April 2018 — One could say that Aungkana Saejeng got her professional start in life at a tender age in the shade of the White Elephant Gate in Thailand’s city of Chiang Mai. Here, a few steps from the 700-year-old wall protecting the country’s second city, Saejeng’s family boiled and ladeled fishball noodle soup in their small but popular Ong Tipros shop.

From her earliest days on, Saejeng’s mission was to help her family succeed. Unlike some other young girls in her neighborhood, she had a knack and a passion for all things technical. Always fiddling, she fixed broken pipes and replaced light bulbs. One day, watching her mother struggle to keep up with a long line of customers, she fashioned an improved, larger noodle strainer to speed things up.

As she continued in school, she contemplated becoming an engineer, which seemed like a natural career path. “I love finding solutions,” she said. “When I spot a problem, I can’t help but find a way to solve it.”

Like the imposing wall behind her, however, the needs of the family kept her close to home, where she, as traditionally expected of many Thai women, could care for her parents.

Her siblings suggested that she consider a career in health. She agreed, becoming a trailblazer in the field of medical technology and protecting her parents and many others over many years from disease. Luckily, she never could shake the impulse to innovate.

This region is the epicenter for the development and spread of malaria that is multidrug-resistant, including resistance to the most widely used antimalarial throughout the world — artemisinins. The spread of drug-resistant malaria to Africa and beyond would have dire consequences for the continent that is most affected by the disease and would undermine global progress to date.

There have been significant gains in Thailand's fight against the disease in recent years, however. Reported malaria cases have decreased 68 percent since 2011, dropping from 44,000 cases to only 14,000 last year.  The number of villages with malaria transmission has also decreased 56 percent.

Today, Saejeng is a medical technologist at the Office of Disease Prevention and Control in Chiang Mai. She started malaria work at the city’s Vector Borne Disease Control Office and was later offered a doctoral scholarship at the University of Sheffield. There, her studies on viral resistance in insects paved the way for developing a simple yet impactful innovation.

While working on her thesis, Saejeng needed a microscope camera, but models available in the market were costly. Undaunted, she invented her own by attaching a webcam to a microscope. It came as a surprise to many that her low-budget device valued locally at $124 worked as well as the high-end microscope cameras. Emboldened and inspired by this early success, she set her sights on something bigger.

While pursuing her Ph.D., her determination to work in health intensified after hearing that a close friend died from malaria. “I asked myself, ‘how could this happen?’ I deeply regretted that even though I worked in the malaria field at that time, I wasn’t there and couldn’t save her,” said Saejeng. “Looking back, if diagnosis was done accurately and timely, it could have saved many lives.”

Currently, malaria diagnosis is conducted by microscopic examination of the patient’s blood. Errors in diagnosis can occur when blood slides are poorly prepared. Realizing this could hinder diagnosis, Saejeng invented a “webscope,” or webcam microscope—a webcam connected to a microscope using basic, everyday materials.

Linking to the internet, this cost-effective, user-friendly device enables microscopists to provide real-time consultation on difficult or critical malaria diagnostic cases to malaria field workers in remote areas.

Aungkana Saejeng’s webscope provides more accurate and timely diagnosis of malaria by connecting a webcam to a microscope.

Richard Nyberg, USAID

And the big news: The webscope reduces blood slide cross-checking time on average from 21 days to only 10 minutes. Before remote cross-checking became available, slides had to be delivered back to laboratories by hand, which could take days. To cut costs, health technicians would often wait to accumulate slides before sending them back to the lab. Now, patients receive a more accurate diagnosis and timely treatment. The device has made a dramatic impact on the poor and vulnerable people living in rural and remote areas with limited access to health care.

“The real-time consultation has improved malaria field workers’ skills and abilities to provide a high-quality diagnosis with less errors,” said Saejeng. “This is a sustainable approach toward the long-term goal of malaria elimination.”

The webscopes were initially deployed in five malaria-affected areas in Mae Hong Son province in northern Thailand and later expanded to 94 malaria clinics throughout the country. The initiative has earned several awards, including the Excellence Award 2016 of Sustainable Innovation Thailand Public Service from the Office of Public Sector Development Commission.

The webscope has also been adapted for distance learning about other diseases from labs/patient wards. Hospitals and medical schools have widely used this technique for remote medical consultation and teaching among public health staff and medical students nationwide.

Currently, Saejeng monitors antimalarial drug resistance with the support of the U.S. President’s Malaria Initiative through USAID and in collaboration with the World Health Organization. Her work, drawing on the success of her device, has helped to better diagnose and treat malaria in Thailand, with potential benefits to the entire region.

"To end malaria for good, it’s important for all stakeholders to join hands and build a network of health professionals where effective and timely communications can be achieved,” said Saejeng.

To realize her goal, Saejeng places importance on her plan to build a data bank as a resource and a training center for inexperienced or non-expert health professionals. The data bank, together with the webscope, is poised to improve and enhance health professionals’ skills in malaria diagnosis, case management and preventive treatment.

Armed with a powerful weapon called innovation, this groundbreaking professional woman continues her fight against malaria in a small lab largely unknown to the world. This lab, a short drive from her family noodle shop where she still forms fishballs in the early morning and strains noodles at night, is where she cooks up innovation to help build a virtual wall to protect us all from malaria.

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