Developer of a prosthetic leg all could afford

Dr. P.K. Sethi, the Indian physician who developed an inexpensive, durable, culturally appropriate artificial leg that restored mobility to millions of poor people injured in accidents and by land mines, died of cardiac arrest Jan. 6 in Jaipur, India, where he lived most of his life. He was 80.

His family confirmed Sethi’s death to the Associated Press.

Sethi “helped amputees to continue their lives without the feeling of inadequacy, for which he shall always be remembered,” said Indian President Pratibha Patil, according to wire service reports.

When Sethi first began working in orthopedics in the 1960s, the only prosthetic available was the so-called solid-ankle-cushion-heel foot, designed in the West and meant for people who wore shoes and sat in chairs.

Only the relatively affluent could afford such prosthetics, and many of those who could abandoned them and went back to crutches because that was more comfortable, Sethi found.

“Wearing shoes, which were integral to the Western-designed limbs, was uncomfortable in our hot climate,” he said. “Our people walk barefoot or in well-ventilated footwear.

“We are essentially a floor-sitting people, requiring a range of mobility in our feet and knees, which is not needed in the chair-sitting culture of the West. We should not expect our people to change their lifestyle because of a design we are forcing on them.”

With few funds available, and facing the derision of his fellow physicians, Sethi was forced to take an unconventional approach to the problem.

Working in abandoned garages with an uneducated master craftsman named Ram Chandra, he devised a lower limb that consisted of a wooden framework embedded in a vulcanized rubber shell that mimicked the shape of a normal foot.

Credit for the design has been the subject of debate, with Sethi saying he drew inspiration from a Sri Lankan physician who covered a peg leg with rubber to help a rice farmer and Chandra saying he got the idea after seeing a bicycle repairman fix his tire.

Regardless of who conceived it, Sethi and Chandra were able to develop a design that can now be produced by craftsmen in less than an hour and that costs only about $30, compared with the hundreds of dollars needed for a solid-ankle foot.

The prosthetics are most commonly made of polyurethane, but local craftsmen have incorporated a wide variety of materials -- including spent shell casings.

The limbs can be worn barefoot or with sandals and are equally effective on flat land and rocky terrain. Users can even climb trees with them. Women often paint the toenails and wear ankle bracelets and other jewelry on them.

The devices, commonly called the Jaipur Limb and the Jaipur Foot, were slow to catch on, with fewer than 60 produced in the first five years, mostly for patients whose limbs were severed after falling off packed trains.

But the situation changed after the 1979 Soviet invasion of Afghanistan, which left thousands of people maimed from land mines.

The International Committee of the Red Cross trumpeted the limbs’ effectiveness, and poor countries around the world began assembling them, a task made easier by Sethi’s refusal to take out patents.

The limbs received a further boost after Sethi fitted one to celebrated folk dancer Sudha Chandran, who lost a leg in a 1982 accident. The Bollywood actress was able to perform athletic dance routines with the prosthetic, including a tour de force dance in the movie “Nache Mayuri.”

The devices are manufactured in more than 25 countries.

Sethi was honored for his creation with the 1981 Ramon Magsaysay Award for community service, sometimes called the “Asian Nobel Prize.” That award led to an acrimonious split between Sethi and Chandra, who felt that his contributions to the prosthetics were overlooked because of his lack of education.

Chandra continues to work for a Jaipur charity that manufactures the device in large numbers and distributes them free to the poor.

Pramod Karan Sethi was born Nov. 28, 1927, in the northern Indian city of Benares, now called Varanasi, and was the son of a physics professor at Benares Hindu University.

He received bachelor’s and master’s degrees in surgery from Saro- jini Naidu Medical College in Agra, India, in 1949 and 1952, then did a residency in Scotland, where he became a fellow of the Royal College of Surgeons.

He returned home in 1958 to join the Sawai Man Singh College and Hospital in Jaipur. The hospital was in danger of losing its accreditation, and Sethi was asked to create a department of orthopedics. His experiences with the poor there led him to create the new prosthetics.

Sethi is survived by his wife of 56 years, Sulochana Patna Sethi, a son and three daughters.

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thomas.maugh@latimes.com