Site Visits

 

Visit Report of James Killam - Nidadavole, February 5-6, 2002

Nidadavole is a 9 hour train ride from Hyderabad. It is small town in a lush but poor area of the state near the Bay of Bengal. The project is run out of a room at the Rajeshwari Ramakrishnan Lions Eye Hospital. This is a very impressive, relatively new facility located at the edge of the town, surrounded by rice paddies and palm trees. The hospital is one of the largest buildings in the town - it is nicely constructed and is clean, quiet and efficient.

It has two ophthalmologists, who each perform about 14 surgeries on alternate days. They have done up to 20 in a single day. While one is doing surgery, the other does assessments.

Currently, not including the patients who are part of our project, 60% of outpatients pay while 40% do not. With surgeries, only 10 to 20% pay. They say their break even point is 30% paying with one deluxe patient per day. They have four categories: non paying, economy at 1250 rs, ($40 Canadian), semi private at 2500 rs and deluxe at 4500 or 5000 rs per day. They currently average 8 deluxe patients per month, 12 semi-private and 15 to 18 economy (excluding our project participants).

There is not a well defined structure for determining economic status. Assessors look at the clothing they wear, their ration card, which comes in 2 or 3 different colors and with walk ins, before they have surgery, they go to the patient's village to determine their living conditions. Mr. Kumar, the administrator of the hospital, said there was "some level of pilferage".

The Project has a large room on the ground floor of the hospital. There are 3 or 4 staff who work in the office and about 12 young field workers who go to the villages by bicycle.

The project was initially viewed, and still is viewed with some suspicion by the villagers. People expect problems in any kind of program and this is a totally new concept.

Nevertheless, everyone involved in it is very enthusiastic and optimistic that the project will be accepted by the villagers. The hospital management hopes that it will eventually replace the paying/non-paying system. This will require at least 70 - 80% participation. They do not think there will be a significant drop out at premium renewal time. Mr. Kumar said "once they taste it, they won't withdraw".

During my visit, I attended two meetings of Women's Groups where the project leaders explained the project and enlisted their support. I also had the opportunity to visit some of the villages served by the project and met about 20 people who had had their vision restored through it. Some of their stories can be found at Those We Help.