Part 2 of series find Part 1 here.
In our previous blog post, we introduced the case of Aravind Eye Care System, an innovative hospital located in Tamil Nadu, India. What makes Aravind interesting to us is its focus on external capacity building. At first glance, this investment into helping other hospitals grow does not seem self-serving, but more rather like helping to build its own competition. This multi-part study, commissioned by Seva, aims to explore what the benefit to Aravind is, in investing outside their own walls.
Supporting the external capacity building of other institutions and individuals aligns and complements Aravind’s historic mission. Aravind’s goal is not to just to eliminate blindness in India, but to eliminate blindness worldwide. To achieve this mission the method they’ve selected is not to proliferate Aravind hospitals in every country in the world, but instead, through training and consultation, to influence the quality and efficiency of eye care services at the policy, systems and individual staff levels. Professionals are motivated to come to Aravind for courses that have been developed largely in response to Aravind’s unique knowledge and experience.
We want to share our successful learning model to the rest of the world in order to fulfill our vision. Our vision is to eliminate needless blindness in as many people as possible. Aravind alone cannot do this whole job because the problem is plenty and it’s everywhere. We thought we would do this through other organizations, through other ophthalmologists, other NGOs so that the quality of our eye work will be spread out to the rest of the world and can multiply the solution.—Aravind Administrator
The Link between Internal and External Demand
Through their capacity building activities, Aravind has developed a unique type of synergy between internal and external demand. The courses that Aravind offers are needed by Aravind itself (internal demand) to develop the people who are going to grow Aravind’s system. Concurrently, by recognizing that hospitals elsewhere need people trained in these same skills and systems thinking (external demand), they have opened the door to more hospitals interested in sending staff or teams to Aravind.
Due to this ever-increasing demand from the outside, almost from its inception, Aravind has been pushed to expand their own internal resources for external capacity building both in staff structure and function. This expansion means that Aravind staff and physicians provide both capacity building consultation at a remote hospital and clinic sites in addition to delivering onsite training at Aravind.
All clinical and administrative staff, both junior and senior, is expected to participate in external consulting as part of their routine work to the degree that no single individual travels so much that it affects their department’s productivity at home. Over time, Aravind’s external consulting has expanded into specialty areas such as pediatric ophthalmology, diabetic retinopathy, glaucoma, and corneal grafting—services that previously were unavailable outside of a few major cities.
Reaching their goal of eliminating worldwide blindness and creating the ability to meet internal as well as external demand helps explains why Aravind invests so heavily in external capacity building activities. However, it does not tell the full story.
Going forward our research to identify and analyze the benefits that capacity building has had on Aravind will be guided by the following questions:
- To what extent do internal and external capacity building grow dialectically becoming mutually defining and reinforcing?
- How does the experience of external capacity building inform clinical practice and physician attitudes and behavior within Aravind?
- Does acting as a change agent elsewhere establish a tension between serving needs of external client vs. serving internal resource and training needs within Aravind?
- Does delivering external capacity building establish a tension between the practices and behavior, which are exported and the various alternate practices at home?
- Does the tension between external and internal capacity building push Aravind to evolve?
As we continue to share this story with you, we hope to not only uncover the answers to these questions but that our findings will be a guide for other institutions and organizations looking to replicate or adapt Aravind’s methods.
Join us next month when our next blog will explore the history and early motivations behind the development of Aravind’s internal and external capacity building activities.