Written by: Alexandra Hecht, Ariana Simone, Bjorn Halvorson, Lindsay Chan

Preparing for Takeoff

Our IBD team of Ally Hecht, Ariana Simone, Bjorn Halvorson, and Lindsay Chan spent the semester supporting the Seva Foundation, a global eyecare nonprofit, in developing a long-term monitoring strategy to measure Vision Center impact. The day Spring finals ended, we packed up and boarded our flight to Delhi, India for 2.5 weeks of in-country client travel.

Week 1 at SNC

The four of us arrived in Delhi on May 12th after a 16 hour flight. After a few hours of sleep, which felt like a midday nap, we met our driver Abeshek to see nearly every attraction in Delhi. The best part… the Punjabi bangers Abeshek played on the radio.

 

On Sunday we took a day trip to Agra to see the Taj Mahal – it truly was a world wonder that we felt humbled by and lucky to experience!

 

 

 

 

 

On Monday morning we met Kuldeep Singh, the India Regional Director at Seva Foundation, at the Delhi airport to begin our week with the Sadguru Seva Singh eye care hospital.

Upon our arrival to our first partner hospital, SNC in Chitrakoot, Uttar Pradesh, the client team greeted us with samosas, chai, and posters of our IBD project! We stayed on the SNC campus in the hospital guest houses for the first full week and quickly got to work interviewing hospital management, touring the hospital outpatient and surgical wards, and enduring bumpy car rides to rural villages to visit satellite Vision Centers.

Touring the Hospital

We kicked off the engagement with a tour of the SNC campus, which includes an OR, outpatient center, inpatient hospital, and lots of facilities for the staff who typically live in the campus. The hospital performsThe campus is also home to a variety of native species like monkeys, cows, and dogs!

Meetings with Management and Operation Leadership

We spent time speaking with hospital management and operation team members who helped us better understand the history and goals for VCs. Our goal was to capture their perspectives to contextualize data analysis we had done throughout the semester and our visit to the VCs.

Vision Center Visits: putting ourselves in the patients’ shoes!

Conducting our first round of interviews with the VC staff and community health outreach workers

 


On our last day in Chitrakoot, we presented our observations and recommendations to the entire team. We had a great discussion with the team about possible improvements like recording patient satisfaction, establishing set benchmarks for monitoring vision centers, and increasing availability of public health materials for community health workers.


Saying goodbye to Chitrakoot with a lychee juice toast!

Week 2 at Aravind

We had the opportunity to conduct 5 different vision center visits all over Madurai’s surrounding villages. These clinics are staffed and led exclusively by women who are trained in the Aravind system and become eye refractionists and patient educators & coordinators. These Vision Center operators wear multiple hats, serving as clinicians, patient advocates, pharmacists, outreach coordinators, community leaders, and business operators. Interviews with the VC operators shed light on their patient volumes, in-depth EMR system, daily benchmarks and goals around new and return patients, glasses sales, and the future of primary eye care in India. We even saw the Google-developed AI retina diagnostic tool in action!

Interested in the patient experience, we got the unique chance to conduct a patient house visit. The woman pictured received a double cornea removal surgery and is thankful for her full vision to be restored, so she can continue operating her banana stand in her village and accurately count customer change.

Aravind conducts regular patient experience outreach surveys, randomly selecting 1% of patients across vision centers each day and reaching out via phone call following their visit. Patient feedback is compiled and shared in weekly meetings with Vision Center operators for performance improvement.


The team had the chance to tour Aravind’s pharmaceutical and medical device company plant, to see where the world’s most affordable lenses and surgical eye tools are produced. Owning 12% of global market share, Aravind builds access to eyecare internationally particularly for low and middle income countries. It was awesome to see the lab staffed by over 80% women.

 

Final Aravind & Seva Monitoring Presentation

At the end of our final week at Aravind Eye Care System in Madurai, we presented a final deliverable to a wide audience of leadership from Aravind, SNC, and the Seva Foundation. While it was challenging to find opportunity areas in Aravind’s model, being global leaders of quality and operational efficiency, we focused on model flexibility that would allow the system to adapt with forward-looking technology, policy, and social change. We highlighted post-grad and lateral hire HR pipelines, embedding automation and customer engagement platforms to get away from manual outreach and processes, and proposed new methods of monitoring impact to include % of need addressed in the population. Moving towards our final Seva recommendations, the team developed a catchment area calculator that measures impact a single Vision Center has in its community during each year of operation. Using actual and projected metrics, Seva can now quickly see a Vision Center’s number of outpatient visits, surgery referrals, glasses sold, break-even trajectory, and percentage of community need addressed. This will allow them a vehicle to request long-term monitoring data from their partner hospitals and a more robust way.

Boarding another 16 hour flight from SFO to Delhi, the IBD team is signing off and taking off! Thank you to the entire IBD program and the Seva Foundation for this unique and transformational experience. We are forever changed and humbled by the opportunity to support Seva, SNC, and Aravind in their global eyecare leadership.

  • Ally, Ariana, Bjorn, and Lindsay
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