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Gift of sight_by_vision_in_practice
1. Fostering the “Gift of Sight”
Adapting the Aravind model of high-quality, high-volume, low-cost surgery in rural China
Vision In Practice: A Humanitarian Commercial Enterprise
2. China Blindness Data
✤ Total number of blind people: 6.6 million (2011 estimate)
✤ Total number of visually impaired people: 13 million (2011 estimate)
✤ National blindness prevalence: 0.5% (2006 estimate)
✤ Leading causes of blindness: cataract, diabetic retinopathy, corneal
disease, glaucoma
✤ Cataract surgical rate: 800 (2010 estimate)
4. Vision in Practice: Our Mission
Vision in Practice strives
to eliminate needless blindness in China (and beyond)
by providing doctors and support staff with
the clinical and surgical training, business skills,
resources and networks they need
to build, operate and expand
high-quality, high-volume and financially sustainable
eye care practices
in any community
regardless of patients’ ability to pay.
5. Cataract surgery training at Aravind
Since 2008, organized training in India of 50+ Chinese surgeons in ECCE, SICS, phaco
6. What awaits these
surgeons upon their
return to China?
✤ Limited access to surgical
opportunities, despite training
✤ Temptation to “moonlight”
outside on nights, weekends
✤ Continuing low salaries due to
“monopoly” of senior surgeons
✤ Collapsing morale, temptation
to abandon medical practice for
industry jobs
7. An Aravind-Inspired Workplace
✤ Demand generation: Intense ✤ Cost recovery: Premium
focus on rural screening camps subsidizes low-cost surgeries
✤ Capacity building: Training, ✤ Reimbursement: Multiple
retraining and recruitment to sources of revenue capture
meet newly generated demand
✤ Nothing is “free”: Standard
✤ Safety is paramount: Low rate Surgery provided at “no cost to
of complications best assured the patient”, but optional
by staff empowerment, high upgrades help drive revenue
skills and accountability
✤ Patient counseling: Even the
✤ Services with dignity: Treat poor can make intelligent,
patients as if they were kin informed decisions
9. Dr Tian Zuolong
Inspired by Aravind in Dr Ramakrishnan’s 2005 lecture at COOC Shanghai
Trained in SICS by Dr Hao Xiaojun following Hao’s 2-year fellowship at Aravind
Founded Xinyimin Hospital in 2009, determined to embrace the Aravind model
Without screening and using only SICS, has restored sight in 1,000+ walk-in patients
In 2011, joined with Vision in Practice to redeploy Xinyimin as demonstration hospital
10. Dr Hao Xiaojun
First read about Aravind in Chinese edition of Ophthalmology World Report in 2003
In 2004, selected as first Chinese trainee as Dr Venkataswamy demanded a China strategy
In 2006, became the first international doctor to undertake a 2-year fellowship at Aravind
Since 2008 has experimented with “screen-to-surgery” model in Hangzhou and Guiyang
Co-founded Vision in Practice in 2009, serving as Medical Director
Co-leading ViP’s overhaul of China’s top residency program at Fudan University/EENT
11. Dr May Khadem
Faculty ophthalmologist at Northwestern University, and veteran anti-blindness activist
Decades of experience as cataract surgeon and surgical trainer in many countries
Deployed to China in 2010 with a personal mission to tackle barriers to quality eye care
Joined Vision in Practice in 2011 as Director of Programs
Leading ViP’s overhaul of China’s top residency program at Fudan University/EENT
12. Jeffrey Parker
Veteran journalist and media executive based in China since 1990
Founding editor of China and India editions of Ophthalmology World Report
In 2007, bridged Chinese and Indian ophthalmologists with surgical training exchange
Founded Vision in Practice in 2009 to foster better venues of practice for Aravind trainees
As ViP’s Executive Director, strives to match resources with opportunity and acute need
19. Outreach in the open air
Despite only one day’s notice, 86 villagers turn out for county’s first free screening
20. Logistical challenges
of poor, rural patients
✤ 88 years old, with operable
cataract in both eyes
✤ Lives alone with no phone,
doesn’t know her own address
✤ Hobbled to screening on feet
that were bound in her youth
✤ Keen for free screening, walked
1 hour from another village
21. Camp Metrics
✤ Screened villagers range from
infants to nonagenarians
✤ Screening differs widely: many
ailments, wide demographics
✤ Nearly 1 in 3 presents with
serious cataracts, most with at
least one operable eye
✤ Many have no means to travel
to hospital or district town
27. Vision in Practice Objectives
✤ Provide access to high-quality, hands-on surgical training that
remains virtually unavailable in China
✤ Provide management consulting/coaching to cultivate a dynamic,
efficient workplace marked by teamwork, smart division of labor
✤ Provide empowerment training to nurses, technicians, marketing,
logistics, finance and other non-physician staff to optimize efficiency
✤ Comprehensive community outreach training to accelerate demand
✤ Facilitate access to insurance reimbursement, grants, investment,
loans and other financing to achieve sustainability/profitability
28. Vision in Practice priming the pump:
Quality flows to all, regardless of
ability to pay
