ARAVIND IS THE WORLD'S LARGEST EYE CARE CENTER ...A ONE STOP SHOP THAT EVEN MAKES MANY OF THE LENSES AND INSTRUMENTS USED BY ITS SURGEONS.
THE SURGICAL ERROR RATE HERE IS ON PAR WITH THE MAYO CLINIC'S...OR ANY OF INDIA'S HIGH TECH CENTERS WHERE RICH INDIANS AND MEDICAL TOURISTS CAN GET FIRST WORLD CARE AT THIRD WORLD PRICES.
THE BIG DIFFERENCE WITH ARAVIND IS THAT ITS PATIENTS ARE AMONG THE WORLD'S POOREST PEOPLE. ITS BUSINESS SUCCESS AND SOCIAL MISSION HAVE LONG MADE IT A MODEL IN PUBLIC HEALTH TEXTBOOOKS...
TWENTY YEARS AGO, THIS-MUCH YOUNGER-REPORTER CAME TO THE ANCIENT TEMPLE CITY OF MADURAI WHERE ARAVIND WAS FOUNDED BY DR GOVINDAPPA VENKATSWAMY-EVERYONE CALLED HIM DR VEE. HE RETIRED FROM A GOVERNMENT HOSPITAL IN 1976 AND SET OUT TO TACKLE "NEEDLESS BLINDNESS." WORLDWIDE, 45 MILLION PEOPLE STILL SUFFER FROM PREVENTABLE OR REVERSIBLE BLINDNESS. 12 MILLION ARE IN INDIA ALONE, WHERE THE EXTREME SUN AND GENETICS ARE BLAMED. MANY PEOPLE LOSE THEIR SIGHT-AND LIVELIHOOD-IN THEIR EARLY 50S..
DR V BEGAN WITH SIMPLE IDEA IN A SPARSE 11-BED HOSPITAL WITH FOUR DOCTORS, THREE FROM HIS OWN FAMILY. IT WOULD SERVE PATIENTS WHO COULD PAY. THE PROFITS WOULD AFFORD FREE CARE TO THE MANY MORE PEOPLE WHO COULDN'T AFFORD EVEN THE BUS FARE.
SO ARAVIND SET OUT TO FIND PATIENTS-MAINLY THROUGH SCREENING CAMPS IN SURROUNDING RURAL AREAS. GROUPS LIKE THE LION'S CLUB PROVIDED BUSES TO BRING THOSE NEEDING SURGERY TO THE HOSPITAL, WHERE THEY ENTERED A BRISK ASSEMBLY LINE OPERATING ROOM. DR V'S BUSINESS ROLE MODEL WAS THE AMERICAN CHAIN STORE.
DR. G. VENKATASWAMY, Founder: In America, you have models, whether it is Sears stores or McDonald hamburgers, you are able to open a chain of stores, restaurants, hotels and you are able to organize them efficiently...
Segue to today:
DR. ARAVIND SRINIVASAN: You spoke to him here, you were sitting here and he was sitting there and talking about McDonalds
Dr. V DIED IN 2005 BUT HIS OFFICE IS LEFT UNTOUCHED AS A SHRINE TO HIM. HIS NEPHEW-OPHTHALMOGIST ARAVIND SRINIVASAN MANAGES A SYSTEM THAT'S GROWN TO FIVE REGIONAL HOSPITALS AND 25 SATELLITE CLINICS. THIS WAS THE FIRST ONE...
DR. ARAVIND SRINIVASAN: This is a 32 year old hospital, so we are probably geared to see about 700 patients a day. Today we are seeing about 1500 to 2000 patients a day
EACH PAYS ABOUT ONE DOLLAR FOR A DOCTOR'S APPOINTMENT. THAT HELPS FUND AN EQUAL NUMBER OF PATIENTS WHO GO NEXT DOOR TO A FREE EYE HOSPITAL. THERE'S NOT MUCH PROFIT MARGIN SO A HEAVY VOLUME OF PAYING PATIENTS-SATISFIED PATIENTS-AND EFFICIENCY-ARE CRITICAL.
DR. ARAVIND SRINIVASAN: They call this a clinic scoring sheet.
DR ARAVIND-WHO ALSO HAS AN MBA FROM MICHIGAN -HAS CONTINUOUS PRODUCTIVITY REPORTS AT HIS FINGERTIPS...
DR. ARAVIND SRINIVASAN: This statistic talks about service time, what percentage have been seen within two hours.
PATIENTS ARE PROMISED A COMPLETED APPOINTMENT IN TWO HOURS IN A BROCHURE DETAILING WHAT THEY CAN EXPECT...
DR. ARAVIND SRINIVASAN: Registration takes about 5 minutes, vision test about 10 minutes, refraction check about 10 minutes/Fred: This is sort of a patients' bill of rights? AS: Exactly...
ARAVIND'S REPUTATION IS DRAWING PATIENTS FROM FARTHER AND FARTHER AWAY...
K.G. ANGENEYULU, Patient: Whenever you say eye operations everyone says go to Madurai...
IT IS THE ONLY REASON 55-YEAR-OLD K.G. ANGENEYULU WAS COAXED OUT OF A THREE-YEAR DEPRESSION THAT BEGAN WHEN CATARACTS BEGAN CLOUDING HIS VISION. HE BECAME COMPLETELY BLIND THREE MONTHS AGO.
ANGENEYULU AND HIS WIFE SHOBHA ENDURED A TWO-DAY TRAIN JOURNEY TO GET HERE...
K.G. ANGENEYULU, PATIENT: I was a sportsman; I used to swim. After the cataract, I could no longer move around, I got stuck at home and I started eating. Then a leg injury made me even more immobile, I had problems being overweight and I developed high blood pressure...
BY NINE OCLOCK THE MORNING AFTER ARRIVING HERE HE WAS BEING PREPARED FOR SURGERY. ALREADY DOZENS OF PATIENTS HAD GONE AHEAD OF HIM
FRED DE SAM LAZARO, CORRESPONDENT: So you've been going for two hours and done 16 surgeries? DR. ARAVIND SRINIVASAN: Yes...
DR ARAVIND AND SURGEONS IN SEVERAL OTHER OPERATING THEATERS OR O/Ts WERE FIRST WORKING THE ROUTINE-MOSTLY CATARACT-CASES
DR. ARAVIND SRINIVASAN: The other O/Ts are not primarily cataract surgeons they primarily doing either glaucoma or cornea and they also do some cataract to contribute to the main volume It's an entire teamwork as you've seen. I'm seeing the patient for the first time in the O/R. So somebody has done a thorough workup of the patient and any challenging cases, they show it to me earlier So those cases that need a little extra attention are segregated from the pool
ANGENEYULU WAS ONE SUCH CASE. HIS HYPERTENSION AND OBESITY POSED EXTRA RISKS...
DR. ARAVIND SRINIVASAN: the margin is about 5-10 minutes to get the surgery done...
ABOUT TEN TENSE MINUTES LATER, DR. ARAVIND HAD REMOVED A PARTICULARLY TOUGH, LEATHERY CATARACT
DR. ARAVIND SRINIVASAN: The cataract was a little obstinate but things went on well. He'll get about 95% vision tomorrow, so when you see him tomorrow, you'll see a very different man, more confident, you know...
BY THE END OF THIS DAY, DR ARAVIND AND HIS COLLEAGUES DID ABOUT 300 SURGERIES-ABOUT HALF OF THEM FREE OF CHARGE.
INCREASINGLY, HOWEVER, PATIENTS ARE SEEN OUTSIDE THE HOSPITAL. TELEMEDICINE CONNECTS DOCTORS TO SATELLITE CLINICS. AND TODAY'S EYE CAMPS OFFER MUCH MORE ON SITE-FROM GRINDING EYE GLASS LENSES TO DIGITAL SCANS.
NEAR THIS CAMP, A SATELLITE TRUCK BEAMED HIGH RESOLUTION IMAGES TO RADIOLOGISTS AT THE HOSPITAL. IT'S ESPECIALLY USEFUL IN DIAGNOSING INDIA'S GROWING PROBLEM OF DIABETES-RELATED EYE DISEASE
TECHNOLOGY HAS IMPROVED CARE AND IT HAS ALSO BROUGHT DOWN COSTS-NOTABLY FOR INTRAOCULAR LENSES, WHICH ARE IMPLANTED DURING CATARACT SURGERY
FRED DE SAM LAZARO, CORRESPONDENT: Aravind began making its own intraocular lenses back in the early 1990s. They used to cost between 50 and 100 dollars each. Today they are made in this factory for as little as two dollars a piece. Aravind lenses are exported to 120 countries and they own eight percent of the global market in intraocular lenses
THIS FACTORY IS A PRIME EXAMPLE OF HOW ARAVIND HAS TURNED SUPPLY PROBLEMS INTO OPPORTUNITIES, SAYS R.D THULASIRAJ A SENIOR ADMINISTRATOR...
R.D. THULASIRAJ, ADMINISTRATOR: Which organization would say you're having a supply problem so start manufacturing or you're having difficulty getting people to work for you, start a training program and in a way that was what defined the organization as well...
SO FAR, HE SAYS 250 HOSPITALS ACROSS INDIA AND 40 OTHER NATIONS HAVE ADOPTED ARAVIND'S METHODS TO IMPROVE THEIR PRODUCTIVITY
R.D. THULASIRAJ, ADMINISTRATOR: In this institution we train organizations to become more efficient, we completely give our intellectual property or our store away. We open up our systems processes, what we charge the patients, our records; it is there, available to anyone who wants to adopt it...
IT'S THE ETHOS SET BY HIS UNCLE. DR V, WHO WAS SINGLE, NEVER TOOK A SALARY; IN FACT HE MORTGAGED HIS HOME TO START ARAVIND. AND HE COAXEDOR INSPIRED 34 MEMBERS OF HIS EXTENDED FAMILY TO WORK HERE, STARTING IN 1976 WITH HIS SISTER NATCHIAR AND HER HUSBAND. BOTH LEFT SURGICAL CAREERS IN AMERICA TO WORK HERE-FOR 20 DOLLARS A MONTH
DR. NATCHIAR: Today oh my god, we are very very happy. At that time in 80s we were not happy, even though Dr V was happy. In the family, like me and my husband and two children, it was not easy for us. We could not even buy a cycle/14:22 At that time, we didn't appreciate his far vision...
THE SATISFACTION OF SEEING PATIENTS, LIKE ANGENEYULU RESTORED TO FULL LIVES MAKES UP FOR ANY MATERIAL PRIVATION, SHE SAYS, ALTHOUGH OVER THE YEARS, SALARIES HAVE GREATLY IMPROVED FOR THE 220 DOCTORS AND SOME 2500 OTHER ARAVIND STAFF...
K.G. ANGENEYULU, PATIENT: My children are starting school on the first, so I want to get going...
DR. NATCHIAR: We'll give you some dark glasses just like a Hollywood actor...
HE'S ONE OF 27 MILLION PATIENTS WHO'VE BEEN TREATED AT ARAVIND AND 3.4 MILLION WHO'VE HAD SURGERY; SURGERY THAT NOW COSTS LITTLE MORE THAN A MEAL AT MCDONALDS.
