Millions of Indians get their sight back for free thanks to solidarity surgery

Dozens of Indians in green hospital gowns wait patiently before benefiting from a cataract operation which will allow them to recover their sight for free thanks to a solidarity chain of ophthalmologists inspired by the industrial model McDonald’s, king of the hamburger.

Founded in 1976, with only eleven beds in Madurai, in the state of Tamil Nadu (south), the ophthalmology chain Aravind now performs half a million surgeries per year, mostly free of charge.

The Aravind system, developed by retired ophthalmic surgeon Govindappa Venkataswamy, is based on the principle of generating very large volumes of surgeries in order to reduce costs, such as hamburger sales at McDonalds.

The doctor had discovered the economies of scale of the fast food chain during a visit to his “burger college” in Chicago.

“If McDonald’s can do it for burgers, why can’t we do it for eye care?” he had said then.

According to the WHO, of the 38 million blind people in the world in 2020, 8.9 million were in India, where blindness is largely attributed to cataracts (clouding of the lens) but also to infectious diseases such as trachoma.

Blindness is perfectly preventable, in the case of a cataract which “is corrected by a simple surgical intervention”, assures Thulasiraj Ravilla, one of the founding members of Aravind.

– Poor in rural areas –

But the pride of the company lies in the itinerant eye consultations available to the most disadvantaged, when nearly 70% of the Indian population lives in rural areas.

“Access (to care) is our main concern, so we provide treatment to the population instead of waiting for them to come and ask us,” Ravilla adds to AFP.

These free consultations have changed the lives of many Indians. Like Venkatachalam Rajangam, 64, who had to give up his job in a grocery store because vision problems made his activity impossible.

But one day, he learned that an Aravind eye consultation was opening near his village in Kadukarai, 240 kilometers from Madurai. He went there and doctors diagnosed him with cataracts in his left eye.

He was taken on a bus with around 100 other patients to the vast Madurai site, where he was taken to hospital.

The next day, he underwent his surgery. “I thought the operation would take an hour, but in 15 minutes it was all over. Yet I didn’t feel it was sloppy. The procedure went smoothly,” Mr. Rajangam recalls, smiling. , just after removing the bandage covering her eye.

“I didn’t have to spend a single rupee (…)”, he exclaims, clasping his hands in gratitude.

– Ingenious development –

According to Aruna Pai, ophthalmic surgeon at Aravind, doctors are specifically trained in rapid and rigorous surgery. Depending on the hospital, the complication rate is less than two per 10,000, while it ranges from 4 to 8 per 10,000 in Britain and the United States.

“We have training labs where we are taught to operate on goat eyeballs. It helps us hone our skills,” says Pai, who performs about 100 operations a day.

Instead of relying on charity or government grants, Aravind uses the income generated by care and consultations paid for by patients who can afford it to cover the treatment of the poor.

The Aravind network also derives significant revenue from the sale of implants and drugs that it produces today, having developed ingeniously. It also has a multitude of specialized care centers, as well as community clinics.

The group is further reducing costs by manufacturing intraocular lenses for the treatment of cataracts itself in its Aurolab production unit, which produces more than 2.5 million lenses per year, six times cheaper than those previously imported from United States.

 
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