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Making Breakthrough Innovation Happen: How 11 Indians Pulled Off the Impossible
Author: Porus Munshi
Publisher: Collins Business
Pages: 236
Price: Rs. 299

Our February edition featured Jugaad Innovation: Think Frugal, Be Flexible, Generate Breakthrough Growth which presented an entirely new and exciting approach to growth and development in India by encouraging Jugaad- innovation at the grassroots.

The book featured this month also revolves around the idea of innovation and presents 11 ground-breaking stories across sectors and regions in India which are immensely inspiring. According to the author, each of the 11 innovations highlighted are extraordinary because they had “shifted their industry’s or sector’s orbit in some way”, defied conventional wisdom and “blazed their own path”.

One such story is that Dr. V and his mission at the Aravind Eye Hospital to eradicate blindness to the extent possible through medical intervention.

Steve Jobs of Apple often speaks about ‘making a dent in the Universe’. But what does it take to do so? To find out, you don’t have to go to Cupertino, California. Just go to tiny Madurai in Tamil Nadu. There you will find a thirty-two-year-old institution that is truly, in Job’s words, denting the world.

Aravind Eye Hospital is internationally recognized as an institution best suited to make not just a dent, but a grand canyon in the world of blindness. There are nearly twenty-four million blind in the world. And nearly one-third of them are unnecessarily blind, which means that they don’t have to stay blind; a medical intervention an treat them. But the intervention in many cases requires surgery. And there just aren’t enough doctors to go around.

Instead of increasing the number of surgeons to cope with the problem of unnecessary blindness, Aravind decided to find ways to increase a surgeon’s productivity. And it has perfected an assembly-line technique of surgery that increases this productivity by a factor of ten. It has also developed such a cost-effective revenue model that thousands of blind poor can be operated on for free or nearly free. Revenues are generated from a small percentage of paying patients.

What’s remarkable about Aravind is that only 30 per cent of its patients pay. And that they pay less than what they would pay elsewhere. The remaining 70% are treated free or almost free. The remarkable becomes astounding when you realize that this is not a small mom-and-pop charity establishment. It’s a full-fledged business that makes a 35 per cent operating profit (all profits are ploughed back into expansion, as Aravind is a not-for-profit institution), treats 2.4 million outpatients and does 286,000 cataract surgeries every year. This makes it by far the largest ophthalmological institution in the world. It is by also one of the most respected, with students from Harvard, John Hopkins, Yale et al coming to it for training and exposure.

Aravind follows a unique business model. It takes its inspiration from STD-booth owners and Xerox-machine operators. Both these small businesses make money on numbers while serving the community’s need for such services. The unit profit margin is low. But this is made up through enormous volumes. Aravind’s business feeds on a virtuous cycle. The more surgeries Aravind does, the more effective it becomes. And the more effective it becomes, the more its reputation grows, bringing in more patients- paying or otherwise.

How did a small-town hospital in one of the quietest corners of India become such a global lighthouse?

Beginning with a Dream

It all began, as most world-denting projects do, with a dream: to eliminate unnecessary blindness in India. This was the dream of a frail, retired professor of ophthalmology at Madurai Medical College.

Dr. Govindappa Venkataswamy, or Dr. V, as he is called, wanted to be a gynecologist after three of his cousins died in childbirth at a young age. But just as he was starting off his career, he fell ill and was bedridden for two years with crippling rheumatoid arthritis. Many thought he would never walk again, much less be a surgeon. But this remarkable man not only left his bed, he also slowly, inch by painful inch, taught himself surgery all over again.

As Dr. V’s fingers were crippled, the usual surgeon’s instruments were of no use to him. He had to devise instruments specially for himself so that he could hold them. He realized he couldn’t do the heavy surgical work required in gynaecology but rather than give up and sink into despair, he took up ophthalmology and went back to medical school. After graduating, he joined government service and then went into teaching. Treating unnecessary blindness became a passion with him. As a professor, he along with his students and colleagues, pioneered rural eye camps in India. His team would go into villages around Madurai and operate on people who had lost their sight due to cataract.

While engaged in this, Dr. V realize that he was doing more than just restoring sight. He was literally extending the lifespan of those he treated. In those days, a blind, elderly person was considered a mouth with no hands and was not looked after too well. As a result, life expectancy after blindness was literally a death sentence. With Dr. V’s surgeries and the restoration of sight, these people went on to live productive lives for many more years.

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