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One man's vision...

M. Somasekhar

... has given sight to thousands of others. Dr Gullapalli N. Rao recently stepped down as the Director of Hyderabad's L.V. Prasad Eye Institute, following the best practices of institutions worldwide. This remarkable doctor now has his sights focussed on rural eye-care.

Dr Gullapalli N. Rao (seated) is all set to pass the baton to Dr Ravi Thomas.

It was called the "04-04-04" event. The day — April 4, 2004 — was marked by an international conference on developments in ophthalmology. But the evening was reserved for flashbacks — rich praise was heaped on Dr Gullapalli N. Rao, founder of the L.V. Prasad Eye Institute (LVPEI) in Hyderabad in 1987. The workaholic ophthalmologist, together with his dedicated team and a large number of supporters, had successfully moulded the institute into one of the finest eye-care centres in the world. What made the day truly momentous though was the farewell gesture — the creation of a `Village Vision Fund' to set up vision centres across Andhra Pradesh. Named after Pratibha and Gullapalli N. Rao, the vision centres would provide primary eye-care in interior rural areas.

This was nothing uncommon, perhaps, in the life of an institution. But what followed was definitely unprecedented. Dr Rao introduced his successor, Dr Ravi Thomas from Christian Medical College (CMC), Vellore. The rapt audience listened as Dr Thomas's teachers — Professor Frank Bilson of the Save Sight Institute, University of Sydney, New South Wales, Australia and Dr J.P. Muliyil from CMC — recalled their association with the incoming Director and gave insights into his personality. Indeed, a smooth transfer of the reins of power had taken place!

Significantly, the power transferred not within the family or even within the institute, which is often the norm, but to a rank outsider. For most outsiders, thiscame as a complete surprise. After all, it is not easy to recall many examples where leadership has been voluntarily abdicated in Indian organisations in recent times. Infosys's N.R. Narayana Murthy is of course an exception.

Admitting that Narayana Murthy was an inspiration, Dr Rao however said that the idea of relinquishing his position at an appropriate time was at the back of his mind for long.

Having detached himself from the institute's day-to-day responsibilities — not a single member of his family is on the Board of Directors — Dr Rao however continues to be distinguished ophthalmologist at the institute. He has now set himself the task of enlarging the vision of LVPEI. His priority is to strengthen eye care in rural areas of Andhra Pradesh. From September 2004, he will assume the presidency of the International Agency for Prevention of Blindness.

Recalling the long journey that brought him to Hyderabad and the creation of LVPEI, Dr Rao says, "I was always driven by a passion to do something for my native land, hence I gave up a lucrative position in the US and launched the hospital project in 1982. My wife Pratibha and I discussed the dream project with the aim of returning to India in 1986. She had the veto power to shelve it as well.

"We informed our friends of the decision, but nobody took us seriously... The common refrain was: `No Indian goes back easily'. I studied various institutions in the US, looking at them with a `different eye' to spot the best. I did a similar exercise with institutions in India. Simultaneously, I prepared a blueprint and formed a foundation to raise funds. The first contribution was our four years' savings in the US. Lots of Non-resident Indians (NRIs) came forward and soon we had $500,000.

"The big boost to the project came when a letter to the then Andhra Chief Minister, N.T. Rama Rao, in 1985 got a surprisingly fast and positive response in 15 days. Land was offered in Himayathsagar on the outskirts." Parallely, A. Ramesh, the son of noted film personality L.V. Prasad of Prasad Laboratories, offered 5 acres of land in the city and Rs one crore towards the trust. Thiswas instrumental in the fast realisation of the institute. Dr K. Anji Reddy, founder of Dr Reddy's Lab, Rao Remala of Microsoft, Somasekhar Mukkamala and a long list of donors backed the hospital at every stage.

The project soon got underway, with N.T. Rama Rao laying the foundation stone on October 17, 1986, "the first and last time a politician graced any major function at LVPEI," says Dr Rao. On June 1, 1987, the first patient was treated. "Several well-wishers told me that it would be difficult to do something like this in Hyderabad. My response was: `I shall try hard and see.' In the last 17 years, the institute has grown beyond my dreams. Today, every single international ophthalmic organisation supports it and every conceivable eye ailment can be treated here," he adds proudly. Quizzed on his decision to lay down office, Dr Rao says, "It was one of my most satisfying decisions. It was well planned and not sudden. My initial goal was to be Director for 10 years. I had offered the Director's post to two other people in the past, but they both left for the US. Finally, in 2002, we selected Prof. Thomas."

The only criterion for the selection: the best candidate available in India. A two-year transition period would ensure that power was transferred seamlessly and that the new Director was fully familiar with the mandate and functioning of the institute.

Dr Rao says that his move was inspired from the experiences of great institutions across the world, including some in India. LVPEI today represents a hospital that has made "excellence and accessibility compatible in the Indian context. Fifty per cent of all surgeries are gratis for the poor. Till date, not a single patient has been turned back because he cannot pay and every form of curable blindness can be treated here," he says.

This has been made possible with all the doctors getting salaries, and not allowed private practice; efficient operating systems put in place; and differential tariff structures for different classes of patients. "All our financial transactions are transparent. I have not run after anybody for favours, nor have we given bribes to anyone for anything," he says. LVPEI's work speaks for itself - the institute is at the cutting edge of eye research, including stem cells. Ophthalmologists in India have a culture of public service, owing to the eye camps conducted by many of them. However, Dr Rao points out, "The need here is to ensure quality service and follow up."

Under a project called `Community Assisted and Financed Eye Care', each member of the community contributes one rupee a month and the LVPEI, in turn, sets up a satellite eye hospital to take care of the community's needs. An experimental project started in a West Godavari village with 50,000 people is doing well. A similar initiative is underway in Adilabad district. In an effort to energise the project, plans are afoot to link it to women's self-help groups. The project has received a major impetus thanks to the efforts of two NRI brothers - Srikanth and Sudhakar Raavi from Silicon Valley.

Hailing from a village near Chirala in Prakasam district, they have pledged to take care of the village's eye-care infrastructure through the creation of a satellite hospital and vision care centres.

When asked how he would make eye care sustainable in the long run, Dr Rao says that a workable financial model should have four ingredients: low-cost community insurance (Re one a month) in villages; enhanced cross subsidy; Government-funded insurance for the poor and greater funding from philanthropists. During 2003-2004, LVPEI achieved a record 1,000 corneal transplants, amply demonstrating the heights to which it had reached. As the new Director, Dr Thomas says, building upon the strong foundation and reputation gained by the hospital is now the challenge before him.

Picture by A. Roy Chowdhury

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