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Walking tall

Dr Vijay Kumar Naik's patented knee brace has brought relief to over one lakh people suffering from osteoarthritis. Teena Baruah reports from a camp he conducted in Delhi

"It feels like I am born again," says Shekhar Puri. At an arthritis camp in Sukhad Sandhya, a day-care centre for senior citizens on the outskirts of Delhi, the 73 year-old has just taken his first step in seven years. Osteoarthritis, a condition arising out of wear and tear in knee joints, had left Puri bow-legged and wheelchair-bound. He needed two escorts to carry him down the stairs of his duplex apartment. Then, he heard about a doctor who could help him walk again, without surgery. This led the resident of Ludhiana to the camp at Sukhad Sandhya to meet Dr Vijay Kumar Naik, a prosthetic expert who has developed a knee brace that can help in even the most severe cases of osteoarthritis.

"It allows you to sit cross-legged, drive a car, use an Indian toilet, take the stairs, run and even go on an excruciating Badrinath trail," says the 50 year-old doctor about the corrective brace. He developed it in 1999 at P R Vadhar Artificial Limb Centre, in Bhavnagar, Gujarat, where he lives. He claims it has helped more than one lakh people walk since then, and is even effective for those in need of knee-replacement surgery. A combi-nation of polyprene flaps, stainless steel hinges and four Velcro fasteners, the brace transfers the weight of the body from the knee to the leg below the knee. As a result, the knee joint suffers no friction.

Over a period of time, cartilage that has worn out because of osteoarthritis grows back, stabilising the knees and correcting the defect. However, Dr Nandu Laud, the Mumbai-based orthopaedic surgeon who was on the team that operated on former prime minister Atal Bihari Vajpayee's knee, believes that once the cartilage erodes nothing can be done except knee surgery. "Internationally, experts are trying to develop cartilage implants," he says. On the other hand, Laud thinks Naik's brace is an effective device "to control and correct slight deformity of bone and pain caused by arthritis, but only if worn in the early stages. But you need to compliment it with painkillers and exercise."

Other braces currently available in the market are supportive in nature and expensive-they cost $1,000 to $ 2,000 (about Rs 44,000 to Rs 88,000). Merely a stopgap arrangement, a supportive brace is usually worn after knee replacement surgery to avoid putting pressure on the operated knee. On the other hand, the custom-made corrective brace for osteoarthritis costs just Rs 2,000 and Naik guarantees 85 per cent recovery in four to five months.

It explains the number of cars parked outside Sukhad Sandhya-there are over 200 people present for Naik's camp. He begins the session with a demonstration of the wobbly arthritic walk, followed by a normal walk. "Lift your knee and then step down," he tells his patients. Kajri Gogoi, 70, indiscri-minately pops medicines that help cartilage growth. Naik has put her on his brace for the next four months. "Take it easy, go slow in the beginning," he explains. "No running, just walk. First create space between your bones, only then can the cartilage grow back." Anjali Gulati, 45, needs to restrict her diet, lose 10 kg and wear her brace continuously. Morning and evening walks are as crucial as popping calcium tablets. He tells everyone to use their own brace ("Don't share your spouse's") and keep it on even while taking their afternoon nap, and explains the causes of osteoarthritis (heredity, old age, trauma, sports, obesity) over and over.

Naik has held over 100 arthritis camps in 15 states since 1999. A camp usually lasts three days to give him time to speak to people about osteoarthritis and how to use the brace, examine every patient individually, take measurements of those who need to be fitted with the brace, and finally supply them with their brace. Helping him is a team of eight dedicated technicians from the Artificial Limb Centre. His two constant companions are his diary and a photograph of his wife and two sons.

It was for his sons Neil and Deip, now 16 and 9 years old, that Naik quit a lucrative research job at the Kessler Institute of Rehabilitation in New Jersey and came back to India in 1992. He was 37 and wanted his children to experience Indian culture and the Indian education system. On his return, he couldn't imagine working at one of the big hospitals with his lack of faith in automated health-care that dictates the number of specialists you get referred to and minimises contact between patients and doctors. "I believe doctors should treat people, not just the disease," says Naik, who chose instead to join the Artificial Limb Centre in Bhavnagar, with a salary of Rs 3,000 per month.

Naik still remembers his first impressions of the centre. "The hospital had 30 people on board and specialised in polio-corrective equipment," he recalls. "I got down from the bus, saw the small building and thought, 'This place needs me, and I can work in peace here'." For Naik, who was born and raised in Barani, a small Goan village, it wasn't hard to get used to a small house or an office without air-conditioning. But it was the first time his wife Neha had to cook on a kerosene stove as there was no gas. Ask her about the adjustments she made with her husband, and the 42 year-old just laughs it off.

The change did Naik good. In 1992, the year he joined the centre, he created the 'Prabha foot'. The lightweight (2 kg), low-cost (Rs 4,200) artificial leg with a foldable knee and mobile foot altered the destiny of 16,000 earthquake victims in 2001, for which he received the Red & White Bravery Award for Social Courage. In 1999, Naik devel-oped the 'myoelectric hand', an artificial hand that functions like a normal one with the help of an electronic network that replaces the nerves that pass messages to the brain-it's popularly known as 'Miracle Hand' and won him the Dr Vikram Sarabhai Young Scientist Award. Also in 1999 came the brace for osteoarthritis. He received patents for the three technologies in 1997, 2003 and 2005 respectively.

Today, with the help of around 30 NGOs across the country, Naik is putting the brace to good use. Last year, an NRI offered to buy the technology, but Naik refused. "The brace is custom-made," he explains. "The technology has given jobs to more than 100 technicians working at PNR Society for Relief and Rehabilitation of the Disabled in Bhavnagar. Also, it costs Rs 2,100; Rs 2,000 for the brace and Rs 100 as registration fee for the camp. I don't earn any profit from it and I don't want someone to sell it for more than it is worth." Dr Mangal Parihar, orthopaedic surgeon at Wockhardt Hospital in Mumbai, agrees with Naik. "That's how the Jaipur foot has remained so effective. But it is only a techno-logy that buys time. It cannot change the shape of your bone. After all, if you are fat you can either burn off calories, or wear a corset when you go out."

For his part, Dr Nandu Laud thinks Naik is getting emotional about his science. "He cannot possibly manufacture 30 million braces for India's arthritic in his factory in Bhavnagar," he says. "So he should sell it to those who will keep a check on its cost. Otherwise, his work will die with him and the world will not even know about it. We should learn from the Japanese-even if they sell milk they think global."

But Naik will not relent. He wants to keep the technology. And though profit is not his motive, he doesn't want to give it away for free either. Colonel (Retd) Kishan Sud, the chief trustee of Sukhad Sandhya, says, "Initially, I wanted to host the camp for free, but the doctor cautioned me against offering freebies as not even the poorest people understand the worth of anything that comes for free." Sud is one of Naik's many patrons. Suffering from osteoarthritis himself, he met Naik in 2003 at a Bangalore camp. Since then, he regularly organises a camp at the day-care.

While Naik doesn't mind travelling every fortnight to a new city, he regrets not being with his family when it counted. "In the past 13 years my wife has asked me only once to come home, after the earthquake in Gujarat," he remembers. "Our building was severely damaged and she was unwell and unable to take care of the boys. But I refused as I was busy treating earthquake victims. Sometimes I wish I could go back in time and rush to her side. She didn't complain and I didn't tell her how much she means to me. I think I will tell her now."

Dr Vijay Naik can be contacted at PNR Society for Relief and Rehabilitation of the Disabled, 53, Vidyanagar, Bhavnagar, 364002, Gujarat; Tel: 0278-2525779;

Featured in Harmony Magazine
February 2006

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