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The Partnership of Aravind Eye Hospital and Seva Foundation

Larry Brilliant, Seva Co-Founder

I don't think that in my life I have witnessed such a great success as smallpox eradication and the birth and growth of our event.

Dr. Larry Brilliant had a key role in the smallpox campaign. But it was the upstart Aravind clinic and its founder, Dr. G. Venkataswamy, that inspired an enduring campaign against blindness.

He was one of the world's first successful social entrepreneurs. And what a success it was. When I first met him he had 12 beds in his home, treating patients. And now, Aravind will see in excess of a million patients a year, and has given back sight to more than two million, three million blind people. It is a success on a scale unimaginable.

Their association began soon after the successful smallpox effort in India. Brilliant and a group of colleagues and friends were looking for their next public health cause.

Larry Brilliant

So there were about 30 people. And they included Leslie Kish, who was a professor of statistician, and Steve Jones, who had just come from CDC, Nicole Grasset, who had run the smallpox program for WHO, a lot of other scientists. But there was also a clown, Wavy Gravy. And there were a lot of counterculture superheroes.

And we decided that what we would do was to try to build a foundation. Now my wife and I had written an article called Death For a Killer Disease in a national magazine. We talked about how hard it was to eradicate smallpox. And readers had sent us money, envelopes with cash in the envelopes, $25,000.

That and other donations seeded the Seva Foundation which, in turn, quickly embraced the fledgling Aravind clinic and its founder, Dr. Venkataswamy. He happened then to be visiting America, a man early Seva members like Suzanne Gilbert came quickly to revere.

Suzanne Gilbert, Seva Co-Founder and Senior Director of Seva's Global Sight Initiative

At that time I was working at the University of Michigan. I was at the medical school, and I planned continuing medical education programs. And Dr. Venkataswamy was very interested in this. And he just, in the middle of a sandwich at lunch, said, "You should stop your research, and you should now focus on why people are not coming to get free cataract surgery at our event."

And it really rung true for me that he was a person who was going to create enormous change in India, a country I dearly love. And I started being a volunteer with Seva and Aravind right from that day forward.

So the partnership thrived. A group of counterculture American medical scientists and an ascetic elderly Indian doctor, who reconciled spirituality and science, and a man who also talked incessantly about McDonald's.

Larry Brilliant

Oh, he hated it. Every time he would talk about the model for Aravind, he would talk about assembly line medicine like McDonald's. And we joked, because every time he stood up to speak it would be about McDonald's. He actually went to Chicago and attended Hamburger University, McDonald's program management training program.

But what he really meant was that when there are eight million blind in India, and they have their name on a waiting list, many of them will die before they're operated on, unless you have programs that are as efficient as McDonald's.

And he used to say, "What kind of a world is it when we can deliver a hamburger to the most remote place in the world and we can't deliver eyesight?"

Suzanne Gilbert

And that led to Girija Brilliant and Larry Brilliant designing a study and conducting it in the late '70s to help eliminate the barriers to a poor person partaking of a free service.

Free services are not free. People have to have an escort if they're blind. Someone has to leave their work for a day or two. Or back then it was for over a week. There's the issue of transportation.

What evolved were Aravind's hallmark outreach programs that bring services to people in villages and transport and other assistance for those who need surgery in the hospital, all this alongside efficient businesses delivering topnotch eye care and producing the intraocular lenses used in cataract surgery.

Suzanne Gilbert

Where Seva and Aravind have worked very closely together is developing the system's internal to Aravind for its training.

Larry Brilliant

I think there's a great deal that we can learn today in America, as we debate health reform, from Aravind.

The difference between five hundred dollars and a dollar is huge. And what creates that difference is the profit, the middlemen, the distribution system, the marketing, the advertising, the detail men and women who call on ophthalmologists, the branding of it. It isn't just the cost of the plastic.

So when we look at the cost of healthcare we don't realize what a high percentage of the cost of our surgery or our advanced imaging is due to branding and advertising, packaging. Aravind stripped all of that away.

But the end product was as good at Aravind as it was anyplace in the world. And the cost was two orders of magnitude less. That's a huge lesson for planners today in the United States.

Larry Brilliant was included in Time Magazine's 100 most influential people in the world. He spent recent years at foundations, now at the Skoll's Urgent Threats Fund, before that at google.org. But it was the tiny Seva Foundation he helped start that hit the jackpot.

Larry Brilliant

You know, for the Seva Foundation, or for any foundation, the highest and the best accomplishment you could ever hope for is that you find a project that you give grants to, that you put your heart and soul into. And it grows up and it becomes, not only great, but self-reliant, not only self-reliant but bigger and better than you are. And that was the case with Aravind.

Aravind, Dr. V., Tulsi and his family, surely if there is a hall of fame for social entrepreneurs and for the good guys, they're at the front of the list.


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