Out of the many stories of determination and success is one of Aravind Eye Care System, the largest and the most productive eye care facility in the world. It sees over 1.4 million patients and performs over 200,000 sight restoring surgeries each year. Two-thirds of its services, are free. Aravind’s a range of activities cover the entire spectrum of eye care delivery.

An exclusive conversation with Dr. S. Aravind, Director, AMECS, from Madurai:

Q. Aravind as an institution is more than an eye hospital, how challenging has it been for you to create an institute of such repute and recognition?

A. The primary aim was not to build an institution, it was to solve a problem, which was  of  ”affordability, accessibility and also knowledge”.

That time the paradigm thinking was: diseases are a problem, but we got to know, how it is on part of the management in terms of efficiency, quality.

Q. How many doctors have passed through your institute till date?

A. We estimate a little more than 2500 people and in India we estimate that 20-25% of all ophthalmologists have gone through one or the other programs at Aravind’s.

Q. What is Aravind’s telemedicine effort look like?

A. In terms of accessibility, we were doing a lot of eye camps but as the longevity of the people has increased so have the various forms of diseases. We realized that camps happen, when we choose them to happen, not when the disease happens. We setup the model called Vision Centers to reach out to a population of 50,000. Since the community could not afford an ophthalmologist at the market price, we trained our technicians to handle the same.

This gave us the idea of connecting the Centers with the base, which was enabled by telemedicine technology from University of California Berkeley. We have about 32 centers today working on the Hub and Spoke model, where the Hub is the base hospital at Madurai and the Spokes are the various centers.

Q. What were the challenges faced in terms of cost of services at the Base of the Economic Pyramid?

A. The community absorbs what we give, provided we give it in an affordable and accessible way. I would rather put the challenge to the management, in terms of innovating towards better efficiency and affordability.

Q. Monitoring health remotely will be involving a lot of technology and how easy is it for you to get access to such infrastructure in India?

A. We use broadband which is prevalent in the areas we operate. We also created our own software like Adres for diabetic retinopathy and EyesTalk to maintain medical records. Also the technology which was provided to us by the University of California Berkeley has helped us along the way.

Q. Have you also tried going into other communities across India and how has the Govt helped?

A. We are already working in Kolkata, Lucknow (UP) but we have only done the Hubs model here and not the spokes (rural centers). The Indian government is doing quite a lot in terms of healthcare.  They invested $140million across the country to establish a strong ophthalmic infrastructure.

Q. What support do you look for from external agencies?

A. We can definitely build a lot of capability and learn from other industries, look out for land, technology.

Q. Is literacy an issue in reaching out to the BoP?

A. Well, no. In fact, we went to UP with the same assumption and were very well received by them. Much more than literacy we have found that the only challenge lies with the people managing the show on the ground. The challenge is to create a highly scalable model. Today we are already the largest eye care hospital in UP.

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*Image courtesy: Sonesh Surana, TIER Project, UC Berkeley