By Chris Marino
When I requested to volunteer at the Kalinga Eye Hospital and Research Center (KEHRC) in Dhenkenal, Orissa, through Unite For Sight, I never foresaw myself working on the hospital’s business matters. Yet, that is exactly what I have found myself doing.
Shortly after the GSE Field Experience ended, I caught a flight to Bhubaneswar to begin another internship in India, this time as an assistant at a rural eye hospital. The Kalinga Eye Hospital is hidden in the most remote region of Orissa. Its outreach program caters to villages up to a five hour drive away from the hospital.
Chris Marino at the Kalinga Eye Hospital Outreach Camps
The hospital informs and offers its services to villages beforehand so that it can be publicized. A team of paramedics and an ophthalmologist reach the village and provide free eye screenings (primarily for visual acuity, glaucoma, cataracts, and diabetic retinopathy). All people found to have cataracts (the most common cause of blindness in India) are informed that they can receive surgery at the hospital. Those who agree to be treated (almost all of them) are loaded onto the bus, and brought to the hospital where they will be fed, sleep a night, and receive surgery. The following day, they will be transported on the bus back home. Recognizing that the vast majority of outreach patients will not be able to afford surgery (the average family daily income in rural Orissa is Rs. 50), the hospital overcomes patient financial barriers by providing outreach treatment free of charge or at a discounted rate without sacrificing the quality of its eye care.
To cover the costs of treatment, it uses a cross-subsidization business model that mobilizes financial resources from capable and financially sound paying patients to patients who cannot afford treatment. The KEHRC also requests supplementary grants and donations to provide surgery to any patient unable to afford treatment.
The eye hospital is adequately staffed. It has a full time team of physicians, optometrists, and paramedics (a pediatric ophthalmologist even visits from Mumbai once or twice a year). All the patients are promptly cared for. They do not need more people doing medical tasks. But what they do need are volunteers capable of working on their marketing campaign.
By utilizing the cross-subsidization strategy the hospital has been transitioning from a charity model to a more self-sustainable business model. The issue is that only 5-10% of patients choose to pay for treatment. This cannot adequately subsidize the free surgeries. The medical director has assigned other volunteers and myself to find out how to attract more paying patients. My job is to assess how patients are counseled for affordable treatment and identify any issues with the process. I will develop a questionnaire tool to collect information and then analyze it for themes and results. Next, in the meantime the hospital cannot stay up and running without grant money and donations. In response I have also been assigned to type documents on the eye pathology situation in central Orissa and what the KEHRC’s role is in finding solutions to eye ailments in the rural countryside.
Just like every social enterprise, the KEHRC strives to be self-sustainable. Unfortunately, keeping its philosophy of “eye care for all” and reaching financially self-sustainability is not an easy task. I am grateful that the GSE seminar and field experience has helped prepare me for these assignments. Perhaps, GSE will continue to be very helpful in unexpected areas.
Its excellent that your GSE project with Dream a Dream and experience at the Kalinga hospital are so symmetric! At Dream a Dream, you helped to design a qualitative questionnaire to assess if children were learning life skills. Now you are designing AND implementing a patient process questionnaire. Way to move up, Chris!