IIMB is pleased to have Dr. Namperumal Swamy, one of the founding members & Chairman Emeritus of Arvind Eye Care System. We join him in understanding his 40-year journey that started in 1976, a journey towards creating inclusive, affordable and world class eye care service for the betterment of the community.
Q: With your long-standing association with Arvind Eye Care for over 35 years, how have you enjoyed the journey so far?
Dr. Nam: We started in a small way and didn’t imagine that we are going to grow this well. We were just sitting there to give a job to each other. But with Dr. Venkataswamy, the founder’s connection with the community, the organisation grew very rapidly, and so much demand arose from the community that we could satisfy only by growing. It was one thing leading to another. When there was demand, we had to supply. In order to supply, we have to grow and produce all accessories needed to satisfy the demand. HR development & community expansion came gradually. I sure have enjoyed the entire journey along with the challenges it offered.
Q: Arvind Eye Care’s motto has been that no patient should be turned down because of lack of money. What are the major factors that have helped Arvind Eye Care to live up to this expectation in spite of inflation & increasing number of patients?
Dr. Nam: The basis of our organisation is ‘work with the community & work for the community.’ Just because people don’t have money, they should not be devoid of access to vision. The biggest problem was that people in rural areas would say “we don’t have money. We are all from poor families. We don’t have anybody who can take us to the hospital. If we come to the hospital, we will lose our daily wages for another week”. These were our obstacles. We had to find a way to support them.
We started working with people who could afford to pay and the money generated from them was used to help those who couldn’t. We gave them all support such as free food/free stay/ medical support and even dropped them back at their homes in villages. We tell those who can afford that because they can afford to pay and are staying in a private room, the cost will be 5-6 times, but they will be next to free patient during surgery”. This improved the quality of performance, productivity & numbers. The system is transparent; we tell them upfront about this. Hence, this system satisfies both the needs
- The affluent patient understands and sees that the money they pay goes towards charity
- The not so well to do patient knows that there is no difference in quality because it’s all equal – same operation room and surgeon and same output – good vision
Some of the work in eye care does not seem to require much skill except those in surgical procedures. So we thought why not train non-medical people to help in these supporting activities that not only gives them a job but at the same time can relieve the doctors of these peripheral duties. Now we have 3000 such people helping us, all girls who have graduated from high school and hail from the same region. We don’t advertise for jobs, those who have been with us for years bring such candidates because they have respect for their jobs. The clients – our patients and girls who serve are from the surrounding region, hence share a good relationship.
Regarding equipment, we have to keep pace with state of the art technology. It may cost more, but also needs a little thought, for instance, in the same operating room, two doctors work instead of one. We line up 20 types of equipment so that more patients can be served. This becomes cost effective but never at the expense of quality. We also consult management professionals for quality control. We also have a Master’s program in hospital management.
You might have also come across that we are one of the very few hospitals that manufacture consumables in the same campus. Initially, we used to get imported lenses from the USA at a subsidized rate, but even that rate of $60-$70/lens was unaffordable because we operate 200,000 times a year. With technological know-how and well-trained staff, we started manufacturing those lenses. Now the lenses cost $3 that quality certified. All these initiatives are a result of innovation that helps us adapt to different circumstances for the betterment of the community.
Q: A significant percentage of blindness can be treated by eye donation. How do we as a society embrace eye donation?
Dr. Nam: In India, ~20 million people are in need of eye transplants. But it is a misnomer that eye transplant can be used for everyone. Only if the black portion of the eyes – cornea is damaged, it can be replaced with another cornea. People are unaware that eyes may be utilised after death. However, now eye donation is catching up. There is yet another challenge to this. Many youngsters are signing up for eye donation. The intention is noble but if they sign up when they are 20, and if they pass away at 80, it’s hard to trace them. Sometimes their spouses/dependents might not agree to the procedure. Basically, we want to spread the message that eyes can be donated at any age, especially for cornea transplants. The only caveat is that the process needs to be done within 6 hours of death.
Q: What are the changes you would like to see in the Indian healthcare industry in the short and long term? What should the Government do to improve the sector?
Dr. Nam: One Govt. program which has been very helpful is the NPCB – National Programme for Control of Blindness. It was a very successful project. It was started with assistance from the World Bank and continued for 10-15 years. Cataract which was the leading cause of blindness was being managed with just 15,000-100,000 surgeries/year across India. But now we have reached a stage where we are performing 5 million operations/year across the country, because of this. The Govt. of India has taken over this and is still continuing to give the sort of allowance. Even private hospitals are performing free surgeries & conducting free eye camps. This kind of an actual transparent subsidy definitely helps. However, healthcare system as whole still needs a little more impetus to rise to the level of other countries.
Dr. Nam signs off by elaborating on the significance of management professionals in the hospital management space