An incubator in a European hospital costs upwards of €35,000. The Incunest one costs €350 in materials, is assembled in a quarter of an hour without a single screw, fits in a suitcase and runs off a car’s cigarette lighter. It is not a cheap version of the other: it is a different product, designed from scratch for a place where the real alternative is not a worse incubator, but wrapping the baby in aluminium foil and putting it next to a radiator.
Behind it is Pablo Sánchez Bergasa, an electronics engineer from Navarre, founder and CEO of Medical Open World. What began as two or three hours a day after work is today more than 250 incubators installed in 40 countries, through which more than 4,000 babies have passed. In this episode of Toque de Ingenio he explains how you design a medical product when the main constraint is not technology, but price, maintenance and logistics.
Guest: Pablo Sánchez Bergasa, founder and CEO of Medical Open World, driving force behind Incunest. Conversation published: 15 September 2026. Running time: 1 h 06 min.
In this episode:
- Why a technology more than a century old still has not reached half the world.
- What you strip out and what you cannot strip out when designing low-cost medical equipment.
- Why 70% of the medical equipment donated to Africa is never used, and how to avoid it.
The problem: no shortage of technology, a shortage of product
Pablo works from a figure that is the origin of everything: around 2.4 million babies die every year worldwide from prematurity and, according to the estimates he cites, some 1.5 million could be saved with basic care, starting with keeping them warm. A premature baby does not regulate its own temperature well and gets cold.
The incubator has existed for more than a century and is not a technological challenge. The problem is that every one being manufactured is designed for Europe and the United States: HEPA filters, double chamber, oxygen sensors, a height-adjustable pneumatic trolley, an enormous regulatory load and expensive maintenance. As Pablo puts it, only Ferraris get built, and in many hospitals in Africa, Latin America or Asia a Ferrari is simply out of reach.
The calculation that drives the design is this: with no incubator, roughly half of premature babies survive; with a European incubator, 99.9%; with the Incunest one, around 90%, at a tenth of the price. Giving up that last stretch is what makes the product viable.
What it does, and what was left out
The incubator is, in Pablo’s words, a simulator of the womb: a thermally neutral environment in which the baby spends no energy regulating its temperature and can devote all of it to developing. That requires two controlled variables, temperature and humidity, and nothing else.
Humidity is not a luxury: a premature baby’s skin is so thin that it loses water, and with the water it loses temperature and weight. Nor is air temperature a fixed number. It is calculated from three variables —gestational age, days of life and weight— using clinical tables, and the incubator adjusts it automatically to keep the baby at around 36.5 °C.
The only added accessory is phototherapy. Around 5% of newborns develop jaundice, treated with a blue light at a specific wavelength. It is cheap, it is common and it fits inside the unit: it goes in. Bacterial filters, controlled oxygen atmosphere and the trolley do not.
A design meant to be assembled on arrival
The structure is two 10 mm polyethylene sheets cut on a CNC, plus methacrylate panels —flexible for the curved dome, rigid for the sides—. The parts snap together like Lego: no screws and no tools. It ships flat, fits in a suitcase, and the hospital assembles it in a quarter of an hour following a set of instructions.
The electrical decision is just as deliberate: everything runs at 12 volts, the voltage of a car or an ambulance. Consumption has been tuned so it can be powered from the cigarette lighter with a three-euro adapter. Where the grid is unreliable, that turns a car battery into an uninterruptible power supply.
The electronics are simple but not naive: they monitor the three or four critical components —that the heater heats, that the LEDs light, that the fan spins at the right rpm— through current sensors, and raise alarms if anything drifts out of range. The stated design goal is not to do the most, but to carry the least risk for the greatest number of lives.
The 70% that is never used: why the incubator has a modem
One figure shapes the whole model: around 70% of the medical equipment donated to Africa goes unused. Units retired from European hospitals arrive, break in transit or lose a button, and there is nobody trained to repair them. Pablo has seen it first-hand: excellent machines sitting idle because nobody knows how to switch them on.
That is why Incunest does not behave like a manufacturer that sells and walks away. They assess every receiving hospital, talk to the staff, deliver training and fit an internet modem inside the incubator itself to follow how it is being used. It was that telemetry that let Pablo see on his phone, in 2021, that a hospital in Cameroon had a baby inside one of his incubators: 500 grams, a weight that would have been written off there. Six weeks later they sent him a photo. They had named the baby Little Miracle.
Three years on a humidifier that already existed
Asked about the project’s biggest technical challenge, Pablo does not pick a problem he solved, but one he should never have taken on. He wanted a humidifier integrated with his own electronics, and decided to design it himself.
«I spent three years getting the humidifier right. And by searching a little harder, there was already a commercial humidifier at half the price of the one I designed, and I could integrate it».
Pablo Sánchez Bergasa, 41:30.
It is the most common make-or-buy mistake in product development, and here it cost three years of a project racing against the clock. The virtue —being stubborn, in his own words— and the flaw are the same thing.
Who builds it: an NGO, eleven vocational colleges and €350 of materials
The project did not start with Pablo. It began as a master’s thesis by Alejandro Escario at an engineering school in Madrid, prompted by what a group of doctors was seeing on their medical expeditions to Sierra Leone: a wooden box that regulated temperature. Pablo joined to rebuild the electronics, and when the others gradually dropped out —weddings, children, moves abroad— he stayed.
Today the organisation is distributed: Medical Open World designs, eleven Salesian vocational training colleges —Pamplona, Madrid, Burgos, Oviedo and others— manufacture the parts as part of their curriculum, and partner NGOs handle shipping and on-site training. The €350 covers materials only, because the colleges contribute the manufacturing. Students who used to turn chess pieces and throw them in the scrap bin now make parts that end up in a hospital.
The funding is just as artisanal. The first round was €2,000 collected after Mass at a parish in Pamplona, in front of around 200 people who did not know him at all; the materials cost €350. They have received no public funding. The Princess of Girona Award —€20,000— is what let him leave his job a year and a half ago. In July 2026 they had 200 incubators on the waiting list.
What comes next: a twin incubator and local manufacturing
In the episode Pablo shows a miniature model of the incubator. The idea is to sell it at cost, around €40 or €50, connected to the internet: when a baby goes into the sponsored incubator, the one at home lights up. The latest units shipped carry a pulse oximeter, so the next version could beat in time with the heart of the baby inside. They call it the twin incubator and hope to open it up by the end of the year.
The underlying goal is more ambitious: setting up manufacturing in the receiving countries themselves. Being an open-source design, anyone can download and build it. The bottleneck is material —sourcing polyethylene and methacrylate in Angola or Ghana is not trivial— but the model is the same one that already works in Spain: a vocational college that manufactures, distributes, maintains and trains.
«The first KPI is to save as many lives as possible as soon as possible. In the end this is a race against the clock».
Pablo Sánchez Bergasa, 50:04.
What another development team can learn
Beyond the social project, Incunest is a textbook case of design under hard constraints:
- Define the real alternative, not the competition. The product does not compete with a €35,000 incubator: it competes with a radiator and aluminium foil. That changes which features are non-negotiable and which are decoration.
- Design for assembly and maintenance on site. Snap-fit with no screws, 12 V and a quarter of an hour of assembly are not production details: they decide whether the unit ends up working or in a storeroom.
- Buy before you design. Three years of development for a component that already existed at half the price. Before opening an in-house development, exhaust the catalogue.
- Instrument the product so you can learn from it. The modem does not sell a feature to the customer; it tells you whether the unit is used, how, and when it fails. In a market where 70% of donated equipment goes unused, that data is the product.
From prototype to production, at i-mas
Taking a wooden box with a thermostat all the way to a unit replicable across eleven manufacturing sites is exactly the journey we make every day. At i-mas we approach product design and development end to end, from prototyping and electronics engineering through to production and assembly, with mechanics, electronics, software and industrial design under one engineering roof.
If your project needs to move from prototype to production, tell us about it.
Further reading: how Cadires x Tororo makes low-cost wheelchairs from PVC in Uganda.
Source: interview by Edgar Guerrero with Pablo Sánchez Bergasa on Toque de Ingenio. The mortality, cost and deployment figures are those given by the guest in the conversation. The quoted passages link to the exact minute. The recommendations for other projects are an editorial synthesis by i-mas.
