In 1914 Dr Sorabji P Shroff, who had just returned from England
after completing his Fellowship of the Royal College of Surgeons (FRCS), set up
his one-room clinic in the walled city of Delhi. The uppermost thought in the
36-year-old enthusiast’s mind was to serve his impoverished countrymen, with
the driving idea being ensuring ‘quality eye care for everyone’.

The clinic filled a long-felt gap for the poor and received such an
overwhelming response from the community that Dr Shroff became convinced about
starting a hospital. Haji Mohammed Ishaq allowed him to use one storey of his
newly constructed building on Burn Bastion Road. Very soon, even this space was
not enough. People from all corners of India and present-day Pakistan thronged
the hospital for the free quality care. As a consequence of a series of
representations, in 1924 the British Administration made land available in
Daryaganj. The current building of the hospital was completed in 1927 and was
inaugurated on 23 March by Lady Irwin, the then Vicerene of India.

As the clinic grew in popularity, prominent citizens of Delhi such
as Dr MA Ansari, Hakim Ajmal Khan, Rai Bahadur Lala Sultan Singh, and Shri
Pyare Lal became associated with it, forming a trust in 1922 with the goal of
building up a dedicated eye hospital. In 1933 the British government awarded Dr
Shroff the Kaisar-i-Hind, a gold medal for philanthropy, and helped with
getting the hospital equipped with amenities and equipment. Meanwhile,
institutions from around the globe visited SCEH to share their insights.

In 1962, the institution was selected as a leading eye hospital by
the International Conference of Ophthalmology held in Delhi. The following year,
just one year before his death, Dr Shroff was awarded the Padma Shri by the Government
of India for his humanitarian efforts. The responsibility of running the
hospital passed on to Dr Shroff’s son, Dr Minoo Shroff.

As time passed, the hospital building, the infrastructure and equipments, and the swelling numbers of patients started demanding more professional management and better logistics. Yet, SCEH also needed to retain its essential character. At this juncture, it received a fresh lease of life when Vikram Lal of the Eicher group of companies joined the board of directors and offered to extend managerial expertise and resources to upgrade and modernize the hospital.

Today, the institute remains governed by a board of directors
representing stalwarts from different walks of life, including the ophthalmologist grandsons of the founder, Dr Noshir Shroff and Dr Cyrus Shroff, as well as Vikram Lal. Partners of SCEH include some
of the biggest international eye-care funding agencies like CBM International,
Germany; International Agency for the Prevention of Blindness (IAPB), London; Rotary
International, USA; Combat Blindness Foundation, USA; ORBIS International, USA;
Massachusetts Institute of Technology, USA; and World Diabetes Foundation,
Denmark. Corporate entities like Standard Chartered and Adobe have also
supported them. In 1996 the Eicher group, came on-board and granted generous
sums of money to upgrade the infrastructure and equipment.

A super speciality eye and ENT (ear, nose, throat) hospital with a workforce numbering
above 400, Shroff’s Charity Eye Hospital (SCEH) has, since its inception, been
devoted to providing effective care to the underprivileged, conducting in a
given year over 5,000 surgeries free of cost or at highly subsidized rates. ENT services were started in the 1960s, not from the time of the hospital’s inception. Eye and ENT in those days were closely linked and internationally, many hospitals had the two specialities together. ENT is a smaller department at SCEH, though it sees over a hundred patients on a daily basis.

The
hospital’s stated mission is to make a lasting impact on the eradication of
blindness and deafness in India by providing quality care to all sections of
society. To ensure that this is not some pipe dream, the institution has always
focused on acquiring cutting-edge infrastructure and seasoned manpower;
adopting globally appreciated quality protocols; and innovating processes and
techniques. At various points in time, the medical and non-medical teams
visited tertiary centres of eye care across the globe; many trained there and
used their experiences to bolster the systems and services here.

The vision of SCEH is clear and sharp – ‘to be the best tertiary eye
and ENT care institution in northern India providing quality care to people
across all economic sections of the society.’ A tertiary institution is one that
focuses on comprehensiveness, training, research, and impact in terms of
numbers and understanding.

To achieve its vision, SCEH works on rotating three-year strategic
plans that are developed internally with the participation of all stakeholders.
The duration of the current strategic plan is 2010–13. The two guiding points
of the plan are: to consolidate its domain leadership in North India, thereby
preparing to become a centre of excellence in eye and ENT care, and to
strengthen the organization, thereby laying the foundation for the next 100
years.

Reaching
out and across
SCEH follows the internationally accepted hub-and-spoke model for
delivery of quality eye and ENT care services. While the Daryaganj hospital is
the hub and the base unit where all the super specialists are present, the
spokes (the secondary centres and clinics) are distributed across various
district headquarters in the states of Rajasthan, Haryana, and Uttar Pradesh.

The base hospital houses all the super specialities under eye and
ENT, and provides tertiary referral support to almost all of North India, apart
from patients identified internally in the network. To support the medical
staff who have trained from various institutes in India and abroad, the hospital
has diagnostic equipment to provide cutting-edge intervention. It is also a hub
for training and research.

In Uttar Pradesh, the hospital is located on the Delhi-Saharanpur
highway at a place called Rampur Maniharan. The facility has been made possible
by generous contributions and support from Combat Blindness Foundation, USA. The
hospital is currently a full-fledged secondary centre with the capability to
deal with all kinds of cataracts. It is supported by six vision centres spread
across various points in the district.

The clinic in Gurgaon (Haryana) provides comprehensive eye care including
glaucoma and paediatric eye-care services. It is supported by six vision
centres spread across various points in the district.

The Alwar hospital is the oldest in the network. It is a full-fledged
secondary centre with the capacity to deal with all kinds of cataract cases and
has diagnostic facilities such as visual fields, fundus flurocein angiography,
and retinal lasers. The standard clinical services are complemented by regular
visits of surgeons across all specialities. The centre focuses on providing
services to the community in the entire district of Alwar as well as
neighbouring districts like Bharatpur and Dausa. The secondary centre is
supported by six vision centres spread across various points in the district.

The community outreach function at the institute has been
constantly evolving. In 2009–10, it focused on developing a network of vision
centres across the districts of Alwar in Rajasthan, Mewat in Haryana, Saharanpur
in Uttar Pradesh, and certain urban slums of Delhi in a bid to reach quality
primary eye-care services to the underserved and the needy. These vision
centres have been set up directly as well as in association with local NGOs
where available. Manned by vision technicians who hail from the local community
and who have undergone intensive 18-month training in primary eye care at the institute,
the vision centres are targeted towards ensuring the delivery of sustainable
and quality eye-care services to the underserved.

Through the vision centres as well as the traditional camp-based
model, the hospital seeks to identify and mobilize the movement of those in
need of eye surgery from various project areas.

Across the entire network, of the total 5,383 surgeries done for free
in 2009–10, the community function was directly responsible for the
identification, counselling, and transportation of 85 per cent, amounting to
4,576 surgeries. Wherever applicable, the hospital also provides onsite support
to various projects being executed in collaboration with a wide range of NGOs
and corporate entities.

The projects that are running in the various catchment areas are:

  • A
    vision centre project funded by ‘Seeing is Believing’, a combined entity of
    IAPB and Standard Chartered Bank
  • A
    community-based rehabilitation project in Malakheda, Alwar District, funded by
    CBM
  • An
    IT resource centre for the visually impaired and low-vision persons in
    collaboration with Adobe India
  • A
    ‘detection and treatment of diabetic retinopathy’ project funded by World
    Diabetes Foundation
  • Project
    Prakash in collaboration with Department of Brain and Cognitive Sciences, MIT
    (in 2009–10, an estimated 20,834 children were screened across various
    locations in Haryana and Uttar Pradesh, apart from Delhi, and 48 congenitally
    blind children were identified. All the 48 were successfully operated upon and
    under various stages of rehabilitation.)

Cross-subsidy
funding

During
the1980s and early 90s, SCEH was passing through a difficult phase. The Shroff
brothers (grandsons of the founder) had moved to private practice and SCEH was
degenerating, and it had even acquired a pretty bad reputation. It had reached
a point where the trustees were contemplating giving the hospital to the
municipal corporation/government to run.

 

It was providential that at that critical
juncture Eicher Inc. with its visionary leader Vikram Lal stepped in to support
the hospital as a CSR initiative. They invested in upgrading the hospital’s
ailing infrastructure and equipment, and more importantly, they provided
administrative support to run the hospital. Eicher has put over Rs 20 crores in
the hospital since the mid-90s. The association has been the single biggest
factor in making the hospital what it is today. Some describe it as the
‘renaissance’ period of Shroff. The CEO of the hospital, AK Arora, is on
deputation from Eicher. Eicher representatives represent half the board of
trustees now. However, Eicher has been a very quiet supporter and one will not
find its name highlighted anywhere.

In any case, with donations and support getting
increasingly hard to find elsewhere during its lean period, the hospital was
running into heavy deficits. A crucial decision was
unavoidable. Thus, in 2002, the board decided on a shift from the 100 per cent
charity model to the ‘cross subsidy model’ to build sustenance and
self-sufficiency. To provide for operational needs and to underwrite the free
provisions made to the underprivileged, the hospital decided to enter the arena
of commercial services. Today, the institution meets about 85 per cent of its operating
expenses from internal accruals and is dependent on external grants/funds only for
funding free surgeries or capital acquisitions.

As its CEO, Arora

has
provided the much-needed focus on financial sustainability and growth.

With constant support from patrons and friends, SCEH has remained
committed to the founding principle of doing a minimum 50 per cent of the
annual work free of cost for those who cannot access it otherwise. Of the 10,356
surgeries recorded at the end of financial year 2009–10, nearly 54 per cent –
that is, 5,571 – was done for free. Over the last half decade, the institution
has more or less doubled its total surgical output without impacting the
founding principle.

As of 31 March 2010, SCEH, as per its financial report, had assets
worth Rs 93,181,403 and generated income of Rs
137,135,223.

SCEH is one of
the very few referral centres in North India, with its network services estimated
to be availed by about 200,000 people annually. The
hospital has so far made progress in its five focus areas: (1) development of tertiary
capabilities in chosen specialities; (2) developing training capabilities in ophthalmic
and non-ophthalmic programmes; (3) increasing the depth and the reach of
community eye-care initiative; (4) basic research; and (5) low-vision
rehabilitation and enhancement.

Energized by the outcome of the previous planning process, a core
team of 35 senior members across medical and non-medical functions was
constituted to develop the focus for the current strategic plan (2010–13). The
participants were divided into smaller groups, who in turn worked on the core
themes of (1) medical and paramedical education, research and training; (2) infrastructure
and equipment; (3) penetration in North India and developing outreach models;
(4) quality accreditation; (5) accountability and employee engagement; and (6)
brand building.

An important person who deserves to be mentioned
is Dr Steven Roy. A leading sports medicine doctor in the United States, Dr Roy
had closed his practice of 25 years and moved to India. He initially came as a consultant
and later as CEO of Shroff, when Eicher took over the management. Dr Roy was an
inspiring leader and laid the foundations for a quality and patient-centric
hospital. During his tenure of five years, the hospital staff, from the doctors
to the housekeeping, was oriented towards quality service. It was during his
tenure that the hospital acquired its ‘vision’. Dr Roy was in the United States
for six years after leaving Shroff and is currently heading an eye hospital at
Dhaka.

 

For
more information, you can contact the CEO at akarora@sceh.net

Dr Steven Roy can be reached at stevenproy09@gmail.com