The Case of Jaipur Foot

Introduction
The number of people suffering from loco-motor disabilities ranges between five and six million in India alone. Of these one million people are estimated to have lost their limbs and another four million suffer from Polio. There has also been rise in road accidents and incidence of other wasting diseases, and almost 25,000 new cases get added to the population of amputees every year . Amputation, apart from being a physical loss, also affects the patient psychologically and greatly restricts his or her productivity. Hence, its economic consequences, both on patient’s household at the micro-level and the economy at a larger level are adverse. This makes the fitment of artificial limbs an important health-care as well as economic and developmental issue in India.

BMVSS
The Jaipur foot, an innovative prosthesis invented by Sh Ram Chandra around the year 1968, has provided mobility to many amputees around the world. Being cheap, convenient and durable it has gained widespread popularity in areas torn by strife and war like Afghanistan and Rwanda apart from India. It is primarily fabricated and fitted by BMVSS, which is a non religious, not for profit NGO. It has seven centers in India and provides prosthesis fittings to 16,000 people and services another 44,000 annually by providing calipers, aids and other appliances. Apart from this, BMVSS organizes mobile camps throughout India and also abroad. So far, these camps have been organized in 19 countries in Asia and Africa.

Between 1975 and 2003, BMVSS had fitted over 2.3 lacs limbs in India apart from 14,000 limbs across the world . A large part of the success is attributed to the organization’s value system and customer centric management practices. The procedures for client admission, treatment and prosthetic fitting have been kept simple. Further patients are provided lodging and boarding facilities till the time they are given prosthetic limbs, calipers or other aids. Importantly Jaipur foot is custom fitted, and often within four hours of the patient checking in.

Products and Services
The Jaipur foot and allied aids has been made keeping in view the developing country lifestyle. It allows for sitting cross legged, squatting, walking on uneven surface and barefoot walking. It compares well with the modern western prosthetic products, given its price which is just a fraction of the price of variflex or college park foot prosthesis.

Business Linkages – Strategy
BMVSS has received support from Rotary International for its activities. The Rotary Jaipur Limb Project (RJLP) plans to spearhead Jaipur Foot Camps across the world. It is also moving towards setting up a permanent International Centre collaboration with BMVSS.

BMVSS has signed an agreement with the Indian Space Research Organisation (ISRO) for its Poly Urethane technology. This technology will help in reducing the cost of the Jaipur foot as well as increasing its durability. Moreover, the time required in fabricating the foot is also expected to come down. The other great benefit of using this technology would be in reducing the weight of the foot from the present 850 grams to 350 grams.

BMVSS: Outreach and Potential
BMVSS’s current method of expanding the reach of Jaipur foot in India and abroad is based on camps. Doctors, administrators and artisans travel from Jaipur to the camp’s site on invitation, where a temporary facility is set up. A camp is typically funded by another organization or government which has invited BMVSS to the site. The camp is supervised by a VSS physician and it takes a day to set up. Closing the camp takes around half a day. The sponsoring organization pays the society’s employees a travel allowance for participating in the camp. The society (BMVSS) usually travels with the expected required materials and equipments needed for fabrication. Material shortages are taken care of through local purchases. The responsibility of camp promotion is taken care of by the sponsors.

The society also reaches out by establishing new locations to fabricate and fit Jaipur foot such as the locations in New Delhi and Mumbai. Further, it encourages the establishment of other charitable organizations to run the clinics. Setting up new facilities is quite important in making the Jaipur foot prosthesis more widely available.

Investment & Cost
As discussed earlier setting up new locations is important in improving the outreach of the Jaipur foot. A new location requires a modest level of capital investment. The most significant piece of equipment is the vacuum forming machine which has an estimated price of around US$ 2,000.00 (approximately Rs 90,000.00). Additional equipment and tools generally cost another US$2,000.00. The Jaipur location provides training and also manuals to outline the fabrication and fitting processes.

Benefits derived
The Jaipur foot has enabled many amputees to lead a near normal life. The society claims that it has enabled cycle rickshaw operator amputees to resume operations, farmer amputees to get back to farming and many other individuals who have lost limbs to once again participate in their previous economic activities. One of the most celebrated cases is of Ms Sudha Chandran who went on to become a dancing movie star after having undergone amputation at the age of 14 years.

Investment opportunities for private partnership and risks
Given the number of amputees in India as well as other countries, the outreach of Jaipur foot is still limited. Investments in opening up more new centers are important to increase impact. Research and Development of lighter and cheaper materials is another area where investments can be made. The Jaipur foot also enjoys a cost advantage which can be translated into a profitable business enterprise including exports. However, there are a few areas of caution which limit its commercial attractiveness at present:
• Jaipur foot is hand designed and suffers on consistency parameters.
• Its weight at 850 grams does not compare favorably with international products.
• It does not have international quality certification

Contact Address
Mr. B.P. Jain (President), Bhagwan Mahaveer Viklang Sahayata Samiti, L-43, Cannaught Circus, New Delhi – 110001, Tel. 0091-11-23416350/23413351, Fax. 23413446
E-Mail: bmvss@jaipurfoot.org