0:00:00.656,0:00:03.873 Living with a physical[br]disability isn't easy 0:00:03.897,0:00:06.096 anywhere in the world, 0:00:06.120,0:00:08.925 but if you live in a country[br]like the United States, 0:00:08.949,0:00:12.018 there's certain appurtenances available[br]to you that do make life easier. 0:00:12.042,0:00:14.691 So if you're in a building,[br]you can take an elevator. 0:00:14.715,0:00:16.971 If you're crossing the street,[br]you have sidewalk cutouts. 0:00:16.995,0:00:19.234 And if you have to travel[br]some distance farther 0:00:19.258,0:00:22.401 than you can do under your own power,[br]there's accessible vehicles, 0:00:22.425,0:00:24.262 and if you can't afford one of those, 0:00:24.286,0:00:26.635 there's accessible public transportation. 0:00:26.659,0:00:29.326 But in the developing world,[br]things are quite different. 0:00:29.350,0:00:32.545 There's 40 million people who need[br]a wheelchair but don't have one, 0:00:32.569,0:00:35.900 and the majority of these[br]people live in rural areas, 0:00:35.924,0:00:39.785 where the only connections to community,[br]to employment, to education, 0:00:39.809,0:00:42.268 are by traveling long[br]distances on rough terrain 0:00:42.292,0:00:45.005 often under their own power. 0:00:45.029,0:00:47.363 And the devices usually[br]available to these people 0:00:47.387,0:00:49.821 are not made for that context,[br]break down quickly, 0:00:49.845,0:00:52.131 and are hard to repair. 0:00:52.155,0:00:56.851 I started looking at wheelchairs[br]in developing countries in 2005, 0:00:56.875,0:01:00.667 when I spent the summer assessing[br]the state of technology in Tanzania, 0:01:00.691,0:01:04.480 and I talked to wheelchair users, wheelchair[br]manufacturers, disability groups, 0:01:04.504,0:01:06.337 and what stood out to me 0:01:06.361,0:01:08.789 is that there wasn't a device available 0:01:08.813,0:01:11.337 that was designed for rural[br]areas, that could go fast 0:01:11.361,0:01:13.953 and efficiently on many types of terrain. 0:01:13.977,0:01:15.736 So being a mechanical engineer, 0:01:15.760,0:01:18.522 being at MIT and having lots[br]of resources available to me, 0:01:18.546,0:01:20.836 I thought I'd try to do[br]something about it. 0:01:20.860,0:01:23.789 Now when you're talking[br]about trying to travel 0:01:23.813,0:01:25.995 long distances on rough terrain, 0:01:26.019,0:01:27.728 I immediately thought of a mountain bike, 0:01:27.752,0:01:29.141 and a mountain bike's good at doing this 0:01:29.165,0:01:30.980 because it has a gear train, 0:01:31.004,0:01:33.814 and you can shift to a low gear[br]if you have to climb a hill 0:01:33.838,0:01:35.440 or go through mud or sand 0:01:35.464,0:01:37.554 and you get a lot of torque[br]but a low speed. 0:01:37.578,0:01:39.669 And if you want to go[br]faster, say on pavement, 0:01:39.693,0:01:41.074 you can shift to a high gear, 0:01:41.098,0:01:43.146 and you get less torque,[br]but higher speeds. 0:01:43.170,0:01:44.727 So the logical evolution here 0:01:44.751,0:01:47.561 is to just make a wheelchair[br]with mountain bike components, 0:01:47.585,0:01:48.919 which many people have done. 0:01:48.943,0:01:52.101 But these are two products[br]available in the U.S. that 0:01:52.125,0:01:54.792 would be difficult to transfer[br]into developing countries 0:01:54.816,0:01:57.342 because they're much, much too expensive. 0:01:57.366,0:01:59.618 And the context I'm talking about is where 0:01:59.642,0:02:03.614 you need to have a product[br]that is less than 200 dollars. 0:02:03.638,0:02:06.045 And this ideal product[br]would also be able to go 0:02:06.069,0:02:10.049 about five kilometers a day so you[br]could get to your job, get to school, 0:02:10.073,0:02:11.901 and do it on many,[br]many different types of terrain. 0:02:11.925,0:02:14.793 But when you get home or want[br]to go indoors at your work, 0:02:14.817,0:02:19.214 it's got to be small enough and maneuverable[br]enough to use inside. 0:02:19.238,0:02:22.619 And furthermore, if you want it to last[br]a long time out in rural areas, 0:02:22.643,0:02:26.681 it has to be repairable using the local[br]tools, materials and knowledge 0:02:26.705,0:02:29.497 in those contexts. 0:02:29.521,0:02:32.437 So the real crux of the problem here is, 0:02:32.461,0:02:35.585 how do you make a system[br]that's a simple device 0:02:35.609,0:02:37.716 but gives you a large[br]mechanical advantage? 0:02:37.740,0:02:39.903 How do you make a mountain[br]bike for your arms 0:02:39.927,0:02:42.594 that doesn't have the mountain[br]bike cost and complexity? 0:02:42.618,0:02:44.995 So as is the case with simple solutions, 0:02:45.019,0:02:48.781 oftentimes the answer is right in front[br]of your face, and for us it was levers. 0:02:48.805,0:02:53.415 We use levers all the time,[br]in tools, doorknobs, bicycle parts. 0:02:53.439,0:02:56.201 And that moment of inspiration,[br]that key invention moment, 0:02:56.225,0:02:58.749 was when I was sitting[br]in front of my design notebook 0:02:58.773,0:03:01.521 and I started thinking[br]about somebody grabbing a lever, 0:03:01.545,0:03:03.634 and if they grab[br]near the end of the lever, 0:03:03.658,0:03:05.468 they can get an effectively long lever 0:03:05.492,0:03:08.293 and produce a lot of torque[br]as they push back and forth, 0:03:08.317,0:03:10.513 and effectively get a low gear. 0:03:10.537,0:03:12.920 And as they slide[br]their hand down the lever, 0:03:12.944,0:03:15.756 they can push with a smaller[br]effective lever length, 0:03:15.780,0:03:17.876 but push through a bigger[br]angle every stroke, 0:03:17.900,0:03:21.535 which makes a faster rotational speed,[br]and gives you an effective high gear. 0:03:21.559,0:03:23.287 So what's exciting about this system 0:03:23.311,0:03:25.890 is that it's really, really[br]mechanically simple, 0:03:25.914,0:03:27.724 and you could make it using technology 0:03:27.748,0:03:29.706 that's been around for hundreds of years. 0:03:29.730,0:03:31.891 So seeing this in practice, 0:03:31.915,0:03:33.868 this is the Leveraged Freedom Chair that, 0:03:33.892,0:03:35.608 after a few years of development, 0:03:35.632,0:03:37.545 we're now going into production with, 0:03:37.569,0:03:39.569 and this is a full-time wheelchair user -- 0:03:39.593,0:03:41.110 he's paralyzed -- in Guatemala, 0:03:41.134,0:03:45.109 and you see he's able to traverse[br]pretty rough terrain. 0:03:45.133,0:03:49.640 Again, the key innovation of this technology[br]is that when he wants to go fast, 0:03:49.664,0:03:53.695 he just grabs the levers near the pivots[br]and goes through a big angle every stroke, 0:03:53.719,0:03:56.620 and as the going gets tougher, he just[br]slides his hands up the levers, 0:03:56.644,0:03:59.216 creates more torque, and kind[br]of bench-presses his way 0:03:59.240,0:04:01.402 out of trouble through the rough terrain. 0:04:01.426,0:04:04.414 Now the big, important point here is that 0:04:04.438,0:04:07.127 the person is the complex[br]machine in this system. 0:04:07.151,0:04:10.473 It's the person that's sliding[br]his hands up and down the levers, 0:04:10.497,0:04:13.195 so the mechanism itself can be very simple 0:04:13.219,0:04:16.267 and composed of bicycle parts you[br]can get anywhere in the world. 0:04:16.291,0:04:17.858 Because those bicycle parts 0:04:17.882,0:04:20.363 are so ubiquitously available,[br]they're super-cheap. 0:04:20.387,0:04:22.543 They're made by the gazillions[br]in China and India, 0:04:22.567,0:04:24.399 and we can source them[br]anywhere in the world, 0:04:24.423,0:04:27.138 build the chair anywhere,[br]and most importantly repair it, 0:04:27.162,0:04:29.591 even out in a village[br]with a local bicycle mechanic 0:04:29.615,0:04:33.946 who has local tools, knowledge[br]and parts available. 0:04:33.970,0:04:36.623 Now, when you want to use the LFC indoors, 0:04:36.647,0:04:40.143 all you have to do is pull[br]the levers out of the drivetrain, 0:04:40.167,0:04:43.420 stow them in the frame, and it[br]converts into a normal wheelchair 0:04:43.444,0:04:46.064 that you can use just[br]like any other normal wheelchair, 0:04:46.088,0:04:48.081 and we sized it like a normal wheelchair, 0:04:48.105,0:04:52.216 so it's narrow enough to fit[br]through a standard doorway, 0:04:52.240,0:04:55.735 it's low enough to fit under a table, 0:04:55.759,0:04:59.728 and it's small and maneuverable[br]enough to fit in a bathroom 0:04:59.752,0:05:02.752 and this is important so the user[br]can get up close to a toilet, 0:05:02.776,0:05:04.456 and be able to transfer off 0:05:04.480,0:05:10.047 just like he could in a normal wheelchair. 0:05:10.071,0:05:13.139 Now, there's three important[br]points that I want to stress 0:05:13.163,0:05:16.771 that I think really hit[br]home in this project. 0:05:16.795,0:05:19.975 The first is that this[br]product works well because 0:05:19.999,0:05:22.006 we were effectively able to combine 0:05:22.030,0:05:26.560 rigorous engineering science[br]and analysis with user-centered design 0:05:26.584,0:05:29.937 focused on the social and usage[br]and economic factors 0:05:29.961,0:05:32.474 important to wheelchair users[br]in the developing countries. 0:05:32.498,0:05:34.962 So I'm an academic at MIT,[br]and I'm a mechanical engineer, 0:05:34.986,0:05:38.510 so I can do things like look at the type[br]of terrain you want to travel on, 0:05:38.534,0:05:41.158 and figure out how much[br]resistance it should impose, 0:05:41.182,0:05:44.166 look at the parts we have[br]available and mix and match them 0:05:44.190,0:05:46.811 to figure out what sort[br]of gear trains we can use, 0:05:46.835,0:05:49.920 and then look at the power and force[br]you can get out of your upper body 0:05:49.944,0:05:51.883 to analyze how fast you should[br]be able to go in this chair 0:05:51.907,0:05:54.254 as you put your arms[br]up and down the levers. 0:05:54.278,0:05:57.913 So as a wet-behind-the-ears[br]student, excited, 0:05:57.937,0:06:00.038 our team made a prototype, 0:06:00.062,0:06:04.913 brought that prototype to Tanzania,[br]Kenya and Vietnam in 2008, 0:06:04.937,0:06:07.047 and found it was terrible 0:06:07.071,0:06:09.484 because we didn't get[br]enough input from users. 0:06:09.508,0:06:12.650 So because we tested it[br]with wheelchair users, 0:06:12.674,0:06:15.156 with wheelchair manufacturers,[br]we got that feedback from them, 0:06:15.180,0:06:18.610 not just articulating their problems,[br]but articulating their solutions, 0:06:18.634,0:06:22.158 and worked together to go back[br]to the drawing board and make a new design, 0:06:22.182,0:06:24.308 which we brought back[br]to East Africa in '09 0:06:24.332,0:06:27.153 that worked a lot better than a normal[br]wheelchair on rough terrain, 0:06:27.177,0:06:30.035 but it still didn't work well[br]indoors because it was too big, 0:06:30.059,0:06:32.033 it was heavy, it was hard to move around, 0:06:32.057,0:06:35.587 so again with that user feedback,[br]we went back to the drawing board, 0:06:35.611,0:06:37.902 came up with a better[br]design, 20 pounds lighter, 0:06:37.926,0:06:41.593 as narrow as a regular wheelchair, tested[br]that in a field trial in Guatemala, 0:06:41.617,0:06:43.617 and that advanced the product to the point 0:06:43.641,0:06:46.840 where we have now that it's going[br]into production. 0:06:46.864,0:06:49.086 Now also being engineering scientists, 0:06:49.110,0:06:52.968 we were able to quantify the performance[br]benefits of the Leveraged Freedom Chair, 0:06:52.992,0:06:55.608 so here are some shots[br]of our trial in Guatemala 0:06:55.632,0:06:59.150 where we tested the LFC[br]on village terrain, 0:06:59.174,0:07:01.174 and tested people's biomechanical outputs, 0:07:01.198,0:07:03.361 their oxygen consumption,[br]how fast they go, 0:07:03.385,0:07:05.052 how much power they're putting out, 0:07:05.076,0:07:07.951 both in their regular[br]wheelchairs and using the LFC, 0:07:07.975,0:07:10.452 and we found that the LFC[br]is about 80 percent faster 0:07:10.476,0:07:12.810 going on these terrains[br]than a normal wheelchair. 0:07:12.834,0:07:16.193 It's also about 40 percent more[br]efficient than a regular wheelchair, 0:07:16.217,0:07:18.736 and because of the mechanical[br]advantage you get from the levers, 0:07:18.760,0:07:20.665 you can produce 50 percent higher torque 0:07:20.689,0:07:24.649 and really muscle your way[br]through the really, really rough terrain. 0:07:24.673,0:07:28.085 Now the second lesson[br]that we learned in this is that 0:07:28.109,0:07:30.985 the constraints on this design[br]really push the innovation, 0:07:31.009,0:07:33.249 because we had to hit[br]such a low price point, 0:07:33.273,0:07:35.559 because we had to make[br]a device that could travel 0:07:35.583,0:07:38.378 on many, many types of terrain[br]but still be usable indoors, 0:07:38.402,0:07:40.669 and be simple enough to repair, 0:07:40.693,0:07:43.036 we ended up with a fundamentally[br]new product, 0:07:43.060,0:07:45.152 a new product that is an innovation 0:07:45.176,0:07:48.069 in a space that really hasn't[br]changed in a hundred years. 0:07:48.093,0:07:51.522 And these are all merits that are not[br]just good in the developing world. 0:07:51.546,0:07:53.961 Why not in countries like the U.S. too? 0:07:53.985,0:07:55.697 So we teamed up with Continuum, 0:07:55.721,0:07:57.721 a local product design firm here in Boston 0:07:57.745,0:08:00.729 to make the high-end version,[br]the developed world version, 0:08:00.753,0:08:03.515 that we'll probably sell primarily[br]in the U.S. and Europe, 0:08:03.539,0:08:06.316 but to higher-income buyers. 0:08:06.340,0:08:09.302 And the final point I want[br]to make is that I think 0:08:09.326,0:08:12.128 this project worked[br]well because we engaged 0:08:12.152,0:08:16.739 all the stakeholders that buy into this[br]project and are important to consider 0:08:16.763,0:08:20.082 in bringing the technology[br]from inception of an idea 0:08:20.106,0:08:24.321 through innovation, validation,[br]commercialization and dissemination, 0:08:24.345,0:08:28.066 and that cycle has to start[br]and end with end users. 0:08:28.090,0:08:30.841 These are the people that define[br]the requirements of the technology, 0:08:30.865,0:08:33.179 and these are the people that have[br]to give the thumbs-up at the end, 0:08:33.203,0:08:35.823 and say, "Yeah, it actually works.[br]It meets our needs." 0:08:35.847,0:08:37.753 So people like me in the academic space, 0:08:37.777,0:08:41.124 we can do things like innovate[br]and analyze and test, 0:08:41.148,0:08:44.220 create data and make[br]bench-level prototypes, 0:08:44.244,0:08:47.387 but how do you get that bench-level[br]prototype to commercialization? 0:08:47.411,0:08:50.799 So we need gap-fillers like Continuum[br]that can work on commercializing, 0:08:50.823,0:08:53.585 and we started a whole NGO[br]to bring our chair to market -- 0:08:53.609,0:08:55.750 Global Research Innovation Technology -- 0:08:55.774,0:08:59.482 and then we also teamed up with a big[br]manufacturer in India, Pinnacle Industries, 0:08:59.506,0:09:01.745 that's tooled up now[br]to make 500 chairs a month 0:09:01.769,0:09:03.548 and will make the first[br]batch of 200 next month, 0:09:03.572,0:09:05.516 which will be delivered in India. 0:09:05.540,0:09:08.255 And then finally, to get this[br]out to the people in scale, 0:09:08.279,0:09:10.803 we teamed up with the largest[br]disability organization 0:09:10.827,0:09:13.090 in the world, Jaipur Foot. 0:09:13.114,0:09:15.369 Now what's powerful about this model 0:09:15.393,0:09:18.176 is when you bring together[br]all these stakeholders 0:09:18.200,0:09:20.145 that represent each link in the chain 0:09:20.169,0:09:22.686 from inception of an idea 0:09:22.710,0:09:25.454 all the way to implementation[br]in the field, 0:09:25.478,0:09:27.005 that's where the magic happens. 0:09:27.029,0:09:29.553 That's where you can take[br]a guy like me, an academic, 0:09:29.577,0:09:32.581 but analyze and test[br]and create a new technology 0:09:32.605,0:09:36.117 and quantitatively determine[br]how much better the performance is. 0:09:36.141,0:09:38.802 You can connect with stakeholders[br]like the manufacturers 0:09:38.802,0:09:41.042 and talk with them face-to-face[br]and leverage their 0:09:41.062,0:09:43.909 local knowledge of manufacturing[br]practices and their clients 0:09:43.933,0:09:46.648 and combine that knowledge[br]with our engineering knowledge 0:09:46.672,0:09:49.978 to create something greater[br]than either of us could have done alone. 0:09:50.002,0:09:52.509 And then you can also engage the end user 0:09:52.533,0:09:55.295 in the design process, and not[br]just ask him what he needs, 0:09:55.319,0:09:58.244 but ask him how he thinks[br]it can be achieved. 0:09:58.268,0:10:01.301 And this picture was taken[br]in India in our last field trial, 0:10:01.325,0:10:03.802 where we had a 90-percent[br]adoption rate where people 0:10:03.826,0:10:07.408 switched to using our Leveraged Freedom[br]Chair over their normal wheelchair, 0:10:07.432,0:10:10.369 and this picture specifically is of Ashok, 0:10:10.393,0:10:13.401 and Ashok had a spinal injury[br]when he fell out of a tree, 0:10:13.425,0:10:16.283 and he had been working at a tailor,[br]but once he was injured 0:10:16.307,0:10:19.166 he wasn't able to transport[br]himself from his house 0:10:19.190,0:10:21.966 over a kilometer to his shop[br]in his normal wheelchair. 0:10:21.990,0:10:23.237 The road was too rough. 0:10:23.261,0:10:26.158 But the day after he got[br]an LFC, he hopped in it, 0:10:26.182,0:10:28.242 rode that kilometer, opened up his shop 0:10:28.266,0:10:30.958 and soon after landed a contract[br]to make school uniforms 0:10:30.982,0:10:34.078 and started making money, started[br]providing for his family again. 0:10:34.102,0:10:35.927 Ashok: You also encouraged me to work. 0:10:35.951,0:10:38.651 I rested for a day at home. 0:10:38.675,0:10:43.107 The next day I went to my shop. 0:10:43.131,0:10:46.085 Now everything is back to normal. 0:10:46.109,0:10:50.170 Amos Winter: And thank you[br]very much for having me today. 0:10:50.194,0:10:54.194 (Applause)