JAIPUR FOOT BMVSS Clinic - February 2, 2019
Although I had visited this Jaipur Foot Clinic back in 2001, I had not been allowed to observe the entire process.
Let me take you, if I can, through the process a member of the public experiences...
Imagine for a moment that you or a friend was a victim of an accident - perhaps a traffic accident, or falling from a train, etc., and one of your legs was severed, above the knee. You recovered from the physical trauma, but were scarred for the rest of your life and relegated to walking either with a pair of crutches, or hopping with the use of one crutch, or confined to a wheelchair. If you were a street person here in India, you might well be tossed aside and forced to live by perching yourself onto a "creeper" (remember the auto mechanics who used to slide under your car - they did so using a flat wooden platform on four wheels, called a creeper.
Fast forward a few years of misery. Then someone told you about a clinic in Delhi, where you could go and be provided with a new leg! Hard to believe, but you took the chance. You entered the Jaipur Foot BMVSS Clinic and signed in at the registration desk. It is probably 10:00 in the morning. You are invited to sit in the waiting area in the lobby until your name is called. You are scared - there is no other term which describes your anxiety. Before too long, your name is called and an attendant comes to you to assist you to the Interview Room. To the person there, you tell your story, how you happened to have lost your leg. You finish the interview and then move out into the corridor and sit down on the bench, alongside other victims of tragedy. Your name is called again.
This time, you are taken to a room where a technician examines your "stump" and then invites you to relax while he or she wraps your stump with Saran Wrap, or a similar plastic film. The attendant then picks up some plaster-infused gauze and wets it in a bucket and then begins to warp it around your the stump that has been wrapped with plastic film. Round and round and round again, until the entire area is covered and he continues to smooth out any wrinkles in the wet gauze material. As the plaster begins to harden, he takes his thumbs and forefingers and makes slight depressions into the wet, sticky gauze where the patella might be located (This is to ensure that the prosthesis not only looks right, bus also fits properly). He continues to check until the plaster wrap has hardened - at least to the point of being able to be slid off the plastic film-covered stump. He asks you to remain there while he takes it to another room in the clinic.
There, the "shell" of the plaster wrap has a metal rod punched through the closed end and then the entire wrap with rod is set into a bucket of sand. It is propped up so it is perpendicular to the sand in the bucket. Another attendant is mixing up a batch of plaster of Paris and once fully mixed, pours the mixture into the wrap until full. That process takes a few minutes and then the waiting begins. in about ten or fifteen minutes, the plaster of Paris has hardened sufficiently and the wrapped plaster cast is removed from the sand bucket and the rod inserted into a vice. The next attendant cuts into the "wrap" and slices it away so not only the plaster stump remains. He uses a coupled of simple tools - a piece of wood and a knife and begins to pare away to create what appears to be a replacement for calf of your leg, which suffered amputation.
Once that process is finished, the plaster cast is taken to the next room and the next technician removes a highly heated (180 degrees Celsius) polyethylene
pipe" which is almost a think liquid substance and pulls it down over the plaster cast until its fully covered. He continues to smooth it out as the plastic pipe begins to cool down. Technician then pulls it up and over the top and down past the bottom of the cast and twists it off, almost like the ends of a salt water taffy candy. Once the pipe has cooled sufficiently, the twisted ends are cut off and the now-hardening plastic is ready for the next step. The plaster cast is inside the plastic and once totally cooled, a steel mallet is used to pound against the plastic to break up the plaster inside until the plastic is completely hollow and ready for the next steps. A rubber foot is affixed to the bottom of the plastic tube and if the prosthesis is to be just below the knee, then a leather strap is riveted to the top and the prosthesis is ready to be fitted to the patient.
Once that fitting has occurred, then possibly for the first time in several years, the patient is encouraged to go to the therapy room where he or she will be assisted to the walking platform, with parallel steel bars - one on each side, to help the patient balance and begin walking without crutches. If the patient has reached a level of confidence with waring the prosthesis and walking with it, it is time to say goodbye and to hopefully begin a new and productive life.
All of this consultation and fitting and the apparatus is free of charge to the patient. The cost for just a foot replacement is $10.00. If there is a calf or a calf and a thigh with a foot, the total cost would be $60.00. If you consider assisting with this process to provide a new life for any patients, feel free to contact me and I will direct you to the appropriate person at the clinic.
Let me take you, if I can, through the process a member of the public experiences...
Imagine for a moment that you or a friend was a victim of an accident - perhaps a traffic accident, or falling from a train, etc., and one of your legs was severed, above the knee. You recovered from the physical trauma, but were scarred for the rest of your life and relegated to walking either with a pair of crutches, or hopping with the use of one crutch, or confined to a wheelchair. If you were a street person here in India, you might well be tossed aside and forced to live by perching yourself onto a "creeper" (remember the auto mechanics who used to slide under your car - they did so using a flat wooden platform on four wheels, called a creeper.
Fast forward a few years of misery. Then someone told you about a clinic in Delhi, where you could go and be provided with a new leg! Hard to believe, but you took the chance. You entered the Jaipur Foot BMVSS Clinic and signed in at the registration desk. It is probably 10:00 in the morning. You are invited to sit in the waiting area in the lobby until your name is called. You are scared - there is no other term which describes your anxiety. Before too long, your name is called and an attendant comes to you to assist you to the Interview Room. To the person there, you tell your story, how you happened to have lost your leg. You finish the interview and then move out into the corridor and sit down on the bench, alongside other victims of tragedy. Your name is called again.
This time, you are taken to a room where a technician examines your "stump" and then invites you to relax while he or she wraps your stump with Saran Wrap, or a similar plastic film. The attendant then picks up some plaster-infused gauze and wets it in a bucket and then begins to warp it around your the stump that has been wrapped with plastic film. Round and round and round again, until the entire area is covered and he continues to smooth out any wrinkles in the wet gauze material. As the plaster begins to harden, he takes his thumbs and forefingers and makes slight depressions into the wet, sticky gauze where the patella might be located (This is to ensure that the prosthesis not only looks right, bus also fits properly). He continues to check until the plaster wrap has hardened - at least to the point of being able to be slid off the plastic film-covered stump. He asks you to remain there while he takes it to another room in the clinic.
There, the "shell" of the plaster wrap has a metal rod punched through the closed end and then the entire wrap with rod is set into a bucket of sand. It is propped up so it is perpendicular to the sand in the bucket. Another attendant is mixing up a batch of plaster of Paris and once fully mixed, pours the mixture into the wrap until full. That process takes a few minutes and then the waiting begins. in about ten or fifteen minutes, the plaster of Paris has hardened sufficiently and the wrapped plaster cast is removed from the sand bucket and the rod inserted into a vice. The next attendant cuts into the "wrap" and slices it away so not only the plaster stump remains. He uses a coupled of simple tools - a piece of wood and a knife and begins to pare away to create what appears to be a replacement for calf of your leg, which suffered amputation.
Once that process is finished, the plaster cast is taken to the next room and the next technician removes a highly heated (180 degrees Celsius) polyethylene
pipe" which is almost a think liquid substance and pulls it down over the plaster cast until its fully covered. He continues to smooth it out as the plastic pipe begins to cool down. Technician then pulls it up and over the top and down past the bottom of the cast and twists it off, almost like the ends of a salt water taffy candy. Once the pipe has cooled sufficiently, the twisted ends are cut off and the now-hardening plastic is ready for the next step. The plaster cast is inside the plastic and once totally cooled, a steel mallet is used to pound against the plastic to break up the plaster inside until the plastic is completely hollow and ready for the next steps. A rubber foot is affixed to the bottom of the plastic tube and if the prosthesis is to be just below the knee, then a leather strap is riveted to the top and the prosthesis is ready to be fitted to the patient.
Once that fitting has occurred, then possibly for the first time in several years, the patient is encouraged to go to the therapy room where he or she will be assisted to the walking platform, with parallel steel bars - one on each side, to help the patient balance and begin walking without crutches. If the patient has reached a level of confidence with waring the prosthesis and walking with it, it is time to say goodbye and to hopefully begin a new and productive life.
All of this consultation and fitting and the apparatus is free of charge to the patient. The cost for just a foot replacement is $10.00. If there is a calf or a calf and a thigh with a foot, the total cost would be $60.00. If you consider assisting with this process to provide a new life for any patients, feel free to contact me and I will direct you to the appropriate person at the clinic.
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