People And Their Problems

New Delhi, 8 February 2008

MAKING FAST STRIDES

By Radhakrishna Rao

For thousands of below-the-knee amputees in conflict zones stretching from Iraq in the Middle East to Rwanda in Africa, Jaipur, a bustling tourist town in Rajasthan, spells hope and a new life. The capital city known for its grand historical monuments, has also made a name for itself over the past three decades as a birth place of low-cost and innovative prosthesis by the name of Jaipur Foot.

By all counts, the Jaipur Foot, which closely resembles the normal human foot, has become widely acceptable on account of its extraordinary mobility, low weight and a high degree of flexibility. More importantly, the experience of those who have been fitted with this artificial limb is that they can run, climb trees, pedal bicycles, work in paddy fields, walk barefooted and even squat on Indian-style toilets without any hassles.

Well-known Indian dancer and actress Sudha Chandran is among the celebrities who got a new lease of life after wearing the Jaipur Foot. Thanks to its agility and robustness, she could easily perform a complicated dance sequence in the Hindi film Nachae Mayuri. The International Red Cross Committee (IRCC) has used the Jaipur Foot widely in war-torn countries to help soldiers who lost their legs in either the war front or in landmine explosions. In the 1999 Kargil war, soldiers who had lost their limbs were fitted with the Foot and given new lease of comfort.

The Jaipur Foot is an invention materialized through the active collaboration between Dr.P.K.Sethi, a Magsaysay award-winning orthopedic surgeon attached to Jaipur’s Sawai Man Singh Hospital and Pandit Ram Chandra Sharma, who mastered the art of temple sculpture and sand-craft from his forefathers. From late 60s, they started experimenting with various materials and succeeded in fabricating a functionally-efficient and aesthetically-appealing artificial foot with vulcanized rubber by 1970. They fine tuned various features of the artificial foot with a focus on Indian amputees, who are accustomed to sitting cross legged and working in paddy fields.

However, the design of the Jaipur Foot was not patented so that it could be widely produced and be available at an affordable cost. Before its invention, the artificial limbs in use used to be bulky and were of solid ankle cushion heel variety fashioned for wearing shoes and sitting on chairs. Though this type of prosthesis would cost a whopping US $ 2500, it would not allow Indian amputees to squat or walk barefooted. Worse, the price tag made it beyond the reach of majority of the amputees here and other third world countries. In stark contrast, the Jaipur Foot costs around US $ 30 and can be fabricated with local materials with ease.

Looking back, in the first five years of its inception less than 60 Jaipur foot were fitted. But this changed following the setting up of the Bhagwan Mahaveer Viklang Sahayata Samiti (BMVSS) in March 75, by D.R.Mehta, former Deputy Chairman of Reserve Bank of India. The BMVSS gave a big boost to the popularization of the Jaipur foot not only in the country but also outside. The Foots fitted each year now touches 16,000 and till now over 3,25,000 people have the Jaipur Foot. No wonder the BMVSS has the distinction of being the largest limb-fitting organization in the world.

According to D.R.Mehta, the Samiti holds regular camps, including those for earthquake and landmine victims in Pakistan and Afghanistan. The amputees are fitted with the Foot and given comprehensive rehabilitation. This apart, the BMVSS has opened centres in African and Asian countries with the support of Rotary Clubs and has a joint venture in Medeline City, Colombia under the name of Mahavir K.Mina. Similarly, two Jaipur Foot centres are in offing in Karachi and Islamabad.

The BMVSS has been striving to improve the Foot technology and make it more comfortable for the amputees. A full-fledged research and development wing headed by Dr.M.K.Mathur has been involved in upgrading the design of the Jaipur Foot by either incorporating indigenous innovations or available elsewhere.

Not long ago the Jaipur Foot used to be made of aluminium with open-ended socket. Today it is produced using High Density Poly Ethylene (HDPE) with a highly advanced total contact system. It is because of its total contact socket that the Jaipur limb has a comfortable stump socket interface. To get the best alignment, BMVSS has succeeded in fusing two distinct alignment systems—wall frame from Endolite Prosthetics of the United Kingdom(UK) and Laser alignment system of Otto Bock Prosthetics, a German enterprise.

With an eye on improving the flexibility and comfort level of the Jaipur Foot, the Samiti has signed an agreement with Indian Space Research Organisation (ISRO) for using polyurethane technology developed for use in launch vehicle structure. The BMVSS has been able to fabricate a few varieties of polyurethane-based Jaipur Foot, which are now undergoing laboratory tests and field trials.

Fortunately, the use of polyurethane has both reduced the weight of the Jaipur Foot as well as improved it aesthetically. Initial feedback from users is quite encouraging. If successful, this is going to be a major breakthrough in limb-making technology. At the same time the BMVSS is looking elsewhere. It has also acquired technology for making total contact socket through sand cast mining from the Centre of International Rehabilitation (CIR), North-western University, Chicago. 

With an increase in the population of amputees in India and other parts of the world on various counts, the need to produce and distribute the Jaipur Foot on a larger scale has become all the more imperative. As Mehta says it will fulfill the BMVSS mission:  “That All May Walk” ---INFA

 (Copyright, India News and Feature Alliance)