I’ve been on, I don’t know how many, field trips over the years and seen NGO projects of all kinds all over the world. I’ve seen some amazing things and met some utterly inspirational people. But until visiting Sankara Eye Care Institutions last week I had never seen this.
Jessie White of Misfit Foundation and some old, bald guy* are watching cataract* surgeries in progress on the Sankara, well assembly line is the most appropriate description, at its hospital in Coimbatore in the South of India. We watched two surgical teams working in parallel perform approximately one operation every five minutes.
Such a streamlined approach was typical of the entire Sankara operation. Everything from the moment a patient was identified in an eye screening camp to their post operation check ups was optimised for efficiency. IT was used effectively to minimise waiting times and duplication.
This must be one of the most cost-effective health systems in the world. Sankara’s nine community eye care hospitals across India perform a total of 150,000 free cataract surgeries a year. That is, they make 150,000 of India’s poorest people who are blind or going blind see again. 91% of the cost of these surgeries is covered by a subsidy from the 30,000 paid surgeries they perform for middle class and wealthy patients. Each paid surgery also funds four free operations. The remaining deficit they have to fundraise for works out as around £20 per surgery***.
It is simple and brilliant. It works because the organisation (they don’t think of themselves as a charity) is completely focused on achieving the highest levels of efficiency without any compromise on patient care. The whole operation of 9 hospitals in 7 states of India is supported by a back office (finance, HR, IT et al) of 40 people. They work really, really hard but are helped by standard processes and systems which automate everything possible.
Sankara have successfully replicated their model across India, in different states with varied cultures and languages. They are adding two new hospitals a year and plan to have 20 by 2020. India has 12 million blind people, there’s still much to do.
But the thing that really stood out for me about this extraordinary organisation is that they have achieved all of this while managing to maintain an ethos of respect and compassion across the whole operation. The inspirational Dr Ramani, the founder (who’s worked there full time for free for 38 years) tells each member of staff to treat all patients, free or paying “as you would your own grandmother” and they clearly take this to heart.
I could go on at length about this place. But enough for now. I’m left reflecting on all the causes and all the things I’ve seen in my life as a fundraiser. It’s not often I’ve had a product to sell that’s been this good. And that’s before I start telling you about their donor feedback…
So fundraisers, why don’t you ask your charities, why can’t we have something to sell like this?
* Quote from my mother, “I was glad to see the back of you”
**A cataract surgery (look away now squeamish people), involves an incision into the front of the eye, the removal of the natural lens of the eye and insertion of an artificial intraocular lens. It’s minor surgery but not something you would take lightly.Cataract is the world’s largest cause of blindness with about 18 million people in developing countries blinded by it.
*** The NHS estimates that each cataract surgery costs it £932 so Sankara’s free surgeries are 45 times more cost effective. Sankara does 2/3rds as many cataracts as the whole NHS in a year.And their success rate is better.