At less than the price of a cup of coffee, it might be one of the world’s most economical lifesaving devices. The “uterine balloon tamponade” does not look like much: a syringe, some blue tubing, a lubricated condom. All this is contained in a plastic bag, along with a checklist and a laminated set of instructions. But, when the condom is attached to the end of a catheter and inflated with water, it can stop uterine bleeding in women who have just given birth—one of the leading causes of maternal mortality in developing countries. “I get pictures every day from women—in India, in Kenya, in Tanzania—from women who have survived,” Thomas Burke tells me, holding up his phone, as we sit in the living room of his house in the Boston suburbs. “We’ve heard it called the miracle device.” In his basement are boxes containing thousands of the kits.

Nearly a decade ago, Burke, an emergency physician who heads the Division of Global Health Innovation at Massachusetts General Hospital, was in South Sudan, where he and a team of doctors had been tasked with setting up programs to improve maternal and newborn health. Complications from pregnancy were at the top of the list. “There are places on earth where between one in six and one in eight women lose their life because of pregnancy,” Burke says. Ninety-nine per cent of new mothers globally who die do so in “resource-poor settings.”

More than half of maternal deaths in developing countries—and one in three of all maternal deaths—are caused by postpartum hemorrhage (PPH), in which the uterus, often fatigued after hours of labor, bleeds uncontrollably. Few of the standard medical responses to PPH—uterotonic drugs, interventional radiology, even hysterectomies—were readily available in the fledgling, conflict-ravaged Republic of South Sudan, so Burke and his colleagues shifted their attention to uterine balloons, a simple mechanism that compresses against the source of the bleeding and helps activate the body’s own clotting response.

But the typical uterine balloon can cost upward of three hundred dollars. Burke had learned about a lower-cost, unregulated UBT—sometimes dubbed Sayeba’s method, after Sayeba Akhter, the Bangladeshi doctor often credited with coming up with the idea, in 2000—constructed from a standard catheter and a condom. Burke and his colleagues wondered if there was a middle ground between the medical-grade balloons and the ad-hoc condom-catheter device. Back in Boston, he began “walking through the aisles of Home Depot, just wandering around our hospital,” looking for inspiration.

Burke is under no illusion of having reinvented the wheel. “This is just about taking some low-cost things that are right in front of us and assembling them in a—people often say, a ‘MacGyver’ fashion,” he told me, with a gently derisive snort. He made some design refinements—like adding a one-way valve to make sure the condom stayed inflated—but the real innovation was presenting the device as a package, a self-contained kit with easily replaced parts and, important in regions where health-care workers often can’t read, graphically rendered instructions.

Today, the E.S.M.-UBT—E.S.M. stands for “Every Second Matters”—has been deployed many thousands of times, in countries from Peru to Zambia. The survival rate of women who received it—many of whom are in advanced or even end-stage shock—is ninety-seven per cent over all, according to numbers compiled by Massachusetts General.

At a rural medical college in Sevagram, India, founded by Gandhi’s personal physician, the UBT has helped save hundreds of lives. It has also lowered costs by reducing the number of hysterectomies and blood transfusions, and the hospital is now working on producing its own UBT kits. This imitation is, Burke says, the whole point: “In India, the government keeps saying, ‘Dr. Burke has been so kind to give us his patent.’ I keep saying, ‘There is no patent, this is yours, go for it!’ ”

The UBT is just one in a series of low-cost medical technologies that Burke and his colleagues hope to disseminate.These devices may not rise to the absolute gold standard of care but they are just good enough—particularly when lives hang in the balance. Their use is most obvious and immediate for doctors in developing countries working with immense constraints and high stakes; but is there a lesson here for wealthier countries, too?

As a practicing emergency physician, Burke long ago learned the art and science of making do. He carries a medical kit with him at all times and has inserted breathing tubes for the victims of car crashes where he happened to be on the scene; once, at a rural hospital in Uganda, he consulted an old British military surgery guide—he isn’t a surgeon—to treat abdominal bleeding. And he has a curious propensity for witnessing historic events, from the standoffs at Ruby Ridge and Waco to the attacks in Benghazi. When I first met him, during his stint as the onboard physician for a round-the-world expedition, he had recently dealt with a midtrip heart attack.

People in emergency medicine often joke “that you can figure out a solution with a couple of popsicle sticks. It may not be the ideal tool, but you can muddle through,” Burke says. Through low-cost, research-backed innovations, Burke wants to take that popsicle-stick thinking and do more than muddle through, to help transition from “crisis to long-term strategy.”

His is a bottom-up approach in a world accustomed to top-down solutions. When it comes to health care, Burke says, “you can go to almost any hospital in the world in a poor setting, and you can see piles of technologies that have been presented from do-gooders.” But, without the right supply chains or technical support, such “upstream” solutions quickly surrender to a sort of reverse obsolescence, outmoded less by the future than by the weight of history. An emphasis on bringing in the latest technology is often misguided. There are some cases where ultrasound machines, for example, are essential, but, Burke says, “we’ve not been able to show that ultrasound during pregnancy changes population-level outcomes of newborns.”

Rather than wait for expensive technologies to become more affordable, or to be helicoptered in by well-meaning relief agencies, Burke shapes his approach by observing what is actually being used on the ground and trying to create a set of best practices. Millions of babies worldwide, for example, Burke says, need oxygen support in the first year of life. But CPAP machines, the standard device in a country like the U.S., are expensive and require uninterrupted electricity. In many countries, Burke says, doctors resort to using a makeshift solution: a Coke bottle filled with water and attached to some tubing. The D.I.Y. approach can save an infant’s life but risks causing blindness. Burke took this simple yet flawed idea and improved it, designing the E.S.M.-CPAP, which is comparable to its high-tech equivalent but costs around thirty dollars. Like the UBT, it comes with a simple how-to.

Or take ketamine—known to many people in the West, if at all, as a recreational narcotic. Burke had long been aware of the semi-underground use of ketamine as an emergency anesthetic—he himself administered it at Ruby Ridge. Ketamine works, he says, because it “scrambles you”: “It’s a dissociative drug—it literally dissociates you from the stimulus that is happening, even the world that you and I live in.” It’s not a perfect anesthetic—for one, it’s not a muscle relaxant—but it doesn’t require expensive machinery, or a trained professional to insure a patient keeps breathing. One recent study found that Ethiopia, a country of eighty million people, had only nineteen anesthesiologists. Ketamine costs a few cents a dose and has now become an ad-hoc, unregulated alternative throughout the world. In Kenya, some eighteen hundred documented surgeries under ketamine have been performed, with no attributable deaths.