Med in India

A bunch of Indian innovators are solving patient-care needs with a range of medical devices that are effective and affordable. 

After the Jaipur Foot and the Aurolab intraocular lens (in which the cost of these eye implants - used to treat cataracts - was brought down from $150 to an unbelievable $2), there haven't been success stories of that magnitude in the field of medical devices innovation in India. But an enterprising bunch of young and not-so-young innovators from across the country are trying to change that with a slew of new, effective and cheap devices. And for once, there seem to be just as many venture capitalists - and even the government - willing to bankroll their ideas and get them into the market. 

The Stanford India Biodesign (SIB) Centre - a joint initiative of Stanford University, Delhi's AIIMS and IIT Delhi funded by the department of biotechnology - is one such venture meant to encourage innovation. Two fellows of SIB, Dr Darshan Nayak, a physician, and Pulin Raje, a mechanical engineer and product designer from the Indian Institute of Science, spent days in trauma centres and ambulances studying shortfalls of current emergency medical equipment. For instance, in case of a road accident that involves fractures, the ambulance carrying the accident victim waits until the victim has been lifted onto the stretcher so that the splint (a board) supporting the fractured limb can be given back to the ambulance staff. It costs about Rs 1,500 and nobody wants to just give it away. The splint, anyway, gets removed if an MRI is prescribed as it has metal in it. All this means repeatedly moving the broken limb, something that should be totally avoided in such cases. 

Nayak and Raje realised that there was a need for a splint cheap enough to be disposable and yet firm enough to immobilize the limb. After testing many prototypes they came up with a splint made of hard cardboard with a unique design that makes it easy to use on either right or left leg by just flipping it over. It doesn't have to be to be removed for X-rays , MRIs or CT scans and costs only Rs 40. 

"Their splint was clinically tested in the AIIMS trauma centre and found effective. It has now been licensed to HLL Lifecare Limited, a public sector undertaking, which will be supplying it to ambulance services and primary care centres in one state. Within three years, the plan is to distribute it across the whole country," explained Dr Balram Bhargava, executive director of the SIB Centre

There are also the lone rangers who start out solo but find support as they go along. Laparoscopic surgeon Dr Atul Sardana noticed how the reuse of certain laparoscopic devices was resulting in infections. In laparoscopic surgeries, a device called a 'trocar' is used to keep the holes, through which the surgery is done, open. Since this disposable plastic device is expensive - about Rs 10,000 if you buy from one made by a big MNC pharma major - it is often sterilised and reused. This often results in post-surgery infections. 

Sardana decided to create a trocar so cheap it could be thrown after a single use. "The one I designed costs just Rs 750. Till date we have sold over 15,000 units and haven't had any adverse reports of infection or injury," explains Dr Sardana. 

Dr Kapil Kochhar, senior laparoscopic surgeon at Fortis Hospitals, says as many as four trocars could be needed in a single laparoscopic surgery. "Availability of cheaper local alternatives encourages doctors to dispose of them after a single use," he said. 

Medical innovation is not just has about pricing but also about addressing an unmet need. Ophthalmologist , Dr Dinesh Verma, who worked for the National Health Service (NHS) in the UK for 20 years, noticed that many elderly people lost vision due to age-related macular degeneration. They would come for treatment so late that nothing could be done to save their eyesight. He decided to manufacture a device that could catch the disease at an early stage. "I thought of designing a device based on virtual reality glasses. With help from a software company in Pune I made a pre-prototype using a smartphone and off-the-shelf virtual reality glasses to test it on real patients. I also filed for a patent on the device, says Dr Verma. 

"At present the only other test to detect AMD is a paper based test called Amsler grid which is not very accurate and picks up distortion only in 13 per cent of the cases of wet macular degeneration that is potentially blinding," says Dr Verma. His more accurate device , he believes, has huge potential in India which has a high incidence of blindness often caused by poor or late detection of the disease. "I am adding an imaging component to the device that can enable it to take photos of retina. With that fine-tuned , it will become a low-cost device that can be used for screening in villages and small towns," says Dr Verma, who has returned to India to pursue his dream of bringing the device to the market. 

There are many more breakthroughs in the pipeline with innovators working on coming up with many more devices - a fourth generation syringe to prevent needle stick injuries, a device to measure haemoglobin levels, knee joints for prosthetics and so on.

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