Taking eye care to every corner of rural India

Jayant Sriram explores the thriving social entrepreneurship model of Aravind Eye Care

December 31, 2015 12:00 am | Updated September 22, 2016 09:55 pm IST

(Clockwise from top) Participants of Jagriti Yatra visit an Aravind Eye Care clinic. About 85 per cent of the company'sstaff menbers are highly-trained women. Dr S Aravind, the current director of the company.— Photos: Special Arrangement

(Clockwise from top) Participants of Jagriti Yatra visit an Aravind Eye Care clinic. About 85 per cent of the company'sstaff menbers are highly-trained women. Dr S Aravind, the current director of the company.— Photos: Special Arrangement

There is a documentary video that is shown to visitors at the Aravind Eye Care headquarters in Madurai as a way for the organisation to remember its late founder Dr G Venkataswamy. In one shot in the video, Dr ‘V’ as he is affectionately known, is driving in a car and speaking about the American fast food giant McDonalds. “McDonalds believes that it can train thousands of people across the world and they will all produce food in exactly the same way in every single place,” Dr V begins.

The film cuts to one of the numerous international eye care experts who worked with him while he was setting up Aravind Eye Care. “He kept talking about hamburgers and we didn’t know where he was going with this,” an American surgeon laughs. Back to Dr V again. “I believe that if I can create and perfect a model for doing eye surgery then I can take that model to every corner of the world.”

Aravind Eye Care was started as a 11-bed hospital in 1976, when Dr Venkataswamy had to retire as a surgeon at the age of 58, but it was always based on a big idea. If companies like McDonalds could sell millions of burgers and sodas then why couldn’t Aravind Eye Care sell a million eye surgeries to people who really needed them to make their lives better?

If the word McDonalds brings to mind an assembly line model then that’s exactly what Aravind Eye Care managed to become. Across its six secondary hospitals and 55 primary health care units in rural areas across Tamil Nadu, they do a new cataract surgery to restore vision roughly every 15 minutes. It’s the time you take for your coffee break. Or the time it might take you to read through this article.

“It’s not that we do anything new clinically,” explains Dr S Aravind, the current administrator of the hospital and a nephew of Dr V. “It’s just about optimising the work that each doctor can do because the moment that he has to do non-doctor work then his efficiency goes down. So the process we have is that per doctor there are six nurses and four support staff. Then we increase efficiency through incremental improvements in technology and innovation.”

Aravind Eye Care is the second role model entrepreneur being explored by the Jagriti Yatra and its business model represents one of the most perfect examples of social entrepreneurship running in the country today. Of the three-and-a-half million surgeries they performed in 2015, over 50 per cent were subsidised, at a phenomenally low cost of Rs 850 for a surgery, or for free. They are paid for by customers who can afford to pay market rates or above.

As much as Aravind Eye Care is based on the idea of scaling up processes it also started by addressing a basic problem: how could private initiatives support government programmes in helping people who are visually impaired? India has the largest number of blind people in the world and Indians are more prone to cataracts at a younger age. “About 12 million people are completely visually impaired but the good news is that 80 per cent of these cases are treatable and a simple cataract surgery can restore vision,” said Ms. M. Dhivya, a faculty at Aravind Eye Care.

Further, about 200 million people need some sort of eye care but only 10 per cent have been reached. “The biggest section that needs to be reached is at the bottom of the pyramid,” Ms. Dhivya added. “Those who are not even asking for eye care, because they have issues with affordability and logistics like travelling to get an eye check up.”

The company therefore had to rethink eye care for the ‘non-customer’ and the solution they landed on was outreach caps where staff from the hospital went out to rural areas and treated patients — either prescribing glasses or taking them back for surgeries. Gradually, it was decided that in order to serve the community’s real needs, a more permanent presence was required and the company started 55 primary centres across the State. Very few patients actually have to be brought back to the bigger hospitals with most surgeries and treatments being prescribed locally.

Today, Aravind Eye Care is not just into running surgeries and clinics but has expanded into training, research and manufacturing high-end eye care products. The company’s manufacturing unit Aurolabs exports to several countries while the Lions Aravind Institute of Community Opthalmology, established in 1992, partners with other hospitals in the country to help them improve surgical methods and formulate rural outreach programmes.

This is the eighth year that the Jagriti Yatra is visiting Aravind Eye Care and several participants are instantly inspired, some even choosing to work with them. “There is no system like this in Maharashtra where I come from,” says Dr. Devendra Tayade, a 2013 yatri who now works with Aravind Eye Care in the field of employee engagement. LAICO, he says, has also partnered with a number of hospitals across the world to transfer some of the learnings accumulated over 38 years of working in eye care.

One of Aravind Eye Care’s partners in taking optical equipment to rural areas in Tamil Nadu is eye wear manufacturer Essilor. The company has launched an initiative called 2.5 vision generation and this year it is holding a competition among the yatris on the train to see who can come up with the best solution to take eye care products to rural India. “There are not many healthcare providers who do work on the same scale as Aravind Eye Care,” said KV Mahesh, business head of Essilor’s Innovation Lab. “In several parts of the country there is only one ophthalmologist per 25,000 people while in developed countries there is one for every 7,000. Through competition we hope to get some innovative solutions for improving this ratio,” he said.

(This article was corrected post-publication)

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