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REACHING OUT

Visionary goals

What began as a small community eye care movement in Coimbatore has now grown into an outreach model being replicated across the country. K.V. PRASAD profiles the beginnings and growth of the Sankara Eye Hospital.

K. ANANTHAN

Eye care for the community.

IN Sanskrit, "Shamkarothi ithi shankaram" means "Do not wait for the suffering to come to you. Go in search of them and do what you can". This statement was the starting point of a community eye-care movement in Coimbatore. Begun in 1985, to eradicate preventable and curable blindness and provide free eye care, including surgery, to the rural masses in and around Coimbatore, it grew into a significant outreach programme, winning nation-wide acclaim.

Its success in the Coimbatore region, and subsequently across Tamil Nadu, led to the demand for prototypes elsewhere in the country. The first replica of the Coimbatore model, that includes a full-fledged super speciality hospital for eye-care, has now been established at Guntur in Andhra Pradesh. Four more — at Bhadravati in Karnataka, Gandhinagar in Gujarat, Uttar Pradesh and Madhya Pradesh — are on the anvil.

Looking ahead

Nineteen years since its launch, the Sankara Eye Hospital, run by the Sri Kanchi Kamakoti Medical Trust, is set to cover the nation in its march towards achieving its goal of "Vision 20/20 by the year 2020".

In 1972, a young doctor couple, with a thriving private practice ahead, preferred to look beyond material benefits. They saw many poor people in search of elusive primary health care. While they treated poor patients free of charge, they searched for a platform from which to launch community healthcare.

In 1977, the Kanchi Kamakoti Peetam planned to open a small dispensary on the premises of the Kamakshi Amman Temple at R.S. Puram in Coimbatore. The couple, R.V. Ramani and Radha Ramani, offered free medical service. But they needed a bigger team. They found 10 others and the Sri Kanchi Kamakoti Medical Centre was born with five rupees as corpus.

In 1982, the Kanchi Kamakoti Medical Trust was formed. Dr. Ramani, the Managing Trustee, says that 1,000 poor patients were treated with the help of five other doctors. Primary health care was extended till 1985 when the trust decided to specialise in eye care.

The Honorary Director of the Trust and ophthalmic surgeon, S. Balasubramaniam, stressed eye banking. "Thus was born the Sankara Eye Centre. We needed a bigger place. Nataraj and his family, our neighbours, gifted us 5.6 acres of land on which our hospital now stands," says Dr. Ramani, who won the "Role Model of India" award for community eye care from the Basic Research, Education and Development Society in 2000.

Efforts to establish an eye bank began amid pessimism, owing to failure of similar efforts elsewhere including Chennai as early as in 1947. "I realised that communicating the importance of donor eyes to the masses was vital," says Dr. Ramani. He coined the slogan: "Miracles cannot cure the blind, you can."

The initial pairs of donor eyes came from Gujaratis and Jains. "Today, we receive a pair of eyes every day and the Government has named ours as the model eye bank for the country."

After "eye banking" became a success, the trust turned its focus towards quality eye care.

It embarked on the "Gift of Vision" programme along with the Rotary Club of Coimbatore Central. Rotary International provided equipment worth $ 145,000. Between 1990 and 1995, Gift of Vision treated 1.2 million rural people with visual defects.

"The Tulsi Trust, based in Mumbai and Nigeria, and the U.K.-based Sight Savers International joined us as permanent patrons. G.V. Easwar, a major contributor, became the Chief Patron. We raised $ 250,000 from philanthropists and covered another 1.8 million visually impaired. Rotary International rated this as among the top 10 projects world-wide."

More patronage

The California-based Sankara Eye Foundation, formed in 1998, brought more patronage for the movement. It even conducted concerts with the theme "Open an eye a month" (through liberal contributions). Now, another has been formed in the U.K. to mobilise support from Indians in Europe.

Dr. Ramani says the trust did not want to conduct eye camps out of academic interest. So, outreach got a new direction. "We went to the community, identified patients who needed surgery, provided them with identity cards and brought them to the base hospital in Coimbatore for the surgery. Transportation, stay and food is still provided free of cost. Improvement in quality is reflected in 90 per cent of the patients undergoing sutureless, small incision phaco surgery."

As for follow-up, the condition of every individual patient, even from the farthest camp, is monitored. "Post-operative follow-up is vital. Else, the purpose of the movement is lost."



The team behind the venture.

As part of preventive eye care, the movement has been focussing on school children since 1988 under the "Rainbow" programme.

"We found that six per cent of the school-going children had undetected visual defects. Now, two million children have been covered. We helped Maharashtra and the state of Lagos in Nigeria conduct similar programmes."

Focus on children

Later, it was decided to get into micro-level planning on "Rainbow" — to break it up into programmes for specific age groups. While this programme focuses on the 6-15 age group, "Swagatham" looks at the zero to three age group and "Maithri" at the three to six age group. "Swagatham", in association with the Coimbatore Corporation, screens newborns for visual defects.

Persistent calls to replicate the base hospital and its activities in other places resulted in one being opened at Guntur in Andhra Pradesh a few months ago with 75 per cent funding from Non-Resident Indians and the balance from within the country. "We expect Guntur to exceed our expectations," says P. Janakiraman, Honorary Director of the Sankara Eye Hospital at Pammal, Chennai, and Honorary Consultant in both Guntur and Coimbatore. "Since the hospital was opened at Guntur in May, 200 surgeries a week have been performed. It reflects public faith in the movement." The Guntur hospital's target is 10,000 free surgeries a year.

Besides the hospital at Pammal, where 15,000 free surgeries are performed every year, there are three sectoral headquarters in southern Tamil Nadu to facilitate follow-up on operated patients: Thanjavur, Kallakurichi and Krishnankoil.

A private trust at Krishnankoil handed over its eye care centre to the Kanchi Kamakoti Medical Trust last year. Named "Krishnarpanam", it also aims to perform 10,000 surgeries a year. "Already, the Coimbatore hospital performs 50,000 free surgeries a year for intra-ocular implant," says Dr. Ramani.

Towards self sufficiency

Dr. Ramani appreciates the contribution from patients who pay. "We charge Rs.6,000 to Rs.14,000 from patients who can afford to pay. The charge varies depending on the facilities they use and the type of lens they opt for. Each paying patient actually funds the surgery of a poor patient. It also helps us towards financial self-sufficiency. We have not yet reached break-even stage. With paid surgeries, we hope to reach it."

Dr. Ramani says the hospital has technology and expertise comparable with the best in the world. "Our Assistant Director, J.K. Reddy, has won worldwide acclaim for Deep Lamellar Keratoplasty and Keratoprosthesis".

In the hospital visitors' book, President A.P.J. Abdul Kalam's words stress the purpose of the movement: "Giving light to the blind is the greatest service to humanity."

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