Started by Dr. G. Venkataswamy, Aravind Eye Case System was created with the idea of creating a sustainable eye care system. The mission if AECS was to eliminate needless blindness. They wanted to provide quality eye care that everyone could afford, to rich and to poor alike. It expanded itself to multispecialty eye care. AECS charged usually lower than comparable hospitals in its payable section. They followed the principle of high volume which would in turn also supplicate high quality in eye care. For patients who came in the free section, they were provided free treatment for most procedures that did not involve expensive supplies.
They were charged a nominal amount of Rs750 for the cataract surgery. For those who could not afford even that, theses charges were waived. They approached eye care in a unique way. Instead of using expensive equipment they perfected their own versions of surgeries, thus ensuring that the best and quick treatment was offered to their patients. The doctors and AECS performed far more surgeries than their counterparts in other hospitals due to this. They also trained paramedics in performing preliminary tests and assessments thus reducing the load on the doctors and ensuring that more patients could be treated.
Aurolab was established to produce quality products at affordable cost. AECS also ran community eye clinics, vision centers and community outreach programs. They valued their personnel. They hired young women to be paramedics. AECS organized 4-5 eye screening camps in a district every month and offered free treatment to almost 67% of the patients with the help of aid from NPCB. Glasses were provided in the camp itself or delivered in a week’s time. Those who needed surgery were taken to the hospital, offered free lunch. Follow up camps were organized as a part of the out-patient check up program.
They worked with the community leaders and service groups to create a sense of ownership. They partnered with organizations as Lions, Rotary, education institutions etc to sponsor the camps. The World Diabetes Foundation funded a mobile unit for eye checkup. AECS also launched a mobile refraction unit. The community outreach program created awareness of the importance and need for eye care. Issues faced by AECS: In spite of the outreach work, not even 10 percent of the population who needed eye care attended. The people in the rural areas did not prioritize eye care. They had fear of surgery.
The cost of time was also a factor. They did not consider treatment in old age to be worthwhile. Also, they believed it was god’s will that they were losing their eyesight and they didn’t want to interfere with it. They also believed they could cope up with the low or no vision. What AECS did: Former patients were recruited and trained to motivate people with cataracts to have surgery. House to house visits by a basic eye health worker and former patients. Screening camps at a central location in the village. Campaigns by field workers to encourage people to get their eyes checked.
Free transportation to and from the hospital and free food. Free glasses. Free surgery. Publicity boards on street corners, shop hoardings, bus stops, loudspeaker announcements, announcements on cable TV, referrals through local doctors, teachers, NGOs, village leaders. Solution: To further improve the attendance at the eye care camps, AECS could do the following: Engage respectable and influential people (RMPs, Primary School Teachers, Sarpanch, Village Heads) in the community and convince them to impart the importance of eye care to the people in their villages.
The people need to be educated in such a way that they understand the negative effects of not getting timely eye care, thereby invoking a sense of urgency. Steps must be taken to ensure awareness about the ailment and the medical care are imparted at the right time and place. There needs to be a behavioral change when it comes to health. The behavior needs to be changed in such a way that it instills a ‘health seeking’ mentality among the target population.
The priority for eye healthcare should also be advocated along with basic health awareness programs. Educating school going children would also act as a feasible option as children can also play an effective role as ‘influencers’, who could then educate their family members thereby making them attend the health camps. If one of the village influencers were themselves to be recipients of the treatment, their message would be even more powerful as peer communication adds value and credibility to the entire process thereby eliminating existing inhibitions regarding the same. Another hindrance is the cost of time.
The villagers need to be educated on how much they would lose if their eye sight were affected as opposed to just the one day of wages that would be lost during treatment. AECS could also follow a community building activity. A database could be maintained of patients. These former patients could be encouraged to form a community to act as strong influencers in their respective communities. During the camps they could be trained to be volunteers and to encourage participation from the rest of the community at these camps.
Seeing people from their own community being a part of the camp organization would inculcate a sense of ownership which would lead to increased participation. As data from the previous year showcase that about 90% of the camp attendees are male, former women patients should be made to feel that they would be playing an important role to play ‘influencers’ in making the women patients attend the eye camps thereby making sure that the womenfolk also get the needed services. Incentives should also be given to the women influencer who would act as a good motivating factor.