CB BureauIn 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 organisation, 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 mobilise 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 the 1980s 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.
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.
Energised 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