#467 2024 · Buckaroo Footwear (with McCann Worldgroup India) · Healthcare access / footwear manufacturing
A clubfoot treatment reached rural India through the one supply chain already in every town: street cobblers
the problem
A medical device that requires custom fitting and ongoing adjustment is nearly impossible to distribute to rural populations, because building a specialized manufacturing and clinical-fitting network from scratch is expensive, slow, and only reaches wherever that new network happens to be built
background
Clubfoot, a common congenital condition, is treatable with corrective footwear, but custom-fitted, medically appropriate shoes are expensive and functionally inaccessible across much of rural India, where formal medical-device supply chains and clinical fitting services simply don't reach. Building a dedicated manufacturing and distribution network for a specialized medical product is the standard response to a supply-access gap like this — and standard because it's the only model most healthcare organizations know how to build, even though it means starting from zero in exactly the areas that most need the product.
Buckaroo Footwear and McCann Worldgroup India instead identified an already-existing, already-everywhere supply chain that could produce the necessary custom fit: India's street cobblers, present in nearly every town and village, who already possess the manual shoemaking and fitting skill the product requires. Rather than build new infrastructure, they trained existing cobblers and equipped them with simple, standardized kits to produce clubfoot-correction flip-flops directly, using the trade already embedded in the communities that needed the product.
what everyone would do
The standard healthcare-access playbook for a custom-fitted medical device is to build dedicated infrastructure: recruit and train clinical fitters, open specialized manufacturing lines, and establish a distribution network reaching the underserved population. That's exactly what a rural, dispersed population makes prohibitively slow and expensive — a purpose-built network has to be constructed town by town from zero, and it only reaches wherever that construction happens to have arrived, leaving most of rural India outside its coverage for years.
what they saw
Buckaroo and McCann saw that the specific skill clubfoot correction needed — custom manual fitting of footwear to an individual foot — already existed, at scale, embedded in nearly every town in the form of street cobblers, an informal trade with no formal connection to healthcare at all. The distribution problem wasn't really a manufacturing problem requiring new infrastructure; it was a skill-matching problem, and the matching skill was already sitting in the last mile, just never trained on or connected to this particular product.
the move
The initiative treated the medical-device distribution problem as a manufacturing-network problem already solved by an entirely different, informal trade — rather than build clinics or specialized factories, it trained the existing cobbler workforce to produce a specific corrective product, turning an established informal profession into the delivery mechanism for a healthcare need it was never previously connected to, while giving cobblers a new revenue stream in the process.
why it works
By training existing cobblers with a standardized kit rather than building parallel clinics or factories, the program inherited a distribution network that was already everywhere the target population lived, with fitting expertise already proven over years of trade — so the only new investment needed was a simple kit and basic training, not a manufacturing line or a clinical workforce built from scratch. Because the cobblers were already trusted, paid tradespeople embedded in their own communities, the product moved through existing social and commercial relationships instead of an unfamiliar new institution, and the cobblers gained a real revenue stream (roughly $2.40 per pair) that gave them a durable incentive to keep making the kits rather than treating it as a one-time charitable favor. The result was distribution reaching over 4,500 cobblers and 228,000 pairs within about a year of a February 2024 pilot — a pace and reach a newly built clinical network would have taken years to approach.
the payoff
Since its February 2024 pilot launch, the program placed kits with more than 4,500 street cobblers and produced over 228,000 custom corrective flip-flops at roughly $2.40 per pair, expanding across multiple regions of Maharashtra with plans for pan-India scale-up, while generating new income for the participating cobblers.
where it breaks
This mechanism depends on an existing informal trade whose everyday skill happens to closely match what the new product actually requires — clubfoot correction worked because shoemaking and custom fitting are what cobblers already do all day; a medical need requiring a genuinely different skill (diagnosis, injections, surgery) has no equivalent adjacent trade to repurpose. It also depends on the informal workforce being trainable with a simple, standardized kit rather than requiring deep new expertise, and on there being a real, durable revenue incentive for that workforce to keep participating rather than only a one-time training session that fades once attention (and awards) move on. Where no comparably matched informal trade exists in the target communities, or where quality and safety require closer clinical oversight than a repurposed craftsperson can provide, building dedicated infrastructure — slow and expensive as it is — may be the only accountable option.
what came after
'Fit My Feet' won a Gold Lion at Cannes Lions 2024 in Health and Wellness (Healthcare Product Innovation), India's first Gold Lion that year, plus a Bronze Lion in Brand Experience and Activation, and is cited in healthcare-access and social-innovation literature as a model for solving a last-mile medical-distribution problem by training an existing informal workforce rather than building parallel formal infrastructure.
references
- [1]Cannes Lions day one: 4-metal haul; gold & bronze for McCann, silver & bronze for Ogilvyafaqs!, 2024afaqs.com
- [2]Cannes Lions 2024: McCann brings home India's only Gold Lion on Day 1BestMediaInfo, 2024bestmediainfo.com