Aravind Leader Challenges Perspectives

Kellogg’s international leaders, from left: Jonathan Trobe, MD, Paul Lee, MD, JD, Thulasiraj Ravilla, Joshua Ehrlich, MD, MPH, Christine Nelson, MD, and H. Kaz Soong, MD
Kellogg’s international leaders, from left: Jonathan Trobe, MD, Paul Lee, MD, JD, Thulasiraj Ravilla, Joshua Ehrlich, MD, MPH, Christine Nelson, MD, and H. Kaz Soong, MD

 The University of Michigan and the Aravind Eye Care System, India’s largest private eye care hospital, have collaborated to cross-train providers, researchers and operational leaders through a partnership that dates back nearly 40 years. This year’s International Night attendees heard from Aravind’s Director of Operations, Thulasiraj "Thulsi" Ravilla. His remarks, titled “Eliminating Needless Blindness—It’s All About Perspectives,” challenged us to see the delivery of vision care services in a new way. 

Thulsi is also Executive Director of Lions Aravind Institute of Community Ophthalmology, Founder and President of Vision 2020 India: The Right to Sight, a global initiative for the elimination of blindness, and a visiting scholar at Michigan in 1982. After nearly four decades in the field, he has concluded that how you view a health problem like cataract-related blindness drives the design of services to address that problem

In developing nations, Thulsi estimates that for every patient that seeks care, four or five do not, and for every patient who receives treatment advice, as many as half may not follow through with the recommended surgery, medication or glasses. Changing these statistics requires a dramatic change in perspective, he argues. “If you don’t own the problem, you won’t make a difference.” 

The success of Aravind in India is a story of owning the problem. Thulsi described how Aravind has transformed their approach to these issues by eliminating barriers to care, including rethinking the costs of care to better reflect opportunity costs—food, transportation and lost wages—and how the hospital views the delivery of care as a moral imperative.

As a result of countless evidence-based innovations touching every aspect of the organization, Aravind has revolutionized the delivery of eye care in India, with programs such as community-based eye centers run by technicians, linked by telemedicine to physicians. Remarkably, in the process, the organization has become financially viable, funding continuing growth through substantial savings. “By doing good,” says Thulsi, “we are doing well.”