Our Healthcare for Everyone: South Indiaworkshop this coming summer will examine different approaches to health in South India. In the post below, and in future posts to come, we will profile some of the most exciting health movements in South India – providing both top-of-the line western medicine and a range of more holistic, traditional health responses.
YOU MAY HAVE NEVER HEARD OF THIS HOSPITAL – BUT IT COULD CHANGE THE WAY WE APPROACH HEALTH CARE
Over the course of the past 37 years, Aravind Eye Hospital, located in Madurai’s sprawling Anna Nagar neighborhood, has grown from a tiny 11 bed operation in rented quarters and with four medical officers who worked without salary to the largest provider of eye care services in the world.
Aravind Eye Hospital was founded by the late Govindappa Venkataswamy (Dr. V) in 1976. Dr. V retired from work as an ophthalmologist in the government hospital in Madurai to work to eradicate blindness in Madurai.
MCDONALD’S + THE TEACHINGS OF SRI AUROBINDO = AFFORDABLE, HIGH PERFORMING HEALTH CARE
Cataracts are the leading cause of blindness in India. There are 12 million blind in India – and the majority of those people have cataracts, which is treatable with surgery. From the beginning, Dr. V provided care to patients who could pay – and then offered free care to the poor with the proceeds.
“The priority is for human welfare,” said Dr. V, who based his model on two ideas that are unlikely bedfellows: the assembly-line efficiency of chains like McDonalds, and the spiritual teachings of Sri Aurobindo, an Indian nationalist and mystic, who taught that the quest for spiritual fulfillment requires engagement in the world.
There are now five Aravind Eye Hospitals in South India, all of which are entirely self-sustaining. These five hospitals see over 1.4 million hospitals and every year perform over 200,000 sight-restoring surgeries. Two-thirds of their services are free.
The Aravind Eye Hospitals each have a section for free and paying patients. Patients can choose whether to pay or not – and while the accommodation available at the hospital varies based on this, the services provided are the same. Each paying patient covers two patients who cannot pay. The quantity of paying patients means that not only are all free patients covered, but there is a surplus at each hospital.
THE NUMBERS MAKE IT WORK
Aravind realized that even ‘free’ services could be prohibitively expensive for patients who lived in surrounding villages and had no way to get to a hospital in Madurai. So they organized mass eye camps, where they brought services to the villages. Aravind conducts 40 eye camps per week in the South Indian states of Tamil Nadu and Kerala. The camps offer eye exams and basic treatment, and then Aravind workers invite all patients who need surgery to one of their hospitals.
The quantity of services provided makes it all affordable. Aravind doctors perform more than 2,000 surgeries per year – this is made possible by the assembly line setup and prep work done by nurses and other staff. (The average number performed by eye surgeons in the US is 125). Aravind maintains high quality (Aravind’s surgeons see half the number of complications compared to British surgeons performing the same procedure), which means that paying customers want to have their eye surgeries there – bringing in the revenue to pay for the free services.
When Aravind found the cost and availability of the lenses needed for cataract surgery to be an obstacle to providing care, they partnered with an American social entrepreneur to manufacture their own through a subsidiary named Aurolab. Aurolab sells 1.8 million lenses for cataract surgeries per year.
LEARNING FROM THE MODEL
Aravind Eye Hospital works with Lions Clubs International and the Seva Foundation to grow eye hospitals in other countries based on this model. On our trip to South India this summer, we will be looking at how innovators like Aravind Eye have been able to meet health care needs using context-specific solutions.
WANT TO LEARN MORE?
There is an excellent online documentary of Aravind Eye Hospital and Dr. V’s vision, which you can watch here:
Sources for this blog post include:
A Hospital Network With a Vision – The New York Times (January 16, 2013)
India Eye Care Center Finds Middle Way to Capitalism – NPR (November 29, 2011)
Two Decades On, India Eye Clinic Maintains Innovative Mission – PBS (September 2, 2009)
‘We set prices not on our costs, but on who can afford to pay how much‘ – The Financial Express (October 29, 2007)