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Bikramjit Basu

Biomaterials
Science and
Implants
Status, Challenges and Recommendations
Biomaterials Science and Implants
Bikramjit Basu

Biomaterials Science
and Implants
Status, Challenges and Recommendations

123
Bikramjit Basu
Materials Research Center and BioSystems
Science and Engineering
Indian Institute of Science Bangalore
Bengaluru, Karnataka, India

ISBN 978-981-15-6917-3 ISBN 978-981-15-6918-0 (eBook)

https://doi.org/10.1007/978-981-15-6918-0
© Springer Nature Singapore Pte Ltd. 2020
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part
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Foreword by The President, Indian National
Science Academy

The Indian National Science Academy has assigned itself an important mandate of
informing society, stakeholders and policymakers on various issues of science that
are of relevance to society. This is being carried out through comprehensive reports
and books, on the status of specific subjects through a narrative of evidence-based
understanding of scientific research at the cutting edge. The literature is presented in
a simple to understand manner and deals with aspects of education, research, and
future possibilities, future challenges and suggestions for policies to take India
forward. These reports project the needs of India during the coming two to three
decades.
This monograph on Biomaterials Science and Implants by Prof. Bikramjit Basu
presents one such effort. The book deals with a complimentary subject of bioma-
terials, with the present science and education scenario, traces the historical
developments, summarises the present status and gazes in to the future. It discusses
various realms of this science that he terms as immigration science, that
derives/depends on contributions from a variety of disciplines, such as material
sciences, especially the synthetic hybrid materials, biological sciences, health sci-
ences, toxicological research besides biomechanics and manufacturing sciences.
Various chapters of the monograph deal with (a) important developments, espe-
cially in the field of medical implants, the need to augment teaching in this disci-
pline and the future possibilities, given that biomaterials will be an important
economic driver for the country; (b) current research scenarios and technical
challenges; and (c) the need for future research. The monograph is well-illustrated
with data and figures to help the reader. This monograph was reviewed by two
experts and we thank them for their help in providing timely and incisive reviews.
Both the experts commended this monograph.
On behalf of INSA, I am pleased to present this monograph to the public and
policymakers, including the scientific fraternity, and I am sure it will eminently
serve the purpose, it was meant for. I would like to place on record our appreci-
ations for Prof. M. S. Valiathan to write a Foreword for this monograph. His doing
so, speaks volumes on the quality of science being presented by the author.
I compliment and congratulate Prof. Basu for his hard work. I sincerely hope that

v
vi Foreword by The President, Indian National Science Academy

this book will enthuse newer communities to join hands to develop major research
initiatives in this important area of biomaterials and bioengineering and create
nationwide traction.
I thank Prof. A. K. Singhvi, Vice President, INSA, for his active role in bringing
this book to fruition. I also would like to place on record my appreciation for Prof.
Gadadhar Misra for coordinating the publication of this book with M/s Springer
Nature India. This is the first book being published and coproduced by M/s
Springer Nature.

Ajay K. Sood
FRS, President
Indian National Science Academy
New Delhi, India
Foreword by M. S. Valiathan

In the last couple of decades, the field of biomaterials science and tissue engineering
is at the frontier of research and innovation, considering the number of scientific
discoveries and their potential impact in treating human diseases. Overall, this book
emphasises the enormous need for the supply of regenerated organs and tissues, as
the spontaneous capacity for regeneration is limited in the human body. To sub-
stantiate the relevance for human healthcare, degenerative and inflammatory
problems of bone and joints affect millions of people worldwide.
In order to address biomedically relevant challenges in orthopaedics as well as
neural and cardiovascular diseases, researchers must blend the fundamental con-
cepts of engineering sciences (materials science), basic sciences (chemistry and
physics) and biological sciences (cell and molecular biology) to engineer synthetic
tissue replacements and develop novel healing strategies. Such an interdisciplinary
research approach requires understanding across the boundary of remotely linked
scientific disciplines. Researchers can develop innovative ideas, as well as under-
stand the language of this important research area of societal relevance. In most
significant terms, this monograph closes with the author's recommendations for the
policymakers, science administrators and lawmakers to facilitate the growth of this
field in near future and long term.
I am convinced that this important monograph, of considerable relevance to
India, should inspire many active researchers as well as young researchers, to think
laterally, while blending sufficient knowledge of biological systems with engi-
neering sciences to develop biomedical materials. The accelerated growth in the
fields of biomaterials and biomedical engineering, when most, if not all, the rec-
ommendations are translated to reality, is expected to facilitate affordable, yet
high-quality healthcare for millions of Indians and citizens of other countries
globally. To accompany the advances, the right regulatory and legislatory changes

vii
viii Foreword by M. S. Valiathan

are required. I personally find this much-needed monograph timely and immensely
valuable for the interdisciplinary scientific community pursuing the field of bio-
materials and biomedical engineering.

Manipal, India M. S. Valiathan

October 2019 Ch.M., FRCS, FRCS(C), FRCP, D.Sc (h.c)
National Research Professor
Padma Vibhushan Awardee (2005)
Former Vice-Chancellor
Manipal University
Former President, Indian National Science
Academy
Former Director
Sree Chitra Tirunal Institute for Medical
Sciences and Technology
Thiruvananthapuram
Preface

Who, What, When, Where, Why and How

We are now in an era of interdisciplinary research, as a matter of necessity and also

of knowledge: in themes and topics, in perspectives and problem-definition, in
execution and evaluation. The field of biomaterials science is one such interdisci-
plinary research field. In this monograph, I have made extensive efforts to sketch
the Indian landscape at work in this socially important area of scientific research,
against the international backdrop. The main aim of this monograph is to stimulate
actions by a wide variety of stakeholders who read this report.
I am a materials scientist by academic training and a biomaterials scientist by
calling. At the initial phase of my career in biomaterials, I was aware of the
challenges involved in entering an unexplored interdisciplinary domain that pro-
mises to have a dramatic impact on critical real-world problems in the next decades.
I can still recollect the uphill battle when I started pursuing science-to-implant
innovation, involving clinicians and companies. Against this backdrop, I have
summarised the major challenges and opportunities in the field, for young as well as
established researchers in the field.
The Indian medical device market is dominated by foreign companies, with over
70% of demands being met through imports. Currently, approximately one million
patients need prostheses and implants every year, and India imports a big slice,
worth Rs. 7000 crore a year (approximately $1 billion USD). Alongside, bioma-
terials research internationally is progressing in leaps and bounds at several insti-
tutions of repute. In this context, I have penned down a set of recommendations,
which I believe should be considered as priority recommendations by all stake-
holders for building the research ecosystem of India’s tomorrow.

ix
x Preface

The Roadmap: Engaging Key Stakeholders

When we define the progress of a particular field, we are required to think of its
issues, challenges and bottlenecks. However, equally important is attempting to
solve these problems, brainstorm recommendations and action plans.
It is high time that a monograph on the national status of research in biomaterials
is presented. It is time for real inquiry into select global institutes of importance, for
highlighting challenges and, most of all, issuing actionable recommendations that
will expedite inventions from the bench to the bedside. There is no one road-map
that fits all ecosystems, and therefore, this monograph is best used as a means to
stimulate thinking in the right direction. The process of building dynamic inno-
vation ecosystems involves not only working out the details, but also mastering the
art of motivation, organisation and negotiation. It is hoped that this text will be
well-received by science administrators, policymakers, legislators and citizens, in
the context of developing countries, taking India as an example.
The monograph, however, also contains valuable information for anyone who is
interested in learning about the current issues and trends, gaps and synergies, in
biomaterials sciences and bioengineering. It should also be useful for those inter-
ested in knowing about the status of major national and international research
centres. The list of global institutes of importance presented here is not exhaustive
and I acknowledge that there are others that have not been highlighted here that are
also of high calibre.
In particular, this monograph is visualised as a strategic roadmap to balance the
needs of the following stakeholders, towards building the regulatory framework:
1. Science administrators
2. Policymakers and legislators
3. Research coordinators, incubators and funding officers
4. Scientists and young researchers, including Ph.D. students, in Academia
5. MSMEs and industry
6. Clinicians

The Guide: Navigating the Monograph

Readers are encouraged to navigate this report by first considering the Contents,
what the purport of each chapter is and then, identifying the sections that are of
greatest importance to the reader, based on their expertise, interests and organisa-
tion. The first four chapters are intended to provide a foundational discussion of the
field and the status of ongoing research, nationally and globally. Subsequent to this,
the fifth chapter, “A Challenging Frontier”, is intended to provide the reader with an
overview of the key challenges in the field. The sixth chapter, “Recommendations”,
is intended to stimulate the minds of the readers on key recommendations and the
accompanying timeline-specific action plans.
Preface xi

Actionable Takeaways: Determining What Actions to Take

The main aim of this monograph is to stimulate actions by a wide variety of

stakeholders who read this report. The actions should be focussed on contributing to
the development of the biomaterials and bioengineering fields. This can be in the
form of actions related to specific challenges and recommendations presented here.
The list, however, is not exhaustive, and the reader is welcome to think of further
challenges and recommendations that can be addressed. I am hopeful that the
monograph will trigger new conversations and discussions among peer groups
towards a more detailed action plan. It is strongly recommended that the policy-
makers and lawmakers make note of actions based on the selected sections of
relevance, in the fifth and sixth chapters. I am confident that the insights gained
from this monograph, and the actions that it will stimulate, will enable a more
robust and congruent ecosystem for biomaterials science and implants. All the
views expressed in this monograph by the author are intended solely for the purpose
of discussion, and are not intended to offend any sentiments of any individual,
research group or other stakeholders in the biomaterial implants ecosystem. The
readers are welcome to share their comments or feedback with the author.

A Note of Thanks

Many challenges and recommendations, summarised in this book, are the reflection
of my understanding gained during the significant interactions with numerous
collaborators from academia, national laboratories, medical institutions and industry
as well as young researchers, in India and abroad. I have acknowledged this in a
separate list, which also contains a number of science administrators or policy-
makers. I am grateful to all of them for their time and useful suggestions. I thank my
current and former students, including Nitu Bhaskar, Srimanta Barui, Subhadip
Basu, Swati Sharma, Vidushi Sharma, Ranjith Kumar P., Asish Kumar Panda,
Gowtham N. H., Soumitra Das, Deepa Mishra, Sulob Roy Chowdhury, Indu
Bajpai, Subhadip Bodhak, Yashoda Chandorkar, Subhomoy Chatterjee,
Ashutosh K. Dubey, Shilpee Jain, Ravikumar K., Alok Kumar, Prafulla K. Mallik,
Atiar Molla, Shekhar Nath, Shibayan Roy, Naresh Saha, Debasish Sarkar,
B. Sunilkumar, Greeshma T., Garima Tripathi and Raghunandan Ummethala.
I deeply acknowledge the support of Dr. Nandita Keshavan, Dr. Damayanti Datta,
Mrs. Prerana S., Ms. Sheetal Chowdhury, Ms. Titash Mukherjee, Ms. Rea Johl and
Mr. Nihal Kottan in preparing this monograph. I also appreciate the comments and
constructive suggestions of the reviewers of this book. Finally, I am grateful to my
wife, Pritha Basu, and son, Prithvijit Basu, as well as other family members for their
xii Preface

unconditional support during writing this monograph. I am also indebted to my

parents, Manoj Mohan Basu (father) and Chitra Basu (mother) for their constant
encouragement and inspiration throughout my life. I truly acknowledge the finan-
cial support received from the Indian National Science Academy, Scheme for
Promotion of Academic and Research Collaboration (SPARC) and Indian Institute
of Science, Bangalore, during the writing of this monograph.

Bikramjit Basu
Ph.D., CEng., FACerS, FAMS, FAIMBE, FNAE, FNASc, FAScT, FBAO
Professor
Materials Research Center and BioSystems
Science and Engineering
Indian Institute of Science, Bangalore
Bengaluru, Karnataka, India
Honorary Professor
University of Manchester
Manchester, UK
Acknowledgements

List of Scientists from Academia and National Laboratories

Consulted

Kantesh Balani, Indian Institute of Technology Kanpur, India

Rinti Banerjee, Indian Institute of Technology Bombay, India
Dipankar Banerjee, Indian Institute of Science, Bangalore, India
Ananya Barui, Indian Institute of Engineering Science and Technology, Shibpur,
India
Naresh Bhatnagar, Indian Institute of Technology Delhi, India
Aldo Boccaccini, Institute of Biomaterials, Erlangen, Germany
K. Muraleedharan, CSIR-CGCRI, Kolkata, India
Vamsi Krishna Balla, CSIR-CGCRI, Kolkata, India
Subhadip Bodhak, CSIR-CGCRI, Kolkata, India
Biswanath Kundu, CSIR-CGCRI, Kolkata, India
Marc Bohner, RMS Foundation, Bettlach, Switzerland
Rajendra K. Bordia, Clemson University, USA
Annabel Braem, Katholieke Universiteit Leuven, Belgium
Sarah Cartmell, University of Manchester, UK
Kaushik Chatterjee, Indian Institute of Science, Bangalore, India
Jérôme Chevalier, Institut National des Sciences Appliquées (INSA), Lyon, France
Pallab Dutta, Indian Institute of Engineering Science and Technology, Shibpur,
India
Mitun Das, CSIR-CGCRI, Kolkata, India
Brian Derby, University of Manchester, UK
Alok Dhawan, CSIR-Indian Institute of Toxicology Research, Lucknow, India
Santanu Dhara, Indian Institute of Technology Kharagpur, India
Christophe Drouet, Centre Inter-universitaire de Recherche et d’Ingénierie des
Matériaux, Toulouse, France
Ashutosh K. Dubey, Indian Institute of Technology (BHU), Varanasi, India

xiii
xiv Acknowledgements

Michael Gelinsky, Technische Universität Dresden, Germany

Liesbet Geris, Katholieke Universiteit Leuven, Belgium
Sourabh Ghosh, Indian Institute of Technology Delhi, India
Swati Haldar, Indian Institute of Technology Roorkee, India
Julian Jones, Imperial College London, UK
Surya Kalidindi, Georgia Institute of Technology, USA
Subramani Kanagaraj, Indian Institute of Technology Guwahati, India
Manoj Komath, Sree Chitra Tirunal Institute for Medical Sciences and Technology,
Thiruvananthapuram, India
Veena Koul, Indian Institute of Technology Delhi, India
Ashok Kumar, Indian Institute of Technology Kanpur, India
A. M. Kuthe, Visvesvaraya National Institute of Technology, Nagpur, India
Debrupa Lahiri, Indian Institute of Technology Roorkee, India
Cato Laurencin, University of Connecticut, USA
Anne Leriche, Université Polytechnique Hauts-de-France, Valenciennes, France
H. S. Maiti, Former Director, CSIR-Central Glass and Ceramic Research Institute,
Kolkata, India
Biman B. Mandal, Indian Institute of Technology Guwahati, India
Saumen Mandal, National Institute of Technology Karnataka, Surathkal, India
Sujata Mohanty, All India Institute of Medical Sciences, New Delhi, India
Subha Narayan Rath, Indian Institute of Technology Hyderabad, India
Abhay Pandit, National University of Ireland, Galway, Ireland
Hardik Pandya, Indian Institute of Science, Bangalore, India
Jouni Partanen, Aalto University, Finland
Falguni Pati, Indian Institute of Technology Hyderabad, India
Yarlagadda Prasad, Queensland University of Technology, Australia
Seeram Ramakrishna, National University of Singapore, Singapore
B. Ravi, Indian Institute of Technology Bombay, India
Rui Reis, 3Bs’ Research Group, University of Minho, Braga, Portugal
Amit Roy Chowdhury, Indian Institute of Engineering Science and Technology,
Shibpur, India
Debashish Sarkar, National Institute of Technology, Rourkela, India
T. S. Sampathkumar, Indian Institute of Technology Madras, India
Jukka Seppälä, Aalto University, Finland
C. P. Sharma, Sree Chitra Tirunal Institute for Medical Sciences and Technology,
Thiruvananthapuram, India
D. D. Sarma, Indian Institute of Science, Bangalore, India
Molly Shoichet, University of Toronto, Canada
Carl G. Simon, Jr., National Institute of Standards & Technology (NIST),
Gaithersberg, MD, USA
Neetu Singh, Indian Institute of Technology Delhi, India
Simone Sprio, Istituto di Scienza e Tecnologia dei Materiali Ceramici (ISTEC),
Faenza, Italy
Acknowledgements xv

N. Ravi Sundaresan, Indian Institute of Science, Bangalore, India

Anna Tampieri, Istituto di Scienza e Tecnologia dei Materiali Ceramici (ISTEC),
Faenza, Italy
H. K. Varma, Sree Chitra Tirunal Institute for Medical Sciences and Technology,
Thiruvananthapuram, India

List of Clinicians Consulted

Aniruddh T. J., M. S. Ramaiah Memorial Hospital, Bangalore, India

Yogesh Chawla, Postgraduate Institute of Medical Education and Research,
Chandigarh, India
Amit. K. Dinda, All India Institute of Medical Sciences, New Delhi, India
Anil Mandhani, Medanta, the Medicity, Gurugram, India
Ivan Martin, University Hospital of Basel, Switzerland
K. V. Menon, Sparsh Hospital, Bangalore, India
B. V. S. Murthy, Ramaiah University of Applied Sciences, Bangalore, India
Sunil Nikose, Datta Meghe Institute of Medical Sciences, Wardha, India
Zahir Quaziuddin, Datta Meghe Institute of Medical Sciences, Wardha, India
C. Rex, Rex Hospital, Coimbatore, India
Vibha Shetty, Ramaiah University of Applied Sciences, Bangalore, India
Balendra Singh, King George’s Medical University, Lucknow, India
D. C. Sundaresh, Ramaiah University of Applied Sciences, Bangalore, India
Rajesh T. R., Sparsh Hospital, Bangalore, India
M. S. Valiathan, Manipal University, India
Ajit Yadav, Gleneagles Global Health City, Chennai, India

List of Science Administrators/Policymakers Consulted

Florent Bernard, European Commission, Brussels, Belgium

Kakali Dey Dasgupta, Department of Biotechnology, Government of India, New
Delhi, India
Katherine Freeman, Healthcare Technologies, Engineering and Physical Sciences
Research Council (EPSRC), UK
Kalaivani Ganesan, Department of Biotechnology, Government of India, New
Delhi, India
Priyankana Mukherjee, IKP Engineering, Design, and Entrepreneurship Network,
Bangalore, India
Gert Roebben, European Commission, Brussels, Belgium
xvi Acknowledgements

Alka Sharma, Department of Biotechnology, Government of India, New Delhi,

India
Ashutosh Sharma, Department of Science and Technology, Government of India,
New Delhi, India
Jitendar Sharma, Andhra Pradesh MedTech Zone, India
Soumya Swaminathan, World Health Organisation
Sandeep Verma, Science Engineering and Research Board, Government of India,
New Delhi

List of Industry Professionals Consulted

Rohan Aggarwal, Vidcare Innovations, Pune, India

S. K. Banerji, Orthotech, Gujarat, India
Debasish Bhattacharjee, TATA Steel Limited, India
Sudip Bose, TATA Steel Limited, India
M. Chandrashekharan, SMATEC b.v.b.a., Belgium
Aroop K. Dutta, Excel Matrix Biological Devices Pvt. Ltd., Hyderabad, India
Ranjna C. Dutta, Excel Matrix Biological Devices Pvt. Ltd., Hyderabad, India
Nilay Lakhkar, SynThera Biomedical, Pune, India
Subrata Mukherjee, TATA Steel Limited, India
Kamlesh Patel, Kaaryans Technical Ceramics, Gujarat, India
Kingshuk Poddar, TATA Steel Limited, India
Sabyasachi Roy, ANTS Ceramics, Vasai, India
Ravi Sarangapani, Biomedical Engineering Consultant, Pune, India
Mario van Wingerde, TATA Steel Limited, India

List of Institutions Consulted

Andhra Pradesh Med Tech Zone, Visakhapatnam, India

BETiC (Biomedical Engineering and Technology Incubation Centre), India
IKP Engineering, Design, and Entrepreneurship Network, Bangalore, India
Istituto di Scienza e Tecnologia dei Materiali Ceramici (ISTEC), Faenza, Italy
Kalam Institute of Health Technology, Visakhapatnam, India
PSG Institute of Advanced Studies, Coimbatore, India
Sree Chitra Tirunal Institute for Medical Sciences and Technology,
Thiruvananthapuram, India
Acknowledgements xvii

List of Funding Agencies

Department of Biotechnology, Government of India

Department of Science and Technology, Government of India
Indian National Academy of Engineering, Gurugram, India
Indian National Science Academy, New Delhi, India
Scheme for Promotion of Academic and Research Collaboration, Government of
India
Executive Summary

“Nothing is more powerful than an idea whose time has come”.

Do you know what hides in your hospital bills? Take a deep breath and prepare
to be surprised: 40% of the expenses are attributed to medical equipment, of which
about 70% come from high-tech diagnostic tests.
Medical devices single-handedly offset the healthcare cost impact. That is
because, nearly 80% of devices come from outside the country: the USA, Germany,
France, Singapore, China and the Netherlands. The dark side of the story is
well-known: one in every four households in India is pushed into debt every year
over healthcare costs. Not just Indians, consider the large number of patients who
come for treatment from the Middle East, Africa and neighbouring countries
(Bangladesh, Sri Lanka, Nepal, Bhutan, etc.).
The deficits of the current research ecosystem in India play a key role in this
chain of skyrocketing costs and unmet clinical needs. A key challenge for inno-
vation is the manufacturing of affordable biomedical devices without compromising
on quality. Made of metals and alloys, ceramics and carbons, polymers and com-
posites and other materials, biomaterials are used every day in surgery, in dental
applications and orthopaedics and drug delivery. Then, there are smart biomaterials,
a field that is developing at a very rapid pace, which can interact with biological
systems, directly influencing cell behaviour.
India has sent out tectonic ripples across the world with its mammoth healthcare
scheme for the under-privileged citizens. In line with the vision of affordable
medical costs, it is essential to develop a national roadmap for indigenous
high-performance biomedical implants and devices, in an accelerated manner. To
bring the benefits of cutting-edge science from the laboratory benchside to the
patient bedside, it is imperative to complete the full cycle of translational research.
For all persons involved in this field, from all sectors, it is the right time to think
about implementing engaging action plans that are tailored to the needs of the
times. In order to introduce the readers to the status of the field, the introductory
chapter discusses important concepts in the field, and the Appendix lists interna-
tionally approved definitions as well as details of the national meetings, which led
the author to conceive this text.

xix
xx Executive Summary

A major bottleneck is the poorly conceived regulatory framework in India. The

strategic road ahead lies in implementing robust national regulatory policy and
translational research programmes with strong involvement of clinicians and
industry, towards the discovery and deployment of new biomaterials and implants.
Furthermore, the author proposes the development of biomaterialomics (biomate-
rials with data science), which relies on a data-driven integrated understanding of
biocompatibility and elements of biomaterials development, while leveraging both
conventional and advanced manufacturing (e.g. 3D bioprinting).
The recommendations laid down in this monograph should help to establish
India as a global market leader for a new generation of bioimplants, whose pre-
dictive clinical performance would be closely tracked by “digital twins”. An out-
come of this strategic initiative would be realised in the creation of new
employment opportunities for skilled and semi-skilled Indians, together with the
education and training of next-generation researchers.
It is the author’s vision that such a text would not only encourage young
researchers to be passionate about understanding the current challenges, and those
of the end-user, but also inspiring them to form strong collaborations for adaptive
problem solving, thereby making significant contributions to the field. Also, this
monograph would be useful in honing the knowledge of those established in the
field by broadening their understanding on the research ecosystem in developed
nations and the national context. These topics are of greater importance towards
building an India of the future, where innovations can have a palpable impact, and
technological innovations meet the healthcare needs of society. Given the right
support, the key recommendations presented here can be highly transformative to
the field. “Nothing can stop an idea whose time has come”, Victor Hugo, the French
epic novelist, once wrote. We have proposed here the idea of the moment. An idea
that can carry forward both people’s wellbeing and the nation’s economy in its
energy and momentum.
Contents

1 Crossing the Boundaries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

1.1 Biomaterials Bloom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.2 The New Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.2.1 The Key Elements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
1.2.2 Defining Biocompatibility . . . . . . . . . . . . . . . . . . . . . . . . 9
1.2.3 Structural Concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
1.3 Stem Cells and Regenerative Engineering . . . . . . . . . . . . . . . . . 12
1.4 Unmet Clinical Needs and Clinical Perspective on Biomaterial
Implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
1.4.1 Musculoskeletal Surgery and Orthopaedics . . . . . . . . . . . 15
1.4.2 Dental Restoration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
1.4.3 Neurosurgical Treatment . . . . . . . . . . . . . . . . . . . . . . . . 18
1.4.4 Cardiovascular Treatment . . . . . . . . . . . . . . . . . . . . . . . . 21
1.4.5 Urological Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
1.4.6 ENT Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
1.5 The Tailpiece . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
2 Economic Impact, Healthcare Initiatives, and Research
Funding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
2.1 Potential Economic Impact of Innovation . . . . . . . . . . . . . . . . . . 30
2.1.1 International Market . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
2.1.2 National Market . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
2.2 India’s Healthcare Initiatives and Translational Research
Facilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... 39
2.2.1 Translational Research Institutes and Programmes ...... 40
2.2.2 Kalam Institute of Health Technology
and the Andhra Pradesh MedTech Zone . . . . . . . . . . . . . 42
2.2.3 NITI Aayog and the National Health Stack . . . . . . . . . . . 44
2.3 Education and Human Resources . . . . . . . . . . . . . . . . . . . . . . . . 46
2.3.1 Bioengineering Curriculum and Indian Academia . . . . . . 46
2.3.2 Medical Education and Research in India . . . . . . . . . . . . 47

xxi
xxii Contents

2.4 Funding Status and Opportunity . . . . . . . . . . . . . . . . . . . . . . . . 49

2.4.1 National Funding Schemes . . . . . . . . . . . . . . . . . . . . . . . 49
2.4.2 International Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
2.5 A Way Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
3 Scientists at Work in India . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
3.1 At the Tipping Point . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
3.2 All About Joints: Hips, Knees, and Spines . . . . . . . . . . . . . . . . . 61
3.3 Bones and Teeth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
3.4 Cartilage, Bone, Cardiac, and Skin Tissue Engineering . . . . . . . . 69
3.5 Eyes, Nerves, and Ears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
3.6 Antibacterial Biomaterials to Combat Implant-Associated
Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 73
3.7 Regenerative Engineering . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 76
3.8 3D (Bio) Printing of Biomaterials, Tissues, and Organs . . . . . .. 78
3.9 National Institutes of Importance and Centres
of Excellence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 81
3.9.1 Sree Chitra Tirunal Institute for Medical Sciences
and Technology, Thiruvananthapuram . . . . . . . . . . . . . .. 81
3.9.2 School of International Biodesign, All India Institute
of Medical Sciences, New Delhi . . . . . . . . . . . . . . . . . .. 83
3.9.3 Biomedical Engineering and Technology Incubation
Centre (BETiC), IIT Bombay . . . . . . . . . . . . . . . . . . . .. 83
3.9.4 Multi-institutional National Research Programs . . . . . . .. 84
3.9.5 Multi-institutional International Translational Research
Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 85
3.10 Nota Bene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 86
3.11 A Path Ahead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 87
4 International Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 89
4.1 Global Landscape of Biomaterials Research Consortia . . . . . . .. 91
4.1.1 Prometheus Group, at Katholieke Universiteit Leuven,
Belgium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 91
4.1.2 McGowan Institute for Regenerative Medicine,
University of Pittsburgh, USA . . . . . . . . . . . . . . . . . . .. 91
4.1.3 ‘Cúram - Centre for Research in Medical Devices’,
NUIG Galway, Ireland . . . . . . . . . . . . . . . . . . . . . . . . .. 92
4.1.4 Wyss Institute at Harvard University, USA . . . . . . . . . .. 93
4.1.5 Centre for Translational Bone, Joint, and Soft Tissue
Research, TU Dresden, Germany . . . . . . . . . . . . . . . . .. 93
4.1.6 Istituto di Scienza e Tecnologia dei Materiali Ceramici
(ISTEC), Faenza, Italy . . . . . . . . . . . . . . . . . . . . . . . . .. 94
4.1.7 3B’s Research Group, University of Minho, Braga,
Portugal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 96
Contents xxiii

4.1.8 National Institute of Standards & Technology (NIST),

Gaithersburg, MD, USA . . . . . . . . . . . . . . . . . . . . . . . .. 96
4.1.9 Wake Forest Institute for Regenerative Medicine,
Winston-Salem, North Carolina, USA . . . . . . . . . . . . . . . 97
4.2 Multi-institutional Research Initiatives and Training Centres . . . . 98
4.2.1 Henry Royce Institute, UK . . . . . . . . . . . . . . . . . . . . . . . 98
4.2.2 Matériaux pour la Santé (MatSan), France . . . . . . . . . . . . 99
4.2.3 Materials Assembly and Design Excellence in South
Carolina (MADE in SC), Clemson University, USA . . . . 100
4.2.4 ARC Training Centre for Innovative Bioengineering,
University of Sydney, Australia . . . . . . . . . . . . . . . . . . . 101
4.3 Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
5 A Challenging Frontier and Status of National Policies . . . . . . . . . . 103
5.1 Accelerating Regulatory Approval . . . . . . . . . . . . . . . . . . . . . . . 104
5.1.1 Current Status and Gaps in Medical Device
Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
5.1.2 Manufacturing-Related Regulations . . . . . . . . . . . . . . . . . 106
5.2 Strengthening Basic Research in Biomaterials Science . . . . . . . . 107
5.2.1 Development of Next-Generation Biomaterials . . . . . . . . 108
5.2.2 Biomaterials and 3D Bioprinting-Based Approaches
for Regenerative Engineering . . . . . . . . . . . . . . . . . . . . . 110
5.2.3 Multiscale Computational Analysis . . . . . . . . . . . . . . . . . 113
5.2.4 Data Science Driven Approach . . . . . . . . . . . . . . . . . . . . 115
5.3 Building Translational Research for Human Healthcare . . . . . . . . 117
5.4 Nourishing Industry Collaborations, Incubators,
and Start-Ups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
5.5 Addressing the Gaps in Medical Education and the Clinical
Research Ecosystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
5.5.1 Education and Training . . . . . . . . . . . . . . . . . . . . . . . . . 123
5.5.2 Clinical Research Ecosystem Development . . . . . . . . . . . 124
5.6 Harnessing the Benefits of Biomaterials for the
Country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
5.7 Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
6 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
6.1 The Translational Gap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
6.1.1 Science at the Local . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
6.1.2 Regulatory Impasse . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
6.1.3 Steering Science and Technology . . . . . . . . . . . . . . . . . . 132
6.2 Priority Recommendations for Fostering Innovation and Growth
of Biomedical Materials and Implants . . . . . . . . . . . . . . . . . . . . 132
6.2.1 Implement National Regulatory Framework
to Streamline Accelerated Regulatory Approval
Processes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
xxiv Contents

6.2.2 Strengthen Basic Research in Biomaterials Sciences

for Accelerated Innovation of Next-Generation
Biomaterials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
6.2.3 Build Up Clinical, Context-Driven, Translational
Research Toward Treatment of Human Diseases . . . . . . . 139
6.2.4 Nourish Industry Collaborations and Capabilities,
Grow and Sustain Incubators and Start-Ups . . . . . . . . . . . 143
6.2.5 Revamp Medical Education and the Clinical Research
Ecosystem, to Train and Collaborate with Clinicians . . . . 146
6.2.6 Introduce and Implement National Policies
and Action Plans to Harness Benefits of Biomaterials
for the Public . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
7 Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155

Appendix: Pedagogy and the Genesis of this Book . . . . . . . . . . . . . . . . . . 157

Appendix A: Defining Key Elements of Biomaterials Science . . . . . . . . . 159
Appendix B: Ethical and Safety Considerations . . . . . . . . . . . . . . . . . . . . 163
Appendix C: International Research Groups . . . . . . . . . . . . . . . . . . . . . . 167
Appendix D: Conferences and Workshops . . . . . . . . . . . . . . . . . . . . . . . . 173
Appendix E: Road-Mapping Meetings. . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Additional Reading and References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
About the Author

http://bikramjitbasu.in/
Professor Bikramjit Basu is currently a Professor at
the Materials Research Center and holds Associate
Faculty position at Center for Biosystems Science and
Engineering, Indian Institute of Science (IISc),
Bangalore. He is currently Visiting Professor at
University of Manchester, UK. After his undergraduate
and postgraduate degree in Metallurgical Engineering
from NIT Durgapur and IISc respectively, he earned his
PhD in the area of Engineering Ceramics at Katholieke
Universiteit Leuven, Belgium in March, 2001.
Following a brief post-doctoral stint at University of
California, Santa Barbara; he served as a faculty of
Indian Institute of Technology Kanpur during
2001-2011. He has taught in UK, Spain, Slovenia,
Belgium and Nepal. He has successfully led interna-
tional research programs with USA, UK and Germany.
Professor Basu has been pursuing challenging inter-
disciplinary research at the cross-road, where Materials
Science, Biological Science and Medicine meet. He has
aptly used the principles of Biomaterials Science and
Biomedical Engineering to develop next generation
implants and biomedical engineering solutions in an
effort to address unmet clinical needs for musculoskele-
tal, dental, neurosurgical and urological applications.
Over the years, he has created interactive and intensive
collaborations with a number of clinicians and
entrepreneurs to accelerate bench science-to-device
prototype development. Encompassing theoretical
predictions, computational analysis, experimental

xxv
xxvi About the Author

discovery and clinical translational research, his

research group has laid the foundation for intelligent
design of implants, 3D binderjet printing of biomate-
rials, science of biocompatibility and bioengineering
strategies, to advance the development of biomedical
implants, regenerative engineering and bioelectronic
medicine. He is currently leading India’s major trans-
lational Center of Excellence on biomaterials with an
interdisciplinary team of researchers from academia and
medical institutions and hospitals. He has published
over 300 peer-reviewed research papers in leading
journals (total citations * 11,000 and H-index: 56).
Many of his former students are currently thriving
research programs in IITs and NITs in India. He has
co-authored 9 books, including 7 textbooks on
Biomaterials, Tribology and Ceramics.
Prof. Basu’s contributions in Biomaterials Science
have been widely recognised. He received India’s most
coveted science and technology award, Shanti Swarup
Bhatnagar Prize in 2013. A Chartered Engineer of UK,
he is an elected Fellow of the International Academy of
Medical and Biological Engineering (2020),
International Union of Societies for Biomaterials
Science and Engineering (2020), Indian Academy of
Sciences (2020), American Ceramic Society (2019),
American Institute of Medical and Biological
Engineering (2017), Institute of Materials, Minerals &
Mining, UK (2017), National Academy of Medical
Sciences, India (2017), Indian National Academy of
Engineering (2015), Society for Biomaterials and
Artificial Organs (2014) and National Academy of
Sciences, India (2013). He is currently serving as
Advisor to TATA Steel New Materials Business and is
an Abdul Kalam National Innovation Fellow.
Abbreviations

3D Three-dimensional
3DP Three-dimensional printing
3DPL Three-dimensional plotting
3DPP Three-dimensional powder printing
AB-PMJAY Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
AcE Accelerating Entrepreneurs
ADMI Association of Diagnostics Manufacturers of India
AERB Atomic Energy Regulatory Board
AI Artificial Intelligence
AIG Asian Institute of Gastroenterology
AIIMS All India Institute of Medical Sciences
AiMeD Association of Indian Medical Devices Industry
AIR Academic Innovation Research
AJRR American Joint Replacement Registry
AMCHAM American Chamber of Commerce in India
AMTZ Andhra Pradesh Med Tech Zone
APIs Application Programme Interfaces
ARC Australian Research Council
BARC Bhabha Atomic Research Centre
BCIL Biotechnology Consortium of India Limited
BCP Biphasic Calcium Phosphate
BETiC Biomedical Engineering and Technology Incubation Centre
BHU Banaras Hindu University
BIPP Biotechnology Industry Partnership Programme
BIRAC Biotechnology Industry Research Assistance Council
BIS Bureau of Indian Standards
BME Biomedical Engineering
BRICS Brazil, Russia, India, China and South Africa (Five major
emerging economies)
BRIT Board of Radiation and Isotope Technology

xxvii
xxviii Abbreviations

CAGR Compound Annual Growth Rate

CASPA Calcium-Sulfate-Phosphate Active Composition
CBE Cellular and Biochemical Engineering
CDSCO Central Drugs Standard Control Organisation
CE mark Certification mark for products within the European Economic
Area
CGCRI Central Glass and Ceramic Research Institute
CII Confederation of Indian Industry
CIPET Central Institute of Plastics Engineering & Technology
CLRI Central Leather Research Institute
CMC Christian Medical College
CMF Craniomaxillofacial
CRO Contract Research Organisation
CRS Contract Research Scheme
CSIR Council of Scientific and Industrial Research
CT Computerised tomography
DAE Department of Atomic Energy
DBT Department of Biotechnology
DCC Drugs Consultative Committee
DEITY Department of Electronics and Information Technology
DRDO Defence Research and Development Organisation
DST Department of Science and Technology
DTAB Drugs Technical Advisory Board
ECM Extracellular matrix
EDEN Engineering, Design and Entrepreneurship Network
EIR Entrepreneur-in-residence
EMC Electro-Magnetic Compatibility testing
EMI Electro-Magnetic Interference testing
ENT Ear Nose Throat
EPSRC Engineering and Physical Sciences Research Council
EXAFS X-ray Absorption Spectroscopy
FDA Food and Drug Administration
FICCI Federation of Indian Chambers and Commerce Industry
GATE Graduate Aptitude Test in Engineering
GCE Grand Challenges Exploration
GLP Good Laboratory Practice
GMP Good Manufacturing Practice
GYTI Gandhian Young Technological Innovation
HA Hydroxyapatite
HDPE High-Density Polyethylene
HTA Health Technology Assessment
IBSC Indian Biomedical Skill Certificate
ICME Integrated Computational Materials Engineering
ICMR Indian Council of Medical Research
ICSSR Indian Council for Social Science Research
Abbreviations xxix

IIEST Indian Institute of Engineering Science and Technology

IISc Indian Institute of Science
IISER Indian Institute of Science Education and Research
IIT Indian Institute of Technology
IKP Trust Innovation, Knowledge, Progress Trust
IMDRF International Medical Device Regulators Forum
IMPRINT IMPacting Research Innovation and Technology
IOP Intraocular Pressure
IP Intellectual Property
IPR Intellectual Property Rights
ISO International Organisation for Standardisation
ISTEC Istituto di Scienza e Tecnologia dei Materiali Ceramici
IVRI Indian Veterinary Research Institute
JIPMER Jawaharlal Institute of Postgraduate Medical Education
KIHT Kalam Institute of Health Technology
LSRB Life Science Research Board
MADE in SC Materials Assembly and Design Excellence in South Carolina
MCI Medical Council of India
MD Molecular Dynamics
MDA Medical Devices Authority
MDTAG Medical Devices Technical Advisory Group
MEDHA Medical Device Hackathon
MEDIC Medical Device Innovation Camp
MHRD Ministry for Human Resource Development
MIILI Make In India leadership Institute
ML Machine Learning
MOU Memorandum of Understanding
MRI Magnetic Resonance Imaging
MSCs Mesenchymal Stem Cells
MSMEs Micro, Small and Medium scale Enterprises
MSRUAS M. S. Ramaiah University of Applied Sciences
MTAI Medical Technology Association of India
MWCNT Multi-Walled Carbon Nanotubes
NATFOS National Frontiers of Science
NHS National Health Stack
NHSRC National Health Systems Resource Centre
NIB National Institute of Biologicals
NIH National Institutes of Health
NIPUN Non-regulatory Innovation Potential Utility and Novelty
Certificate
NIST National Institute of Standards & Technology
NIT National Institute of Technology
NML National Metallurgical Laboratory
NPPA National Pharmaceutical Pricing Authority
NSF National Science Foundation
xxx Abbreviations

NSTIF National Science, Technology & Innovation Foundation

PACE Promoting Academic Research Conversion to Enterprise
PANI Polyaniline
PCL Polycaprolactone
PCT Patent Cooperation Treaty
PDMS Polydimethylsiloxane
PFMEA Process Failure Mode Effects Analysis
PGA Polyglycolic Acid
PGIMER Postgraduate Institute of Medical Education and Research
PLA Polylactic Acid
PLGA-CNF Polylactic-Polyglycolic Acid-Carbon nanofibre
PM-RSSM Pradhan Mantri-Rashtriya Swasthya Suraksha Mission
PM-STIAC Prime Minister’s Science, Technology and Innovation-Advisory
Council
PSP Process-Structure-Property
PTH Parathyroid Hormone
PVA Polyvinyl Alcohol
PVDF-CNT Polyvinylidene Fluoride-Carbon Nanotube
QA Quality Assurance
QC Quality Control
QCI Quality Council of India
R&D Research and Development
RCT Randomised Controlled Trial
ROME Reorientation of Medical Education
SBIRI Small Business Innovation Research Initiative
SCTIMST Sree Chitra Tirunal Institute for Medical Sciences and Technology
SEARN South East Asia Regulatory Network
SEED Fund Sustainable Entrepreneurship and Enterprise Development Fund
SERB Science and Engineering Board
SF Silk Fibroin
SGPGI Sanjay Gandhi Postgraduate Institute of Medical Sciences
SIB School of International Biodesign
SIIHEI Start-up India Initiative for Higher Education Institutions
SME Small-to-Medium Enterprise
SPARC Scheme for Promotion of Academic and Research Collaboration
SPARSH Social Innovation programme for Products: Affordable and
Relevant to Societal Health
SRISTI Society for Research and Initiatives for Sustainable Technologies
and Institutions
SSSIHMS Sri Sathya Sai Institute of Higher Medical Sciences
STEM Science, Technology, Engineering and Mathematics
SUPRA Scientific and Useful Profound Research Advancement
TCP Tricalcium Phosphate
TCS TATA Consultancy Services
TERM Tissue Engineering and Regenerative Medicine
Another random document with
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—Wa’tte? beefde ontsteld bange Plomp,.… watte sait tie?.… wa’
mo’k mi’ die tieme?.…

—Stil, we sitte hier tussche vier koddebaiers, klankloos fluisterde

Delker,.… aa’s die f’rrekkelinge ons in ’t stroatje pakke.… kenne wai
de krentetuin in!.… Nou Piet, Plomp uitkaike!!.… aa’s t’r g’foar is!.…
roep je wachtwoord: Hoarelim.… aa’s ’t goed goan.… Aimuide?.…
kenne sullie deurgoan.… Enn aa’s de wind lait.… leg gie op s’n
buik.… jullie ook.… kè je bestiger hoore ankomme!.…

—Mo’k jou achteròp, vroeg Piet?.…

—Stil, dâ’ goane hullie, heeschte zachter Delker, sloan d’r bakkesse
in mekoar aa’s se je pikke.… aa’s hullie mi Kees an de stok kraige.…
steek ie hullie rejoal deur d’r donder.…

Breugel zat op z’n knieën, voorover in duistering, met lichtbak aan

touw om z’n hals. Kees hurkte naast ’m, z’n geweer ladend en zacht
bemorrelend.

Even schimde rossig kerelstoetje òp in ’t waskaarsvlammetje van

Breugel, die diep in den bak gebukt, beschut door jassen en lijven,
de lamp aanstak. Na wat gepeuter en geknars van [231]’t schuifglas,
dat ie op en neer trok, was ie klaar. Plots schoot flikkerende
lichtstraal, als goud zoeklicht bliksemend over duisteren weigrond,
die sneeuwbevracht lag.—Maar snel had Breugel, gonjen zak over
den bak geslagen.

—Hailige moagd, schrik-schreeuwde Plomp, t’met sien se ons.…

aa’s die bak.…

—Hou je bek, woede-fluisterde Kees, die nu klaar met ’t geweer aan

schouder, in de donkering wachtte op Breugel.—
—Alles kloar.… wachtwoord.… kloar?.… Kloas?.… Piet? Delker
kloar?.…

—Ja,.… presint.… merkeer de pas.…

—Merkeer de paas, dofte stem-gesmoord Klaas terug, ikke

konsteteer van ’n prêchtig weertje.… die regen en windbeweging is
prêchtig, lolde ie springend van joligheid.

Plomp begreep niks van den kerel. Hij rilde van angst, en nattigheid
droop van z’n pet en haren den nek in. De wind joeg als ’n razende,
ongrijpbare reuzenstoet van dol-kermenden, langs z’n kop en in
kleeren, dat ie rilde tot op ’t gebeente. Huilen kon ie, grienen van
woede en angst, onbestemden angst, dat ie mee was gegaan, daar
nou zoo maar stond in ’t stikke duister, of ze ’m geblinddoekt hadden
en dwongen met stooten en boffen voort te gaan.—Piet en Delker
stonden ’n eind van elkaar af. Delker zweepte luchtigjes z’n teenen
door de lucht, in suisgeraas, tegen weer zachteren wind in.

—Da’ ken je hullie ’n sneebeweging van gaife.… op da’ terain! lachte

Klaas gesmoord, alweer vergeten dat er niet gebabbeld mocht
worden. Een bof van Kees in z’n rug deed ’m schrik-stil zijn. Breugel
stond nog even te morrelen aan ’t schuifglas van z’n lichtbak en z’n
nektouw. ’n Endje van ’m af lag Delker al op z’n buik, met z’n oor op
den grond gedrukt, te luisteren, nu de wind klaag-ver zacht schreien
bleef uit boschduin.

Inéén liet Breugel zakpunt van lichtbakglas afsullen. ’n Felle stroom

goudlicht schoot ’t donkere weiland over, tot aan heuvelige
duinglooiing ver, heel ver. Kees stond soms hoog in rosgloed als
achter vlammen, doorsmoord van donkeren rook, [232]waar éven
rosse tongen uitlekken, in zwartbronzen brandschijn naast Breugel,
die in snelle kring-zwenkingen den lichtbak, voor z’n buik op- en neer
bewoog en schommel-cirkelde over de wei, in al breeër lichtbaan.—
Dat had Kees noodig; overal moest ie zien. Ingebukt, ’t hoofd scheef
’n beetje, stond ie met z’n hand aan den trekker, soms wild, grillig
verlicht even, dàn plots in ’t duister, dàn even beglansd weer op dij
en rug. Vlak achter hen, in d’r diep-zwarte schaduwen stappend,
donkerde Koome. ’n End in duistering achteraf, bleven Piet en
Delker de wachters, meezwenkend met lichtbaan, in staar
rondloerend de duisternis in, achter de kerels. Plomp, schuchter,
stond angstig met z’n zwiepende teenen in de hand, beweegloos.
Snel ging Kees’ stap, en statiger in rossig roodgoud gekring,
slingerwijd kaatste fellen brand, door fonkelende reflektors
uitgeschoten, over den schichtigen sneeuwgrond.—

En in duizel-drom, helsch-geheimzinnig, sloop stroopersstoet in felle

schaduw, breed goud omrand, als ingebeiteld met lichtende kontoer,
beweeglijk op den vlam-sneeuwigen weigrond, spraakloos in
spanning, tegen de windbuldering in, die weer orkanen kwam.

Plomp sidderde. Z’n beenen strakten soms als werden ze

vastgemoerd aan de aarde. En voort toch, in wassenden angst,
stapte ie mee, met de groep voor ’m, in helschen schroei, tegen de
lichtduizeling over wei. Soms bij plotsen zwenk van lichtbak,
rossigde uit stikdonker òp, achter Breugel en Kees, buldogkop van
Klaas, den „hazewind”, met z’n handen vooruit, dan weer ineen, bij
nieuwen lichtschommel als weggeslingerd in duister duinbrok.

Bij nieuwen zwenk stond hoog, in één weer, achterhoofd en arm van
Kees in ’t goudrood bevlamd. Hun schaduwen schommelden wijd
rond, telegraafpalig, mager-verrekt, als dronken silhouetten,
kruipend, inbuigend de wei langs, in kopstoot tegen glooiingen òp,
soms in één gebroken, al langer, bang-langer van lijf.—Dan in ééns
hield Kees in z’n stap, was er donker geschuifel, slopen de
schaduwen, korter fel-zwart op rossigen sneeuwgrond, als turend en
peinzend spel van schimmen, soms [233]plots, bij snelle lichtbak-
wending van Breugel, in donkere aardeworsteling elkaar
bevechtend. De stroopers-voeten sidderden in rossig licht,
verdwenen weer plots, als ander weibrok vergloeide, in gouïge
vochtdamping te trillen lag in vervliegende lichtbaan. Gejaagd, in al
sterkere schommeling zwierf de lichtbak voor ’t lijf van Breugel,
hijzelf in ’t donker, als levend, hijgend vuurbeest.—Onverwacht
blondden zacht, twee konijntjes in ’t licht. Stand hield de bak-drager.
Eén dierke zat rechtop, verbluft kijkend uit z’n rooiïge oogjes, als
blindgeworpen met helle lichtglansjes. ’n Poefknal galmde achter
hevigen windpats en angstige windhuil suisde om den loop-mond
van zijn geweer. Snel laadde Kees, ingedrongen z’n beenen,
vastgeplant in drassigen weigrond, schoot ie weer dat vuurvonken
zigzag bliksem-blauwig uit z’n loop kronkelend wegflitsten in den
dreignacht; liep ie door, snel in duizeling van licht om z’n voeten,
tusschen den zwaveligen kruit-stank van schotwalm. Zwaarder
knalde ’n schot, vergalmend nu wind uitgebulderd, klagelijk zacht
rond-doolde.—Koome was achterop gehold, om ’t geschoten wild te
grijpen. Konijntje, dat Kees ’t eerst geraakt had, kroop nog voort met
pieperige kreuntjes, langs sneeuwgrond in donkerend bloedspoor. In
wilden storm, voortstappend tusschen de zwabberende
lichtstroomen, die alweer andere hoeken induizelend, over de
snelstappende beenen heenschroeide, greep Klaas ’t weghinkend
konijntje. Geweldig, beefzwaar van hartstocht, duwde ie den kop in
z’n mond, beet ’t bloed-bespatte dierke met tandenhap den nek in.—
Nou was ’t afgemaakt, kon ’t den zak in. Snel bukkend en spring-
jolig, als ’n verhit dier, rende ie af op konijntje twee, door Kees
geraakt. Uit zijn strot gromde kwaadaardigen drift, als ’t zacht-
grommende keel-onweer dat ’n hond maakt vóór ie te blaffen dreigt.

—Magge sullie hoarlemèrdaikies moake in de sak!.… lolde ie, nà ze

den kop ingebeten te hebben. Voort, zonder rust, laadde Kees
opnieuw, klaar-staànd, z’n ingedoken reuzige gestalte soms even
beflitst van lichtbak, in koorts van jacht, niets voelend van helleweer,
nacht en angst. Plomp sidderde [234]en kreunde. Moe holde ie mee
over de vlakte, aldoor denkend weg te zinken in greppel of sloot, als
ie struikelend verzakte in drassigen kuil of aan den kant tegen
sloothakhout opliep. Telkens voelde ie op z’n nek, sprong van
koddebeiers, zooals ze ’m verteld hadden, dat ze deden. Piet joeg
mee, half buiten adem, ongerust, niet wetend waar ie stond, hij, die
dacht van heel Wiereland en Duinkijk elke duimbreed te kennen.—
Maar stil bleef onrust in ’m woelen. Plomp mopperde achter hem
aan. Heel alleen bleef ie in z’n angst, volgend den stoet, omdat ie
niet staan dùrfde blijven, toch niet wetend wààr ie was.—Telkens als
wind even stomde, hoorde ie suiszwiep van Delkers teenen, die al
maar loerde, àchter, opzij, om hem heen.—Alles viel Plomp nou in.…
Alderlei gehoorde avontuurtjes dwarrelden in z’n kop.….. die k’naine,
die soo moar hinkend en half dood s’oafens de sak uitkrope.… en
van de bijpatters.… drie.… vier gulde boete!.… aa’s tie d’r s’n aige
nou erais stilletjes liet graipe? Want hai was toch allainig
baipatter!.… niks droeg ie.… niks!.… gelukkig.… z’n tieme had ie
allang weggegooid.… Kaik.… nou net.… weer.… doar had ie weer
gedochte van die koddebaier die se pakt hadde an de ruïne van
Braale.… ’s nachts.… nog net soo.… da’ hullie tòen met d’r viere
vastgebonde hebbe.… op ’n plankie.… en soo ommekeerd boven ’n
sloot hebbe hongere loàte.… wâ benauwing.… hailige moagd.…
aa’s se nou d’rais dochte, da’ hai da’ mee an doan had.…
meeholpe.…?

Langs ’m donkerden Delker en Piet.

—Kaik uit Plomp! ’t is hier heet … puur heet!… hullie loere van alle
kante t’glaik.…

Met ’n woeste lichtslingering, die als zoeklicht over beenenstoet

vlam-rossigde, was Breugel plots gekeerd, langs ’n duinglooiïng bij
slootkant, laag den lichtbak tegen één plek grond richtend.
Verdonkerd nu, zwartten hun rompen in snelleren schaduwgang, met
évene beenbeschijning in fel rosgoud.—Langs prikkeldraad
silhouette stoetje ’t donker in, als schichtig bevlamde spoken-
opstand.—Klaas Koome dwarrelde [235]achter en om den lichtbak, in
hazewindsprongen, soms dwars over lichtbaan heen, in z’n
ophitsend, zacht gegrom wetend, dat als ie nou zou spreken, Kees
’m ’t geweer perdoes op z’n hersens zou stuk slaan. Plots klonk
bang-kort, kreet-angstig.… Hoarlem!.…

De lichtbak doofde.… strakke duisternis staarde op ’t weiland, helle-

duister. Visioen-bang was rossige lichtstoet verzonken in den nacht.

Van ’t nabijë kanaal dreunde òp ontzettende pijp-zang in winterweer,

van reuzige boot, klaag-bas, diep en geweldig aanzwellend, als
jammerende mammouth-stem in oer-nacht. Orkaangier zangloeide
na, diep uit ’t duister. Plomp had in doodelijken angst, doorloopend,
zich plots omklemd gevoeld om z’n beenen. Niet beseffend wàt er
gebeurde had ie noodkreet uitgestooten, in angst-reflex om iets
maar te doen. Nou, ingekrompen, gebukt in den loeinacht, zag ie,
voelde ie niets op zich aandreigen, niets dat ’m knellender
vastgreep. Snel, in goochel-routine had Breugel den lichtbak
gedoofd en van z’n hals gelicht. Met de anderen was ie, zeker in z’n
sprong, de sloot ingestapt. Kees stond met z’n stukgevreten
modderlaarzen en doorrotte zolen in ’t nat, tot z’n knieën. Ril-kou
sloeg om z’n beenen, ijzigend voelde ie ’t water op z’n naakte karkas
inzuigen. Giftig stoof in ’m òp wilde dierlust om ze neer te hakken,
zich in speelschen schijn even te laten pakken. Maar de kou
verkoelde z’n gift, beet op ’m in, nuchter, verkillend. Heel z’n
toestand, zag ie weer klaar, met stroopersroutine. Maar wat donder
woar bleef Delker?.… en Koome?.… gromde ’t in ’m.

Die waren ’n eind verder neergehurkt in ’t donker, roerloos voor de

sloot. Ze wisten allemaal wel, dat ze met den lichtbak, tusschen de
koddebeiers doorgemanoeuvreerd hadden, dat t’r heet was, maar
nou kwam er niks, hoorden ze niks.

Want dâ was ook wel hoarlie stiekeme pakmenier.… blaif sitte,

jonges, sitte, bromde Klaas zacht voor zich uit. Piet lag zwaar-
ingehouen ademend te loeren in ’t duister nachtgat voor ’m, te
luisteren of ie stappen hoorde.… maar de wind [236]gierde áán.
Eindelijk stond Klaas zacht overeind, keek ’t diepduizelige donker
in.… Nergens hoorde ie geloop of aandreigend geschreeuw.

Kees floot licht.… Dat kon ie niet langer verdragen.… Zacht seinde
Breugel hem terug, wachtend op windstootrust. Koome en Delker
hurkten vlak bij elkaar, zonder dat ze ’t wisten. Delker, hoorend vaag
signaal, sloop òp, stootend tegen Koome.… Alleen Piet en Plomp
durfden zich niet roeren van hun plaats. Want zeker had ie ’t
gevoeld, Plomp, dat ze an z’n beenen getrokken hadden.—

Kees woedend en doorbibberd van kou, was uit de sloot

gesprongen, zong met zachte stem hoe.… éét.… hoe.… ééét!—Op
’t geluid àf nu, naderden de donkere kerels elkaar..

—F’rrek Delker, wá’ hai je roepe.. d’r is g’n vlieg op ’t pad..

—Ikke hep g’n bek ope doan.… ik docht dá’ Piet roept.…

—Ikke?.… ikke?.… hep niks sait.… Plomp waa’s ’t!..

—F’rrek, waa’s ’t die snaiboon?… woedde Klaas Koome, heul goed

snurkert, we motte je weer meehebbe foàdertje.… op da terain
poàtertje.… die skreeuwbeweging is nie kwoad f’rdocht.… ikke
konsteteer van dà’ j’ mi’ moedwil dàan hep.… op dâ terain bin ik
deùrpokt en deùrmoàseld.… nou legge de k’naintjes f’rdomd achter
de poap!
Even klonk stemmengedreig van Delker en Breugel in ’t duister,
tegen Plomp. Uit de nachtbefloersde koppen gromden zware
vloeken.… Koome kon niet ophouên. Nijdig hakte Kees in
stemmegefluister de ruzie door, met korte beveelwoorden, tegen
gierwind in. Rondom den duisteren kerelsstoet, zwol ààn uit alle
duinhoeken, helsch stormorkest, saamgeschald in nachtspraak.—
Bange, sidderlange fluitgeluiden stegen hoog in woest-gillende
vervoering, boorden dóór schaterende krakingen van dooreen
gewaaide orgelklanken, met warrenden jammer van violen, wild en
ijlend. En vèr.… vèr.… bòven laag toongestorm en gedreig, georgel
en gezang,—als plots stòm bleef ’t fluitgeluid,—droefde klagelijk
weemoed van diepen hobo-toon, die moduleerde, àl moduleerde, als
zangstem van zingende waanzinnige in eenzaamheid, meestijgend
en dalend [237]met ’t duistere lied van de nachtzee. En soms weer, uit
helsch donkerdiep nachtzwart, kaprioolden vreemde gonggalmen,
geluiden en zangen van nooit gehoorde instrumenten, mysterieus en
angstig-ver.… Geschrei dat zong, zong, versidderend van weenende
harpen uit duisteren nacht, zachte mijmeringsklanken van aëolienen
en gitaren.…. rondo’s en stakato’s, ijl-verzwevend boven ’t woest
donderend stormorkest. En lager, lager, in grondtoon, demonisch
breed, ’t dieper gezang van adagio’s, doorstormde
klankenplechtigheid, stukgeslagen akkoorden uit nachtkathedraal
aangewaaid, smachtend en zwellend door ’t duister; zwellend van
mijmerende melodie naar woeste klankschalmei.—Scherzo’s
afgestooten en verslierd in jubel, in snerpende triolen, gracieus van
spot, als schaterende karbouterstemmetjes.—En zacht, ijl,—in
stilstand even van vlagen, bij pauzen van donkere razing, dreighevig
als zwarte stormgolven, aangedonderd uit zeeduister—weer
mijmerend nageklaag van motieven, weenende harpenzang uit
duister, en weemoed van ronddolende ziels-mandolines.

Onbewust voelden de stroopers iets van de stemmen-mysterie

rondom. In het duister orkaangeraas liepen ze dichter bijéén, tegen
de stil-donkere duinruggen, die dreigden dààr, in hel nachtzwart,
hoog en geweldig in hun aaneenrijging. Breugel stapte naast Kees,
die z’n achterlader weer be-hageld had. Barre wrevel wrokte weer op
tegen Plomp.

—Aa’s sullie tog van achtere komme.… gaif je hullie tog ’n poar
strieme.… daa’se veur meroakel legge.… da’ tuig.… op da’ terain.…
barstte Klaas uit.

—Joa, moar.… haperde stem-angstig Plomp, die niet wist, hoe zich
te verdedigen nou er geen koddebaiers op ’m gesprongen waren,
zich doodschaamde voor de kerels.… ze hadde main tog fideel beet
van ondere.…

—Wá’ beet.… beet, bosluis.… se moste je mostere.… waa’s

netuurlik ’n struikbeweging woa’ je mi’ je pootjes in vasthoakt bin.…
stoan doar ommers de paas te merkeere.… sloerie.… Is je spuit in
orde Kees? hée Breugel!.… gaif màin effe de brom.… ik hep
stikkedorst.… ’n urretje ken [238]ik best likke nou.… warrempies
hier.… wà jou?.… tussche drie loer-miroàkels!.…

Koome kon niet stil zijn. Plomp beefde als ’n aar.… Nou zag ie nog
niks.… aa’s tie nou moar van ’t pad weg snappe kon.…

Kees en Breugel stapten spraakloos naast elkaar.

—Hier Breugel.… hier Kees! jai ook ’n slok.…? sî heete suuker in.…
f’rvloekt lekker!.…

Kees gaf geen antwoord, dronk nooit onder ’t stroopen, Delker en

Piet sjokten weer achter Klaas aan, met Plomp midden in, voort,
almaar voort. Ze zouen ’t maar weer eens probeeren. Plomp bromde
in zich zelf, dat ie nou z’n bek zou houen al sprongen d’r tien
kottebeijers te gelijk op ’m af; al worgden ze ’m. Bibberend van kou
en regennat sjokte ie, toch wat minder bang voort, tusschen de
kerels in. Hij voelde nou ook minder angst voor Kees, die ’m geen
woord verwijt gedaan had. Eerst dacht ie, dat ie ’m ’n hagelschot
door z’n rug zou jagen.… Dat hadden ze’m van alle kanten gezegd
als ie meegong en hai deed wat tegen Kees’ zin. Nou gromde dìe ’t
minst en lichter voelde ie zich met z’n stappen, in ’t zwarte, eeuwig-
zwarte voor ’m, rustiger ook, nu stormgerucht schrei-zachter
verklonk.

Bij ’n woest duinbrok, dat hoog lag, als donkere dreiging tegen éven
doorschijnenden luchtkring, morrelde Breugel weer aan z’n lichtbak,
gingen Delker en Kees ’m dekken. Plots schoot zoeklicht van fellen
reflektor over ’t sneeuw-modderig duinpad en hevig-hoog, in ’t licht,
rossig-goud bevoet, aan den top dampiger lichtgeel, onder helle-
zwart, drongen uit duistering de duinbulten òp, schuw aangegloeid,
omknellend aan alle kanten de donkere kereltjes. Als reuzige
mensch-stierruggen, hoog bijéén, stuttend elkaar dromden ze áán
tegen ’t kleine menschenstoetje in. En telkens uit anderen hoek, in
lichtslingering van bak, rugden ze op, zwijgend rond de kereltjes, nu
kleingeslagen tot dwergjes in ’t woeste licht, ’t ros-wilde licht, dat
éven gloeide over de opéen dringende, en starend-blinde,
besneeuwde minotaurus-kudde. [239]

Op en àf sloop ’t stroopersstoetje en dwars in den lichtbrand, met

woesten rem, schoot schaduwspel dooréén, zich bemoeiend in
jachtpassie der kerels. Telkens stond nieuwe dreighoek in ’t rosgouïg
licht te dampen, staarde de Nacht boven de lichtkringels uit, bòven
bang-hooge rugbulting, als duistere heerscher, opjagend den
reuzigen minotaurus-stoet tegen de poerende mannetjes; slingerde
weer wèg de lichtbaan, viel dicht over de ros-sneeuwige ruggen de
nacht in nog angstiger zwart, dan vóór den kaatsbrand. En zwaar, in
stomme razernij tuimelden de schaduwen mee, gebroken doorhakt
in brokken, als spottend, springend in den grondbrand, plots weer
verdwijnend in donkering. Verder door de nachthel, in sluip,
kromden, kropen en joegen ze voort bij lagere duinbulten, die als
stomgeslagen in schrikboei, roerloos ’t licht langs zich slingeren
lieten, verbaasd in rossigen staar; weer wègsliertten uit slingerkring,
de duistering in, vóór ze schreien konden, méé met den al zwakker
kermenden windzang.

En voort ging ’t stoetje, in de weenende eenzaamheid van loeinacht

en verstervend stormgerucht, om kronkelpaden, overal omdreigd
van de stom-zwijgende zee-wachters, ingekneld tusschen den
mensch-stierigen opstand, aandrommend in rosgouën damp. Voort
stapten de stroopers, nu levend in één loer, één adem, niets
beseffend van nachtangst, vastgemoerd in hartstocht van vangst.
Snel en zeker, zonder struikeling, gingen Kees en Breugel voorop, in
lichtdonkeren beenengang. Maar nergens nog verschichtigde wild.
Breugel vloekte van nijd. Sneller wentelde ie z’n bak, dat de cirkels
in golfstroom over de titanische duinwezens den nacht inrilden, als
goud-schel weerlicht.

Plots stònd Kees, knalde ’n schot, nog een, nog een.…

Koome vloog achterop in wilden dans, greep toe, stopte in dol

gebaar van hartstocht alles den grooten zak in. Even bukte z’n
schooier-mager lijf, met belichting van rooien halsdoek, bloederig in
den fellen lichtslag van reflektor, en zwaar beefden z’n lippen van
jacht-passie. Telkens éven schoot ie tusschen Kees en Breugel dóór,
soms vlak ònder windvlaag verschreienden geweermond, waaruit ’n
noodlots-stem klaagde; [240]sprong ie terug, plat op den grond, of
bukte in rossigen lichtbak-brand, dat z’n vurige tronie vlamde, z’n
beeflippen weer zwollen in den gloeistroom. Woest schroeide z’n
tronie, met bloedvlekjes om z’n mond gespat, trilden nog wittige
haartjes op z’n beeflippen, van woesten nekbeet aan elk konijntje dat
vóór den greep nog krampte en hinkend klagelijk verpiepte,
smartgeluidje op den sneeuwgrond.

Tien passen van Kees af, zat ’n konijn recht op, met trillenden
schrikstand van de lange stijve ooren, oogjes beduizeld van licht, z’n
gelig-wit bedonsd haarborstje bevend, pootje over z’n angstig
bewegelijk neusje te wrijven.

—Mo’ je nog ’n booskap.… lolde Koome.… doen t’ met.… aers gain

tait.…

’n Schot dof brandde uit; vuurvonken en blauwige lichtjes kronkelden

vlamgrillig om Kees’loop. Achter ’m ààn, sprong Klaas, z’n schaduw
woester meeslingerend in den grondbrand. Even sleurde z’n zak
langs de sneeuw.… wou ie wat lollen, toen Kees dreigfluisterend ’m
roerloos hield.

—Blaif doar!.… sitte nog twee!.…

—Woar snof’rjenne?.… ik sien puur niks!.…

Weer knalde ’n schot, daver-echoënd als ’n slag van onweer en met

geelwit borstje sprong hoog in duizelkramptrek, ’n ander in de
lichtbaan, voor Kees’ voeten; kermend klein lijfje, donker bebloed.
Koome, gretig, snoof bloedgeur, greep toe, beet konijntje den kop in,
vlug en tandscheurend-raak, in ’t weeke beenderenstel, dierke
neerkwakkend op zakbodem.

—F’rrek, juichte z’n stem; wat ’n lampies die vint hep.… f’rvloekt aa’s
ik nie docht daa’t ’n molshoopie was.… waa’n lampies!.…

—Hou je bek driftte Kees, die één loer was, elk grasje zag trillen, elk
plekje bewegen op het lichtbrok dat voor ’m uitcirkelde, in duizel.—
—Kristis, juichte gesmoord Klaas, nou he’k sain ook in de lampies,
twee langoore!.…

—Bek dicht, heeschte Kees, en langzaam even mikte ie, in lichte

kromming van romp, dat noodlots-geschrei van zachten [241]wind
vóór zuiggat van geweerloop angstiger verklonk in de stilte, alsof de
naakte Duivel zèlf in z’n knokige pezigheid ingehurkt zat te blazen op
helschen misthoorn.

Knal-donderend spatte schot uit, en zonder te weten of ie raak was,

zeker van Kees, holde Klaas in de baan vooruit, vlak achter het
davergeluid dat verwaaid nog natrilde, tusschen de duinruggen in.
Piet keek telkens verbaasd naar Klaas’ sprongen, vergetend dat ie
zelf uit kijker was. Alleen Delker loerde in den nacht, op verren
afstand goud-zwart-rossig stoetje volgend. Plomp holde weer mee,
dan hier, dan daar, in zweetangst, van vetten Breugel naar Kees,
vóór Klaas, die ’m wegduwde en stompte, als ie ’m voor de beenen
liep. Dàn voelde Plomp zich benauwd, benauwd, dat Kees per
ongeluk hem raken zou in lichtbakzwenk. Bij elk schot rilde huivering
door z’n lijf, tot z’n teenen, zag ie uit ’t duister de kottebijers klaar in
hun sprong. En telkens had ie lust den bak uit te blazen omdat die
ze zoo brutaal aanwees wáár ze stroopten.—

Maar niks gebeurde, niks om ’m.

Nog ’n uur sjouwden de kerels, zonder dat er geschoten werd. Kees

was met Breugel anderen kant van ’t duin ingeslagen, bij ’t landgoed
van van Ouwenaar, vlak bij ’t bosch.

—Hoe loât is ’t, vroeg Breugel, doodop, zak-lap voor lichtbak éven
wegtillend om Koome te kunnen laten zien op z’n horloge.—

—Vaif uur, t’met Piet, aarzelde Klaas uit, bukkend in den gloei-
flakker van reflektor.—Van Ouwenoar lait op s’n ruggetje, lolde ie
voort, naar Hassel, die achter z’n hielen aanliep.

—Nou ik stop!.… gromde Kees, ik goan terug!.…

—Nou.… ikke ook, zei Breugel, ik sterf van de kou en natte.…

—Trug vraier?.… wai hebbe nog niks t’met, zei Klaas, stem-ontsteld.

—Ke nie dondere.… m’n vingers stoan aa’s hoakies.… ken gain
poot meer an de trekker sette.… en d’r komp tog g’n luis.…
hoeveul?.… [242]

—Twintig k’naine.… drie langoore.… gommenikki.—Verleje week hai

je’r veertig.… en vaif hoase!.…

—Ke’ nie bokkeme.… ikke set stop!.…

—Nou, en ik bin saik tut op main botte, klaagde Delker.—

Bij elkaar dromde ’t stoetje. Snel had Breugel z’n lichtbak gedoofd.

Als in stemmebetasting naderden ze elkaar in ’t dikke duister.

—Nou van Ouwenoar, lolde Klaas weer, nou mo’s je wete dá’ wai
hier stoane!.… op dâ terain ke je de paas nie merkeere poatertje?
zeg Breugel, jai nog ’n slok?.…

—Nou ikke ook, wâ hèe?.… verweet Delker, die gulzig inzoog

jenevervocht uit de kruik, en in donker op tast ’m weer Klaas terug
gaf.

—La’ stikke.… die kerel.… verslikte ie hoesterig.—

Kees was over scheerdraad heengesprongen met de kerels achter

aan. Plomp, langzaam, moest geholpen worden door Piet, die ’m er
half oversleurde dat z’n broek haken bleef in de pennen.…
—F’rrek! nou kost ’t main nog ’n broek!.…

—Allo!.… kaik!.… woar sit je.… kom!.… ik sien hoarlie nie meer.…
skàr.…, nijdigde Piet, die geen weg wist en niet van den stoet af wou
dwalen.…

Breugel giftte nog tegen Klaas.—

—Ze frete main heule tuin op.… die meroakels van k’naine, f’rleje
joar hebbe se main heule oogst f’rwoest.… die krenge.… om hullie
he’k nie betoale kenne.… die stinkpoone!—

—Nou, hitte Klaas, aa’s ’k half dood ben, goàn ’k se nog achter
skot.…

—Jai!.… jai!.… da’ doen jai veur je pelsier.… moar wai noakende
rotte.… wai hebbe ’r van te laie.… de groote heere hebbe d’r lol
van.… moar wai niks aa’s ongeluk en f’rdriet.… ’t is puur onhail!.…

—Hou toch je snoàters, snauwde Kees, wie f’rkoopt?.…

—Wâ!, je ken nou sooveul babbele aa’s je lust.… geweer [243]en

bakkie in ’t sakkie.… nou is ’t ’r nie eens meer ’n baipad te
moake!.… op dâ teràin.…

Plomp dobberde weer mee in ’t duister, achter den zak van Breugels
lichtbak. Hij gromde in zichzelf, dat ie ’t nooit zou leeren. Nooit had ie
docht, dat ’t soo gevoarlik was. Nou aas tie doar nou wa’ mee mos
bai f’rdiene, kon is s’n aige wel ophange.…

Z’n angst verzonk, toen ie hoorde, dat ze waren op publieken weg

bijna, en nou vast wist dat de lichtbak uitgedoofd in de zak bleef.

—Seg Kees, begon Klaas Koome weer, loopend en sprekend ’t

duister in, wee je.… nog verleje week? Seg Breugel!.… da’ ha je bai
motte weuse.… ses hoane hep ie skooie!.… soo.. poeff! in ’t
donker.… uit de boom!.… Piep.… sait t’r één, bai ’t bossie.… piep!
sait d’aer op ’t Hoàneprejeeltje.. piep-piep! sait derdes en vierdes in
’t Kruisgrot je.… se snertte d’r so t’met uit de takke.… dá’ waa’s d’r ’n
piepbeweging op da’ terain.… Ik konsteteer van daa’ tie ’r ses soo
hep neersmete!.… allegoar in ’t donker.… op ’n aere plek.… hep ie
hoarlie paas loate merkeere.… enne toe gong hai moar verder!.…
Enne.… op de terugtocht hep hullie in vaif menute al die meroakels
vonde.… Dá’ noem ’k werk hée? da’ heppe hoarlie de paas loate
merkeere.… Op da’ terain is t’r nie ééne!.… seg moar hoe ie ’t
lapt.… soo al die plekke in s’n test!.… hee?—

—Wá’ he je weer te klesseneere, snauwde Kees.… wie f’rkoopt?.…

Maar Klaas hoorde niet. Woest voelde ie nog in zich ’t genot van de
vorige week.…

—Nou, as se sain.… op de hiele hadde sete, hei Piet.… wa’ jai? se

hebbe mit d’r achte op ’m loert.… en nie eens ’n baipad.… ha! ha!
ha! wat ’n kuikes.… verleje moand hep ie nog sprenkels had, al s’n
strikke hebbe sullie ganneft.… op da’ terain!.…

—Hep ie wa’ vange nog?

—Of ie!.… éen hoas, mit s’n veurpoot d’r afdroaid.… [244]jemi!
kroemi!.… wa da’ kreng skreeuwde.… hai hep se rejoal d’r
afknepe.… de sprenkel!.… je had sain ’n smoel motte sien trekke.…
toen ’k sain de borst indrukt hep!.… Moar de strikke hebbe sullie
pakt.… sullie lagge op de loer.. en van Delker hebbe sullie de strikke
pakt.… en s’n spoor!.. da’ kuike hep ’n nieuweling meebrocht die in ’t
sand loope hep!.… doalik hadde se s’n spoor!.… hai hep achtien
doage had!.… wa’ ’n vuile hée?.… da’ heerskap van de droaibank.…
hee.… op da’ terain.…
—F’rrek,.… achttien doage? vroeg ongeloovig Delker.

—Nou wa’ sou ’t.… daa’s al drie keere.… dat ie ’n prent thuis
kraigt.… kè se waif an ’t beskot hange.… veur ’n pronkie.…

—Kerel hou je bek nou.… wie f’rkoopt? drong Kees aan.

Piet en Plomp telden niet mee; wouen niks hebben. Piet vloekte.…
Nog nooit was ’t ’m zoo ellendig naar ’t hart geslagen, de kou en de
beroerderigheid. Was dat lol?.… hij rilde van koorts! Liever vaif steek
diep, elken dag, dan soo’n grap!.… Doorzogen was ie tot op z’n
huid. De eerste en laatste keer.… Jesis, wa’ begreep ie nou goed,
dat Kees d’r de pest an had. Kapot was die d’r van!.… Kapot.… en
de slaap duizelde in z’n kop.… Kloas was ’n kwoàje.… moar
Kees!.… Kees, gain stom woord had ie t’met teuge sain sait.…

Plomp, dood op, vroolijkte bij, nu ie geen gevaar meer voelde.

Wind loeide nog maar bij eenzame vlagen zwaar bulderend achter
ze aan, uit ’t duister, al uit duister.…

Bij ’t duinpad waar Kees krot lag bleven ze even staan.

—Nou g’nacht!.… aa’s ’k poar uur slape hep.… goan ik mi sprenkel

van Joap ’t duin in.… Seg.… Kloas.… goan je bai pelier van ’t
slangetje.… breng murge moar sinte.. ’t k’nijn nie minder aas vaiftig
sint!.… ’k si droog..

—Bestig kapetain!.… op da’ terain wee’k ’n eenige

pelierbeweging.… hai merkeert de paas bai ’t bruggetje van
Woagestroat in Aimuide.… ikke konsteteer van da’ tie duizend
k’naine p’r dag.… f’r.… [245]

—Nou nacht manne, brak Kees af.… ’t zwart-stille pad òpstappend,

tegen ’t donkere krot aan.
Stil van ’m af, donkerde ’t stoetje den modderweg naar Wiereland
op.

[Inhoud]

III.

Zacht had Kees de deur van de klos gelicht en zachter nog stapte ie
binnen. Benauwing van duffen slaapstank wasemde uit ’t stikduistere
slaapkrot op. Hij rilde, z’n lijf dreef in nattig, drabbig vuil en z’n plunje
dampte regenlucht uit naar z’n hoofd. Onder het uittrappen, moeilijk
en hijg-zwaar, van z’n kleef-zuigende hooge schoenen hoorde ie
zwak-weeke stem van z’n vrouw slaperig zang-neuriën:

Sloap, maideke sloap

d’r buite lo-oopt ’n skoàp
Hai hep vier wi-tte voetjes
Hai drink se mellikie soe-oetjes.

’n Wilde wrevel steeg ’m naar ’t hoofd.… f’rdomme was die maid nou
weer an ’t skreeuwe.… Nou da’ hai d’r juus tukke gong.… Was da’
nou nie moedwil van ’t waif.…

’n Stoot, dof-krakend tegen ’n kruk had ’t kindje weer uit den dommel
gescheurd. Krijscherig-scherp jammerde met langen kramphuil in
zuigelingdrift ’t kindje uit ’t donkere bedholletje.—Wimpie woelde
rond en-om, zonder wakker te worden.

Dol-driftig liep Kees naar de bedstee, en heeschte in stikwoede, die

bij vlagen in ’m ophitten kwam, door niets te temperen:
—Is ’t weer soo wait?.… Kâ se d’r bek nie houë.… waif!

—D’r bek houë?.… ’t Skoàp hep taa’nndjes.…

—Rooit na’ niks! ’k mo’ d’r in.… taa’nntjes!.…

—We’ ja! Hier-oppan!.… skreeuw Wimpie wakker!.. leg je aige moar

neer.… hee?.… [246]

Heviger gistte er razernij in Kees.… Hij zou d’r ’n pats tegen d’r kop
geven aa’s se nog ’n woord zei.…

—La’ die prop d’r bek houë.…

Hij kon bijna niet meer van drift-moeë nijdigheid.

Maar heftiger krijschte zuigeling, in barstende zwelling van huil-kreet

er doorheen.

—Je bek dicht, duifel! helhoak! spoog ie uit, meppend ’t kind in

donker tegen Ant’s lijf aan.

—Hierop-pan!.… sloan d’r van mekoar, nijdigde Ant ertusschen, we-

joa.… f’rmoor d’r moar.…

Kees voelde dat ie z’n drift moèst temperen. Hij zou Ant en ’t kind
anders tegen elkaar plat slaan.…

Over zuigeling heen, was ie met z’n regenstinkende modderplunje

nat en vuil in ’t slaapholletje gesprongen. Andere bedekking dan wat
rotlappen was er niet.… En hij trilde te veel om zich uit te kleeden.

Ant had zelf driftig ’t kind op d’r haverdoppenzak gesmakt, was

opgestaan, om ’t lampje aan te steken.—Maar alléén zich voelend,
krijschte heviger ’t kind òp, dat Wimpie schokte in z’n bedje.…
—Hou je smoel satansprop! donderde Kees weer uit, ’t
onbeschermde kind nu, van uit z’n hoek op ’t kopje patsend in
driftwaanzin, dat dof de klappen bonkten en z’n ellebogen stootten
tegen ’t beschot. In wilde rammeling schudde ie ’t lijfje heen en weer,
dat ’t kind stuipiger aankrijschte, heviger in zwelling.

—Godskristis, t’met sou die d’r hersens te pletter sloan, teuge de

grond.… aa’s se d’r bek nie hield.… raasde ’t in Kees.… Ant was
toegehold, had ’t kind opgelicht en in d’r armen gesust. Kees kòn
niet meer, wou stilte, slaap, niks dan slaap, slááp, hijgend òp van
vermoeienis en aftobbing. Op ’r vuile voeten, maatgangde Ant, heen
en weer wiegelend, ril-koud, in ’r smerig hemd. Laag groezelde ’t
lampje wat licht neer in ’t killige vertrek.—

Zachter nu dreinde de zuigeling.… z’n eeèè’s.… eè.… èèè’s,

afgebroken door sus-schokjes van Ant’s been. Ze was
[247]neergeslobberd op ’n stoel. Haar borst hing roodgebeten van ’t
persend-mummelende zuigelingsmondje. Niks meer had ze er in.

Zwaar-rood gezwollen kransten er donkere pijnkringen om de tepels.

Maar dóór gulzigde zuigelingsmondje naar zwarte zog, slap-
voedselloos néérhangend aan grove borst. Driftig frommelde Ant vuil
doekje naast ’r, tot ’n propje, beet ’t week, met sterke tandhappen,
dodderde er speeksel op en duwde ’t zóó, klefferig doorzogen,
gulzig-kreunende zuigelingsmondje in. Zwaar-rampzalig schraapte ’r
triest-zwakke stem in huivering, door ’t zwak-gelende kamergrauw,
onder zacht maatbeweeg van één been:

—Sloap.… maideke sloap.… d’r buite lo.. oopt ’n skoap..

Droef en diep-eenzaam bleef zeurig nagalmen ’r tobstem, in den hel-

nacht, lang, heel lang, ééndeunig. En ingeslonken verschrompeld,
bibber-kleumde ’r afgebeuld lijf, ’r beenen gespreid tot schoot, waar
zuigeling met z’n kopje plat in wiegelde.