Guest contribution by Pepijn Veling

A few weeks ago, Pepijn Veling visited our office. He had just returned from his master thesis field study in Thailand, where he had spent some time with Dr. Jivacate, founder of the Thai Prostheses Foundation. Pepijn shared his experiences in an inspiring presentation during our monthly team meeting. This excerpt is a story about pro-poor innovation, driven by constraints.

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“Innovating for the poor is a challenging task. It is difficult to know what they need and how to develop affordable and appropriate innovations that are useful to them. Hence, local innovators can play a vital role. Their inherent immersion amongst the poor enables them
to discover and deeply understand their needs and relevant contexts. Additionally, local
innovators’ limited access to resources tends to stimulate frugal innovation processes, which can result in highly affordable and appropriate innovations.

The case of local innovator Dr. Jivacate and the Thai Prostheses Foundation
proves to be an inspiring example. Over the past 40 years, they have developed and delivered over 25,000 affordable and appropriate artificial legs to amputees in remote areas of Thailand and surrounding countries.

The intimate relationship between Dr. Jivacate and his patients showed him that conventional artificial legs were unaffordable and inappropriate for the majority of Thai amputees. The reasons being they were made of expensive, imported materials and designed for amputees with different (Western) cultural practices. Additionally, they were only distributed in Bangkok, limiting access. This resulted in amputees making their own artificial legs from local materials such as bamboo. However these were most often too painful to use. This inspired Dr. Jivacate to define their most essential need: to walk without pain. He set out to develop a solution.

As a local innovator, Dr. Jivacate had to overcome limited access to resources. Lacking
appropriate technological knowledge and capital, Dr. Jivacate modified existing technology
from the US and applied this to local materials. His goal was to eliminate the need for
expensive imports. Amazingly, after numerous experiments, his first artificial legs were
developed out of mere recycled Yakult bottles, soda cans, sandals and pieces of wood. These artificial limbs were not only extremely cheap, but they were also lightweight, durable and comfortable. As professionally skilled technicians were obviously too expensive to hire, Dr. Jivacate instituted a training program for those amputees who showed a special interest in the fitting process. Hiring amputees as technicians stimulated the need for product and process simplification and allowed immediate feedback on improvements. Additionally, it created an instant recognition between these so-called amputee-technicians and the patients. The absence of distribution systems spurred the creation of a highly efficient mobile unit and 27 satellite workshops in local areas. Between 1992 and 2011 the mobile unit has made more than 115 trips serving over 16.000 amputees. It has recently broken the Guinness World Record of serving 864 amputees in 13 days.

Originally targeting the poor, continuous innovation efforts have drastically improved the quality of the artificial legs over time (ISO certificates pending). The limbs are now also used by more affluent amputees in Thailand and beyond.

This all-inspiring success story shows how local innovators, like the Prostheses Foundation, have developed affordable, appropriate and accessible solutions for the poor. Due to their inherent immersion amongst the poor, it is these local innovators who are capable of understanding their needs whilst their constrained access to resources conversely stimulates an incredibly frugal innovation process.”

This is an excerpt of Pepijn Veling’s master thesis at the Utrecht University, The Netherlands, which looked at frugal innovation by local innovators based on a 6-weeks in-depth field study at the Prostheses Foundation. Pepijn Veling is a Dutch student-entrepreneur involved with sustainable innovation in both developed and developing countries.
Contact: schrijf@deinnovatieman.nl