Who's Seva: Our History of Eye Care

"There is no greater calling than to serve your fellow men. There is no greater contribution than to help the weak. There is no greater satisfaction than to have done it well."  Walter Reuther

In 1978, a remarkable conference of friends and colleagues gathered together in the US to ask this question: How could they be of service?

The answer turned out to be Seva.

Seva means "service" in Sanskrit. In 1978, after working with the World Health Organization (WHO) to end smallpox in India, Dr. Larry Brilliant and his wife Girija Brilliant, a public health specialist, published an article entitled Death of a Killer Disease. It was a personal account of their decade in Asia, first as youthful travelers, then as spiritual seekers, and eventually as part of WHO's successful smallpox eradication team.

They concluded the article with an appeal to readers to find the compassion and understanding to support international health programs to benefit those struggling with poverty.

Readers were moved, and soon $20,000 of donations arrived in Larry and Girija's mailbox — with the first $5,000 coming from not-yet-famous computer inventor, Steve Jobs.

An Eclectic Rolodex
Inspired by the supportive response, the Brilliants convened a conference of friends and colleagues to consider what to do next now that smallpox had been eradicated — how could they best be of service?

Using their personal Rolodex of health professionals and cultural activists, the Brilliants invited an eclectic group that included the World Health Organization’s Dr. Nicole Grasset, spiritual teacher Ram Dass, and Berkeley activists Wavy Gravy and Jahanara Romney.

The Sight Program is Launched
Dr. Grasset introduced the group to Dr. G. Venkataswami, a retired eye surgeon in India known as "Dr. V" who was just setting out to fulfill his vision of making cataract surgery as "ubiquitous as McDonalds," and therefore affordable to the poor. That was the beginning of Seva's partnership in the high-volume eye clinic that would become the internationally known Aravind Eye Care Systems.

Since then, Seva-supported programs and partners have helped nearly three million blind people to see again through affordable cataract surgeries. In just the past year, Seva's Sight Program benefited over 500,000 people worldwide, including more than 25,000 children.

Seva Canada Born in 1982
Seva Canada was incorporated in Vancouver in 1982 at the impetus of Alan Morinis and Bev Spring. Alan and Bev knew the Brilliants from the smallpox eradication program in India and both were serving on the Board of Seva Foundation. They wanted to develop support for Seva’s work in Canada and engage Canadian government support and funding.

Seva Canada’s activities initially focused on providing a supporting role to the Foundation’s activities. Like the Seva Foundation, Seva Canada began to branch into areas other than sight and became involved in funding a street youth program and a literacy program in Vancouver. At a strategic planning meeting in 1999, Seva Canada decided to focus only on our area of greatest strength, the work to preserve and restore sight to those who need it most.

Seva Canada and Seva Foundation - sister organizations

In recent years, Seva Canada has developed its own program goals and objectives complementing those of the Seva Foundation, but which are also uniquely its own. Our particular focus is on community ophthalmology programs and the barriers women, children, the very poor, and those living in rural area face in trying to access eye care.

For many years Seva has worked with partners in India, Nepal, Tibet and Tanzania. In July 2008, three more countries were added to Seva Canada's sight programs: Guatemala, Cambodia and Egypt. These three country partners had been supported by our sister organization, Seva Foundation, for some time.

Here are some highlights of Seva’s 30 years of innovation in blindness prevention:

Groundbreaking Surveys

Seva Foundation in the US spearheaded the Nepal Blindness Survey of 1980-81, the world’s first nationwide, population-based study of the causes and distribution of blindness. The survey found that most of Nepal’s blindness is cataract-related and most cataract blind people do not know cataract surgery exists to restore their sight. Results of this survey, a collaborative effort with the WHO and the Government of Nepal, guided the development of the national program, which has grown into a network of 15 eye hospitals and training programs. The survey findings and Seva’s work have shaped the entire field of blindness prevention in developing countries.

Lessening the Tragedy of Rubella

In many countries, a significant proportion of children’s congenital cataract is caused by rubella – a disease that is largely forgotten in countries that provide childhood immunization. Seva Canada board member and pediatric ophthalmology advisor, Dr. John Pratt-Johnson, successfully advocated for the simple inclusion of rubella in the basic list of immunizations required by the World Health Organization – a move that promises to prevent untold numbers of children from suffering blindness, profound hearing loss, cardiac deformities and other lifelong problems.

Seva and Aravind Eye Care System, India

Seva has worked with Aravind staff and partners to expand from an 11-bed clinic in a rented house to a 3,950-bed network of eye hospitals. Aravind is now the most productive eye care organization in the world, serving over 1.7 million patients a year (two-thirds for free) and providing more than 247,000 eye surgeries in 2005 alone.

Together Seva and Aravind have pioneered a model of high-volume, high-quality care in which fees are charged to those who can afford them and thus subsidize free care to those who cannot. Seva has applied this approach elsewhere, helping to establish a pricing system for that ensures both financial sustainability and affordable care.

Seva also helped create Aravind’s Aurolab, a nonprofit business trust that is now a leading manufacturer of intraocular lenses (IOLs), sutures and other vital supplies for eye care. Aurolab revolutionized eye care throughout the developing world by bringing the cost of IOLs down from approximately $300 per lens to under $10. Aurolab has now become the developing world’s leading supplier of IOLs.

Lumbini Eye Care Program, Nepal

Seva sponsored the Lumbini Eye Care Program in Nepal. LECP includes a large hospital with 12 full-time ophthalmological specialists and a resident training program, six rural clinics, over 50 screening camps and 6 surgical camps each year. With Seva support, Lumbini became the first rural eye hospital in a developing country to be financially self-sufficient from affordable patient fees.

Redressing the Gender Imbalance

Two out of three blind people are women, yet they are the least likely to obtain sight-restoring services. Seva is a global leader in efforts to address barriers to care for women and girls and to increase access to health education, eye care and treatment. Through studies and advocacy work, Seva is bringing the issue of gender inequities in eye care to the attention of the World Health Organization and the international community.

Incorporating Local Health Traditions

Seva makes special efforts to understand the health beliefs, practices and preferences of the people our programs are designed to serve. We believe culturally appropriate programs are ultimately more sustainable.

Improving Cataract Surgery

Seva Canada board member and ophthalmologist, Dr. Marty Spencer, helped to revolutionize eye care surgery in the developing world by pioneering the use of modern surgery techniques including the use of intraocular lens implant.

Reducing Obstacles to Eye Surgery

Seva led research in India to find out why so few blind people came for free, locally available eye surgery. Seva found that even “free surgery” can be too expensive when the cost of transportation, meals and lost wages for an escort are included. Today Seva is a global leader in studying and addressing barriers to accessing eye care.

Building Local Capacity

Seva’s approach to sustainability means investing in people. For 30 years, Seva has helped provide clinical training for thousands of local eye care workers, in every aspect of eye care from cataract surgery to nutrition education to dispensing eyeglasses. By sharing advanced technology for sight restoration with our partners, Seva reduces costs and enables the programs to continue without depending on support from abroad.

Vision and Leadership

Perhaps the biggest hurdle for a program to overcome is the sustainability of its management and leadership capacity. A program that has grown under one charismatic leader may flounder when that leader moves on. In recent years, Seva has focused increasingly on supporting management training in every program, so that our partners have not only the clinical skills to restore sight but the management skills to find the people who need eye care and provide them with the services they need.

Looking Ahead

After 30 years of service and innovation in eye care, Seva is taking the lessons we have learned and sharing them more widely with many different partners – from individual eye doctors and hospitals to national governments and international agencies. With the assistance of long-time partners, we plan to carry Seva’s blindness prevention initiatives into the coming decades to help reduce the burden of blindness worldwide.

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