Visionary doctor kept his eye on the prize, changed ocular healthcare in India forever
In 1976, Dr. Govindappa Venkataswamy -- perhaps better known as Dr. V -- founded the Aravind Eye Hospital in Madurai, India. Dr. V had once been head of the Department of Ophthalmology at the Government Madurai Medical College, as well as the head eye surgeon at the Government Erskine Hospital in Tamil Nadu. After his mandatory institutional retirement at age 50, Dr. V decided to change the game.
In service for sight, the 74-year-old ophthalmic surgeon opened Aravind with just 20 beds and three licensed surgeons: his sister, her husband, and Dr V himself. By 1992, the hospital had grown into one of the largest, most effective, and most innovative health centers in the world with under 250 people on staff. Dr. V's vision was to "clear the back log of 20 million blind eyes in India," but despite performing 1.2 million cataract surgeries a year, another two million Indians fell victim to blindness.
Aravind's Main Hospital, like the vast majority of hospitals worldwide, charged patients for services ranging from cataract surgery (ICCE) to retina detachment repair. The beauty of Aravind system was that its Free Hospital sat proudly just one block away. Crowded, but clean, patients received the same attention Aravind's paying customers did: vision recording, prelimiary examinations, testing of tension and tear duct function, refraction testing, and a final examinations. And yet, virtually every surgery performed at the Free Hospital was just that: Free.
Dr. V's model was unique in India. As opposed to calculating how many operations his hospital could afford, Dr. V did things a bit differently:
"We try a different approach; quality care, in large volumes, at profit," said Dr. V. "We try to tell [other charitable eye hospitals] that by changing from charity to quality, at whatever price the people can afford to pay, they can increase their services, retain their staff, and generate continuous growth. The money is not for the shareholders but for the institution to grow."
In 1993, the Indian government received a $120 million loan from the World Bank to supply hospitals with equipment to increase the quality of the country's healthcare services. Six years later, the number of cataract surgeries increased threefold to 3.5 million. For Dr. V, this was not enough. He wanted to perform 8 million operations per year. He wanted to eradicate curable blindness by 2020 -- an issue afflicting over 40 million people around the world.
"When you restore a person's vision, they can go back to work and support their families. When you restore an elderly person's vision, they are no longer a burden to their children. Imagine if 8 million people get their sight back. If they each earned $1 per day, that's $8 million dollars per day added to the economy. Tell me, what better return on investment is there than that for society."
Today in Bangladesh, Professor Muhammad Yunus has adopted the Aravind model and is championing Dr. V's cause with the Grameen Eye Hospital, a social enterprise offering quality medical treatment with a variable pricing structure.
The Grameen Eye Hospital was inspired by the work of Dr. V and, with a stock of state of the art medical equipment from around the world, has begun to tackle the pressing health issues faced by underserved populations in Bangladesh and beyond.
The hospital is run on a cost subsidy basis, where 50 percent of the patients pay a subsidized amount, 40 percent pay a premium, and 10% receive treatment free of charge. "We show the rich no mercy," laughed chief medical officer Dr. Nabi when explaining the service model.
In a word, the Grameen Eye Hospital has been a success. Its post-operation patients have a vision seven percent higher than the World Health Organization average. The effectiveness of Grameen's enterprising health initiative can be attributed to its mission statement:
"Grameen Healthcare will design and develop a bottom up healthcare infrastructure that can take lessons from successful efforts around the world and improve upon them to deliver the highest quality Healthcare, in an efficient and sustainable manner, primarily to the poorest of the poor but also to the non poor, who may pay a little more than the target population."
Empowering the poor and most vulnerable is the key to effective social entrepreneurship. And the Grameen Eye Hospital demonstrates that it isn't always necessary to reinvent that wheel from the proverbs.
Dr. V, a visionary who dedicated his life to marketing cararact surgery the same way McDonald's sells hamburgers, passed away in 2006. His legacy lives on to this day -- from April 2009 to March 2010, Aravind treated over 2.5 million outpatients and successfully performed over 300,000 surgeries.