A Forbes article discusses how Jaipur Foot, a non-profit social enterprise that provides artificial limbs to physically challenged people living below the poverty line in India, came to be one of the world’s most technologically advanced organizations. Costing just $45, the ultramodern prosthetic is fitted to 20,000 new patients a year, while the organization provides wheel chairs, crutches, and other aids to 45,000 patients per year. Devendra Raj Mehta who has been an Indian civil servant for 40 years and heads Jaipur Foot, explains that the non-profit keeps costs low by spending all donations and grants strictly on its core objectives. Further, the organization records large amounts of patient information to show funders how its capital has been used. To date, Jaipur Foot has fitted 400,000 limbs since its first year of operation in 1975.

“The minute you start instituting a charge for your service, the most vulnerable populations are the first sector of society to be marginalized, and it’s precisely this sector of society you wish to serve the most,” explained Devendra Raj Mehta of Bhagwan Mahaveer Viklang Sahayata Samiti (BMVSS), the world’s largest limb fitting society based in India. Under this umbrella organization, Mehta, a graduate of the Sloan School of Management at MIT in the United States, heads the Jaipur Foot team, which provides world-class artificial limbs, rehabilitation aids and other appliances to physically-challenged individuals below the poverty line, and at no cost to the beneficiary. Not even one rupee, ever.

Their $45 ultramodern prosthetic is simply unmatched when compared to a similar $12,000 limb produced in the United States. The beauty of the Jaipur Foot is its lightness and mobility, as those who wear it can run, climb trees and pedal bicycles. Their knee replacement developed in cooperation with Stanford University costs a mere $20, and was named one of the 50 best inventions in the world by Time Magazine. “That’s quite an achievement for an NGO,” reflected Mehta in a recent interview with me. “Too often the NGO sector relies solely on sentiment. We need to marry sentiment with science.” The Jaipur Knee is made of self-lubricating, oil-filled nylon and is both flexible and stable, even on irregular terrain. Comparable devices include a titanium replacement, which can cost US$10,000 or more.

As a non-profit social enterprise staffing 20 centers across India and servicing 65,000 patients each year, 20,000 of whom require new feet and leg replacements while the remaining 45,000 require crutches, wheelchairs, hand-peddled tricycles and other aids, Jaipur Foot is not only a global leader in prosthetic science, production and manufacturing, but also surgical in its fiscal discipline. “Accountability leads to credibility,” said Mehta. “But this is an evolutionary process, and one must have patience.”

Founded in 1975 with less than US$10,000, Jaipur Foot is now operating with an annual budget of US$3.5M, and funded by donations, government support and earned income. About 60% of the budget is a collection of donations, small or big, and from India or abroad. Roughly 30% of the budget is in the form of government grants, and the remaining 10% is met by their own income on the corpus built up over time. Dipping into the corpus monies from time to time, in order to maintain operational integrity, is a key component of their financial and management strategy.

With overhead costs hovering at 4%, an extraordinary low percentage considering the non-profit industry at large hovers at 20%, Mehta has proven time and again that his organization spends each and every dollar mindful of its source. “From the beginning, I instituted a culture that did not allow the use of funds for any other purpose than our core objective. I did not even serve tea during our meetings, and tea costs two cents in India,” stated Mehta. “I believe that if I divert even one penny to an activity other than serving the poorest of the poor, I am committing a moral sin and a legal wrong.”

As an Indian civil servant for nearly 40 years, Mehta has held such positions as the Deputy Governor of the Indian Reserve Bank and Chairman of the Securities and Exchange Board of India (SEBI), which is the equivalent of the Securities and Exchange Commission (SEC) in the United States, among several other high-profile posts.

When asked about his prior experience in government, and its relation to his current work with Jaipur Foot, Mehta explained that his tenure in public service conditioned him to be accountable. “For government grants to Jaipur Foot, we detail an Excel spreadsheet that spans 17 columns of information about our patients, including their signature and thumbprint. This is not our money, and therefore it is our duty to be absolutely accountable for these funds, or we might not receive them again,” continued Mehta.

The marketing of Jaipur Foot is intimately tied to their culture of accountability and the quality of their products. Indeed, the government and other donors want to know that their money is being used for intended purposes and in the most effective and efficient way possible. Therefore, the backbone of the organization’s steady growth is clearly rooted in rigid expenditure policies and cent-by-cent accounting, coupled with a suite of incredibly cheap, world-renown prosthetics, aids and appliances. The two go hand in hand, or in this case, foot in foot.

In 1975, during their first year of operation, the Jaipur Foot team fitted 59 limbs. Today, nearly 400,000 people have such limbs fitted. In addition, there are mobile clinics setup in 26 countries around the world, including the war torn regions of Iraq, Afghanistan and Sudan. “You will find the Jaipur footprint in the most difficult places on earth,” asserted Mehta. “Those are the places that need the most help, and urgently.” Setting up a mobile clinic in Libya is currently being considered.

Dow Chemicals, one of Jaipur Foot’s largest corporate donors, contributes $250,000 per year, or 5,000 limbs, as Mehta likes to analogize, but despite such success, funding still remains the organization’s largest challenge. “At the current setup in Jaipur, we have the capacity to fit 10,000 more limbs each year, but we lack the funding to fulfill that capacity,” said Mehta. “Because of this challenge, I’m the biggest beggar in India.”

In a wonderful story that displayed both Mehta’s learned skill-set as a professional fundraiser and the sheer quality and efficiency of Jaipur Foot’s operation, Mehta recalled a telephone call he received from an individual abroad who wished to donate US$10,000. Refusing the donation, Mehta explained that he did not accept such large gifts from individuals who have not yet witnessed the operation in action, and thus he invited the donor to view their facility in India. After touring the operational headquarters, and witnessing firsthand individuals limping in one day and walking out the next for a meager $45, a check was written for US$20,000—double the original intention. “Seeing is believing,” said Mehta. “Lives are instantly changed, and to witness such transformation is an experience like none other.”

While a pioneer in prosthetics, and having served more than 1.2M individuals to date, Jaipur Foot is much more than an organization that fits high-quality limbs at zero cost to those living in poverty. “We wish to restore and advance the human dignity and self-respect of those we serve,” stated Mehta. “And simply put, doing good to others is my religion.”

At the end of our interview, I explored the issues of compassion and respect for human life in the context of his work. After a long pause, filling the room with palpable courage and conviction, Mehta recited a quote from Dr. Albert Schweitzer, a philosopher, physician and medical missionary, whose words have inspired him since time immemorial. “Let us all join the fraternity of those who bear the mark of pain,” said Mehta. “Before I die, I hope to prostrate before his burial in Gabon, West Africa.”