Making heart-lung machines work in India: Imports, indigenous innovation and the challenge of replicating cardiac surgery in Bombay, 1952-1962.

Abstract

In 1962, surgeons at two hospitals in Bombay used heart-lung machines to perform open-heart surgery. The devices that made this work possible had been developed in Minneapolis in 1955 and commercialized by 1957. However, restrictions on currency exchange and foreign imports made it difficult for surgeons in India to acquire this new technology. The two surgeons, Kersi Dastur and PK Sen, pursued different strategies to acquire the ideas, equipment, and tacit knowledge needed to make open-heart surgery work. While Dastur tapped Parsi networks that linked him to local manufacturing expertise, Sen took advantage of opportunities offered by the Rockefeller Foundation to access international training and medical device companies. Each experienced steep learning curves as they pursued the know-how needed to use the machines successfully in dogs and then patients. The establishment of open-heart surgery in India required the investment of substantial labor and resources. Specific local, national, and transnational interests motivated the efforts. Heart-lung machines, for instance, took on new meanings amid the nationalist politics of independent India: Even as surgeons sought imported machines, they and their allies assigned considerable value to 'indigenous' innovation. The confluence of the many interests that made Sen and Dastur's work possible facilitated the uneasy co-existence of conflicting judgments about the success or failure of this medical innovation.