The gift of vision

In 1996, two-year-old Michael was brought to the Sankara Eye Care Hospital in Coimbatore, blind in both eyes. The child was born deep inside a tribal hamlet in the Bargur forest, Tamil Nadu. After delivering him, the mother died and the villagers decided the ‘evil' child had claimed her life. In a gory ritual to remove the “evil spirit”, a concoction was poured into his eyes. He lost vision and ended up in an orphanage.

Seated at the sprawling lush-green five-acre campus of the hospital, the Founder and Managing Trustee, Dr R.V. Ramani, recalls that one of the child's eyes was completely gone and the second had just a two per cent chance of regaining vision. A corneal transplant was done, during which an old man from the Kanchi Mutt, a patient, chanted slokas for the success of the operation. “This is what India is about,” says the doctor.

He adds that on the third day, after the bandage was removed, a doctor entered the child's room to find him waving his fingers before his eyes. “He was two, but was seeing light and movement for the first time in his life. Can you imagine what would have been our feeling at that time? A million dollars cannot give you such satisfaction,” he smiles.

As I do the hospital rounds with Dr Ramani, the statistics — 500 free surgeries a day at the 10 Sankara eye hospitals in India, including 200 at Coimbatore, come alive through the stated and unstated gratitude of several patients seated at various areas of the hospital, awaiting investigation and medical or surgical treatment.

About 70 per cent of the surgeries are for cataract removal, so most of the rural patients seated in the spanking clean hospital are elderly. Asked about their age, they smile and say: “Must be 60”! But most of them are clearly much older. It is difficult not to get a lump in your throat as you interact with these villagers with eye patches, looking a little lost in that spanking clean and plush environment.

Mariyayi must be 80, but says she is 60 and is seated there with her walking stick. Coming from a village near Vridhachalam in Tamil Nadu, she has come for a cataract surgery in her second eye. Most of the 600-700 patients present in the hospital that day have come from extremely poor backgrounds. But for the free screening, investigation, transport, accommodation, food, surgery and post-op care, hardly any of them have a hope of getting their vision restored.

In one of the wards, seven-year-old Abhinaya is playing with a stuffed toy. Both she and her brother, from a village in Villupuram, Tamil Nadu, were born with congenital cataract, but as it was left unattended for so many years, explains Dr Ramani, she has developed a squint. The cataract has been removed from both the eyes, and in the next stage the squint will be corrected. Her brother has already been operated. The children of an agricultural labourer, but for this entirely free medical service, they wouldn't have had a chance of surgical rectification and quality vision.

All the 10 Sankara eye hospitals work on an 80:20 ratio; with one-fifth of the paying patients making free treatment possible for the 80 per cent poor patients. But yet, it is difficult to avoid a deficit.

Along with his co-founder wife, Dr Radha, an anaesthesiologist, Dr Ramani had run a roaring medical practice in Coimbatore from 1972. In 1977, he responded to an appeal by the Kanchi Sankaracharya to senior Coimbatore doctors to do some voluntary work for the poor. “In those days there was no model for setting up such a service, so we asked 10 of our doctor friends to give us two hours of their time every week.” Ten responded and they began in two 10x10 ft rooms in the temple; the pharma companies gave medicines and friends pitched in with tables and chairs.

Darkness or light

In the second year they did immunisation for the Rotary clubs, third year they got a lab and some equipment and by the fourth year — when a doctor gave them 10 free beds in his hospital — the group of doctors had expanded to 75. City industrial houses pitched in too, and under the Sankaracharya's guidance, an eye hospital for the poor was set up in 1985 because “there is a huge need for eye care in our country. Proper treatment makes a huge difference in the quality of life. Somebody comes to us totally blind with a bilateral mature cataract, we do an operation and put an IOL (intraocular lens) and he walks out with 100 per cent vision. The difference is between darkness and light,” he says.

A patient of his donated five acres, a friend put up a borewell, other friends donated 100 coconut saplings, next came a drip irrigation system from somebody. “Much before the buildings came up the greenery was ready. Next a friend constructed a 1,000 sq ft area from which the hospital operated. Today the campus has 1.25 lakh sq ft built-up area.”

Dr Ramani recalls that his first goal was to set up an eye bank. In 1985, India was dependent on Sri Lanka for donor eyes; he started an eye donation campaign with the tag: ‘Miracles cannot cure blindness; you can.' “I must have addressed thousands of organisations; we now have a model eye bank and receive a pair of eyes every day, sometimes even two, and corneal transplants are conducted routinely,” he says.

Normally the hospital doesn't disclose the names of donors, “but our name ‘Sankara' makes people think we cater to only one religion or community. To convince people that we have broken the religious, regional, linguistic barriers long ago, I give the instance of our founder trustee Dr Sudhakar Rao's eyes giving sight to Noorjahan from Kerala. After all, God did not create separate corneas for separate religions.”

In the mid-1990s this social entrepreneur gave up his practice, and after five years Dr Radha followed, to serve the Sankara institutions as Director for Paramedical Training. “We felt we have enough; we have a house, and car and enough savings to meet our needs,” says Dr Ramani. Their only son, a PG in computer applications, worked with Infosys for a while, but impressed with his parents' work, did Masters in Hospital Management at the Tata Institute of Social Sciences, and then a course in community ophthalmology at the London School of Ophthalmology. He is now an employee here and heads the rural outreach service.

Serving rural India

The most impressive part of their work is reaching the rural masses. Not wanting their rural services to be a mere “one day mela ”, Sankara institutions have charted out a foolproof rural outreach programme and “we've managed to reach out to the villages for 10,000 weekends without a single break. Even during election time, our teams went a day earlier so there was no break,” says Dr Radha. Reeling off statistics, Dr Ramani adds that one fourth of the world's blind — about 15 million — live in India, and 80 per cent of this blindness is preventable or curable. And, six per cent of school-going children have undetected visual defects. “The child sitting in the last row not able to see the blackboard with one eye, is brought to the front row, but he is still not able to see. So subconsciously the child will stop using that eye and sees only with the other eye. And the unused eye goes totally blind.”

He was shocked to find that the child of one of his eye surgeons was amblyopic in one eye. “If his mother, an eye surgeon, didn't know this, imagine the plight of the millions in rural India,” he sighs.

The Sankara teams train local youth and teachers to test vision using charts and also diagnose common eye problem like squinting. The children who fail the test are given a red card, and after examination by eye doctors, those requiring surgery are brought to the Sankara hospitals and treated free of cost. So far, 35 lakh children have been screened for defective vision and eye problems.

“But all this work requires constant financial support; we are now looking to industrial houses to help us with land, endowments and funds to keep going,” says Dr Ramani. He admits that he has come so far with the support of corporates and friends. “In the next stage, we want to get donations from the general public to help us move forward.”

Donations can be given for cataract surgery (Rs 1,000), surgical endowment (Rs 10,000) and paediatric surgery (Rs 5,000).

rasheeda@thehindu.co.in

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