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A Light Shines in the Darkness

At the age of 61, Padmashree Dr Gullapalli N Rao, Founder and Chairman of LV Prasad Eye Institute, continues to scale new heights. Jayata Sharma takes you through the story of this super-achiever

It is difficult to isolate the identity of Dr GN Rao from his brainchild LV Prasad Eye Institute (LVPEI). Unsurprisingly, he says that he wants to talk about the institution first and then about himself. After carefully describing the history of LVPEI, he relates his own journey as a reformist in the field of ophthalmic surgery, when there existed no high-end infrastructure for his dream of eliminating needless blindness.

Born in the Krishna district of Andhra Pradesh (AP), little did Dr GN Rao think he would scale such heights. All through his career, he has made the ophthalmology fraternity proud with firsts in many techniques and positions. His main contributions are in the areas of microsurgery, corneal diseases, contact lenses, community eye health, eye care planning and policy.

He also holds the unique distinction of being the Chairman of the Board, and President and Chief Executive of the International Agency for Prevention of Blindness (IAPB). Dr Rao is the first Indian President and the first person in the 30-year history of the organisation to hold all these positions. "This is a huge responsibility and I feel very privileged to be asked to do this. I am heading this organisation for the past four years," says Dr Rao with pride.

Seeing Possibilities

His ophthalmologist father Venkateswara Rao raised his awareness about the wide prevalence of blindness, which moved him to join ophthalmology. He also drew inspiration from two others. First to excel, from AIIMS professor Prof LP Agarwal, and second from the Director of his medical institute Prof Ramalingaswami to get involved in research in the field of ophthalmology. "Prof Agarwal always used to say “Do well in whatever you do”, which has proven a golden rule for me all through my life," avers Dr Rao.

He lists several other reasons for his continuing dedication to the profession at the age of 61. He recalls an incident while he was in Rochester, USA for 10 years. He was involved in patient care, teaching and research. A regular day turned out to be most memorable when a young male came to consult Dr Rao for an infection he developed after a cornea transplant operation. "With the kind of infection he had, normal prognosis was really bad. The eye was as good as written off," remembers Dr Rao. With the help of his team, Dr Rao was able to operate on the patient and save his eye and vision. "I rarely saw such dramatic results afterwards in my life," he says.

Back home, he derives immense satisfaction from treating children with grave eye problems. "When these kids grow up and become productive citizens, it is quite a gratifying and touching experience. To save a person's vision and to be able to provide him/her the required opportunities to develop skills is what keeps me going," says Dr Rao. Another inspiration is when doctors trained under him are seen to be changing the landscape of eye care in all over India and the developing countries.

Seeds of LVPEI

The idea of starting a not-for-profit eye centre struck Dr Rao in 1982. "I wanted to come up with a centre which will provide high quality care to all people," Dr Rao informs. He visited top institutes in America, Europe and India to study their functioning, and then chalked out a concrete plan for an eye centre. To fund the centre he set up a foundation in the US in February 1985 with the help of friends and colleagues, the Indo-American Eye Care Society.

"In the summer of '85, I got a call from a cardiac surgeon friend saying that he wanted me to talk to a gentleman called Ramesh Prasad, son of veteran film producer LV Prasad," says Dr Rao. Prasad learnt from this friend about Dr Rao's plan to start a hospital. The Prasad Trust had some funds available, which they wished to invest in a hospital set-up in India. "Prasad was impressed by my plan for the hospital and decided to support me. Four months later, when I visited India, he conveyed this decision to me," recalls Dr Rao. Later, Dr Rao met NT Rama Rao, the then chief minister of AP, and made an appeal for some land for this purpose. Rama Rao donated eight acres of land near Golconda, where Optometry School and Centre that deals with Public Health and Rural Outreach is currently located. Concurrently, Dr Rao started the Hyderabad Eye Research Foundation to fund ongoing research activities at the institute.

Dr GN Rao, with his staff at LVPEI (L), and (R) while receiving the Padmashree Award from former President KR Narayanan

Visionary Zeal

The visionary in Dr Rao is evident from the fact that he has always stressed on the very best in ophthalmology and brought in the best and the latest in eye care when he started in India: "I brought in and popularised techniques which were already established in the West," he says.

He began for the first time specially designed courses for imparting training to ophthalmologists in the country. "When I came back here, I felt a dearth of proper training for doctors in my field. This motivated me to start training courses for my fellow doctors," he says. His contribution did not stop at this. He introduced corneal transplants and started the Ramayamma International Eye Bank, the first world-class eye bank in the country. Earlier, the percentage of eye donations was quite poor. When Dr Rao realised this, he, with his dedicated team, started imparting awareness to common people about the benefits of donating corneas to needy people. His efforts have borne fruit, as is evident from the fact that of the 101 eye donations received in the month of December 2006, 63 were motivated by the team of grief counsellors at LVPEI. The Hospital currently performs the highest number of corneal transplants from a single institute in the world.

Dr Rao started the first dedicated children's wing for ophthalmology, outside the US, at LVPEI, the Jasti V Ramanamma Children's Eye Care Centre. The Centre also takes care of the rehabilitation activities of blind children, where they are taught life skills so they can live independently. "If there is nothing that I can do about curing the blindness in children, at least I want to make sure that we train them to be financially independent in the future," informs Dr Rao.

Freedom of Sight

Dr Rao believes in imparting the best eye care at affordable cost, and where possible, free to people who cannot afford the care. Hence, LVPEI conducts 50 per cent of its surgeries and eye procedures absolutely free, and sees the largest number of patients related to eye problems. "We offer comprehensive ophthalmic care to both paying and non-paying patients without any discrimination. This is supported by training, research and rehabilitation facilities," says Dr Rao. He has set up rehabilitation centres at both the set-ups in Hyderabad to take care of adults who cannot be cured of their blindness.

The centres are a huge success. An instance: Recently, Chandra Supriya received the Role Model in India award from the President of India, Dr APJ Abdul Kalam on World Disabled Day, December 3, 2006. A High Court advocate, Supriya is legally blind and has been a patient of LVPEI's rehabilitation services for the past seven years. "Such results make me feel great and I am inspired to work even harder," Dr Rao avers. Rehabilitation services too are free.

Spreading the Light

Dr Rao is considered a role model for various reasons by the healthcare industry. Apart from introducing numerous techniques in ophthalmology, he is instrumental in forming a unique model of pyramidal system of eye care from community to advanced care, spreading it across the rural areas of AP, including Adilabad, Mahabubnagar and Prakasam districts. A brainchild of Dr Rao, the model stems from the fact that doctors from urban areas hesitate to practice in the rural sections. "Hence, I planned to train people from the rural areas to take care of the diagnosis of the eye problems and provide primary care like issuing spectacles. If a surgical intervention is required, they refer the patient to a secondary centre or a tertiary hospital," informs Dr Rao.

For secondary and tertiary care, Dr Rao has formed partnerships with local secondary care hospitals like Venkata Lakshmi Eye Centre at Karamchedu, Seshanna Chennawar Eye Centre at Adilabad, and others which are near primary care centres. "Only 20 per cent of the people with eye problems actually require complex care while the rest can be taken care of by currently available methods. Hence, I thought of planting primary eye care centres (Vision Centres) in rural areas, where we can detect eye problems pretty early and cure at the nascent stage itself, avoiding the extra cost of surgeries and travelling long distances."

The dream of affordable and accessible eye care always dwelt in Dr Rao's heart, and this is why when rural populace needs to come to the hospital for a procedure, the entire cost is borne by the hospital trust. "Right from their travel to food to stay and cost of the surgery, we take care of everything. Also, relatives are given accommodation at the hospital in serious cases." This model is quite popular and has been replicated by institutions all over the world like Chicendo in Indonesia, Islamia Hospital in Bangladesh, Fundacion Vision Hospital in Paraguay. The icing on the cake is that countries like China, Kenya, Ghana, South Africa and Egypt have all lined up and approached Dr Rao for help in implementing this model.

In the 20 years since its establishment, LVPEI has provided outpatient services to over two million people and surgical care to over 2,50,000 patients—almost 50 per cent of them free. "In addition, we have trained over 10,000 doctors and para-medical personnel from India and abroad, and made over 1,700 research presentations at national and international meetings. We have also published 800 papers in top tier journals and helped in the rehabilitation of over 25,000 visually challenged individuals," says Dr Rao.

His Personal Story

Dr GN Rao was born in a village with a population of two-three thousand in the Krishna district near Vijayawada, Andhra Pradesh on September 21, 1945 and lived there till the age of 10 with his aunt. He then moved to Guntur, where his father was a practicing ophthalmologist, and mother, Venkata Lakshmi, a homemaker. He completed his MBBS from Guntur Medical College, and went to AIIMS, New Delhi for his post-graduation in ophthalmology. In 1974, he went to Tufts University in Boston for speciality training in corneal transplantation and later on worked at University of Rochester for 10 years. When he left the university, he was an Associate Clinical Professor and the Director of Cornea Research Laboratory. In 1973 he married Pratibha, who is associated with a non-Governmental organisation called Lok Satta in Andhra Pradesh. He returned to India in 1986 to set up the LV Prasad Eye Institute at Hyderabad. Dr Rao has two children. Son Raghav is an entrepreneur based in New York and daughter Vaidya is a law student at Harvard University studying public interest law. When asked why neither of his children chose medicine, he is quick to quip, "Maybe I couldn't inspire them enough." His brother, Venkat Ratnam, takes care of the family property business, and both his sisters are based in the US. In his initial days, his moral support were his parents and later his wife.

Vision 2020

As the president of IAPB, Dr Rao leads the global initiative to eliminate avoidable blindness by the year 2020. He is mainly executing this responsibility by the way of advocacy. "For meeting the target of 2020, at the beginning of this year, we passed the World Health Assembly Resolution and are translating it to numerous nations and setting them specific targets for elimination of blindness. It has been a great success and we are getting good response."

Dr Rao is also setting up training centres with the help of corporate bodies in countries with high prevalence of avoidable blindness. Such centres are already set up in Indonesia, Nigeria and Tanzania. When asked, what about India, he avers, "India does not need more training, as we already have many training centres and courses here. What we need is implementation of this acquired training." Another gigantic task undertaken by Dr Rao is to mobilise resources by convincing national Governments all over the world to allocate more funds for eye care.

Just Rewards

Dr Rao has many awards to his credit, but he names a few which are closest to his heart. The most recent award Dr Rao was given is the International Blindness Prevention Award 2006, from the American Academy of Ophthalmology. His favourite award is the Honorary Doctorate in Science from the University of New South Wales, Australia. Also, being elected in 1998 as one of the 50 members of the Academia Ophthalmologica Internationalis, the group of 60 top academicians in ophthalmology of the world, is close to his heart. "I am the second Indian to be elected here after Prof Agarwal, and this is a rare privilege—to be the next one after my teacher. I was also quite surprised when I came to know about the Padmashree," he enthuses.

Looking Ahead

After such a long career, there is a general curiosity about when he would hang up his boots. The answer is whilst he is at the peak of success. "I want to exit while I am at the top and away from pride," he says. By pride he means that although he has been a reformist in a way, he does not want to nurture the feeling of being the only person who can change the face of ophthalmology. "People get carried away by such thoughts and this destroys them," he says. However, there are a few things he wants to take care of before he steps aside.

When Dr Rao started his career, his interest was tilted towards research and patient care. However, with changing times and responsibilities, his preferences have shifted. "Now I am more into policy making and charting out plans to penetrate the remotest section and the most marginalised people of our society to reach timely eye care to them," he reveals.

Under his guidance, LVPEI made significant contribution in the use of stem cell transplantation in the eye in India. Quizzed about how he feels being tagged as a giant in the field of ophthalmology, he humbly answers, "I did what I could. In fact, there is still so much left undone." He believes he has seen all comforts of the world and it is his responsibility to give back to society according to his capacity.

The prime goal of Dr Rao is to ensure LVPEI is amongst the top 10 eye institutes in the world. Also, he wants to eliminate as much blindness as possible from this world. "LV Prasad is no longer restricted to Hyderabad, it has a national and international responsibility now. People from world over have invested in LVPEI and hence we have a responsibility to make sure their investment is utilised in eliminating needless blindness to the maximum extent," avers Dr Rao.

He also wants to reformat the current medical education system in India. "Our educational system stinks right now. It needs an overhaul," he says. The Government has paid no heed to his advice regarding this issue, but he refuses to give up. Until this status is reached, we can be sure that Dr Rao will keep working for this noble cause and will ensure a stronger presence in the history of medicine.

jayata.sharma@expressindia.com