Ask anyone at one of India’s Aravind Eye Hospitals and they’ll tell you that their system for eye care doesn’t start at their well-equipped tertiary hospitals. Yes, these exemplars of clinical and operational precision may support the finest ophthalmologists with the greatest efficiency. However, the entire organization is for naught if it can’t receive any of the 12 million blind people sequestered in their homes spotted around the country into their waiting rooms. Aravind begins in the country in its eye camps.
Think of the camps as a traveling circus. They load their handful of materials in a brightly colored van and then begin across the country side to a new place every weekend. When they arrive they immediately unload their few boxes of supplies and pitch their “tent” in a residential school or temple. When everything is set up the casual onlooker is left wondering how so much could have come out of that truck. Like circus each worker has their own booth that they tend to the entire day for their customers.
I got to visit one, waiting in the corner because unlike every other busy worker in this camp I had no role to play. I sat alongside the ophthalmologists as they took patient after patient and performed the same routine. Each patient came with a paper that the doctor took. He asked them to look at his ear then proceeded to shine a light in their eyes. After a few seconds he jotted some notes on the slip, mumbled a few words, and passed the patient on. Of course there were a handful of special cases who required more time, but the work was routine and monotonous. But like any system there was a bigger picture. I followed the paper trail, where did these patients come from and where did they go?
The doctor’s station was one stepping stone to a complete, comprehensive diagnosis. Patients were passed along, completing the most basic sight tests to determine their vision, going to doctors, then getting split to refraction or more diagnosis. Every patient left with a new pair of glasses, or the same paper sheet, completed, a medical record, so they could go to Aravind next week.
The camp was a perfect demonstration of the pairing medical training with a mindset for efficiency. Those tasks that did not require a trained ophthalmologist were led by Aravind’s technician sisters. Each camp prepared with past statistics of their camps and cataracts prevalence to properly assign the roles to the right number of technicians. And while each task could be considered simple and repetitive, the beauty of it was that that was all that was necessary to leave every patient with a proper and complete diagnosis.
After 230 patients had passed through the multitude of stations at our camp we began to wrap things ups. A large bus from aravind arrived to pick up 65 patients that were to be admitted for cataract surgery next week. These were all patients who had come to the camp by word of mouth. They had glimpsed a flier on the side of a road to alert them to Aravind’s presence and out of a need for help they brought themselves here. Now they were on a bus to an even bigger system than they could have foreseen.
Interested in a more complete breakdown of the steps and estimate processing times of this eye camp? Click the link below! Pardon the imitation of my professor.
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