The inspiration, Dr. V says, comes from McDonald’s. He first discovered the golden arches at the age of 55 and it changed his life.
“In America, there are powerful marketing devices to sell products like Coca-Cola and hamburgers,” he says. “All I want to sell is good eyesight, and there are millions of people who need it…If Coca-Cola can sell billions of sodas and McDonald’s can sell billions of burgers, why can’t Aravind sell millions of sight-restoring operations…? With sight, people could be freed from hunger, fear, and poverty.
“In the third world, a blind person is referred to as ‘a mouth without hands,’” says Dr. V. “He is detrimental to his family and to the whole village. But all he needs is a 10-minute operation. One week the bandages go on, the next week they go off. High bang for the buck. But people don’t realize that the surgery is available, or that they can afford it, because it’s free. We have to sell them first on the need.”
The hospital picks up the tab for those who can’t pay. Paying customers are charged 50 rupees (about $1) per consultation and have their choice of accommodations: “A-class” rooms ($3 per day), which are private; “B-class” rooms ($1.50 per day), in which a toilet is shared; or “C-class” rooms ($1 per day), essentially a mat on the floor. Paying customers choose between surgery with stitches ($110) and surgery without stitches ($120).
Since he began, his eye hospitals have restored the sight of more than one million people in India. Even with such tiny revenues per patient, Aravind makes a profit, with a gross margin of 40%. One operation is completed; another is begun right away. It is apparently a very efficient and productive enterprise.
Aravind now does more eye surgeries than any other provider in the world, though it accepts no government grants. The hospitals are totally self-supporting. Nor does Dr. V. try to hustle a profit from the enterprise for himself. He lives on a pension, taking no money out of Aravind.
Dr. V. is helping the poor in a big way. But he also helps them in a way very different from the typical world improver. He sees them as individuals.
“Consultants talk of ‘the poor,’” he says. “No one at Aravind does. ‘The poor’ is a vulgar term. Would you call Christ a poor man? To think of certain people as ‘the poor’ puts you in a superior position, blinds you to the ways in which you are poor – and in the West there are many such ways: emotionally and spiritually, for example. You have comforts in America, but you are afraid of each other.”
Dr. V set out only to do eye operations…quickly and cheaply. The world improvement came – as it always does – as a by-product of private action. In Tamil Nadu state, where his main hospital is located, the incidence of blindness is 20% below the rest of India.