With its population of over 1 billion people, India is believed to have around 15 million blind people and 52 million visually impaired. Of these 67 million Indians with poor or no sight, around 11 million are children.
The tragedy is that many causes of blindness are treatable. One of the leading charities in the field is Orbis International, which has been active in India since 1988. Orbis estimates half of India’s blind children could be cured if adequate facilities and medical staff were available. India has long suffered from a severe shortage of eye clinics and trained optometrists. The country needs around 40,000 eye specialists, but currently has fewer than 10,000.
A recent article in the Guardian highlights how one local not-for-profit organisation in India – the LV Prasad Eye Institute (LVPEI) – is tackling the problem of needlessly blind or visually impaired people. LVPEI offers free eye care to poor families, while charging those who can afford to pay. These fees help to support its work, along with money received from private donors and organisations. This funding allows LVPEI to run a chain of over 80 eye care centres across India. These provide services to around 1 million people annually and the organisation’s network is expanding.
LVPEI says that over half of patients receive free treatment. For many, this simply means receiving a pair of prescription glasses. Indian children are often blind because of uncorrected refractive errors (myopia, hyperopia or astigmatism), meaning the eye fails to focus light and make a clear image on the retina. These conditions are easily diagnosed and corrected with glasses.
While it may seem unfair to charge some people for their treatments, while others receive the same care for free, LVPEI believes this system is one way to address the huge need. Apart from having only half the number of health centres required to serve its population, around 70% of India’s hospitals are privately owned. Since most poor Indians have no form of health insurance, families are often unable or reluctant to find the money to pay for eye care, worrying that if they take out a loan, they will be unable to repay their debt. Cross-subsidies appear to be a workable and affordable solution to provide free care to such people.
Other hospital chains, such as those offering heart surgery or maternity services, have also introduced systems where prices are tiered according to ability to pay.The Indian government appears keen to adopt this kind of model more broadly, including suggestions for tiered pricing of health services in its five-year plan. Meanwhile, hundreds and thousands of children are being offered new vision by a local scheme which is already proving a success.