Sunday, April 27, 2008

Visiting Aravind

After years of hearing about the incredible Aravind Eye Hospitals, I finally was able to visit this prototypical social enterprise. Their model is to charge 30-40% of their patients enough to pay for their costs as well as the rest of the patients, as well as something extra (which generates funds for capital expansion).
Street view of Aravind Eye Hospital

I visited the main hospital in Madurai, where Aravind was founded by the late Dr. Venkataswamy ("Dr. V"). This was Dr V's retirement project! He came back from a visit to the United States impressed with McDonald's as a service delivery system, and decided to bring that same systematic approach to eye care. I've met with Thulsi, the executive director, in Europe at different events, but this was my first time on his (impressive) home turf.

Wall-plaque with the words: <br />Loss of sight can be the greatest tragedy next to death, yet hundreds of thousands of people in the world are suffering from blindness.  Participation by the public is the urgent cry in this mission of restoring vision.  Dr. G. Venkataswamy, Founder, Aravind Eye Hospitals<br />

Aravind's mission is to eliminate needless blindness, and they approach this objective with an amazing level of rigor. They are data-driven in a way that it is transparent to patients and staff alike. Every facility I saw had boards noting the daily activity. Target plans were readily accessible: I was visiting during school holidays and they were expecting more patients than typical.
white board with patient numbers
I went out to one of their rural facilities, which was one year old. Aravind's data indicated that their outreach camps were only reaching 7% of the people they needed to reach. So, they decided to create rural outreach clinics with a small staff (4 in the case of Alanganallur).
sign outside rural clinic in english and Tamil
The first thing I noticed was that the start-up costs had been supported by Lavelle Fund, which is also funding our first major project in India (more on that later). Aravind doesn't like to borrow money, and start-up costs are either drawn from earnings or grants. The analysis of the placement of the Alanganallur site was reminiscent of what MacDonalds must go through when deciding to site one of their restaurants. The number of people in the town and surrounding areas, assumptions about prevalence of different eye conditions, lists of other NGOs and doctors in the area and so on. I was there the day before the one-year anniversary, and the facilities white board told the story of basically meeting the expectations set before its launch. Based on that, their business plan was to break-even after a another two years.

Patient being seen by eye professional

One thing I was impressed with was the telemedicine facility. Telemedicine always seemed to me to be pretty heavily hyped, and not used as much as it has been hyped. At Aravind, it doesn't seem to be hyped but gets a ton of use. While I was in the main hospital, there was a doctor on telemedicine calls with a couple of outlying facilities. The patients actually get to speak with the doctor via the link.
radio antenna
When I went to the field operation, there was the terminal with the doctor online, from the other side. The doctor was talking to another clinic, but you could see that we were next up to talk to the doctor. On the roof, I was able to check out the point-to-point Internet connection to the main hospital (30 miles away, I think).

Aravind has a plan to quadruple their activities in India over the next few years, and I am not skeptical at all about their ability to meet those objectives. People sometimes decry the infiltration of "business approaches" into the nonprofit sector, but when you visit an incredibly poor country like India and see such a systematic social enterprise campaigning successfully against needless blindness. Certainly, this is an example of where it works well. India and the region seem to specialize in these kinds of approaches. It seems required when you're trying to help millions of people!

Friday, April 25, 2008

Zeno's British Airways Baggage Paradox

I remember being fascinated with Zeno's Paradox as a kid. The version I heard had to do with never getting someplace because you always had to get half-way there first (and then half-way of the remaining difference, and so on). The idea was that motion and getting someplace is an illusion.

And so it seemed with our baggage from British Airways on my current trip to India.

We had heard about the Terminal Five woes a month back, and thought they were solved. Unfortunately, solutions are an illusion. We were scheduled to go from San Francisco to Heathrow (London, UK) and then to Chennai, and then to Madurai. But, flight delays on leaving SFO meant that we wouldn't made our connection. Although the front desk agent missed this boat, the staff in the club caught it, rebooked us through Bangalore and retagged our bags before the plane took off. So far so good.

But, when we arrived in Bangalore to collect our bags, they were missing. The Bangalore staff had a sign up asking for us to check in. They gave us a claim check, 35 British pounds on a debit card for our trouble. And thence our journey into the paradox began.

airport tarmac, Air Deccan prop plane in background, Virginia and Jim Fruchterman
Looking pretty good in Bangalore, photo credit: Kate Fruchterman

The Paradox Unfolds

Day, Promised Arrival, Mode
Sunday morning
24 hours
Air

They said the bags would come in the next day and be delivered to our hotel. OK, we said, we can go out and buy shirts and an extra pair of underwear. And, we did that when we got to Madurai.

Day, Promised Arrival, Mode
Monday morning
12 hours
Air

We sent email and got an auto-response that BA would "revert within three days." Not wanting to revert on that timetable, we worked through the phone systems and spoke to someone. Yes, our bags had come in to Chennai and would be in Madurai by the evening.
OK, we can deal without a little longer. But Monday evening came and went with no bags.

Day, Promised Arrival, Mode
Tuesday morning at 7 am
6 hours
Air, then courier

So, another day, more phone calls. Well, actually, it turns out that the bags didn't come into Chennai. They came into Bangalore. OK, no problem, just pop them onto the 1 hour flight from Bangalore to Madurai and they'll be here soon. My wife and daughter buy Indian clothes. I keep wearing the same pants, but now have two shirts and two pairs of underwear that the hotel washes one of each day.

Day, Promised Arrival, Mode
Tuesday afternoon at 3 pm
3 hours
Courier

Well, it turns out that British Air claims that can't fly our bags from Bangalore to Madurai. But, we did it. As a matter of fact, British Air arranged for us to fly from Bangalore to Madurai when we missed our Chennai connection. So, for some reason BA refuses to send our bags by air, and sent it by courier service overland. But, the bags came into Bangalore yesterday morning and were then sent, so it should be here really soon now. It's only a twelve hour drive. This is cheaper?

Day, Promised Arrival, Mode
Wednesday morning at 7 am
2 hours
Bus courier, auto-rickshaw?

We call again. It turns out that it's not a trucking firm. It's guy on a bus. And, he got here last night but couldn't find our hotel. Odd, it's the only Taj hotel in Madurai. But cool, bus-courier-man will be here any minute. He'll just take an auto-rickshaw to get here, we assume (those cool three ubiquitous 3-wheeler). We're scheduled to check out of the hotel at 9 am to go to our next destination (Thanjavur, aka Tangore). We're just beginning to suspect that things aren't right (ok, I exaggerate). We ask for the mobile number of the delivery guy, just in case.

Day, Promised Arrival, Mode
Wednesday morning at 10 am
1 hour
Ox-cart?

Another missed deadline. Maybe it will never get here. Maybe the guy hired a bullock cart: that's why it's taking so long because the hotel is 10 minutes from the bus station.

By this time, the hotel staff are getting concerned. Will this American whose been wearing the same pair of pants for five days keep hanging around their lobby asking about his baggage? One of the front desk guys calls the delivery guy. He says, no problem, one hour more.

Day, Promised Arrival, Mode
Wednesday morning at 1130 am
1/2 hour
Wheeling our bags on foot?

By now, the general manager of the hotel has been offering to help for some time. He calls the courier mobile. Half an hour. More questions. Ooops, it's actually a guy from a courier company in Chennai. The courier doesn't have a mobile. Maybe, there is no courier at all.

The general manager decides to stop this sequence of ever-shortening time periods that never actually occur. Pretty soon, we should be able to see the delivery guys crawling along the road, always traveling half the distance to the hotel. But, we don't see him.

Day, Promised Arrival, Mode
Wednesday morning at noon
15 minutes
Hotel cowboy rides to rescue, intending to intercept the bags

So, the manager of the hotel decides to cut the Gordian knot of our dilemma [two Greek references in one blog post!]. He sends his own staff guy to the bus station. Soon, we'll find out what percentage of what British Air has been telling us is true. Are the bags at the bus station? Are they in Bangalore? Are they in Chennai? Could they still be in a pile at Heathrow?

Day, Promised Arrival, Mode
Wednesday at 1230 pm
10 minutes
Hotel cowboy ropes in the bags

We have word from the hotel staffer that the bags were indeed sitting at the bus station and he's on his way back: he'll be here in ten minutes (I cannot tell a lie, they didn't promise 7.5 minutes at this point, they promised ten).

Day, Promised Arrival, Mode
Wednesday at 1238 pm
They do!
Bellhops (3) wheel bags into our room

A miracle. My own malaria pills (I cadged my missing doses from Virginia, my wife, who was not so stupid as to have packed her pills in the checked baggage!).

Clean pants. My shaver. Sandals. Phone charger.

Vacation saved. And, Zeno's paradox has been broken by GM Ravi Khandige and the intrepid staff of the Taj Garden Retreat Hotel, Madurai, Tamil Nadu, India. [by the way, terrific hotel]

Oh, I fly home tomorrow through Heathrow on BA. Pray for me and my bags!

Monday, April 14, 2008

Looking back at the Skoll World Forum

It's amazing how time flies so quickly these days. I blinked and the Skoll Forum was already in the past. It's worth recapping some of the events that stuck in my brain.
Four women seated in chairs on a stage
On the opening evening, my favorite section was when Pat Mitchell (former head of PBS) moderated Dr. Nafis Sadik, Karen Tse and Jody Williams. Dr. Sadik has worked on women's health for many years in the UN system and mentioned her unsuccessful audience with the Pope (I assume John Paul II) on some of the policies coming out of the UN's Population and Development conference in Cairo in the 1990s. Jody Williams was bold and outspoken (I assume, as usual) and funny: she received the Nobel Peace Prize for her work on the campaign to ban landmines. And, Karen Tse, one of my fellow Skoll social entrepreneurs, gave such a dramatic and inspirational remark near the end that Pat Mitchell simply declared the session done and we floated out of the room looking forward to changing the world after being inspired by four powerful women!

Jimmy Carter

Jimmy Carter's keynote was awesome. He pulled stories from his past that were completely on point for an audience of social entrepreneurs (although he's still grappling with the term, I'm sure he has it now).

Al Gore
Al Gore has been working with Jeff Skoll for years, and their partnership has led to the movie an Inconvenient Truth and now the Alliance for Climate Protection. The Alliance launched its media campaign shortly and Gore gave some previews of this when he met with the social entrepreneurs after the final keynote session (where Gore spokes and Paul Farmer was the fiery voice of the social entrepreneur). Gore was relaxed and funny as he and Jeff talked to us for over an hour. You can tell this is what he's really committed to doing: he's found his calling.

I look back at all this and think how lucky I am to be part of this community. Hearing directly from people who have accomplished so much more and being able to ask them questions is incredibly inspiring and motivating. I know I'll aim higher for Benetech and evangelize even more passionately for helping society!

Tuesday, April 01, 2008

Skoll World Forum in Oxford

I'm coming home from my annual pilgrimage to Oxford for the Skoll World Forum. The Forum has become the international event for social entrepreneurs, and has now been heavily, heavily oversubscribed for the last two years.

This is my fourth time to the Forum: and each time actually gets better (as it gets harder to imagine how they'll pull it off again next year). For me, the highlights are the networking (especially peer networking) and the rockstar plenaries. The number of Nobel Peace prize winners has been just incredible: I think we had at least three speak at plenaries this year.
Dining hall by candelight
The event kicks off with a Tuesday night dinner for grantees at Exeter College, which is what Hogwart's (in the Harry Potter movies) was modeled after. The new Skoll Award winners each get three minutes to tell us a story.
Martin Fisher, Karen Tse and Willy Foote
Wednesday during the morning and early afternoon are sessions for the social entrepreneurs. Jeff Skoll spends an hour and a half explaining what he's been up to since stepping down as CEO of Participant Productions (actually, seems like stepping up to Chairman). Jeff has a track record of following through on his ideas.
Jeff Skoll, speaking
My first session like this three years ago was on Participant Products, which went from scratch to delivering movies like An Inconvenient Truth, Good Night and Good Luck, Syriana, Charlie Wilson's War and many others. When he started it, he was told "the streets of Hollywood are littered with the carcasses of people like you!"

This session is always a high point of the Forum for me. I think it's quite atypical for a founder of a major foundation to spend time allowing his grantees to ask him questions! One of his favorite quotes is from John Gardner: "Bet on good people doing good things." I think that sums up the Skoll Foundation's approach to grant-making.

People at tables listening to a speaker out of sight to the left

The rest of the time is focused on small groups tackling issues of common interest. This year, I engaged in sessions on using the Internet for advancing mission (I and Jill from Social Edge were the experts/moderators), leadership and succession, and reforming education. Although these sound really broad, the emphasis is on real experience. Each of us walks away having shared something important to us and receiving many good insights.

More in my next post!