Gujarat, India - Surya is ten years old. When she was almost two, she lost her left leg and her right foot in a tractor accident that also killed her mother. Surya and her father live three miles from the closest school. Up until recently, she had not been to school very often, as the only way she could attend was for her father or a neighbor to carry her. Surya’s severed limbs were raw from her attempts to drag herself from place to place.

Sometimes even the smallest step toward independence is of immeasurable value to a child and its family.

A leg to Stand on (ALTSO) is a non-profit organization dedicated to the cause of providing disabled children around the world with the opportunity of a better life through the use of corrective surgery and prosthetic limbs. “Our goal is to transform the lives of children with limb disabilities by offering them the physical capability to access the opportunities and self-esteem earned through education, work and mobility.” said Ms. Claire Mackay, Executive Director of ALTSO. Most disabled Indians live below the poverty line, including the estimated 1-million who need prosthetic limbs. Getting a prosthesis for many of these amputees/disabled is a distant dream as they cannot even afford basic health care. Widespread poverty, places prosthetic care beyond the reach of many, if not most, Indians.

Says Mr. Mead Welles, Co-founder and President “ I was in Indonesia a couple of years ago and I was sitting outside eating dinner at a restaurant completely wiped out. I had just visited 4 countries in 2 days and spent hours fighting long lines at customs and lugging my baggage all over the place. In my exhaustion, I found myself thinking about how hard it had been since I left my job to be an entrepreneur and how I couldn't wait until the day I wouldn't have to go through all the physical struggles because I had to conserve money.

Then I saw two young boys pulling a rope that was tied to the lid of a garbage can. The two boys were begging for money. On the lid, sitting sadly, was another young child who was being pulled. As I saw the little child go by I noticed that his leg was severely deformed. I couldn't tell if it was a result of a birth defect or an injury, but it made me feel sick just looking at it. It was clear that the boy had been walking on the stubbed part because it was raw and bleeding and he couldn't stand on it any longer.

I also noticed that the child's knuckles were raw and bleeding, which meant hat he had for a while been dragging himself around on the lid. I sat there paralyzed, but I couldn't look away. I just sat there and watched the three go by.

I went up to my hotel room after dinner with a pit in my stomach and I sat on my bed. While I was complaining to myself about how hard I had it With all the sacrifices that I had to make to start and run Octagon, I failed to recognize how lucky I was to have my health. The personal sacrifices and physical hardships were the price that I had to pay in order to have the chance to have a better quality of life for me and my family, present And future.

Then I began to cry. I cried because I could only imagine the pain that that child has to go through every day, every minute, every second of his life. I cried because that child will never have the same opportunities that I have because of his leg. And I cried, because I could have easily taken that child to a local hospital and for under a thousand dollars (which I Could have charged on my credit card), given that child a new life.... ....but I didn't.


Mr. Mead Welles met Dr. Dinesh Patel at a social gathering soon after, and they began to talk about starting an initiative to bring prosthetic care to children from underprivileged countries. Dr. Dinesh G. Patel, Chief of Arthroscopic Surgery, Massachusetts General Hospital and Assistant Clinical Professor, Orthopaedic Surgery, Harvard Medical School decided to put this initiative into play and he approached Dr. Harold Van Bosse an attending pediatric orthopaedic surgeon at the Hospital for Joint Diseases and NYU Medical Center.
ALTSO was born.

ALTSO hopes to restore mobility and independence to disabled children worldwide by providing the best available practical solutions for prosthetic care and rehabilitation.

The team: Harold van Bosse, M.D. - Medical Advisor
Dr. Van Bosse is an attending pediatric orthopaedic surgeon at the Hospital for Joint Diseases and NYU Medical Center. His areas of speciality include spinal deformity, upper and lower limb deformities, hip problems and neuromuscular diseases. Dr. Van Bosse has participated in two pediatric orthopaedic medical missions in Colombia, South America, by volunteering his expertise and time as a surgeon to the Silver Service Children’s program through the Shriner’s Children’s Hospital in Chicago, Il.

Dinesh G. Patel, M.D., F.A.C.S.
A pioneer in arthroscopic surgery, Dr. Patel was raised and educated in Nadiad, Gujarat, India. He came to the United States in 1963 and trained in Orthopaedic Surgery at Harvard University. Dr. Patel currently serves as Chief of Arthroscopic Surgery at Massachusetts General Hospital and on the faculty of Harvard University and the Massachusetts Institute of Technology (MIT). As an accomplished arthroscopic surgeon, he has trained and lectured extensively across the globe.

C. Mead Welles, President
Mead Welles, found and manages Octagon Asset Management, LLC, Octagon Financial Services International, LLC and CommodityFinance.com, LLC (a joint venture with Rabobank International), all of which are financial services companies that specialize in global emerging markets.

Claire M. Mackay, CSW, MsEd - Executive Director
Claire is a graduate of Columbia University’s School of Social Work and Bank Street College of Education where she received a dual Master’s degree in social work administration and special education. Claire began her career in the non-profit world at Saint Vincent’s Hospital and Medical Center as a member of a multi-disciplinary psychiatric treatment team, developing and leading therapeutic and rehabilitative groups focusing on task performance and independent living.

Catherine A. Carroll - Chair of Advisory Committee
Catherine most recently was the Director of Product Marketing for CRM and Sabre Virtually There Inc., located in Southlake, Texas. Prior to joining Sabre Inc., Catherine earned an MBA in Finance and Organizational Behavior at the University of Chicago. Catherine has a strong background in Business Development, Marketing and Finance. Her broad skills include process improvement, internet strategy, corporate finance, written and oral communications, team management and group leadership.

Gujarat, India - The week of ALTSO's inauguration Surya was fitted with a prosthetic limb for her left leg and an orthopaedic boot to replace her right foot. She returned to the clinic the following day to show us how she could now walk to school by herself.

Amputees in developing countries, particularly those living in rural communities, rely on their prostheses as a matter of survival. To be able to walk again is to be able to work and provide for the family or attend school with friends.

In developing countries, prosthetic services are minimal and hardly available to rural communities. The need is great for regular outreach services to these remote areas.

An overwhelming need for good information and emotional support exists. As the child develops, so too does the child's image of him/herself. Society is organized on the basis of a two legged, two armed, walking model. It is, therefore, inevitable that people who diverge from this model may well experience problems. The child's awareness of the condition is, to a large extent, rooted in the way the family deals with the situation.

Loss of limbs is often devastating to children and their families. Rehabilitation is often a long, grueling process, requiring long-term, intensive physical and emotional therapy.

Prosthetics is the profession of designing, fabricating and fitting man-made body parts used by a person who is missing a limb due to a war injury, an accident, disease or a birth defect.

While allowing children a much greater sense of independence ALTSO is also improving the lives of families—putting smiles on their faces.
As they are aware that comprehensive prosthetic and orthotic rehabilitation efforts can be far more significant than simply providing an artificial limb or brace, ALTSO is training physicians in India so that they can follow up on the patients and attend to their needs.

To enable children with physical disabilities -to enjoy the rewards of personal achievement, physical fitness, and social interaction.

The team’s commitment to the cause is overwhelming. This reporter talked with various members of the team.

Why did you decide to initiate this project in India?

ALTSO was co- founded by Mead Welles and Dr. Patel. Dr.Patel who is originally from Gujarat and had established an Arthoscopic teaching lab there already. He had the resources and contacts in Gujarat and had access to good medical resources for ALTSO to begin its initiative there.
On Februrary 15, 2003, A Leg To Stand On (ALTSO) team members, Mead Welles, Founder and President, Dr. Dinesh Patel, Co-Founder and Director, Claire Mackay, Executive Director, Catharine Carroll, Chair of Advisory Board and Dr. Harold van Bosse , Medical Advisor; traveled to Ahmedabad India to assist with the inauguration of ALTSO's first clinic and local chapter. With the support of the Honorable Mr. Jadeja Minister of Health and Mr. Nanda, Secretary of Health both of the State of Gujurat, clinic space at the Paraplegia Hospital, Ahmedabad Civil Hospital was donated for ALTSO's long-term use.
The inauguration of the local chapter of ALTSO received extensive media coverage in India and within days, the team saw an influx of patients from all over the state line up for these services. “We were quite overwhelmed by the warmth of the welcome and soon realized how rewarding the process was going to be for us too.” 82 disabled local children have enrolled for ALTSO's services . While we were there we saw numerous children be evaluated and fitted with prosthetic limbs, we were fortunate enough to witness two children walk again for the first time.

How will children there be served while the team is based in the USA? Where does the fabrication of the prosthetic units take place?

We are in the process of training doctors and other healthcare workers in India. In fact Dr. M.M. Prabhakar, Director of Paraplegia Hospital and Paraplagia Hospital's senior orthotist, Mr. Joshi, will be travelling to the United States in the fall of 2003 to be the first recipients of the ALTSO's Fellowship Training Program.

Being crafted in India, limbs will be developed under the guidance of an engineering leader, to customize each limb for each child, to do it on site. This involves measurements, sittings and rehabilitation. That is one thing that differentiates us from other orgs that provide prosthesis support. ALTSO is committed to providing long-term care to each and every child enrolled for assistance. Children registered with ALTSO will receive comprehensive orthopedic care until their eighteenth birthday. We’re making arrangements for trained physical therapists to visit children in their homes and provide therapy. We realize that comprehensive prosthetic and orthotic rehabilitation efforts can be far more significant than simply providing an artificial limb or brace.
In November, we hope to take doctors to India so that they can perform orthopaedic surgeries using modern surgical techniques which can be taught to local orthopaedic surgeons to further their education and training in India.

How will you take ALTSO to other underdeveloped countries?

That is dependent on fund raising capabilities, also we want to be sure when we enter a country that we connect with the local authorities . To enter the system and start work , we need to have some connections and resources in place. We were fortunate to have great connections through Dr. Patel in Gujarat. We’re eager to expand services to help kids all over the world.
Once the program is established, we can be leaders in this area, we could create a model for countries that have great need for this kind of help. We will not discriminate based on religious or political differences or ethnic rifts, and we will even go to countries such as Iraq.
Some Orthopedic companies are assisting us in training prosthetists from India here. They include John Eschen Company, Arimed, Orthopedic Alternative and United Orthopedics.
Dr Van Bosse is also assisting us in attempting to form a partnership with the Hospital for Joint Diseases and NYU Medical Center.
For more information on these and other initiatives, or if you would like to lend your support, please visit www.ALTSO.org. A Leg To Stand On is a registered 501 (c)(3) tax exempt charitable organization in the United States.

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