being on electro-medical devices. Armed with knowledge of microelectronics, electronics, computer interfacing and software, he could guide young students in designing of electro-medical devices in Bangladesh, with all necessary quality and safety features. He also took to entrepreneurship together with ex-students, which led to a remarkable success. His efforts attracted young and talented team members of BiBEAT who share the same philosophy and passion of doing something useful for the deprived humankind in the LRCs. This combination of the old and the new have given BiBEAT a unique strength, available to very few other groups in Bangladesh or other LRCs and we feel our team is best placed to deliver the proposed solution. Other team members include,

Mr. Abdulla Mahbub, M.Sc. (Mathematics), 8 years, Management, Sales, Finance.

Kamrul Hussain, B.Sc. (EEE), 7 years, Analogue-digital electronics design, IOT, Embedded systems, electro-medical product design.

A K M Bodiuzzaman, B.Sc. (EEE), 7 years, Analogue-digital electronics design, electro-medical product design, promotion of products.

Dr. Zihad Tarfader, B.Sc (Mech Eng), 7 years, Telemedicine Software.

Al Amin, B.Sc. (EEE), 4 years, Electronic & mechanical design, Embedded systems.

Md. Wadud Rahman, B.Sc. (ICE), 1 year, Robotics, IoT, Machine Learning.

Others with varied experience and expertise in signal processing, software, embedded systems are also involved part time. 

Bi-BEAT Ltd is partnering with Department of Biomedical Physics & Technology (BMPT) of Dhaka University and ‘Relevant Science & Technology Institute (RSTI)’, an organ of ‘Relevant Science & Technology Society, Bangladesh (RSTS)’. All these organisations were initiated by the project leader and shares a common philosophy of not patenting their innovations. This philosophy stemmed from the observation that majority of the global population remians deprived of the benefits of modern technology.  Commercially viable products coming out of R&D at BMPT and RSTI are taken up by BiBEAT for manufacture and distribution. BiBEAT and RSTI share a common premises, combining their R&D work appropriately. Both BMPT and RSTI also oversees and ensures that the products made by BiBEAT satisfy international quality and safety standards.

Highly educated scientists and engineers of the LRCs hardly contribute to the development of their individual people. They mostly go abroad or carry out research with the sole purpose of publishing papers in journals. An eco-system has been created through BMPT, RSTI and BiBEAT, a model that can be followed in other LRCs in order to utilize their highly educated manpower to solve problems of the deprived humankind of the globe.

All products of BiBEAT are for improving health of people, using modern technology. These products have the potential to save lives or prevent permanent disability, whether in cities or in rural areas, the latter being deprived much because of existing socio-economic factors. Bangladesh has a population of 167 million but there are no local manufacturers of similar products. Competitive imported items are very expensive and cannot survive for long under our weather and power line abnormalities, and it is virtually impossible to get these repaired in most cases. Bi-BEAT gives two-year warranty on its products, and a low cost repair beyond that period. The sales will be a mix through dealers, direct to hospitals and clinics and direct to patients for specific items. Sale of telemedicine system will be to NGOs, Government agencies and large hospitals.

Essentially there is no competition, but the challenge is in getting people’s trust in local products. Given the proposed funds, we can bring this trust within a short time. In future, marketing will be tried in other low resource countries with a very large target market. BiBEAT is a social enterprise, nobody can take shares of the profit. The income generated will be reinvested to expand the business, and later, surplus funds will be channeled to RSTI and BMPT to support their R&D. Thus the triangular eco-system is poised to become self-sustainable in the long term, a model that can be breakthrough if replicated in other LRCs. 

BiBEAT started with small donations by its members themselves, in terms of cash or expert time investment. The income generated from sales gradually tried to cover the expenses. There was a small startup grant from the Government (USD 11,821) which was helpful. The revenue (including income from grant) and expenses of Bi-BEAT from its inception (in 2013) to the last monetary year 2018-2019 were USD 71,862 and USD 65,568 respectively. It is clear that BiBEAT had made a small amount of profit in spite of the financial difficulty in the initial period.

If awarded the international winning amount of USD 2 million under the challenge fund, BiBEAT expects to generate a sales revenue of about USD15 million within the next 5 years, of which the net margin would be about 50% of the above, i.e., about US$ 7.5 million. This amount would be enough to take BiBEAT’s activity forward as well as to support R&D at RSTI and BMPT.

We are applying to the Tiger Challenge mainly for initial financial support that will hopefully make a breakthrough in the activities of BiBEAT. It is ready with several products, has made low level marketing efforts that has also given the opportunity to improve the products and to attain confidence in the quality, performance and acceptability of the products. Although BiBEAT will hire people with marketing expertise, but we expect marketing support through Tiger IT in order to take BiBEAT’s products to other LRCs of the world.

Bi-BEAT already has partnerships with RSTI, and BMPT of Dhaka University. It would like to partner with similar research and academic institutions in the low resource countries, particularly in South Asia and Africa and would like to propagate the triangular model of our proposed eco-system. It would also like to partner with R&D institutions in the advanced countries for further addition and improvement of technology provided they agree to our philosophy of not patenting of the product innovations.