Dyson College of Arts and Sciences

Aravind: A Brief History In 1976, Dr. Govindappa Venkataswamy, affectionately known as "Dr. V." to colleagues, patients, and friends, retired, at age 58, as Head of Ophthalmology at Madurai Medical College, a government institute in the south Indian state of Tamil Nadu. At this point Dr. V., who retained the energy of a much younger man well into old age until his death in 2006, decided to develop a venture to help the poor deal with eye-care problems such as cataracts and other preventable causes of blindness. Along with his sister and brother-in-law, he started a clinic in Maduri, the city where he had spent most of his career. Inspired by the teachings of Sri Aurobindo, one of the great Hindu sages of south India, Dr. V. decided to call his organization the Aravind Eye Hospital. Initially the clinic had eleven beds, but it grew very quickly along with its reputation for high-quality, compassionate, affordable eye care services available to anyone, regardless of their ability to pay (Sezgi & Mair, 2010). As it nears four decades of operation, Aravind comprises a network of five regional hospitals that perform over 400,000 cataract operations per year, the vast majority of them at little or no cost to the patient. According to Aravind's latest annual activity report (2015), each day the hospital system sees a total of about 15,000 patients and performs around 1,500 surgeries. Though Aravind provides an entire range of eye care services from primary eye care to tertiary eye care, the system's surgical capacity has gained it international renown and a reputation as the world's most productive eye care facility. As per the World Health Organization, there are about 314 million visually impaired people worldwide, of which about 45 million are blind. Approximately 87 percent of these individuals live in developing countries such as India, where over 12 million people are visually handicapped (WHO, 2009). To tackle this issue, Aravind has developed a high-volume approach, combined with low costs, to treating diseases of the eye such as cataracts. For instance, during the one-year period from April 1, 2014 to March 31, 2015, the Aravind Eye Care System saw 3,522,527 patients and completed 401,529 surgeries. Of these, 198,423 surgeries were paid surgeries, about 49.4%. The remaining 203,106 surgeries, about 50.6%, were either subsidized by the hospital (110,290 / 27.5%) or provided at no cost to the patient (92,816 / 23.1%). Table 1 provides further details on Aravind's patient statistics. The core of Aravind's high-volume/low-cost approach is a unique network structure which allows the organization to reach a large rural population in Southeast India via innovative operational processes and social marketing techniques. This is a population which, for the most part, does not have access to funds for transportation to regional hospitals. By providing these patients with transportation services, Aravind facilitates the development of scale economies in its patient care. Additionally, at the primary care level, careful screening and triage reduces patient variability at the specialized treatment centers, which further facilitates the development of high-volume care. Finally, Aravind also facilitates cost reductions by integrating in-house production facilities for supplies and process innovation into its operations. It has created systems for developing, managing, and retaining specialized medical personnel, a critical skill in a sector which sees high turnover. When taken together, these elements, combined with the organization's financial sustainability and a lack of reliance on donors, makes it one of the leading hospitals and social enterprises in the world (Sezgi & Mair, 2010). Understanding how these elements help Aravind develop a strong degree of organizational resilience (Ortiz-de-Mandojana & Bansal, 2015) has the potential to provide important lessons for organizations in the health care sector and more broadly, including organizations using a social enterprise model (Chowdhury & Santos, 2010; 20

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