By Swati Chopra January 2004 The Jaipur foot is the unpatented, durable hero of medicine that has made a normal life possible for lakhs of amputees around the world The cheap, unpatented, and highly effective Jaipur foot represents a fruitful interface between sustainable grassroots technology and human need More than 30 years ago, a barely literate artisan and an orthopaedic surgeon created a miracle—a light, cheap and durable artificial limb that has since then enabled approximately six and a half lakh amputees lead a normal life. Called the ‘Jaipur foot’ after the city where it was conceived, this remarkable prosthetic has never been patented by the duo that created it, the reason being their firm belief in the motivation behind their creation—the greatest common good. This has ensured that the foot is available at the cheapest price possible and can be afforded by the common person not only in India but anywhere in the world. This fact was celebrated in an October 1997 story in Time magazine, which labelled it the ‘$28 foot’ from India, in obvious contrast with the thousands of dollars artificial limbs cost elsewhere. Its low price is only half the reason why the Jaipur foot is manna from heaven for amputees throughout the developing world. It is light and easy for the body to adapt to, enabling wearers to live as normal a life as possible. They can sit, even squat, run and pedal bicycles wearing the Jaipur foot. This makes it ideal for developing world professions like farming, and also lifestyles that require you to eat, sleep, cook and worship on the floor. The foot is also an excellent example of low, sustainable technology—it is mostly made of rubber, wood and aluminium and can be put together using locally available materials. So that in Afghanistan, the foot is hammered out of spent artillery shells, and in Cambodia, where one out of every 380 people is a war amputee, rubber for the foot is sourced from truck tyres. The Jaipur foot’s illustrious, globe-spanning career is much beyond the wildest dreams of its co-founders—Ram Chandra and Dr Pramod Karan Sethi. The disparate duo met more than three decades ago, when the latter was an orthopaedic surgeon at the Sawai Man Singh Hospital in Jaipur, and the former was a master artisan, teaching lepers handicrafts in the same hospital. At that time, options available to orthopaedic amputees were limited. Most were resigned to spending the rest of their lives on crutches, while the rich could order artificial limbs from abroad, which were heavy and unwieldy. The artificial limbs that were being manufactured were of the solid-ankle-cushion-heel (SACH) variety, which were culturally inappropriate as they were fashioned for wearing shoes and sitting on chairs. Observing this situation at the hospital, Chandra was convinced he could create a much better alternative. He approached Dr Sethi, who explained physiological aspects of the human foot to him, such as pressure points and the movement of bones. For two years, the two experimented with willow, sponges and aluminum moulds, which turned out to be either too fragile or too unwieldy, or simply too impractical. Then one day, Chandra saw repairmen retreading a tyre with vulcanised rubber. He rushed to the hospital and returned with Sethi, an amputee patient and a foot cast. They asked the repairman if he could cast a rubber foot. Rubber alone was not good enough since it shredded soon. So they tried an alternative—to construct the rubber foot around a hinged wooden ankle, wrapping it in lighter rubber and then vulcanising this composite. And it worked! The resulting limb takes only 45 minutes to build and fit on the patient and is sturdy enough to last for more than five years. From 1968 to 1975, only 59 patients were outfitted with the Jaipur foot, but the use of the new limb spread outside India during the Afghan war in which Russian land mines caused thousands of injuries. The International Committee of the Red Cross discovered that the Jaipur foot was the hardiest for the mountainous Afghan terrain, and distributed it there. Thereafter the Jaipur foot became a popular choice in countries with landmine amputees, such as Vietnam and Cambodia, among others. The Time article quotes Dr Sethi as saying: “Western aid agencies have helped millions of amputees, and they’ve found that they can’t do it as cheaply as with the Jaipur foot.” Ram Chandra now works with the Delhi-based Bhagwan Mahaveer Viklang Sahayata Samiti (BMVSS), a non-profit organisation that provides artificial limbs free of cost to the disabled and also works to rehabilitate them in society. The Samiti organises mobile camps where people are fitted not only with artificial limbs but also with polio callipers. According to the BMVSS website, on an average 15,000 people are fitted with the Jaipur foot and 35,000 with other aids every year. Last year, BMVSS donated a thousand limbs to be fitted to war amputees in Afghanistan. Millions could have been made off the Jaipur foot if its founders had stuck to their intellectual property rights and patented their creation. But that would have ratcheted up the cost substantially and put the foot out of reach of those who needed it the most. As a publisher’s note in the January 2002 issue of US-based technology magazine Siliconeer acknowledged: “Where a Western prosthesis can cost several thousand dollars, the Jaipur foot costs less than $30. Sethi and Chandra could have minted money with this device, but their humanitarian impulse triumphed. In a world where patent rights rule supreme and intellectual property rights can be cause for war, it’s particularly striking that an innovation that has changed the lives of millions of amputees was never patented.” Today, the Jaipur foot is emblematic not only of a fruitful interface between technology and human need, but also gives us in its own way reason to hope. This is reflected in what Ram Chandra, still the simple artisan, pointing out a girl who had lost her leg in an accident, told Time: “People said I would be a rich man if we had patented the Jaipur foot, but it’s enough satisfaction for me to see the joy on that girl’s face when she walks again.” The Jaipur foot continues its journey on that hope. w Contact: Bhagwan Mahaveer Viklang Sahayata Samiti, email: email@example.com; website: www.jaipurfoot.com
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