Social Interventions in Kumaramangalam, Bela Village Transformation achieved through a Tertiary Eye care centre

SOCIAL INTERVENTIONS@

Transformation achieved through aTertiary Eye care centre1Presentation at ICBM, Hyderabad on date December 20th 2014

Preface41 village families have direct access with a rural eye hospital named Koumudi Grameena Netralaya and is sensitized with the relevance of livelihood

41 families have realised that Village is also a place of propriety to explore opportunities and to have stake for their disposable income

Banks and Financial institutions were forced to realise the importance of Evolution of a mission in a village through the services of a tertiary eye care hospital

2The Spirit of Desire Life is about change, self determined change, towards a predetermined goal, to create a future for ourselves by self effort with the assistance of the higher power we call Master - Master P. Rajagopalachari , Shri Ramachandra Mission

India lives in the Villages -Mahatma Gandhi

Dr G.Venkataswamy, Aravind Eye Care quotes

Eye care services do not operate in a vacuum. Rather, it should be viewed in the broader context of the society for which it is intended. Hence, development of skilled manpower oriented to the needs of the community is vital in our crusade against needless blindness. In contrast to an individualised health-care system, a community approach to eye care aims at improving the eye health of the entire community.3The Macro platform that NecessitatedPopulation index is exponential in India.

Village in India has been the icon of growth

Regularizing the need of food stuff for others comes from villages

Brightness delivers the concept of progress in human beings. Hence the relevance of Eye health care had to be objectively framed.

The state of Kerala is no more an exception. Sources and insights indicated that only two ophthalmic doctors were present in the district of Kasaragod in 2001.

Bela village, Kasaragod was the sample of discretion selected.

4The Macro base of EvolutionKerala population3.33 crore Number of Eye hospitals in Kerala35Kasaragod population12.03 lakhs Number of Eye hospitals in Kasaragod 1 (a small eye clinic in the town)Kerala village population2.20 crore (70% of total)Number of eye hospitals in villages of Kerala7Kasaragod village population7.05 lakhs Number of eye hospitals in Kasaragod villages0Number of grama panchayats in Kasaragod41Number of ophthalmologists in Kerala96Number of ophthalmologists in Kasaragod 2Major Source of income for Kasaragod villagersAgriculture Tobacco,Paddy, Arecanut,Cashewnut 5The Nuances that lead to the selection of GeographyGlimpse of Kasaragod Villages RemarksMajor Agriculture0.164 million tonnes is the district contribution to stateTobacco,Cashew,Coconut, PaddyFishing10% of Kasaragod population contribute to fishing80 kms long sea coast extending from Trikkaripur to Manjeswaram Trading4.46% in villages live with tradingHardwares,Food and SnacksConventional treatmentsMore than 80% of villagers believe in conventional and traditional treatmentsAyurveda and Sidha Labourers 15.3% villagers work as labourers People work in individual houses for long periodsReligious activitiesMore than 30% people are deeply involved in religious activitiesPriestly oriented efforts6

Business Model R1, R2 and R3 Revenue Generation platform

How was opportunity translated?Shift of a family to Bela villagePhysical presence of Dr Sunil.N in Bela

Clustered village Family level Health Talks and awareness campaigns

Informal talks with traditional authorities in the village

Bela Village in 2001Basic UnderstandingHealth as a factor of CommonalityA retired central school Teachers missionStatusReal economic gaps among villagesAgriculture an economic, traditional and a valued activity

Problems in Bela Lack of good treatment place found in villageConnectivity Logistics problem of village with the town for eye treatment Opportunity?The Village problem understandingLack of Awareness/seriousness among villagersCommon eye ailmentsCorneal ulcer (due to insect bites), Cataract, Diabetes Retinal Problems in village

Medical eye campsGround zero understandings by visiting adjacent villages

Other Problems in Bela Power shortages (voltage fluctuated from 50v 230v)Great Water shortages

Status of InnovationCommunity ParticipationFact - Tertiary health care in a villageLivelihood through Agriculture for villagersVillage employees of the hospital understanding QWL

Process for AchievementPhysical development of an eye hospitalSupport and assistance to agriculture familyRecruitment of Village folks and training themSlow implementation of systems

Lack of support No initial idea of capital R1- Intellect capital R2- Implicit monopoly R3 Margin of expenses comparatively low in villageSituational Understanding and The Phenomenal Decision (2001)Shift of entire family from town to a remote village and commencement of the mission

Opportunity Elevation and Opportunity Affiliation1st Financial assistance in 2003Social conscience Medical services gets cemented77Finance Reflections on a Macro scaleFYAsset valueAdditional investmentsWC assistance (from Bank)TurnoverExpensesNet Profit 2001-021,90,335NILNIL27,89911,34416,0002002-034,34,567NILNIL76,7861,40,445 (-) 64,0002003-041443146NILNIL216579502542 (-) 2859622004-051461083NILNIL498686578861 (-) 800002005-062085140NILNIL11641879855821786052006-072456137370997NIL12767029278903488112007-082747837291700NIL178564214198253658172008-093496944249107NIL202247414866295358452009-104327028830084NIL256164621088024528432010-11109196336688060NIL357145627575838138722011-1211805709886077NIL6803789570835110954372012-13139058112100102NIL597359750392049343938External SupportSl.NoHighlightsDonor DetailsRemarks1Important Equipment sponsors Anaesthesia machine, Fluorescent angiography, NRI Voluntary contributors in the year 2006 and 2007The authors maiden visit to UAE, was supplemented by a Asianet FM radio 35 minutes interview with the program Director Mr Chandrasenan2Other important sponsorsVery few friends and relatives (meagre amount), Patients (after their medical treatment)Purchased furnitures and canteen utensils 3Village Eye campSupport of a Social reformer Sai Ram BhatEye camp undertaken every Saturday in the village4NGO/Social service organisation support for additions like Rain water harvesting and Bio gas plantNo DonorSelf sustenance 9Innovation Credit Finance, Savings and InsuranceAll employees working in the hospital are from adjacent villages. Each employee has the benefit of having a savings bank account. Each employee comes from a family where no history of consistent employment was found.Each Savings Bank account has been assigned with the facility for taking personal loan for their domestic and agriculture oriented effortsDependents of each employee undertakes additional value added works like cattle/milk processing, agriculture (paddy/arecanut), supply food snacks to hotels (hotels/mess/canteen in and around 15 kms)Every employee is credited with the facility of Health insurance One lakh coverage under Bajaj Allianz insuranceHospital employees dependents are recognized with a 50% concession on every eye ailment, both medical and surgical. A charitable society named Koumudi Grameena Health point recognizes a) Relevance of financial assistance for very poor villagers b) Undertakes free medical eye camps in association with local village clubs / social service organizationsThe hospital recognizes 10th standard meritorious village school students with cash awards

10Interface with Markets and Delivery SystemMedicalCamps invillagesAwarenessCamps in villagesHelps inImprovedExpectations in villagersTertiary eye care delivery system in a village Learning spirit in village childrenEmployability Status of villagers improvesSustenance of agriculture as livelihoodRural segmentation and positioning

QWL concept gets a platform in a villageInternal infrastructural facility Treatment Family living spiritual support and emotional attachment

11Financial innovation in Bela and adjacent villagesIt is quite significant to acknowledge the recognition of

Number of employees having Savings bank account in Karnataka Bank, Nirchal (a village bank) is 41 as on dateNumber of Savings Bank accounts in Karnataka bank, Nirchal in 2001 - 987Number of Savings bank in Karnataka Bank, Nirchal presently is 7567Turnover of Karnataka Bank, Nirchal in 2001 2 croresTurnover of Karnataka Bank, Nirchal in 2014 43 crores (N.B: Turnover of this increased from 18cr to 43 cr during the last 5 years)Number of loans availed by the people for their household purpose on their respective Savings Bank account in the Karnataka Bank on date July 31st 2014 is 5623

12ImpactYear 1Year 3Year 5Year 7Year 9Year 11 Year 13Number of overall patients42521093581431586061235618675Number of patients from villages4031783312336767345923413980Number of Eye camps/village awareness programs conducted in villages5131921263442Number of surgeries0519119738617025435Total number of full time Doctors and staff1/21/71/101/132/213/353/41R/O Turnover (lakhs)0.272.1611.6417.8425.6168.0359.7313The Transformation

2001 - 1st building2014 The campus nowCanteenan inside view14Uniqueness and Replicability of the Innovation The uniqueness of the project has been the core effort of a Joint family to transfer their base en masse from a city to a village and to be there physically with high level of commitment and perseverance. Replicability prospects will definitely depend on the level of team understanding in a family.

15Constraints and Challenges* Lack of Government support and interest (Panchayath, Village office, other government departments in the rural areas has no sense of understanding the importance of the project)

No financial assistance or support from Banks or financial institutions in the first 4 years. Banks have a philosophy of following business returns of the investment. All banks consider investments in village as a loss.

Lack of power supply Kerala state Electricity Board (State Government) has miserably failed in supporting this social cause (N.B: No surgery in the hospital till date has been undertaken with KSEB power)

Lack of understanding among relatives and friends during initial hardships

Conventions, traditions and other social values inherited by villagers will provide a bad turf for evaluating prospects of commencing such projects and to progress

Sourcing good manpower from villages alone (if it is a policy)

16LearningsOrganisational effectivenessStrategic perspectives Replicability of the projectOrganisational and Social DevelopmentFamily Business ManagementInclusive growthCause Marketing

This Management case can be comprehensively analysed and discussed in MBA / PGDM classes

17Thank you18