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Saturday, Jan 17, 2004

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Blending business with service

Rasheeda Bhagat


President A.P.J. Abdul Kalam and KG Hospital Chairman Dr G. Bakthavathsalam at a recent initiative launched by the hospital to screen children for eye defects.

Manikannan is in his mid 20s and, with the confidence of a trained professional, goes through his job of medical transcription at the swank office of the KG Information Systems Pvt Ltd (KGISL) in Coimbatore. As he proficiently taps at the computer keys, it is only the dark glasses he wears that give you an inkling that he is a visually-challenged person.

A postgraduate in Public Administration from the Madras Christian College, he came to know that there was an opportunity for people like him in the field of medical transcription through the National Institute for Visually Handicapped (NIVH).

After undergoing 18 months of training, he has been at his job, which fetches him a salary of Rs 5,500 for over two years. Asked if he found the job daunting, he says, "Not any more. Only in the beginning I found it a little difficult, but I am very comfortable now."

But doesn't he feel nervous about making mistakes?

"Not really. We have a software called JAWS (Job Accessory With Speech) here. This reads out to me what I have typed, so if there are any mistakes, they can be corrected."

Beaming with self-confidence, Manikannan is not afraid to spell out his dream for the future. "I feel that now I am ready for the next level. I'm planning to do commercial writing, and am undergoing training for that."

So what kind of salary does he expect?

"I don't know, but I know it will be good," he says quietly.

The Managing Director of KGISL, Ashok Bakthavathsalam, explains that the company does "commercial writing" for investment-related activities in the developed countries. "We cover 60 different industries in developed countries where publicly-traded companies have to conduct the equivalent of an AGM every quarter." This is done through tele-conference with investment analysts around the world who track the company. The questions they ask and the answers provided by the company are recorded and summarised by the commercial writers sitting in Coimbatore who are plugged into the conference. "We have been doing this for two years. We service 2,000 companies from Microsoft, to IBM to Boeing," he says.

The KGISL handles medical transcriptions in a big way, but the idea of providing this skill to blind people was mooted to them first by Rajalakshmi, Director of the Software Technology Parks of India. "She suggested to me that since we were doing medical transcriptions, we look into this possibility tooand put us in touch with the NIVH, which helped us to identify seven people who had basic English capability, because we can't start everything from scratch," says Ashok Bakthavathsalam.


A visually-impaired employee of KG Information Systems Ltd, Coimbatore. — Picture by K. Ananthan

The seven visually-challenged men and women now employed at the company earn around Rs 5,000. This is, of course, less than what others make, because they take a longer time. "As the quality norms are stringent and the turnaround time has become very important — some reports have to be given in less than two hours — we give these people less stressful work," says Ashok Bakthavathsalam.

"But their capacity to learn on the job is amazing and now we will give them value added work. They are very meticulous. Teach them 5,000 words and they will never go wrong. That is their strength," he adds.

One of the pioneers in the field of medical transcriptions, KGISL employs 700 people for this work and has trained over 2,000 people. "Go to any transcription company in India today and I can guarantee the top two people will be from KGISL," he says.

He has two challenges before him; one is to give a decent career to blind people like Manikannan and the other, "to give respectability to the career of medical transcription and attract talent."

After undergoing rigorous training, which involves understanding medical terminology, and English language — both grammatical and phonetic — skills, "they are almost half doctors by the time they are through. Some of them even start prescribing over-the-counter medicine," he says.

The commercial writers have to be equipped with financial knowledge, SEC (Securities Exchange Commission) regulations, GAPP, summarising and journalistic skills. "Today we are meeting the needs of 40 per cent of Fortune 500 companies worldwide."

Community service

What is impressive about the KG group is the accent on community service. The KG Hospital, run by his father Dr G. Bakthavathsalam, is a multi-speciality, 500-bed hospital, where "a solution is given to every health problem, and we do all kinds of surgery except bone marrow transplant," says its chairman.

Nothing unusual in that, considering that the objective of any hospital is to solve health problems. But what strikes you about this private hospital, which is not a corporate but a medical Trust hospital, is that it is an institution with a heart.

Take the KG Eye Hospital, for instance — a 250-bed hospital that has taken as a challenge prevention of blindness due to cataract. In 1995, it began its programme called `Everything for Vision' and since then it has screened about three lakh people for cataract and has done over 47,000 Intro Ocular Lens (IOL) operations, most of them on people from surrounding villages.

It all began, says Ashok Bakthavathsalam, with his grandfather — K. Govindaswamy Naidu — developing a cataract in an eye 15 years ago, when IOL procedures were not freely available in India. "Whatever was available was experimental and he had to spend Rs 5 lakh by going to the US for a single cataract surgery. We estimated there are 10 million people who are blind in India due to cataract, about 70 per cent of them in rural areas, who can't afford treatment. So he said we should strive to reach an IOL to every needy individual at least in our part of the country."

With the KGISL a major donor, and making use of grants from the government and service organisations like Lions, the KG Eye Hospital regularly sends out screening teams to the villages around Coimbatore to identify people who need cataract surgery.

Says Dr D. Chandrasekhar, Medical Director of the Eye Hospital, "Since 1995 we've gone to 1,328 villages and do about 7,000 to 8,000 IOL implants a year. Before conducting the eye camps in villages, we put up posters and banners and those needing the surgery are brought by our buses to the Hospital and they have to come prepared for a three-day stay." It is pathetic to find, says Ashok Bakthavathsalam, that many elderly people who undergo IOL surgery at their hospital, totally free, are "often more grateful for the three meals they get here for those three days, than the actual operation. That is the level of poverty in some of our villages."

But it is more than food that this hospital gives to its elderly patients. Often at the camps, the people who come and leave their aged parents are "really indifferent to their plight because with vision problems, they cannot contribute much to the family. But once the parent or parents go back with the IOL restoring their eyesight, they become socially acceptable to the family, and play an important role in looking after the grandchildren."

Adds Dr Chandrasekhar, "Apart from the gift of vision, what better gift can you give a child than the love of a grandparent?"

President A.P.J. Abdul Kalam has also been a kind of partner to the KG group in looking after children with eye-related problems. "Globally, every five seconds one person goes blind and every minute one child goes blind," says the ophthalmologist.

With the KG group taking up a programme to prevent childhood blindness, this hospital has become a referral for children with vision problems. Recently a former MLA, who believes in nursing his constituency even when out of power, visited a school where he found that five-year-old Priya, whose parents have deserted her and who is being taken care of by her grandparents, was getting 100 per cent marks in oral tests but doing very badly in written exams. So he took her to an ophthalmologist, who diagnosed a cataract in her eye, and he later referred her to the KG Eye Hospital where the surgery has been done and the child has started doing very well in written tests too!

A child can get cataract either due to hereditary factors or because the mother has taken some harmful drugs during pregnancy or got an attack of German measles. "We also had a three-month-old baby, whose mother had an attack of German measles during pregnancy, developing cataract in both the eyes, along with a cardiac problem. We operated her on the same day, as the KG hospital has all the specialities, so her cardiac problem could also be monitored," adds Dr Chandrasekhar.

Interestingly, of the 14,000 children screened for vision, "we found 974 children, all of whom were doing very badly in class, with refractive errors. We prescribed glasses for them and most of them are now doing well at school."

Value for money

Dr G. Bakthavatsalam adds that at the KG Hospital, "we try our best not to send away anybody because he or she does not have money. We somehow try to raise the money... from the KGISL, our medical Trust, the Lions and the Rotaries and, of course apply for grants from the chief minister and prime minister's funds for heart patients. Even for the paying patients, we do an open-heart surgery in the private room for Rs 95,000 and in the general ward for Rs 85,000. This must be the only hospital in the country where a kidney transplant costs Rs 1.25 lakh for a paying patient. And we provide free dialysis for patients who can't afford to pay.

"The wonderful thing here is that sometimes the well-to-do dialysis patients give a little extra to facilitate the free service. Those who have to suffer without dialysis know the value of dialysis and contribute."

Chief of the renal transplant team Dr R. Balasubramaniam gives the example of 35-year-old Muthuraj, an army officer who underwent two renal transplants, both times with kidneys donated by relatives, which failed on the operation table. "This happening twice is very rare, and he was discharged from the army. As he was young, the family wanted to risk a third transplant, which no other centre was willing to do in Chennai or Mumbai. The advice they got was: Don't waste a third kidney."

He debated the pros and cons for six months and finally a successful transplant was done about four months ago. Dr M.K. Mani of Apollo Hospital, when told this, told his student, "I'm proud of you."

Muthuraj will have to be on cyclosporine for three years, "but the hospital has given a lot of concession and helped him to get the drug at a cheaper cost," he adds.

The cardiac team headed by Dr T. Jayarama Pai does about 250 open-heart operations a year. Under the AIADMK's Idayam Kapum scheme, his team has done 12 cases, without waiting for the sanctioned sum of Rs 30,000 a case "and without compromising on anything."

This one could see from a round of the paediatric ICU where the children recouping after surgery included six-year-old Radhashri, the daughter of a labourer from Ooty. Born with a hole in the heart, she required an open-heart surgery. "We have applied for the CM and PM's funds (Rs 25,000 and Rs 20,000). The money is yet to come, but the child couldn't wait. The father pledged the house and brought Rs 30,000 and the surgery has been done and the child is fine. Once the money comes, we will return the money to the father," says Dr Pai.

Dr Bakthavahsalam adds that all this is possible because as a Trust hospital "we have no compulsion, like corporate hospitals to make a huge profit and declare dividend for the shareholders. Hence we are able to keep our costs low, and even give free treatment to some poor patients. The result is that we are getting patients from all over India. The difference between us and corporate hospitals is that we feel we should not be a disease care but health care hospital, and hence our accent on going out to rural areas."

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