Jaipur foot: The limb that revives life

The Jaipur leg is a rubber-based prosthetic leg produced under guidance of Dr. P. K . Sethi by Masterji Ram Chander in 1969 for victims of landmine explosions. Designed in, and named for Jaipur, India; the prosthetic leg was designed to be inexpensive, quick to fit and manufacture, and to be water-resistant. The jaipur foot is fitted free of cost by Bhagwan Mahavir Viklang Sahyata Samiti, founded by Devendra Raj Mehta. It costs approxamately U.S. $40.To further improve the quality of Jaipur Limb, total contact socket systems have been incorporated in below-knee prosthesis. For the above-knee prosthesis design have been changed from quadrilateral sockets to Ischial Containment sockets using IPOS brims and total contact sockets. All these improvements have been possible because of the Research & Development work supported and promoted by BMVSS Jaipur. The BMVSS is working under the leadership & guidance of Mr. D. R. Mehta and because of his Managerial background this research work could be organized. Indian Space Research Organization (ISRO) (Indian equivalent of the NASA of USA), the most prominent Scientific Institution of India, dealing with space research and products has signed an agreement with BMVSS for the development of polyurethane foot (instead of vulcanized rubber). Already field trials, mechanical and laboratory tests are under way and the results up till now are quite encouraging.

The beauty of the Jaipur foot is its lightness and mobility--those who wear it can run, climb trees and pedal bicycles--and its low price. While a prosthesis for a similar level of amputation can cost several thousand dollars in the U.S., the Jaipur foot costs only $28 in India. Sublimely low-tech, it is made of rubber (mostly), wood and aluminum and can be assembled with local materials. In Afghanistan craftsmen hammer the foot together out of spent artillery shells. In Cambodia, where roughly 1 out of every 380 people is a war amputee, part of the foot's rubber components are scavenged from truck tires.The inventors of the Jaipur foot seem a mismatched pair. Dr. Pramod Karan Sethi, 70, an orthopedic surgeon, is a fellow of Britain's Royal College of Surgeons, while his collaborator, an artisan named Ram Chandra, reached only the fourth grade in Jaipur. Their paths first crossed more than 30 years ago at the Sawai Man Singh Hospital in Jaipur. There, Sethi was helping his orthopedic patients wobble down the corridor on their crutches, and Chandra was teaching lepers to make handicrafts. 22045 Chandra is a kind of Pygmalion: he can turn whatever piece of stone or gold he touches into a lifelike creation. Born into a family that had been master artisans for four generations, he quickly established himself as one of Jaipur's finest sculptors, and his talents were sought by temple priests and princes. "If all I saw was your nose, it would be enough for me to sculpt a likeness of your entire body," says Chandra, 75, whose folded hands are like a box of old wooden tools. "It's all to do with proportions. That is the way God has made men."

In 1971 Sethi felt confident enough about the invention to present it to British orthopedic surgeons at Oxford, who were impressed by the artificial limb's suppleness and durability. 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, which began in the late 1970s. Russian land mines--some diabolically shaped like butterflies to attract curious children--caused thousands of injuries, and the International Committee of the Red Cross discovered that the Jaipur foot was the hardiest limb for the mountainous Afghan terrain.Since then, countless land-mine victims in many countries have been fitted with the Jaipur foot. "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," says Sethi. In India most of the 72,000 amputees wearing the prosthesis were migrant laborers injured while trying to hitch free rides by clinging to train roofs and windows. During their long journeys to the harvests, many of these workers slipped off the trains and were run over.22044 .Much of the credit and many of the awards for the Jaipur foot have gone to Sethi; the two inventors have not seen each other since the surgeon retired from active medicine in 1981. Chandra works with a Jaipur-based charity, the Bhagwan Mahaveer Viklang Sahayata Samiti, which provides free artificial legs for the poor not only in India but in other countries too. He says he feels no bitterness over Sethi's greater fame. At his Delhi workshop, where he has been developing above-the-knee artificial limbs, Chandra points out a little girl whose leg was severed in a bus crash. "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." He adds, "I'm still learning from my patients. I haven't done anything yet.".He too is semi-retired. He dresses in a simple white dhoti and lives frugally. "I only need money for the barber and occasionally the tailor," he says, laughing. He rises at 4:30 a.m., milks his cow and prays until breakfast time. Only then does he resume his ongoing effort to improve the Jaipur foot and create new artificial limbs that will be as real and useful as humanly possible.