uChek uses the iPhone’s camera to capture the color changes in commercially available urine dipsticks. Results of the test can be stored, emailed and analyzed over time.

It may not be glamorous, but it’s true – each year, urinary tract infections lead to more than 9 million doctor visits in the United States alone. But the infection can now be tested for through an iPhone app — uChek — developed by TEDFellow Myshkin Ingawale. This app could also be an effective tool for diabetics whose doctors have recommended regular urine analysis, and for the monitoring of bladder, liver and kidney disorders. It could also be a powerful tool for healthcare professionals in the developing world who hope to bring testing to patients wherever they are, instead of the other way around.

Ingawale, who previously created the noninvasive anemia diagnosis tool ToucHb, has just released the app, which was demoed at TED2013. But there have been adjustments made since.

“Early prototypes like the one demoed at TED 2013 were ‘work in process’ and were susceptible to certain ambient light changes and movement errors, and when checked against a conventional laboratory urinalyser it showed lower accuracy,” Ingawale says in a Q&A with the TED Fellows blog. “We made some design changes in the system — most notably, the introduction of our patent-pending ‘cuboid’ — a foldable, reusable stand for the iPhone, which improved the accuracy of the new system, making it comparable with a laboratory urinalyser.”

Ingawale explains that the changes were needed to move uChek from being considered a “wellness tool” to being a “medical device.”

Next up for Ingwale — expanding uChek to Android and other platforms. And, of course, coming up with new ideas for medical apps. “This is our first really big initiative in the world of apps,” he says. “We are looking forward to seeing where this road leads.”

At TED2013, Rose George talks about a major global health problem—the 2.5 billion people who live without toilets. Photo: James Duncan Davidson

A single gram of poop contains 50 diseases, one million bacteria, 1,000 parasites, 100 worm eggs and 10 million viruses, by journalist Rose George’s tally. For people who have flushing toilets, this is something that they rarely have to think about. But for the 2.5 billion people in the world who have no toilet at all, feces is to blame for a devastating toll of disease.

Consider these other numbers. Four thousand children die every day from diarrhea, a common symptom from exposure to many of those fecal microbes. That’s more than die from HIV/AIDS, tuberculosis and measles combined. Each year, $260 billion is lost because of lack of sanitation. Despite this, just 10 to 25 percent of related budgets focus on sanitation, compared to 75 to 90 percent for clean water. Rose George: Let's talk crap. Seriously.Clean water is no help when it is continuously contaminated by poor sanitation.

In today’s talk, given at TED2013, George describes how she “plunged into the world of sanitation, toilets, and poop,” an odoriferous adventure that she chronicled in her 2009 book The Big Necessity: The Unmentionable World of Human Waste and Why It Matters. If you’re hankering for even more dirty talk, we spoke with George about people’s reactions to her project, the surprisingly wide-ranging impact of sanitation and the future of poop.

In your talk, you start off with a story about your own bathroom experience — the first time you thought, “Wait, where is this stuff going?” What happened after that? How does a reporter start researching poop?

Well, there’s a long story and a short story. I’ll give you the short one. The first thing I did when I decided that I was going to dive into the world of poop was look at who was doing stuff in that world. The first I came across was the World Toilet Organization. So one of the first things I did was to go to their annual show in Moscow. I ended up in a Russian winter near the Kremlin, and the WTO had its exhibit on one floor and, on the floor below, was a fur coat exhibition. There were more people in the fur coat exhibition.

It’s quite a select gathering of people. It’s certainly changed over the past six years, but at that point, it was really quite a small field. That’s where I started making my acquaintances and getting to know who was who and who was doing what. A few people I met in that couple of days ended up being written up in the book — like Joe Madiath in Orissa, and Jack Sim. This guy Scott Chapman, who I met in the café, looked really bored. We started having this conversation, and he said, “Why should I be interested in toilets?” I started telling him what I had learned by that point — that 2.6 billion people don’t have a toilet — and he looked really surprised. He became a really enormous toilet evangelist. So that was really quite fun to watch.

That is where I started, and then I went to a couple of other WTO events. I just ended up sort of wandering around the world with people who I found were doing interesting things.

What was it like pitching the topic of poop to editors and your agent? What was their reaction? Did they get it initially, or did it take some convincing?

I have two main publishers. My first was the British publisher Portobello. It was bit of a weird process because I went to them with another idea for a book, about Darfur. For various reasons nobody wanted it, and the publisher there, we were sitting in his little office and he said, “Rose, I don’t want that book but I do want you.” I can’t remember the exact list [I pitched him] but toilets was about number three. His face was not that impressed. And he said, “Um yeah, well, what do you mean?” So I started on my 2.6 billion, and Sulabh International, and untouchables in India who have to clean toilets with their bare hands in this day and age. And I do remember that he actually got up out of his chair with excitement, and from then on was fully behind it.

Then on the back of that book deal was a four-part series for Slate on the world of sewage. I went down to the sewers in London and looked at a campaigning group in London called RATS, Rowers Against Thames Sewage, and I went to Sewage School and hung out with kids learning to make sewage soup and how to clean sewage. And it was great — really good fun. Subsequently, I ended up getting a publishing contract with Metropolitan Books, and they were absolutely behind it from the beginning. There was never any question — which is weird. There is certainly a perception that Americans are more prudish about this kind of stuff, but that absolutely has not been the case. Americans have been much more enthusiastic about this book all the way through, and I’ve done far more American radio interviews, far more American publicity, and I still get emails from Americans and Canadians. So that’s been quite a revelation for me.

Why do you think this topic is so taboo in general? Obviously there are various reactions depending on where you are, but why in general do you think this is something we don’t talk about enough?

I actually don’t think it’s true that it is taboo — I just think there’s no avenue for discussion about it. It’s been my experience that people are very happy to talk about it. When I was doing the research, which was a two-year process, honestly only about two or three people changed the subject. And I was asked all the time what I was working on, and I’d always say ‘toilets’ or ‘public health’ or ‘sanitation.’ Invariably, people would pause just to take that in. Then they would go, “Oh, well I’ve got a great toilet story!” The thing is, we do or think about this stuff every day. Every parent with a toddler has to think about it when they change a nappy or diaper. Everyone who has to find a decent toilet in a shopping mall has to think about it. Everybody has to think about it because they spend a lot of time in the toilet.

I think there are two areas where poop still is taboo. I think it’s been taboo in advertising on TV. The toilet industry and the toilet paper industry have felt unable to be frank about their product, but I think that is changing quite a lot. In the last few years, there have been lots of plain-speaking toilet paper ads that I’ve seen in the US and in the UK as well. But the more important place where I do think it is very taboo still is in the corridors of power, and in the people who fund sanitation as a development issue. Certainly when I started, it was considered for some reason unspeakable. Politicians don’t think it is a vote-getter because they don’t hear people demanding toilets — whereas they do demand clean water. The other thing is that it sort of gets kicked around between various ministries. Because sanitation has so many effects across all aspects of development — it affects education, it affects health, it affects maternal mortality and infant mortality, it affects labor — it’s all these things, so it becomes a political football. Nobody has full responsibility. There’s no Minister of Sanitation. There doesn’t necessarily need to be one, but the responsibility for it in a political environment gets shared around and doesn’t really get the attention it deserves.

I think that’s changed now because sanitation has become a human right, so governments are going to be obliged to take it seriously. I think that’s a wonderful change. I think the taboo is breaking all over the place, so it is quite exciting.

You mentioned all the different areas that poop and sanitation actually touch. In your talk, you also mention education and economics. At what point in your research did you realize that your topic had such wide impact? Was it a gradual process, or was it something you had a hunch about early on?

It was definitely a learning process. I mean, everybody is an expert on poop, really, but I started out not knowing how to make the connection. Because none of it is rocket science. If you have a girl who doesn’t have a toilet at school, she is not going to want to go to school when she’s got her period. It’s pretty straightforward. But I just didn’t make the connection. Only along the way, it was talking to people like Joe Madiath or the Water Supply and Sanitation Collaborative Council, the UN advocacy agency that deals with sanitation — people who were in the field. The other thing was there wasn’t much connection between people working in sanitation. There’s all sorts of divisions in development — in water, and health, and education and sanitation — so you kind of have to learn from all sorts of people.

But the economics, that was actually specifically a guy called Guy Hutton who’s been really, really excellent at putting together the economic argument. And again it makes sense. If people can’t work, obviously there’s going to be an economic impact. But I would have never linked that to the toilet.

When you started your research, did you have a hunch that toilets would have such a serious impact on human health?

I had no idea that people — that children — were dying of diarrhea at the rate that they do. That was a real shock – in fact, I still find that shocking. It’s completely shameful because it is so preventable.

Another thing I found really striking were the unexpected health aspects. For example, malnutrition: Children who are malnourished, you can find them in a well-fed family. Relatively recently, people have figured out, it sometimes is because they have diarrhea. So no matter how many high-protein foods the child is given, it goes straight through them. There’s now been research that links sanitation to stunted growth. That’s pretty new to me. And vaccinations. When my book came out, someone wrote to me who is a vaccinator. And he wrote, “You know, people just don’t realize that sometimes because these kids are malnourished and because they have diarrhea, we have to give them six or ten times the amount of vaccine to take it in. People don’t know the connection.” They don’t link sanitation to all these things. I find that really fascinating.

On a lighter note, what was the silliest thing you learned about toilets or poop? Were there any crazy gold-plated toilets, or crazy advanced Japanese toilets?

Oh yeah. I used to work at Colors magazine as a writer and researcher, before I started writing the book, and someone had a bit of an obsession with toilets. We used to regularly feature the latest gold-plated toilet, usually from somewhere in Asia. And then there is of course a senator in South Korea who built a toilet-shaped museum, or a toilet-roll-shaped museum, I think. There’s all kinds of stuff. And I think it is important to have the funny humor stuff, because that is what disarms people and makes it easier to talk about.

People like Sulabh International, a fantastic Indian NGO that has built toilets all over India, they know that, so they set up the International Museum of Toilets, which is in a compound near the international airport in Delhi. And it’s great. It’s just one room, but it’s got replicas of toilets and it’s pretty humorous. They have a copy of a French commode in the shape of books.

Wacky is fine — I knew I had to have some humor in it. Sulabh really helped, and Japan helped as well. But I always was careful and determined not to write a book of toilet humor. Other people have done that, and that’s fine, but it is a serious subject. It was quite tricky doing that balancing act.

Yeah. I’ve been to Japan and I was amazed about the toilets and the technology they have.

Once you use a Japanese toilet, you’re spoiled.

Are there any sanitation initiatives that you think are doing a particularly good job acknowledging this poop problem and trying to address it? I’m thinking in particular of the Gates Foundation’s Toilet Challenge.

Over the last two or three years it’s been really exciting because a lot has changed. I think the Gates Foundation should absolutely be applauded, because I think they’ve been really instrumental in that. As soon as Bill and Melinda Gates started talking about toilets — and they openly use the word ‘toilet’ — that gave the subject huge legitimacy that it didn’t have before. I think that’s broken the ice for NGOs that were maybe a little shy about talking about toilets. They disguised it as water-related illnesses, or as ‘people need water.’ And they do. But what’s the dirtiness in the water? It’s usually poop. I think that’s been an opening of the floodgates a little bit.

And there’s all sort of exciting stuff going on. Sanitation hackathons, people working on apps. Matt Damon doing his famous press conferences. All that is really, really great. And it’s new. It makes me hopeful actually that maybe something has changed.

Speaking of the Toilet Challenge, do you have a favorite amongst the winners?

No I don’t, actually, and I’m sort of careful not to. When people ask me, “What’s the best toilet? What’s the best solution?” I’ve always said the solution is flexibility. The solution is understanding that we need all sorts of solutions. So I think they’re all great. This is a bit of a cop-out, but my favorite is the actual job description that they put out, which is that it has to be low-cost and it has to be sustainable. To me, that is brilliant. I don’t mind beyond that. The more ideas, the better. It’s pretty obvious if you travel in the developing and the developed world, it’s not one-solution-fits-all. Some countries have more water than others — some can afford to use clean water to flush their poop away and some can’t.

So I think the best thing that reinventing the toilet did is not provide actual innovations in toilets — which is true, it does need innovating — but make us examine the system itself, which has been unquestioned for so long and is high-energy and high-cost. Even in the US and the UK, our sewers are crumbling. It’s a pretty unsustainable system. I think that’s what they’ve done that is really valuable. 

One last question: What do you find most hopeful about the future of poop?

That we’re talking about it. For heaven’s sake, I’ve just done a TED Talk on it. Six years ago, I never would have thought that was possible. I think things have changed so rapidly in the past few years, and I am really hopeful, actually, even though the statistics are still so woeful. Even though it’s the most off-track in the Millennium Development Goals, I think there is a legitimacy around it now. There are ads on American TV for, I can’t remember which toilet paper, but they were saying toilet paper doesn’t clean you — it’s like having a shower with a dry towel. And I think, “Oh, I said that!” But it’s great to see it on TV. I remember four or five years ago, Toto put an ad in Times Square showing bare bottoms, and they had to be taken down. So I really think there’s hope that this is going to be a more talkable subject. And maybe when people get an invitation from an NGO or a charity, maybe they’ll give money for a toilet and not just a clean water supply.

Eric Dishman is used to thinking about how technology can transform the world of health care. As an Intel Fellow and general manager of the company’s Health Strategy & Solutions Group, his job is all about finding innovative new approaches to healthcare. Eric Dishman: Take health care off the mainframe And he’s no stranger to talking about them. At TEDMED 2009, in the talk featured to the left, Dishman asked us to “Take health care off the mainframe,” boldly comparing the current American health care system to mainframe computers circa 1959.

But just two weeks ago, at TED@Intel, Dishman tells the much more personal story of his battle with kidney disease.

To say that his battle is with disease isn’t the full story. Instead, as he describes in this second talk, his fight is not only with faulty kidneys, Eric Dishman: Health care should be a team sportbut also with a flawed healthcare system.

Two decades ago, when he was a college student, Dishman had several fainting spells. This kicked off months of testing by six different doctors, in what he describes as a “clash of medical titans.” Dishman was told he would not live longer than two or three years.

The doctors were wrong — but not because they weren’t good doctors. Instead, they were stuck in an old-fashioned system that lacked technologically advanced tools and a culture of communication.

With smartphones and tablets becoming increasingly ubiquitous, and social networks connecting us more and more, Dishman sees three major steps to achieving better, individually-tailored healthcare that takes pressure off of brick-and-mortar hospitals and clinics, and empowers a patient to be the captain of a team working toward their well-being: Care anywhere, care networking, and care customization. To hear what each means, watch this talk.

On the stage, Dishman demonstrates MobiSante’s smartphone-based ultrasound imaging system, called MobiUS, which he used to scan his newly donated kidney. A doctor hours away at Legacy Good Samaritan Hospital in Oregon examined the kidney live over the Internet, dispelling worry over a few dark spots and noting they’d double check them at Dishman’s next scheduled appointment.

Here is a round up of other disruptive products and projects that could hugely impact the way we think about our health care. Have more to add? Put them in the comments.

Health tests on your smartphone
MobiSante’s affordable, portable ultrasound isn’t the only medical device to take advantage of mobile networks and the power of smartphones. Some other examples:

• Lifelens’s app can detect malaria in a blood sample and allow a diagnosis from across the world.
• University of Oxford’s stethoscope kit is a low-cost way for patients to take recordings of their hearts to send it to their doctors for analysis.
• MIT Media Lab’s NETRA is a cheap eye test that connects to a smartphone. Here, a look a TED Blog Q&A with one of its creators.
• Withings’ blood pressure monitor lets users take their own blood pressure with an iPhone, iPad, or iPod touch.

The doctor isn’t in… but that’s okay
InTouch Health’s RP-VITA Remote Presence Robot is the first-ever that will connect doctors to patients across the world.Daniel Kraft: Medicine's future? There's an app for that Doctors can do rounds in a hospital across the country or the world, controlling Jetson-like robots that show their faces on a screen. Through the robots, the doctors can visit with and diagnose patients from afar.

Another less-futuristic option: as Daniel Kraft, the chair of the FutureMed program at Singularity University, mentioned in the TED Talk, “Medicine’s future? There’s an app for that,” the website AmericanWell.com can connect you to physicians and specialists in your state who do appointments over secure chat, Skype or the telephone.

Health care at your local drugstore
While it isn’t tech-heavy, the move towards what this recent article from The Economist calls “retail clinics” is taking some health services out of hospitals and doctor’s offices and into malls and popular pharmacy chains. The article details how CVS and Walgreens are bringing basic care clinics to many stores – 640 and 372 of them respectively.

Medical devices that can leave the hospital
The U.S. Department of Health and Human Services put out a recent request for information seeking new approaches for smart medical hardware that can remain on even during power outages in natural disasters. The goal is to to protect hospital patients on life-saving medical devices — including ventilators or IV pumps — by keeping the machines on and mobile if there is need for evacuation.

Are you interested in where health care is going? Watch the TED Playlist, the Future of Medicine, below.

A look at the crystallites of AZT, the first antiviral approved for the treatment of HIV/AIDS. Originally, AZT was created to treat cancer — but it failed in tests.

When you pop a pill, do you know how it works? Most modern drugs target specific molecules, interacting with disease at the molecular level. But while we know the molecular causes of roughly 4,000 diseases, a very slim 6 percent of those diseases have a safe and effective drug to treat them. Why? Because of the incredible difficulty and cost of finding a compound that is perfectly shaped to interact with a molecular cause, and that also happens to be safe.

Francis Collins, the Director of the National Institutes of Health, wants to help this process along. Francis Collins: We need better drugs -- nowIn yesterday’s talk, given at TEDMED 2012, Collins makes a bold case for translational research to produce better drugs, faster. What does “translational” mean? It means research that takes a particular look at basic scientific discoveries and asks: how can we make an actual medicine from this? To that end he helped launch the NIH’s National Center for Advancing Translational Sciences in 2011. NCATS aims to do away with the costly and time-consuming bottlenecks that prevent new drugs from coming to market.

Collins hopes to encourage pharmaceutical companies to open up their stashes of drugs that have already passed safety tests, but that failed to successfully treat their targeted disease. He also wants to look at how drugs approved for one disease could successfully treat another. We can teach “old drugs new tricks,” Collins says in his talk, by matching them to the molecular pathways of other diseases.

Doing so will require academia, the pharmaceutical industry, government agencies and patient advocacy groups to work together, in conjunction with talented researchers and ample funding. After all, a single drug can cost billions to develop. Still, it’s possible.

In his talk, Dr. Collins mentions two failed cancer drugs that were successfully repurposed: zidovudine (AZT), the first antiviral approved for HIV/AIDS in 1987 and, more recently, farnesyltransferase inhibitor (FTI), which was used to successfully treat children with the rapid-aging disease Progeria in a 2012 clinical trial.

Fascinated, we asked Collins to share more. Below, read his list of seven drugs that have been repurposed. Of them he writes via email, “None of these drugs could have been developed without collaborations between drug developers and researchers with new ideas about applications, based on molecular insights about disease.”

1. Raloxifene: The FDA approved Raloxifene to reduce the risk of invasive breast cancer in postmenopausal women in 2007. It was initially developed to treat osteoporosis.
   .
2. Thalidomide: This drug started out as a sedative in the late fifties, and soon doctors were infamously prescribing it to prevent nausea in pregnant women. It later caused thousands of severe birth defects, most notably phocomelia, which results in malformed arms and legs. In 1998, thalidomide found a new use as a treatment for leprosy and in 2006 it was approved for multiple myeloma, a bone marrow cancer.
   .
3. Tamoxifen: This hormone therapy treats metastatic breast cancers, or those that have spread to other parts of the body, in both women and men, and it was originally approved in 1977. Thirty years later, researchers discovered that it also helps people with bipolar disorder by blocking the enzyme PKC, which goes into overdrive during the manic phase of the disorder.
   .
4. Rapamycin: This antibiotic, also called sirolimus, was first discovered in bacteria-laced soil from Easter Island in the seventies, and the FDA approved it in 1999 to prevent organ transplant rejection. Since then, researchers have found it effective in treating not one but two diseases: Autoimmune Lymphoproliferative Syndrome (ALPS), in which the body produces too many immune cells called lymphocytes, and lymphangioleiomyomatosis, a rare lung disease.
   .
5. Lomitapide: Intended to lower cholesterol and triglycerides, the FDA approved this drug to treat a rare genetic disorder that causes severe cholesterol problems called homozygous familial hypercholesterolemia last December.
   .
6. Pentostatin: This drug was created as a chemotherapy for specific types of leukemia. It was tested first in T-cell-related leukemias, which didn’t respond to the drug. But later NIH’s National Cancer Institute discovered that the drug was successful in treating a rare leukemia that is B-cell related, called Hairy Cell Leukemia.
   .
7. Sodium nitrite: This salt was first developed as an antidote to cyanide poisoning and, unrelated to medicine, it’s also used to cure meat. The National Heart, Lung, and Blood Institute is currently recruiting participants for a sodium nitrite clinical trial, in which the drug will be tested as a treatment for the chronic leg ulcers associated with sickle cell and other blood disorders.

Interested in more thoughts on how we can change the long, clunky process of testing pharmaceuticals? Watch these 5 TED Talks with fascinating ideas for medical research »

Video still from Le Chal, courtesy Anthony Vipin Das.

A haunting black-and-white video screened during the TED Fellows talks depicted people speaking into a device and then walking — at first taking halting steps, then more confident strides. As the video unfolds, the camera zooms in on the faces of the walkers — revealing that they are blind.

With his team, TED Senior Fellow Anthony Vipin Das, an eye surgeon, has been developing haptic shoes that use vibration and GPS technology to guide the blind. This innovation — which could radically change the lives of the vision-impaired — has drawn the interest of the United States Department of Defense, which has recently shortlisted the project for a $2 million research grant. Anthony tells us the story behind the shoe.

Tell us about the haptic shoe.

The shoe is called Le Chal, which means “take me there” in Hindi. My team, Anirudh Sharma and Krispian Lawrence and I, are working on a haptic shoe that uses GPS to guide the blind. The most difficult problems that the blind usually face when they navigate is orientation and direction, as well as obstacle detection. The shoe is in its initial phase of testing: We’ve crafted the technology down to an insole that can fit into any shoe and is not limited by the shape of the footwear, and it vibrates to guide the user. It’s so intuitive that if I tap on your right shoulder, you will turn to your right; if I tap on your left shoulder, you turn to your left.

The shoe basically guides the user on the foot on which he’s supposed to take a turn. This is for direction. The shoe also keeps vibrating if you’re not oriented in the direction of your initial path, and will stop vibrating when you’re headed in the right direction. It basically brings the wearer back on track as we check orientation at regular intervals. Currently I’m conducting the first clinical study at LV Prasad Eye Institute in Hyderabad, India. It’s very encouraging to see the kind of response we’ve had from wearers. They were so moved because it was probably the very first time that they had the sense of independence to move confidently — that the shoe was talking to them, telling them where to go and what to do.

How do you tell the shoe where you want to go?

It uses GPS tracking, and we’ve put in smart taps: gestures that the shoe can learn. You tap twice, and it’ll take you home. If you lift your heel for five seconds, the shoe might understand, “This is one of my favorite locations.” And not just that. If a shoe detects a fall, it can automatically call an emergency number. Moving forward, we want to try to decrease the dependency on the phone and the network to a great extent. We hope to crowdsource maps and build up enough data to store on the shoe itself.

The second phase we are working on is obstacle detection. India has got such a varied terrain. The shoe can detect immediate obstacles like stones, potholes, steps. It’s not a replacement for the cane, but it’s an additive benefit for a visually impaired person to offer a sense of direction and orientation.

Are you still in the development stage?

The insole is already done. We are currently testing it. I’m using simple and complex paths — simple paths like a square, rectangle, triangle and a circle, and complex paths include a zigzag or a random path. Then we are going to step it up with navigation into a neighborhood. From there we’ll develop navigation to distant locations, including the use of public transportation. It will be a stepwise study that we’ll finish over the middle of this year, then go in for manufacturing the product.

You’re an eye doctor. How did you get involved in this?

I’m an eye surgeon who loves to step out of my box and try to see others who are working in similar areas of technology that are helpful for my patients. So Anirudh Sharma and I, we’re on the same TR35 list of India in 2012. I said, “Dude, I think we can be doing stuff with the shoe and my patients. Let’s see how we can refine it.” There was already an initial prototype when he presented last year at EmTech in Bangalore. Anirudh teamed up with one of his friends, Krispian Lawrence of Ducere Technologies in Hyderabad, who is leading the development and logistics to get this into the market. We just formed a really cool team, and started working on the shoe, started testing it on our patients and refining the model further and further. Finally we’ve come to a stage where my patients are walking and building a bond with the shoe.

Are these patients comfortable with the shoe?

Yes, it’s totally unobtrusive. And more importantly, we are working on developing the first vibration language in the world for the Haptic Shoe. We’re looking at standardizing the vibration, like Braille, which is multilingual. But even more crucial than the technology, the shoe is basically talking to the walker. How they can trust the shoe? So that’s an angle that we are looking at. Because at the end of the day, it’s the shoe that’s guiding you to the destination. We’re trying to build that bond between the walker and the sole.

Building a bond with the sole. That’s good. I’m going to use that.

Through crowdsourced funding and a network of experts, Jimmy’s Rare Genomics Institute enables rare-disease patients and their families to fund and design personalized research projects.

How far has the RGI come in the last year since you were last in Long Beach?

Over the past year, RGI has raised over $750,000 for rare diseases, helped discover one genetic disease, and helped numerous families start their path of create projects studying diseases that are otherwise not addressed.

How has the Fellowship help make this possible?

The TED Fellowship has played a major role in our growth with RGI — whether through collaboration with other Fellows, helping spread the message and hope of research, or cheerleading and support from the TED team, Fellows and coaches. RGI would not be able to help as many children and diseases without the help of TED.

One of the coolest part of the Fellows program is the great diversity of skills, interests, and passions. It was great to collaborate with Lope to tell the importance and burden of rare disease, but also inspire hope for the patients, families and the whole community.

Photos: James Duncan Davidson

A trip to a public bathroom stall several years ago inspired journalist Rose George to think.

“I asked myself the question: Where does this stuff go?” George remembers. “With this question, I found myself plunged into the world of sanitation, toilets and poop. And I have yet to emerge.”

Many people don’t think much about toilets. As she suggests during Session 9 of TED2013, we think of a toilet as a right, not a privilege. But more than 2.5 billion people worldwide don’t have access to a toilet — that’s 40% of world. Instead, large tracts of the world’s population relies on open defecation: pooping by the side of the road.

The problem with this system is that poop can carry 50 communicable diseases – a typical amount is 1,000 parasite cysts, 1 million bacteria, 10 million viruses and 100 worm eggs. Fecal particles on hands lead to the contamination of food and homes, leading to disease. In our culture, we joke about diarrhea — but this illness kills 4,000 children every day. And even though it is the second biggest killer of children worldwide, diarrhea gets a fraction of the funding of other diseases.

The solution, of course, is the toilet. When created in the mid-19th century and installed en masse in London, child mortality dropped by the most it ever had in history. The toilet may be one reason the human lifespan has increased so dramatically. Says George, the author of The Big Necessity: The Unmentionable World of Human Waste and Why It Matters, ”I think [the toilet is] so good – it doesn’t smell, we can lock it behind a door, keep it in our homes — that we’ve locked it out of conversation.”

In both developing and developed countries, 75% to 90% of health and sanitation budgets goes to clean water. And only 10 to 25% goes to toilets. All of this is sad because fecal matter can actually be used for good. If feces is put into a sealed environment, it gives off gas — gas that can be safely harnessed, even for cooking. George gives the example of a prison in Rwanda, where 75% of the cooking fuel comes from the prisoner’s poop.

So how do we get more attention for the issue of toilets and sanitation?

“We need to understand human psychology,” says George. Old habits die hard. Even when latrines are given out freely, in many parts of the world, many people opt not to use them, and walk right by to use the familiar bathroom outdoors. But she notes a strategy that might be able to change this. “In the early 19th century, they tried selling soap as healthy. No one bought it. They tried selling it as sexy, and everyone bought it.” She points to a campaign in India to convince young women not to marry into homes without a toilet. Think of it as “No loo, no I Do.”

George sees a lot of promise in the example of Japan; 70 years ago, it was a country that relied on pit latrines. Now they have the world’s most deluxe toilets — ones with heated seats and automatically lowering lids.

“They brought the toilet out from behind the locked door. They made it a conversation piece. People now go out and upgrade their toilets,” says George. “So I ask you for one thing: please go home, speak about the unspeakable and talk shit.”

Photos: James Duncan Davidson

Ron Finley describes himself as a “renegade gardener,” and he’s here to tell us all about his home, in South Central, or South Los Angeles, as city planners attempted to rebrand the area. Whatever you call it, the truth is that the area comprises liquor stores, fast food and vacant lots, and it epitomizes the stark reality that 26.5 million Americans live in a food desert. Truth is, “the drive-thrus are killing more people than the drive-bys,” says Finley. “People are dying from curable diseases in South Central Los Angeles. The obesity rate in my neighborhood is five times what it is in Beverly Hills, eight miles away.”

Tired of seeing wheelchairs “bought and sold like used cars,” tired of seeing ”drop-in dialysis centers popping up like Starbucks,” and tired of “driving a 45-minute round trip to get an apple that was not impregnated with pesticide,” he could only come to one conclusion: “This has to stop.”

So he started working with the organization L.A. Green Grounds to install a vegetable garden on the 150 ft x 10 ft patch of ground in front of his house, that strip between the sidewalk and the street that the city owns but the resident has to keep up … and was promptly issued with a citation to remove the garden. Then he was served with a warrant for arrest. “Come on, really? A warrant for growing food on a strip of land you could give a f– … care less about? I said cool. Bring it.” Finley, it is clear, is not one to be cowed. The city backed off, a councilman endorsed what he was doing, and the city of Los Angeles is now set to change its ordinance. And why not? “There are 26 square miles of vacant lots in the city,” Finley says. “That’s 20 Central Parks; that’s enough space for 724,838,400 tomato plants. Why in the hell would they not okay this?”

“Growing your own food is like printing your own money,” he says, to applause. Then he tells us why this really matters to him. “I raised my sons in South Central. I have a legacy here. I refuse to be a part of this reality that was manufactured by other people; I manufactured my own reality,” he says. “I am an artist. Gardening is my graffiti. A graffiti artist beautifies walls; I beautify parkways and yards. I treat the garden as a piece of cloth and the plants and the trees are the embellishment of that cloth. You’d be surprised what soil can do if you let it be your canvas.”

“Gardening is the most therapeutic and defiant act you can do, especially in the inner city,” he continues. “Plus, you get strawberries.”

One night, he looked outside to see a mother and daughter in his garden at 10:30. “They looked so ashamed,” says Finley. “It made me feel ashamed to see people this close to me who were hungry. This reinforced why I do this. People ask me, ‘Aren’t you afraid people are going to steal your food?’ Hell, no! That’s why it’s on the street! That’s the whole idea! I want them to take it and take back their health.”

To date, Green Grounds has planted 20 gardens; 50 volunteers have come to their “dig ins.” The benefits are clear, says Finley: “If kids grow kale, they eat kale. If they grow tomatoes, they eat tomatoes. But if they’re not shown how food affects the mind and the body, they blindly eat whatever’s put in front of them.” He wants to help the young people he sees, guide the disenfranchised away from a track leading nowhere. As far as he’s concerned, gardening provides an opportunity to take over those communities, to have a sustainable life.

He wants to plant a whole block of gardens, he tells us. “I want to take shipping containers and turn them into healthy cafés,” he says. And for anyone concerned about the business model. “I’m not talking about no free shit. Free is not sustainable. The funny thing about sustainability: you have to sustain it.” The audience loves this. “What I’m talking about is putting people to work, getting kids off the street, about the pride and the honor of growing your own food. We’ve got to make this sexy,” he proclaims. “Let’s all become renegades, gangsta gardeners. We have to flip the script on what a gangsta is. If you ain’t a gardener, you ain’t gangsta. Let that be your weapon of choice!”

Finley knows he has the audience’s attention. He’s not done yet.

“If you want to meet with me, don’t call me if you want to sit around in cushy chairs and have meetings where you talk about doing some shit,” he concludes. “If you want to meet with me, come to the garden with your shovel so we can plant some shit. Peace.” A standing ovation.

Photos: James Duncan Davidson

When Jack Andraka was 15 years old, he didn’t know what a pancreas was. Now, this teenager has created a test for the early detection of pancreatic cancer that, while still in the preliminary stages, looks promising. So how did he become an health innovator?

Andraka tells the story during Session 6 of TED2013.

“Have you ever experienced a moment in your life that was so painful and confusing, you just want to learn everything you can to make sense of it all?” he asks.

For him, that moment came when a family friend, who’d been like an uncle to him, passed away from pancreatic cancer. In Andraka’s Googling, he discovered startling statistics about this kind of cancer — that in 85% of cases, pancreatic cancer is diagnosed late when a person only has a 2% chance of survival. As Andraka explains on the stage, this is because the same (very expensive) pancreatic cancer test has been used for decades, and is only given if a doctor already suspects you have the disease.

“It’s a 60-year-old technique — that’s older than my dad,” says Andraka.

Andraka set out to develop a new test for pancreatic cancer that’s inexpensive, rapid, simple, sensitive, selective and minimally invasive. He began by looking for a protein in the bloodstream that would be a biomarker for pancreatic cancer — one that would be found in all cases, even in the earliest stages. The problem: there were 8,000 possible proteins. When Andraka was “close to losing sanity on the 4,000 protein,” he finally found one that could work — mesothelin.

But then he found a whole new problem — how would he go about detecting it?

“My inspiration came from the most unlikely place for innovation — high school biology class, that absolute stifler of innovation,” says Andraka, to big laughs from the audience.

While studying carbon nanotubes, Andraka had a flash of insight — that he could lace antibodies to these nanotubes so that they would react to mesothelin. This gave him the idea to make his cancer sensor out of paper. While he swears that doing this was “as easy as making chocolate chip cookies,” he realized that he needed to find a lab in which to do his work. “I can’t really do cancer research on my kitchen countertop,” says Andraka. “My mom doesn’t like that.”

Andraka wrote to 200 scientists asking for space in their lab. He received 199 rejections. And even at the one lab at Johns Hopkins University where a professor was willing to entertain his theory, he was bombarded with questions from grad students trying to sink his procedure. Andraka realized that his method did indeed have blank spots.

“Over the course of the next months, I painstakingly filled all those holes,” he says.

In the end, Andraka has created a paper censor that costs 3 cents — about 26,000 times less expensive than the current pancreatic test. The test takes five minutes. And it appears to have close to 100% accuracy, potentially allowing pancreatic cancer to be detected in its early stages, when a person has a much better prognosis. This accomplishment not only made Andraka the winner of the Intel International Science Fair – it has the potential to save many lives.

Even better, Andraka thinks it could potentially be used to test for ovarian and lung cancer too. And by switching out the protein the test reacts to, it could — down the road — be used for diseases as varied as heart disease and HIV/AIDS.

“Thorough this journey, I’ve learned an important lesson — that anything is possible with the internet,” says Andraka. “You don’t have to be a professor with multiple degrees to have your idea work.”

Read the TED Blog’s Q&A with Andraka.

Lee Cronin: Print your own medicineIn today’s talk, Lee Cronin asks: “Could we make a really cool universal chemistry set? In essence, could we app chemistry?”

With his team of researchers at the University of Glasgow, Cronin has created a 3D printing application that allows scientists to print out laboratory equipment specific to the experiment they wish to run — something they’ve called “reactionware.” Someday, Cronin says, the same software that runs reactionware could open up the doors of possibility. In this talk, Cronin shares one application — the idea that, in the future, people could print their medicine. With a custom-built 3D printer and chemical inks, users would download the appropriate molecules to perform “on-the-fly molecular assembly.” Meaning that they could print out whatever medications were needed that day — even if they were for a new superbug.

At TED, we love sharing stories of 3D printing and its rapidly developing power to make new things possible. TED Fellow Bre Pettis’s Makerbot; the Thingiverse  database allow makers worldwide to share designs for printers; designers printing artificial limbs; artists re-inventing their process — we can’t wait to see what’s next. In honor of 3D printers here are some TED and TEDx talks on understanding this technology.

Lisa Harouni: A primer on 3D printing
So what exactly is 3D printing? Lisa Harouni breaks it down — from machine to design to product. Learn how it all works in this talk from TEDSalon London Spring 2011.

Klaus Stadlmann: The world’s smallest 3D printer
Klaus Stadlmann built the microprinter, the smallest 3D printer in the world. In this talk from TEDxVienna, he demos this tiny machine that could someday make customized hearing aids — or sculptures smaller than a human hair.

Scott Summit: Beautiful artificial limbs
In his work, prosthetics designer Scott Summit noticed that a lot of people had to hack their own artificial limbs — with socks, bubble wrap, even duct tape — to feel comfortable. In this talk from TEDxCambridge, he describes how he turned to 3D printing to create limbs that not only match a person’s body, but their personality as well.

Anthony Atala: Printing a human kidney
The shortage of organ donations is a crisis in healthcare. A possible solution? Printable organs. In this stirring talk from TED2011, Anthony Atala describes his research into the development of an organ-printing 3D printer, and introduces a recipient of the product of a similar technology — a bladder grown by borrowed cells.

Marc Goodman: A vision of crimes in the future
Sometimes, despite the very best intentions, the things we create aren’t used in the ways we thought they would be. In this talk from TEDGlobal 2012, Marc Goodman draws from his experience in law enforcement to show the dark side of technology — what happens when great tools get into the wrong hands. In his talk, he shows a way 3D printing could be used for harm and cautions us to guard against these potentials.

David F. Flanders: Why I have a 3D printer
David F. Flanders is a 3D printing guru and the host of PIF3D, a collective dedicated to hosting “build parties,” during which 3D printing experts help curious outsiders build personal 3D printers. In this talk from TEDxHamburg, he discusses the development of the technology and the implications of its mass use, including 3D printers’ role in recovery relief, architecture, and the office supply closet.