Against All Odds

Undetered by his severe rheumatoid arthritis, he set up Aravind Eye as an 11-bed hospital post retirement. The legacy of the institute continues after his death

Late Dr Govindappa Venkataswamy (1918-2006) Founder, Aravind Eye Hospital, Madurai

Born in 1918 in Vadamalapuram in Tamil Nadu to a farming family, he pursued his Bachelor of Arts in chemistry from American College in Madurai in 1938, Doctor of Medicine from Stanley Medical College in Madras in 1944, Doctor of Ophthalmology at the Government Ophthalmic Hospital in Madras in 1951 and Honorary Doctorate from University of Illinois, 1985.

Why an entrepreneur?

In the late 70s, when good quality ophthalmology care was available only to the affluent and blindness was untreatable, a 58-year-old ophthalmologist decided to reform the situation. In 1977, post-retirement, Dr Venkataswamy (popularly known as Dr V) set up an 11-bed clinic. The mission of his organisation in his words was ‘to eradicate needless blindness’. Today, this institute has flourished into 4,000-bed network of hospitals.

Before being an entrepreneur

He started his career by first joining the Indian Army as physician in 1945. He had to retire pre-maturely in 1948 after developing severe rheumatoid arthritis — a disease that left his fingers crippled. Despite his disability, he earned a diploma and masters degree in ophthalmology. He had instruments specially designed for his arthritic hands. These instruments enabled him to perform as many as 100 cataract surgeries a day and his fame as a cataract surgeon spread wide.

He was appointed as the HOD of ophthalmology at the Government Madurai Medical College, and an eye surgeon at the Government Erskine Hospital at Madurai. He held these posts for 20 years and made remarkable contributions to research, clinical service and community programmes.

He introduced a number of innovative programmes to attack the problem of blindness in India, including the outreach eye camps, the initiation of a training programme for ophthalmic assistants and the world's first rehabilitation centre for the blind. Thus he soon came to be known as the 'father of community ophthalmology'.

The first move

In 1976, upon his retirement at the age 58, he formed the GOVEL Trust under which the Aravind Eye Hospital was founded. It was his dream of being able to market 'good eye-sight' to the world, the way McDonald's sells hamburgers. In his words "in Aravind, we scan new horizons and look forward to exploring new vistas in eye care".

Over the years

Dr V offered cataract operations at a low cost. He achieved this by training a team of paramedicals to do substantial work required in each surgery, thus allowing doctors to do more number of surgeries. He also made Aravind Eye Hospitals produce their own low-cost intra-ocular lenses and other ophthalmic supplies to make eye-care affordable and mass-producible. Today, the Aravind Eye Care System encompasses five hospitals, four managed eye hospitals, with a combined total of nearly 4,000 beds, a manufacturing center for ophthalmic products, an international research foundation and a resource and training center.

The work of the organisation has grown in many dimensions. "The significant areas are expansion of activities to the northern part of the country through managed care. A state-of-the-art manufacturing plant has been established to be able to manufacture world class ophthalmic products at an affordable price. In the name of Dr V, a research institute has been established which will contribute towards basic research in the field of ophthalmology," says S Aravind, Administrator, AEH.

Contribution to healthcare

Instead of relying on donations and funding, AEH developed the ability to manufacture most of the materials it needed. Its self-sustaining model is being copied in at least 30 countries around the world. The hospital was also one of the early starters to integrate ICT in its healthcare services as early as in 1983. Amidst all this, Dr V has also authored three books, in Tamil, on eye diseases and diabetes.

Overcoming roadblocks

Catering to the needs of millions who needed cataract surgery was not easy. Mass marketing and an operating system that resembles an assembly line helped the modest hospital to grow steadily in service delivery and infrastructure. And a system that enabled Aravind to provide free eye care to two-thirds of its patients from the revenue generated from its one-third paying patients.

One of the main hurdles was getting patients to the hospital. Often elderly patients required escorts, or could not afford transportation and the rural-urban divide was more evident than ever. AEH started an outreach programme using community organisations to identify and assist potential patients with the help of tele-opthalmology. Today, the patient acceptance rate is between 95 to 98 per cent.

Awards

He was conferred with Padma Shri by the Government of India in 1973, International Blindness Prevention Award, American Academy of Ophthalmology, 1993, Helen Keller International Award, 1987, WHO Award for Health for All, Academy International Blindness Prevention Award, International Social Entrepreneurship Award, Medal of the Presidency of the Italian Republic, Raja-Lakshmi Award for the year 2001 from Sri Raja-Lakshmi Foundation, Chennai, Lifetime Service Award from the International Agency for the Prevention of Blindness, 1982, Harold Wit Lectureship, Harvard Divinity School, 1991, Pisart-Lighthouse for the Blind Award, 1992, Susruta Award, Asia Pacific Academy of Ophthalmology, 1997, World Telugu Federation honoured him in the year 2000 and Dr BC Roy Award in 2001.

An entrepreneur that he admired in healthcare

"He admired Dr MP Mehra who set up Sitapur Eye Hospital in UP," says Aravind.

The road ahead

Before Dr V passed away, a leadership shift was made in 2000 and this leadership team manages the hospital and other activities now. The leadership team consists of 10 people and decisions are taken after due deliberation. "As the process was started when Dr V was there, it had time to mature with his guidance,” says Aravind.

Having succeeded in building the capacity of over 200 eye hospitals located all over India through a consultancy process, AEH is moving one step ahead to provide management services to eye hospitals in areas of need in India and other parts of the world. Since it opened, AEH has given sight to more than 3 million people. The operating model is open for other hospitals to learn from and help realise its vision of eliminating needless blindness by 2020.