An Infinite Vision: The Story of Aravind Eye Hospital

I pay $1 to have an eye test. I can come two more times in the next three months and I will not be charged. I first do a glaucoma test, and then I am tested for vision, and then examined for a detailed uveitis test an eye disease which I suffered in my youth. I am given a clean bill of health.

The hospital is spanking clean. Everyday it sees 1200 patients and the doctors perform over 200 operations. But then this is only the beginning of an amazing story. It is part of a network of eye hospitals that has seen 32 million patients in 36 years, and performed more than 4 million eye surgeries most of them ultra-subsidized or free.

All this originates with a vision of one man, Dr. Venkatasamy, affectionately known as 'Dr V.' In 1976 he founded Aravind, as a post retirement project when he was 58. He was inspired by one of India's legendary philosophers, Sri Aurobindo, whose reflections on the transience of humankind influenced many thinkers. He spoke to the prerequisite for a collective and radical transformation of consciousness of the human spirit.

Dr. V represents that ascent of that 'revolutionary staircase' that unites the inner soul and the logic of nature. He set his goal to give the right to sight to the 12 million people in India suffering from preventable blindness. No bank wanted to lend him money. "You are too old," they said. "You are prepared to operate for free on patients who cannot pay. You don't have a business model we can fund. "

So he mortgaged all the jewelery of his family members and was created the first 12-bed hospital in Madurai in the south of India, one of the country's oldest cities and home to the famed Meenakshi Amman temple, dating back to 6 BC. Here, the patient has the choice to decide whether to pay or not. In a country where a huge majority of people live on less than $2 a day he ripped of the price tag for access to world class quality eye care.

And then he decided he would never ever ask for a loan again. Aravind would run as a Trust that controlled the operations and the only surpluses would be used for extending the operations. Today there are seven major Aravind Hospitals, over 50 vision care centers and they consult and work with eye hospitals in over 30 countries.

As Kami, my son, and I walk through the hospital, we are amazed at the energy that resides within. It is a railway station. But there is an air of serenity. It is spotless but I do not see a single cleaner. I ask the outreach manager, a young beautiful woman called Pria how they manage such an efficient operation and yet remain so calm. She laughs. "We love our work here. Dr. V had a vision: 'To see all as one; to give sight to all.' We believe that vision." I understand. It spans a beautiful rainbow arch that unites an avant-garde business model with a profound compassion of our shared humanity.

How sadly lacking are we today on a global and local stage of selfless leaders such as Dr. V. His goal was 'to spread the Aravind model to every nook and corner of India, Asia and Africa; wherever there is blindness we want to offer hope. Tell me, what is this concept of franchising? Can't we do what McDonald's and Burger King have done?' The only difference I would add is that Aravind is delivering high quality health rather than junk fast food.

Today the Aravind Eye Care System is the largest provider of eye surgeries in the world. They see more than three million patients and perform over 300,000 surgeries a year. That is almost 7 percent of the global total. And their record of proficiency is better than that of the UK health care system. The simple philosophy of creating awareness that blindness is largely preventable, building trust that Aravind will deliver world class treatment even if it free and ensuring access to the most remote communities through the outreach camps and underpinned with the values of humility, compassion and service.

I ask Dr. Poobalan from the hospital administration in Pondicherry how he can run such a fantastic facility and achieve so much:

We have commoditized our operations. Everyone knows exactly what they have to do. The clinical staff must do the diagnosis. We have the most sophisticated equipment here. The doctors must prescribe and operate. The counselor staff must explain all the procedures to the patient. The administration must work like clockwork. There is no laziness here. Staff that do not have the work ethic of Aravind do not stay long. For us the patient is the focus of everything we represent.

I think back to our health care system in South Africa. I know that we have islands of excellence that match this but the norm is that the system is more designed to serve the interests of bureaucrats, politicians and staff rather than the patient.

Kami asks Pria how they manage to ensure efficiency. She takes me to the data clerks outside each major section of the hospital. They have a real-time system. It monitors the waiting time in each unit of those waiting versus those seen. At any time staff can be allocated instantly to where they are needed.

I ask what the average costs will be if a patient requires a complicate eyed surgery such as a cornea transplant. Dr Veena, a senior surgeon, replies: "The average cost for the most complex surgeries will vary between $200 and $400. It will cover all the tests, the cost of the operation, the hospital accommodation and medicines. The patient will have to pay separately for food. And if you cannot pay it will be free. You will get exactly the same operation and treatment but accommodation will be in general wards."

We are stunned. Why can't this be the mode across the world for all our health care needs? I ask what the costs of spectacles are, knowing that we pay hundreds of rands for them in SA. On average a set of quality spectacles costs on average R50 here at Aravind. The only variable is volume and the efficiency of the system. But even then I know that the real reason in SA is an uncompetitive monopoly that drives up the costs that puts profits before the patient.

As we debate the future of our health care system and the proposed National Health Insurance, I ask myself how these ethical human values can be integrated into the way our health system works. Throwing money at our problems is not going help. I know here every member of staff will bring their children to this hospital because they know the quality of health care they are delivering to the patients who flood their gates every morning.

Here Pria is not the exception. She is the norm. Workers have their heart in their work. It gives them meaning in their lives. They are here to serve and the do that from a deep seated feeling that we are all born equal and united by the human spirit. It's more than the salary package. It's about service with passion and an infinite vision.