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Aravind Eye Care System
Aravind Eye Care System was started by Dr.GovindappaVentkataswamy in South Indian State as an eye clinic in 1976 with only eleven beds. Initially it was called Aravind eye hospital that only treated a few individuals. It was expanded to provide total eye care due to visual problems and other eye related complications especially in Indias rural areas. By 2010, it was the worlds largest provider of eye care services. By 2010, it was receiving over six thousand outpatients, performing close to a thousand surgeries and having about five outreach camps. The facility was expanded to include five hospitals performing close to three hundred thousand surgeries annually and it helped to restore vision to many people (Velayudhan, Sundaram, & Thulasiraj, 2011).
The facility has increased both in the range of eye care services provided and area of operation. Eye care services include ophthalmic equipments and an eye bank. There is also a research foundation dealing with outreach programmes, primary and secondary eye care. Aravinds used an approach of providing quality eye care services at affordable price both to the poor and the rich. Revenue generated by a third of the patients was used to provide free eye care to the other two-thirds. This approach was aimed at restoring sight to many, eliminating blindness and providing eye-care to all (Velayudhan, Sundaram, & Thulasiraj, 2011).
Services offered increased over time to include specialities treatments such as glaucoma, cornea and retinal disorders, neuro-opthalmology and low vision. In addition, it included community outreach programmes composed of eye-screen camps. Five screening camps were organized in each district every month. There were several camps including paediatric camps, workers screening camps, diabetic retinopathy camps and comprehensive eye screening camps (Ramani, Mavalankar, & Govil, 2008).
Prices for eye-care services were competitive where costs were much lower comparing to hospitals in India. Consultation fee was INR50, cataract surgery at between INR 4,100 and 6,000. Those not able to afford are waived. The optical shop in the hospital also charges less than other optical shops. The very poor who attended the camps were provided with free transport, food and post-operative medications.
Aravind approach was efficient in that the levels of productivity were high because of the number of people, volumes and technology. High quality services at a large volume are sustainable since it involves low cost. Paramedics were recruited based on their ability and attitude and given quality training. Doctors and surgeons productivity was better than in any other hospital. Counsellors were helpful to patients in making choices related to costs and treatment (Ramani, Mavalankar, & Govil, 2008).
Planning for expected patients was done on a yearly basis, monthly and daily to ensure the availability of resources. Technology including means of communication and computers helped save time. The hospital had seven base hospitals, five community eye clinics and thirty six vision centres. Aravind had introduced better salary packages for the doctors.
In India for every one hundred people there was only one eye doctor. A national programme for control of blindness was launched in 1976 to reduce blindness prevalence. According to a survey in 2001/02, blindness prevalence was at 1.1%.
India population was prone to blindness due to diabetes and cataracts each accounting for 60 and 50 per cent respectively. Many patients were afraid of surgery and did not know that blindness could be cured. Even though surgeries to the poor were free, some did not attend due to transport costs and unfamiliarity with the town. Men were more likely to attend the camps than women. Aravind developed a delivery model that was comprehensive with services at the base hospital, community centres, screening camps, vision centres and mobile units (Mehta, & Shenoy, 2011).
Base hospital was also a training centre providing secondary and tertiary services. Community centre clinics reached consumers in the outlying areas. Vision centres worked within a five kilometre radius. Eye screen camps concentrated their activities in the rural areas while the mobile units required vehicles.
Early 201, Aravind launched a mobile refraction unit to enable address refractive errors in the rural areas. Announcing eye-screen dates was done using loudspeakers or through word-of-mouth. The community outreach programme created awareness on the importance of eye-care through education. Outreach methods included posters, loudspeaker announcements and handbills (Rangan & Thulasiraj 2007). They organized camps and searched for sponsors to support the camp.
They devised intervention strategies for increasing acceptance and awareness for cataract surgery. It included health education approaches and economic incentives such as free transport, eyeglasses and meals. After the interventions, cataract surgery was accepted in those communities. In spite of huge outreach, the uptake in the rural communities remained low, hence, a need to examine how to bridge the gap. Overcoming this, it required awareness creation on the importance of eye care among the rural population.
To sponsor an eye-camp, organizations or individuals were required to follow some guidelines. Such organizations included rotaries, industries, banks and religious groups. Their role consisted of setting up the campsite, publicising, volunteering to look after publicity, delegating and arranging facilities. They were also to arrange for transport between the campsite and the villages. For an area to be identified as a campsite, it had to have a population of between thirty to fifty thousand people.
In conclusion, in organizing for a mobile refraction unit, sponsors were to provide space, organize for power supply, rally local people and help during the activity. On the other hand, Aravinds role was to transport the medical team and incur all costs that are related to refraction unit.