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I am beginning my journey in Kolkata and traveling along the river Ganges by train. I will document what I see and hear along the way. The trip takes 14 days and this first leg of the journey will end in Rishikesh at the foothills of the Himalayas. I will then go down to South India for two weeks on my own, back to North India (Delhi & Rajastan) for a ten day tour of a number of Social Enterprises. My last stop in India will be the Bollywood capital, Mumbai. I am happy to share my travel stories with you...

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Monday, February 7, 2011

Arvind Eye Care in Madurai (now in many other states in India and Africa)


What is special about the Arvind Eye Hospital is that while providing free or pay as you please eye care (yes, exactly), they are preventing blindness in India in significant numbers, AND making it financially. Go figure!

I read about Arvind eye hospital in C.K. Prahald’s “Bottom of the Pyramid.”  Seeing the facility in Madurai was an experience to remember.  I spent half a day there first attending a presentation of the eye care system followed by a tour of all their clinical facilities. 

Statistics: Twenty five percent of the world’s 3.5 million blind people live in India. Seventy five percent of the blindness here are avoidable. Arvind hospital’s mission is to prevent blindness at no cost or at affordable cost to the patients. Their pricing system puts the sophisticated economic pricing models (& assumptions) to shame.  The concept is simple: provide the services to everyone who needs it.  If they can afford to pay for the services they will. And they do.

When patients come to the clinic they are asked to choose the price they can afford to pay.  For example, they may choose to pay Rs.100, 50, 25, or none if they cannot afford to pay at all. The patients are not required to show proof of income or any other documents to qualify for the free service. In fact I could have walked into the clinic and received eye care at no cost, no questions asked (other than my name of course).

In the year just ended their ratio of paying to non-paying outpatients is 3:1 and for cataract surgeries it is about 1:1. (When they started 20+ years ago all patients were treated for free.)  On average every paying patient covers the cost of two non-paying patients. All clinical staff, fellows, and volunteers have to work in all areas: paying and non-paying hospitals and outpatient clinics.  The quality of clinical care received by all patients is the same.  Paying inpatients get single rooms (with attached bathroom) with extra bed for health attendant, or shared rooms if they pay a lower price. Non-paying inpatients get shared room with cots or floor mats of their choice.   

About 3000 patients go through their outpatient clinic in Madurai each day.  They use telemedicine to reach out to rural patients-  roaming vans equipped with satellite communication devices are used to reach out to people in rural areas.  They also now have primary care centers in villages. 

There is something else they seem to have figured out well- the “system” that uses limited resources in the most efficient way.  Their cataract surgeries use production line like organization to make best use of the surgeon’s time.  About 350 cataract surgeries happen each day in the Madurai hospital alone. They do eye transplants as well (smaller number).  

 The day I was there, I saw high school age children attending an exhibition on eye health.  Preventative care through education is a huge priority for this hospital. 

I was told by the way that MBA students from Wharton School of Business were currently on their campus studying strategic growth.  

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