WEBVTT

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Living with a physical
disability isn't easy

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anywhere in the world,

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but if you live in a country
like the United States,

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there's certain appurtenances available
to you that do make life easier.

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So if you're in a building,
you can take an elevator.

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If you're crossing the street,
you have sidewalk cutouts.

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And if you have to travel
some distance farther

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than you can do under your own power,
there's accessible vehicles,

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and if you can't afford one of those,

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there's accessible public transportation.

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But in the developing world,
things are quite different.

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There's 40 million people who need
a wheelchair but don't have one,

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and the majority of these
people live in rural areas,

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where the only connections to community,
to employment, to education,

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are by traveling long
distances on rough terrain

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often under their own power.

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And the devices usually
available to these people

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are not made for that context,
break down quickly,

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and are hard to repair.

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I started looking at wheelchairs
in developing countries in 2005,

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when I spent the summer assessing
the state of technology in Tanzania,

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and I talked to wheelchair users, wheelchair
manufacturers, disability groups,

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and what stood out to me

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is that there wasn't a device available

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that was designed for rural
areas, that could go fast

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and efficiently on many types of terrain.

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So being a mechanical engineer,

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being at MIT and having lots
of resources available to me,

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I thought I'd try to do
something about it.

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Now when you're talking
about trying to travel

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long distances on rough terrain,

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I immediately thought of a mountain bike,

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and a mountain bike's good at doing this

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because it has a gear train,

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and you can shift to a low gear
if you have to climb a hill

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or go through mud or sand

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and you get a lot of torque
but a low speed.

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And if you want to go
faster, say on pavement,

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you can shift to a high gear,

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and you get less torque,
but higher speeds.

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So the logical evolution here

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is to just make a wheelchair
with mountain bike components,

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which many people have done.

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But these are two products
available in the U.S. that

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would be difficult to transfer
into developing countries

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because they're much, much too expensive.

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And the context I'm talking about is where

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you need to have a product
that is less than 200 dollars.

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And this ideal product
would also be able to go

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about five kilometers a day so you
could get to your job, get to school,

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and do it on many,
many different types of terrain.

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But when you get home or want
to go indoors at your work,

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it's got to be small enough and maneuverable
enough to use inside.

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And furthermore, if you want it to last
a long time out in rural areas,

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it has to be repairable using the local
tools, materials and knowledge

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in those contexts.

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So the real crux of the problem here is,

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how do you make a system
that's a simple device

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but gives you a large
mechanical advantage?

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How do you make a mountain
bike for your arms

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that doesn't have the mountain
bike cost and complexity?

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So as is the case with simple solutions,

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oftentimes the answer is right in front
of your face, and for us it was levers.

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We use levers all the time,
in tools, doorknobs, bicycle parts.

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And that moment of inspiration,
that key invention moment,

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was when I was sitting
in front of my design notebook

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and I started thinking
about somebody grabbing a lever,

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and if they grab
near the end of the lever,

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they can get an effectively long lever

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and produce a lot of torque
as they push back and forth,

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and effectively get a low gear.

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And as they slide
their hand down the lever,

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they can push with a smaller
effective lever length,

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but push through a bigger
angle every stroke,

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which makes a faster rotational speed,
and gives you an effective high gear.

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So what's exciting about this system

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is that it's really, really
mechanically simple,

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and you could make it using technology

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that's been around for hundreds of years.

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So seeing this in practice,

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this is the Leveraged Freedom Chair that,

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after a few years of development,

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we're now going into production with,

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and this is a full-time wheelchair user --

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he's paralyzed -- in Guatemala,

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and you see he's able to traverse
pretty rough terrain.

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Again, the key innovation of this technology
is that when he wants to go fast,

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he just grabs the levers near the pivots
and goes through a big angle every stroke,

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and as the going gets tougher, he just
slides his hands up the levers,

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creates more torque, and kind
of bench-presses his way

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out of trouble through the rough terrain.

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Now the big, important point here is that

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the person is the complex
machine in this system.

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It's the person that's sliding
his hands up and down the levers,

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so the mechanism itself can be very simple

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and composed of bicycle parts you
can get anywhere in the world.

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Because those bicycle parts

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are so ubiquitously available,
they're super-cheap.

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They're made by the gazillions
in China and India,

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and we can source them
anywhere in the world,

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build the chair anywhere,
and most importantly repair it,

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even out in a village
with a local bicycle mechanic

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who has local tools, knowledge
and parts available.

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Now, when you want to use the LFC indoors,

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all you have to do is pull
the levers out of the drivetrain,

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stow them in the frame, and it
converts into a normal wheelchair

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that you can use just
like any other normal wheelchair,

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and we sized it like a normal wheelchair,

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so it's narrow enough to fit
through a standard doorway,

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it's low enough to fit under a table,

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and it's small and maneuverable
enough to fit in a bathroom

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and this is important so the user
can get up close to a toilet,

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and be able to transfer off

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just like he could in a normal wheelchair.

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Now, there's three important
points that I want to stress

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that I think really hit
home in this project.

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The first is that this
product works well because

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we were effectively able to combine

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rigorous engineering science
and analysis with user-centered design

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focused on the social and usage
and economic factors

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important to wheelchair users
in the developing countries.

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So I'm an academic at MIT,
and I'm a mechanical engineer,

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so I can do things like look at the type
of terrain you want to travel on,

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and figure out how much
resistance it should impose,

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look at the parts we have
available and mix and match them

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to figure out what sort
of gear trains we can use,

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and then look at the power and force
you can get out of your upper body

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to analyze how fast you should
be able to go in this chair

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as you put your arms
up and down the levers.

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So as a wet-behind-the-ears
student, excited,

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our team made a prototype,

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brought that prototype to Tanzania,
Kenya and Vietnam in 2008,

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and found it was terrible

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because we didn't get
enough input from users.

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So because we tested it
with wheelchair users,

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with wheelchair manufacturers,
we got that feedback from them,

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not just articulating their problems,
but articulating their solutions,

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and worked together to go back
to the drawing board and make a new design,

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which we brought back
to East Africa in '09

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that worked a lot better than a normal
wheelchair on rough terrain,

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but it still didn't work well
indoors because it was too big,

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it was heavy, it was hard to move around,

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so again with that user feedback,
we went back to the drawing board,

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came up with a better
design, 20 pounds lighter,

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as narrow as a regular wheelchair, tested
that in a field trial in Guatemala,

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and that advanced the product to the point

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where we have now that it's going
into production.

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Now also being engineering scientists,

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we were able to quantify the performance
benefits of the Leveraged Freedom Chair,

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so here are some shots
of our trial in Guatemala

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where we tested the LFC
on village terrain,

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and tested people's biomechanical outputs,

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their oxygen consumption,
how fast they go,

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how much power they're putting out,

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both in their regular
wheelchairs and using the LFC,

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and we found that the LFC
is about 80 percent faster

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going on these terrains
than a normal wheelchair.

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It's also about 40 percent more
efficient than a regular wheelchair,

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and because of the mechanical
advantage you get from the levers,

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you can produce 50 percent higher torque

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and really muscle your way
through the really, really rough terrain.

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Now the second lesson
that we learned in this is that

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the constraints on this design
really push the innovation,

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because we had to hit
such a low price point,

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because we had to make
a device that could travel

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on many, many types of terrain
but still be usable indoors,

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and be simple enough to repair,

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we ended up with a fundamentally
new product,

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a new product that is an innovation

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in a space that really hasn't
changed in a hundred years.

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And these are all merits that are not
just good in the developing world.

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Why not in countries like the U.S. too?

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So we teamed up with Continuum,

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a local product design firm here in Boston

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to make the high-end version,
the developed world version,

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that we'll probably sell primarily
in the U.S. and Europe,

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but to higher-income buyers.

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And the final point I want
to make is that I think

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this project worked
well because we engaged

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all the stakeholders that buy into this
project and are important to consider

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in bringing the technology
from inception of an idea

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through innovation, validation,
commercialization and dissemination,

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and that cycle has to start
and end with end users.

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These are the people that define
the requirements of the technology,

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and these are the people that have
to give the thumbs-up at the end,

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and say, "Yeah, it actually works.
It meets our needs."

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So people like me in the academic space,

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we can do things like innovate
and analyze and test,

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create data and make
bench-level prototypes,

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but how do you get that bench-level
prototype to commercialization?

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So we need gap-fillers like Continuum
that can work on commercializing,

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and we started a whole NGO
to bring our chair to market --

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Global Research Innovation Technology --

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and then we also teamed up with a big
manufacturer in India, Pinnacle Industries,

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that's tooled up now
to make 500 chairs a month

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and will make the first
batch of 200 next month,

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which will be delivered in India.

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And then finally, to get this
out to the people in scale,

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we teamed up with the largest
disability organization

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in the world, Jaipur Foot.

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Now what's powerful about this model

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is when you bring together
all these stakeholders

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that represent each link in the chain

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from inception of an idea

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all the way to implementation
in the field,

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that's where the magic happens.

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That's where you can take
a guy like me, an academic,

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but analyze and test
and create a new technology

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and quantitatively determine
how much better the performance is.

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You can connect with stakeholders
like the manufacturers

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and talk with them face-to-face
and leverage their

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local knowledge of manufacturing
practices and their clients

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and combine that knowledge
with our engineering knowledge

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to create something greater
than either of us could have done alone.

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And then you can also engage the end user

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in the design process, and not
just ask him what he needs,

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but ask him how he thinks
it can be achieved.

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And this picture was taken
in India in our last field trial,

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where we had a 90-percent
adoption rate where people

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switched to using our Leveraged Freedom
Chair over their normal wheelchair,

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and this picture specifically is of Ashok,

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and Ashok had a spinal injury
when he fell out of a tree,

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and he had been working at a tailor,
but once he was injured

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he wasn't able to transport
himself from his house

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over a kilometer to his shop
in his normal wheelchair.

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The road was too rough.

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But the day after he got
an LFC, he hopped in it,

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rode that kilometer, opened up his shop

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and soon after landed a contract
to make school uniforms

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and started making money, started
providing for his family again.

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Ashok: You also encouraged me to work.

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I rested for a day at home.

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The next day I went to my shop.

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Now everything is back to normal.

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Amos Winter: And thank you
very much for having me today.

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(Applause)