Excerpts of the interview with Dr. Vishal Rao

To begin with, can you throw some light into the idea and process that went behind the making of the AUM Prosthesis?

Speech and communication are among the essentials to sustain life with dignity in this planet considering the demanding times we are living in. In my humble experience as a doctor, cost constraints played a significant role when it came to the delivery of medical services to those afflicted with speech related disorders.

The inspiration behind developing the prosthesis could be attributed to a professional experience I had had when I met Mr.Sannathimayya, a resident of Chikkaballapur, who had throat cancer and had come for medical help. He had undergone a surgery and had his voice box removed. To a person of his background, the prospect of getting a voice prosthesis implanted was beyond his means. Sannathimmaya’s case for some reason remained in my mind and I ran it by my friend Shashank Mahesh, Co-inventor of this prosthesis and a prominent industrialist. It was Shashank who brought up this suggestion of manufacturing affordable prostheses. He had industrial expertise and I had technical. That was how the humble journey, to make a difference in the lives of those who had speech disorders, began.

In India, the causes for throat cancer can be traced down to the usage of cigarettes and beedis,especially among those who belong to the lower strata of the economic pyramid and in most cases medical help is sought only in the later or advanced stages, when organ preservation is no longer possible. The possibility of implanting an artificial prosthesis is often, as I said earlier, not possible owing to economic constraints.

We often hear a lot about the disastrous effects of throat cancer and it often varies from person to person. Can you help the readers understand the quality-of-life issues that you come across while dealing with your patients?

Loss of speech, inability of breathe through the nose,owing to a permanent hole in the throat are some of the serious issues which can dent the normalcy of life.

Can you describe the difference AUM has brought about in the treatment of throat cancer?

The biggest challenge that lay ahead of us was to merge the best technology could offer with the best practices in the industry and to make the device available to patients at an affordable cost. The blend of these three important factors – technology,best practices and affordability- defines the difference this device has brought about in the treatment of Throat cancer.

The naming of the device seems to have drawn inspiration from ancient Indian mythology. Can you share the thought process that went behind the naming of this device?

‘AUM’ is a primeval sound, comprising three important elements – Creation, Sustenance and Annihilation.There is hardly any religious connotation to it.

We felt the process of giving voice to some one using the prosthesis after s/he had lost it resonates the philosophy that is embedded in the the word AUM. It is in so many ways a process of rebirth.

You have,as a matter of fact, achieved a terrific feat by making available voice prostheses at a price as low as INR 50 while the current market price for similar prostheses range anywhere between INR 15,000 - 30,000. Could you list down the factors which enabled you to bring the price down by such a significant margin?

Our motive was to make available the best medical technology at affordable prices to the needy. Our team comprised of manufacturers, suppliers, engineers, physicists and technical experts, got behind the philosophy behind AUM. We did not charge for our time and talent. Financial gains or market dominance was never a factor.

You have undoubtedly made an impact in the lives or thousands of patients whose lives had been affected by cancer and its destructive after effects. What do you feel, when you see the scores of people whom you have helped come back to normalcy after getting diagnosed with cancer?

It is incredible and no amount of words can contain the emotions I feel when I see a patient who hasn’t spoken for years suddenly start to speak.

Could you give us a preview of what lies ahead for Aum? Do you have anything planned that you want to share with our readers?

As the next step. We are planning to reach out to all the Regional Cancer Centres across the country. We are planning training and introductory sessions to take the technology to doctors who are interested to help rehabilitate patients who had lost their voice owing to cancer.

To begin with can you guide us through the factors that motivated you to develop this device?

Speech and hearing are indispensable assets that enable humans to lead a life with dignity and freedom. And in my humble experience as a doctor, cost constraints was the main factor that stood in the way of patients who had lost speech owing to cancer.

I once had a patient by the name Sannathimayya, a resident of a village in the district of Chikkaballapur. He had is voice box removed and couldn’t afford a voice prosthesis that was available in the market at that time. I discussed this quandary of Sannathimmayya with a friend of mine,Mr. Shashank Mahesh, who is an industrialist. It was he asked me-why don’t we make a device that is both affordable and efficient? He offered his industrial expertise and me the technical. That was how this device was born.

How much time went into the development of this device?

We were’nt working on it full time. It took us about two years to work on the principles and to develop it.

Who all were involved in the development of this device? What was your team size?

The idea was conceived by me and Shashank, but it wouldn’t have been possible without the relentless efforts of Shashank’s team of engineers, technicians and support staff. They gave us valuable inputs and forced us to think beyond the norms. So yes, it was a collective effort.

How do you think your device differentiate itself from those already in the market?

We haven’t looked at other products in the market for inspiration. Our objective is our key differentiator to my mind,which is to come up with a competent product which even the poorest of the poor can afford. That is why we priced it at <1$ (50Rs).

Can you describe to our readers the thought process that went in behind the naming of the device - AUM voice prosthetics?

Aum is a word that has been in the subconscious of the Indian imagination since the mythological times. It has 3 elements to it – A signifying ‘creation’, U signifying ‘Sustenance’ and M signifying Annihilation.In a way, the whole process of giving back the power to speak to someone who had lost it forever is a sort of ‘rebirth’. It restores normalcy back in their life

Can you explain to our readers how the device help people who have throat cancer?

A prosthesis is a device that serves as a replacement for a lost or missing body part. A voice prosthesis is a silicon contraption that enables laryngectomized people to speak. Laryngectomy is a surgical process by which the larynx or the voice box of a person is removed. It results in an opening between the food pipe and the windpipe -the tracheo-esophageal puncture. This puncture disables their speaking capabilities. So the need for a prosthesis is inexorable, if we are to bring them back to the world of speach and communication. Our device helps those patients who had lost their voice to throat cancer.

How much does this device cost and where does this device stand in terms of price in the global market?

The devices popular in the global market costs anywhere around INR 15,000 – 30,000, which is inhibitive to those who are in the lower rungs of economic prosperity. The Aum voice prosthesis is priced at INR 50 (< 1$)

Is this device available in the market at present?

We are expecting it to launch within the next one month. As of now one cannot find it in surgical shops.

Can you share with us the future plans related to this device?

We are planning to reach out to all the regional cancer centers around the country as an initial steps. We have begun the process for filing patents for this device. The scientific and ethical approvals are all in place and once we have secured the patent rights we are planning to begin a cross-country study in partnership with various interested players for an initial feedback on the device’s functionality.

What is the life span of this device? Does it require a patient to replace the device after the device has outlived its lifespan?

Ideally, the device is safe and should function without any problems for a period of 6 months. As is evident from the studies we had conducted on the foreign made prostheses and how people in India use it, people persist with the same device for as long as 2 years. This can primarily be attributed to the inhibiting price tag these devices come with. This can be avoided if we can provide an effective alternative which is affordable.And Aum does precisely this.

Firstly let us congratulate you on the extraordinary success you have had with your innovation - Aum. Could you explain a bit about your brain child - AUM voice prosthesis?

Aum was conceived with the notion of making affordable the treatment of throat cancer and in helping people regain their speech at a cost they can afford. I was made to think about developing a device after I discussed with an industrialist friend of mine,Mr. Shashank Mahesh, the case of a throat cancer patient – Mr.Sannathimayya, a resident of the Chikkaballapur district. He had had his voice box removed because he had throat cancer. He was constrained by financial factors which held him up from getting a prosthesis implanted in his throat. It was Shashank who suggested that we make our own device and offered help with logistics. That was the birth of Aum.

The prime reason of throat cancer in India can be attributed to the smoking of tobacco in the from of cigarettes and beedis. Most of the cancer inflicted ones are from the poor class and the disease would have reached a critical point before they had sought medecal help. In these cases organ preservation is almost impossible and they end up losing their voice box.

We named it AUM as we felt the process of giving someone their speech is akin to rebirth in some ways. AUM has 3 elements to it A signifying ‘creation’, U signifying Sustenance and M signifying Annihilation. It is a primeveal word and in all senses we felt it is the right terminology.

Could you take our viewers through your sparkling career as a successful Oncologist and a Head and Neck Surgeon?

I completed my graduation and post graduation at the prestigious JNMC Belgaum. I pursued my training in Oncology at the Tata Memorial Hospital in Mumbai in the department of head neck surgical oncology. For a brief period of time I was a visiting scholar at University of Pittsburgh before I finally returned to India to join the regional cancer centre – Kidwai Memorial Institute of Oncology whwere I worked as an asst.professor for 2 years. HCG – HealthCare Global Cancer Centre at Bangaloreis where I am currently practicing my profession.

Head an Neck cancer cases are ubiquitous in India. What are your views on THE WAYS to prevent it and reduce the mortality rate?

Usage of tobacco in the form of cigarettes and beedis can be sighted as the prime reason behind contracting this particular variety of cancer. We doctors and researchers alike are so hell bent in finding an antidote to this when eradicating tobacco is the only way by which we can stop this disease. I feel the whole Head and Neck Oncology dept need not exist if not for tobacco.

How did you get into the fields of research and innovation? Were there any guiding or inspirational aspects?

Quoting Sri Satya Sai Baba “ The End goal of education is knowledge and end goal of knowledge is service”.I was lucky enough to offer my services at Super Speciality hospital at Puttaparthi where I saw the finest services being offered to the poorest of the poor. This experience could be sighted as THE most inspiring factor which made me think of innovating simple devices for the betterment of the poor. Other than this, my family and teachers has played a significant part in inspiring me.

Our civilization would have come to a stand still if it wasn’t for the innovators and researchers. We would have gotten stagnant and even our daily work would have become monotonous.Dr. Anil Dcruz, Director of Tata Memorial Hospital,Dr.Mandar Deshpande, Dr.Pankaj Chaturvedi, Dr.Devendra Chaukar, Dr.Prathamesh Pai are some notable names that I cannot avoid mentioning when talking about those who inspired me.

ustice M N Venkatachalliah – Ex chief Justice of India is someone I have a lot of respect for and always look up to him for mentorship and guidance.

Were there any roadblocks that you could think of, in retrospect, while you were developing the device?

Feasibility of actualizing many ideas was the main demotivating aspect while we were building this device.We had to learn from our failures and the time we took to do so affected our delivery rate.

Your device is priced at Rs 50. How did you make this possible?

The main motivation behind this venture was to come up with a device at par with the competition while keeping the prices at a bare minimum.Several of our manufacturers, suppliers, engineers, physicists and technical experts who appreciated the real intent behind our innovation offered their services for free and didn’t charge for their time or talent. This helped us in keeping the price at a bare minimum.

Could you shed some light on the other aspects a researcher should keep in mind to take the first step towards entrepreneurship and reaching out to the target audience - Finance,Management,etc..?

Talking about innovations in medicine, genetics, drug delivery, electronic medical records, big data in medical analytics, prediction and prevention are all of prime importance. Integrating technology is a crucial aspect. It is high time that we stopped importing equipments for our local use. This is where innovation comes in.

It is believed that doctors in India are so busy treating patients that there is little or no time at all to look into innovations or new technologies. What is your take on this?

I for one do not agree with this. For me, “A busy man is a man who has time for everything, the rest is poor imitation”.

Is there anything in pipeline? Any new projects?

Yes, we are collaborating with chemical experts and physicists in area of oncology on a new hypothesis that has emerged. Also, a project intended to address the needs of the much neglected voice rehab in neuro muscular degenerative disorders is also in pipeline.

What would be your message to the upcoming doctors of our generation?

We often relate the word Health with the word disease and in my opinion it shouldn’t be the case considering the times we live in. Too much focus on the medical world is on diseases rather than in care or prevention. Quoting Sai Baba “A Healthy society should have less doctors, less hospitals and less illness”. My philosophy is based on 3C’s improved Concern, effective Communication and eliminating commercialization. And this precisely is my advice to all the young medical practitioners out there. Ambition and purpose are a lethal combination. When they meet inside, You change. Dare to dream and then be wise to wake up and work hard.