Finding Superman: Changing a prolific surgeon to a social entrepreneur
December, 2015This was my second trip to Sambalpur, a nondescript town-city in western Odhisha. I was introduced to The Vision Mission (TVM) by my colleague, Dr. Jayant Iyer when I was working in Singapore. He along with his friends (Avinash Jayaraman and Jason Lee) had established a non-profit organization to help under served areas in south and east Asian regions in providing eye care. They started their first project in Sambalpur trying to convert a modest hospital into a world class eye care center. They send a team of doctors from Singapore three times a year to help the partner hospital to improve services. This project is 2 years old now. When I returned to India, Jayant asked if I would consider volunteering for TVM. I readily agreed and have made two wonderful trips there thus far. The Vision Mission is bringing specialized eye care, education and training to Sambalpur. It’s partner organization in Sambalpur is Trilochan Netralaya (TN).
I want to talk about one man here- Dr. Shiva Prasad Sahoo– Founder/CEO/Ophthalmic surgeon of Trilochan Netralaya, Sambalpur- the inspirational man behind this veritable institution. He was a man of limited means and yet he dreamt of providing eye care to the poorest of the poor in districts of Bolangir, Sambalpur and Kalahandi. He does about 12,000 cataract surgeries a year.
He has built a hospital with OT facilities in the city of Sambalpur with another large hospital with OT in the outskirts of the city. It also houses “Betty Ashram” which is used to house patients before and after free cataract surgeries. They are fed, tested, sheltered and given medicines in that ashram. He does most of the 12,000 surgeries free of cost.
The Vision Mission (TVM) is one of the supporters that Dr. Shiva has by his side. TVM’s main purpose behind having these mission trips is not so much to teach Dr. Shiva cataract surgery- which he’s obviously an expert when you see the numbers. TVM sponsors 1000 cataract surgeries every year thanks to their donors. TVM’s long term vision is to get Trilochan Netralaya (TN) match up to global standards of sub-speciality eye care and make it sustainable in the long run. They wanted to start with management of diabetic retinopathy (DR) and glaucoma as their focus areas to start with and then go on to develop other sub-specialities.
On my first trip in March they had just brought in new laser machines, fundus camera, OCT machine, Ultrasound and UBM machines. Instruments available in the best of eye hospitals in big cities in India. I was on the trip to assess whether Oculoplasty services could be offered along with the DR and glaucoma services. We conducted a CME and had training sessions in clinics and Laser. I recommended ways to get the Oculoplasty set up going. We thought we had done our bit and returned.
They had another trip with another team in October, 2015. They reinforced what was done the previous visit.
When we went this time in December, 2015- I realized the challenge Dr. Shiva was up against. He is obviously very driven to get better at running his hospital- to get his patients the best possible care. He had funds-now that Mr. Subrato Bagchi (CEO of Mindtree) has promised to support this cause. But I understood that just money and infrastructure would not help him build his dream. TVM had to help change this very prolific surgeon to a social entrepreneur. This is going to be hard since he spends most of his working hours doing cataract surgery and seeing patients. He had too much on his single plate. He needed more dedicated doctors and trained technicians to work with him to achieve his goals. He needed to be the guy moving the organization towards the right direction. As counter intuitive as it sounds, he needed to be less a surgeon and more an entrepreneur.
Dr. Shiva does not do these humongous number of cataract surgeries out of some ulterior motive to be a hero or to monetarily benefit from it. He does so out of a selfless desire to help people and the ambition to provide modern eye care to the community he lives in. In fact he and his family live in a room atop the hospital. Such is his dedication towards his work.
The numbers of patients are staggering and it never ends. The ashram is teeming with patients waiting to be gifted their vision. His day starts at 5am and ends at 11pm. Everyday. He is so burdened with work that he does not get time to go out of Sambalpur area for any extra training. It certainly is a herculean task to maintain this level of surgical work and yet try to build on what he has and get to the next level. I do have to marvel at what he has achieved despite this high surgical load. I as a surgeon mostly have to worry about my patients and my surgery. Not much else. Despite his busy schedule, Dr. Shiva has to ensure that everyone else does their part. This is the job of a leader. Every philanthropic work needs to apply principles of entrepreneurship to be successful. For example, Bill Gates can donate billions of dollars to charity but just throwing obscene amounts of wealth will not make his money work in the way he wants it to. So he has taken over the Melinda Gates foundation himself and ensuring that his vision is accomplished by giving direction as a leader. The challenge we have here in Sambalpur is quite similar.
Sambalpur is the biggest city/town in western Odhisha. The western Odhisha region-about 300kms radius around Sambalpur is one of the poorest regions in India having little or no access to even basic eye care. The extreme poverty is very apparent in the dusty roads leading up to the villages housing thatched dwellings with little access to safe drinking water or electricity. There are old people in these villages struggling to make ends meet with earnings of less than Rs. 20 a day. These are the people of India we forgot when we went on the road to progress.
Philanthropy, to be successful has to pay for itself eventually. The successes of the Aravind Eye hospitals, Shankar Netralaya, LV Prasad Eye Institute in India are testimony to this fact. TVM’s long term vision is to try to convert TN into a smaller version of the three big eye institutes. Even social causes such as this needs to be run like a business. The multi-tier payment model adopted by the big eye institutes in India is the way to go. Income generated by paying patients can fund the treatment of the very poor ones and also sustain the institution. In India we are lucky to have volumes of patients who can support such a model. These volumes will eventually drive down costs of healthcare for everyone.
I hope that in time the TVM-TN collaboration results in something special for these forgotten parts of India. I feel privileged to be part of this process. I hope to add my small little contribution to the great work done by Dr. Shiva, his team in TN, the generous donors and TVM.
We need supermen like Dr. Shiva for healthcare in India. People who have to be physicians, surgeons, entrepreneurs, philanthropists and managers combined into one person. People who can take on multiple responsibilities in this endeavor without an almost non-existent government support and yet be driven enough to bring about a social change. We have found one, I’m sure we would find more.
Below is the documentary based on one of the mission trips by the TVM team
Photo credits: Ng SiRui, Avinash Jayaraman, Raghuraj Hegde, Jason Lee, Edric Wong, Jason Lee, Jayant Iyer.
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