Vishal Rao's innovation: A cheap voice box for throat cancer patients

An oncologist, Vishal Rao built an innovative voice prosthesis that costs just Rs 50 to help people who've lost their voices, finds Alnoor Peermohamed.

There is something strange about Vishal Rao, an oncologist at the HCG Hospital in Bengaluru.

You would expect doctors, especially surgeons, to be calm and composed - a trait we associate with them, given the gruelling medical procedures they need to pull through.

Rao seems a fish out of water. He is bubbly, impatient to speak and masks his use of expletive not so subtly.

It is then surprising, as well as ironic that Rao spends a lot of his time treating patients that have lost their voices to throat cancer.

"I cannot shut up for a minute and here is this guy that has not spoken for 16 years," said Rao, pointing to one of his patients that set him off on a journey to create Aum, a Rs 50 voice prosthesis to help people who've lost their voices.

"Around 5,000 people in India are diagnosed with stage-IV throat cancer each year, and there's no procedure today to keep their voice boxes intact."

Cancer is the second largest killer in India after heart disease, with the country having the largest number of individuals affected by cancer of the mouth, throat and voice box in the world.

Rao estimates the number of reported cases of throat cancer is as high as 50,000 each year, with most cases being reported in the later stages of the disease, owing to lack of education and a medical system built around cure than prevention.

Rao, who dreamt of becoming a chef or a biker as a teenager, was forced into studying medicine by his parents because he had secured good marks in his biology exams.

Even while he pursued medicine, his interest in other streams such as automobiles failed to die, as Rao recalls being obsessed with learning how the internals of engines work even through his semester exams.

He keeps his passion for motorcycles alive by riding around on his Suzuki Intruder, a 1,800cc beast that costs nearly Rs 20 lakh, and says he wants to own a Ducati next.

When it came to building Aum, Rao says it was the first time he felt some sort of a purpose in being a doctor.

"Being a doctor is considered a noble profession but I never saw it like that. It was just another profession for me."

He had already helped several needy people when it came to arranging donations to pay for their medical expenses and had waived his consultation charges, but none of that figured as giving back.

A device that virtually anyone could afford, is something he wanted badly.

A voice prosthesis in the market costs between Rs 25,000 and Rs 40,000, out of reach for many.

Rao says he had implanted enough of them to know everything there is to know about the devices.

So, when it came to building his own, he had his work cut out. Moreover, his inquisitiveness about motorcycle engines and science in general he says helped him visualise what the device would be like.

The Aum tricks the brain into thinking there is a voice box when air is forced from the lungs into the throat.

Speech is a function of the brain, rather than the contraction of muscles in the throat and the voice box, can be simulated by a prosthesis, with some training from speech therapists.

Rao says he picked the name Aum (Om) for the device not due to any religious affiliations but as he believed it was the first sound that resonated in the universe.

"I am a boring doctor, but I firmly believe science is not science if it is not accessible to everybody," he says.

While Rao's friend Shashank Mahesh, an industrialist, helped him build the Aum, Rao surrounds himself with mathematicians, quantum physicists and other scientists in order to figure out new ways of making medicine easier and even work on theories of how cancer forms and spreads in the human body.

There is a sense that Rao thinks of himself as an outsider in the medical profession.

His ideas are radical - everyone he knew said his plan to create and sell Aum at Rs 50 would fail.

There were others asked him to monetise the project, which he has done, but not at the scale that was suggested.

For every Aum that is sold, Rao says he makes Rs 3 of profit. While he pushed the boundaries of cost, quality is something that was not forgone.

The Aum is made of medical grade materials, has been certified for use in India and Rao is now pushing for global certification.

"I have applied for patents not to get my name on the device, but to make sure no one comes up tomorrow saying they did this first. I will open it (the patent) up to others if they want to make the device or want to make it better," says Rao.

Having successfully implanted the Aum in 17 patients so far, Rao has had a 100 per cent success rate.

He knows that won't remain for long, as the number of patients go up, so will the rate of failure and says he is ready to face that.

In the short term he plans to train doctors at one cancer centre in each state, on how to implant the voice prosthesis - a procedure that takes just 15 minutes if the incision in the throat of the patient has already been made.

Soon he says he wants to take the Aum to neighbouring countries Bangladesh and Pakistan, from where he is already receiving calls and emails from patients.