Black ticks on their foreheads marking the eye to be operated on, dozens of patients in green overalls wait in line, beneficiaries of a pioneering Indian model that is restoring sight to millions. With a highly efficient assembly line model inspired by McDonald’s, the network of hospitals of the Aravind Eye Care System performs about 500,000 surgeries a year — many for free.
More than one-quarter of the world’s population, or about 2.2 billion people, have a vision impairment, and 1 billion of the cases could have been prevented, WHO data shows.
There are about 10 million blind people in India, and 50 million have some form of visual impairment. Cataracts — clouding of the eye lens — is the main cause.
Photo: AFP
“The bulk of this blindness is not necessary because a lot of it is due to cataract, which can be easily set right through a simple surgery,” said Thulasiraj Ravilla, one of the founding members of Aravind.
The hospital was set up by Govindappa Venkataswamy, a doctor who was inspired by former McDonald’s CEO Roy Kroc and learned about the company’s economies of scale during a visit to the Hamburger University in Chicago.
“If McDonald’s can do it for hamburgers, why can’t we do it for eye care?” he famously asked.
Aravind started as an 11-bed facility in 1976 in Madurai, a city in Tamil Nadu state, but has expanded to care centers and community clinics across India.
The model has been so successful that it has been the subject of numerous studies including by the Harvard Business School.
However, it is the outreach camps that have been the cornerstone of its no-frills high-volume work — as nearly 70 percent of Indians live in rural areas.
“It is the access that is the main concern, so we are taking the treatment to people rather than waiting for them to come for us,” Ravilla said.
The free eye camps are a boon for those like Venkatachalam Rajangam who received care close to home.
Rajangam said he had to stop working because he was unable to see the money customers at his provisions store gave him, and also stumbled on the stairs or when out after dark.
The 64-year-old found out about a camp next to his village in Kadukarai, about 240km from Madurai, where doctors screened his eyes and detected a cataract in the left one.
Rajangam was taken in a bus with about 100 others to a shelter run by the hospital, which also provides basic meals and mats to sleep on free of charge, and underwent a procedure to remove the cataract.
“I thought the operation would be for an hour, but within 15 minutes everything was over. But it didn’t feel rushed. The procedure was done properly,” Rajangam said after the bandage roll covering his eye was removed.
“I didn’t have to spend even a penny,” he said.
Aravind eye surgeon Aruna Pai said that the doctors receive rigorous training to make sure they can perform surgeries quickly.
The complication rate is less than two per 10,000 at Aravind, compared with four to eight per 10,000 in the UK or the US, the hospital said.
“We have wet labs where we are taught to operate on goats’ eyeballs. This helps us to sharpen our skills,” said Pai, who performs about 100 surgeries per day.
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