Are ideas ready to flow in the opposite direction: from the developing world to the developed?
Situated in a chaotic corner of Delhi, Jaipur Foot is revolutionizing public health. Actually, it has been for the last 40 years. Few can argue with its business model, which creates low-cost prosthetics for the disabled, charging them nothing for its services.
Dr. Mehta, one of the leading figures of the organization, hands me a prosthetic foot to play with; it costs the price of one Starbucks latte with soy milk. It’s designed to resemble a real foot, complete with nails, individual toes and an arch.
“We don’t want them to feel uncomfortable or any less than the person walking next to them,” he explains.
Even in that low-price point, approximately $5 a foot, they’re looking at the minute details. It has to be flexible, it has to be real, it has to be durable.
For the complete package, including consultation, fitting, and the device, it’s $50. The entire process takes one day. And with the help of financial supporters, Jaipur Foot is able to offer it free of cost to its patients.
Needless to say, I’m eager to visit to see how Jaipur Foot makes it happen. I’m traveling with a local Rotarian from Moorpark, Matt Miguelena, who works as a physical therapist.
I translate the Hindi to English for him; he translates the medical terminology to layman’s terms for me. It’s a great pairing. Matt tells me that the equivalent service back home would cost nearly $5,000 depending on the patient. And it would certainly take more than a day to complete.
Seeing Matt’s face as Dr. Mehta describes the process is just as thrilling for me — he’s humbled, stunned and amazed. That’s exactly what I had intended: How one medical professional can learn from another, coming from opposite corners of the planet, and in this case, opposite price points in the market. The entrance to Jaipur Foot is modest at best. In fact, if you didn’t know that it was Jaipur Foot’s facility, you wouldn’t be able to find the place — it doesn’t market itself.
A long bench lines the entry way. Ten patients are waiting for consultation. Many already have prosthetics or calipers. They’re coming for a new set or refitting. Dr. Mehta asks them to get up, pull up their trousers and show us their treatment.
I asked them, what is the cause of their condition. Polio, most answer. In fact, nine out of 10 answer polio. For a disease that’s largely forgotten in much of the world, here it comes alive.
One man is being fitted with his caliper for the first time. He’s seated in a small cubicle until an attendant can help him walk. Each consultation takes places in cubicles with 4-foot-high walls. The surroundings are barren. The ambiance speaks of service, not of business. There are no frills here.
Frugality is key instead. Little money is spent on the building. For some, it would be archaic, inhospitable. But from this facility alone, which is only one of Jaipur Foot’s 30-plus facilities in the country, it is able to provide 250 calipers every month.
Not only does it provide the services on site, it also manufactures the low-cost devices in its backyard where a factory has been set up, baking prosthetics into molds much like one would bake bread in a bakery.
It’s dusty and chaotic but completely efficient. It is in many ways symbolic of modern India where frugal innovation is thriving.
In an effort to build a more inclusive economic system, one that actually ropes in the lower class and working class, nonprofits, businesses and even government are looking at how to craft products for low cost. The ingenuity is not in high-tech, but low-tech.
Some of the procedures are from eras past. But they work. And they cost less. So, they’ve kept them, forgoing expensive equipment for more affordable options. While we fret about the interior of the building, the look of the facility, here they fret about how many people they’ve treated and how many more could they reach.
We peek into the cubicles as consultations take place. At home that would not be allowed; many would argue against it, citing privacy regulations. Here, there’s little to hide.
In fact, when we ask these doctors why can we not replicate these low-cost ideas back home, after all, we’re stuck in tough economic times with more and more Americans needing assistance, they all say one word — regulations. There are too many regulations in the U.S., preventing them from taking their experiment there.
While some regulations are necessary and valid, others could be reconsidered, they say. It’s not just the higher labor costs; it’s the endless list of regulations that one must abide by to avoid troubles with the law. Too many rules, though, deter creativity and experimentation. Creativity thrives in chaotic environments.
In India, where little makes sense, but where the system still seems to work (to an extent), creative models of low-cost innovation are emerging. Perhaps, we could take a lesson from these institutions.
For Matt and me, it was an opportunity to be a student again, learning how to speak a different language — one of frugality, creativity, spirituality and basics.
Can more of these ideas cross over? I hope so.