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An American’s Vision Healed – in India
            By Shlomo Maital

Kristos Stavropoulos
Kristos Stavropoulos is Chief Information & Technology Officer at Maguire Investments.  The only reason I mention this, is that I assume he has the resources to get top-flight medical care anywhere in the US. 
   Instead he went to … India.
   India?
   Stavropoulos recounts that he had a corneal scar – a scar on the thin transparent layer that covers the iris and pupil of the eye and refracts light.   A scar on the cornea can be a major problem.  Caused by an eye infection, the scar affected his vision – rather crucial in his line of work.  So he travelled all the way to Hyderabad, in southern India, to the L V Prasad Eye Institute.    (I have visited LVPEI several times, and recently met with its amazing founder, Dr. G. N. Rao,  in Israel).  
    At LVPEI   Stavropoulos consulted Dr. Sayan Basu.  She is an expert in a highly complex and revolutionary treatment, that uses stem cells to regrow and repair corneas.  Stem cells are human cells that have the ability to become whatever is needed – include corneal tissue – depending where they are.  But they are notoriously difficult to work with.   Here is what Stavropoulos said, after successful treatment:
     “My experience at LVPEI has been exceptional.  When you think of surgery, it’s scary, especially with eyes.  But the great thing about this institute is the positivity and expertise  that the doctors and the team have.  Most importantly, I trusted Dr. Basu and was assured about the success of the treatment that I was provided.”
    So far, over 1,600 innovative stem cell procedures have been performed at LVPEI, Patients from India, and from all over the world, have benefited from these innovative procedures.  At LVPEI,  wealthy patients pay for patients who have no money.  But everybody, EVERYbody, gets the same quality of medical care.  And the enormous scale of the medical care means that even experimental high-tech procedures can be tried, improved, studied – and made standard.
      At LVPEI I learned about an even more amazing technology under development – use of stem cells to regrow RETINAL cells (the retina is the kind of mirror, or light receptor, at the back of the eye, subject to retinal detachment, or macular degeneration [e.g. holes in the retina] ). 
    So, if you have eye disease, and if your doctors tell you they can’t treat it – check out LVPEI.   Because Indian people have so many eye diseases and problems,  LVPEI experts have vast experience – and creativity plus experience leads to innovative medical care that pushes frontiers to amazing places.  In the past 31 years, LVPEI has treated 28 million people, many of them from very poor villages. 
     By the way, Dr. Rao is now working to establish an LVPEI-type clinic in Monrovia, Liberia.  This,  despite Liberia’s strong links with the United States (it was founded by former American slaves).  It is hard for even top American doctors to understand how to establish medical care centers in very poor countries – but LVPEI knows how.  Liberia’s legendary former president Ellen Johnson Sirleaf,  who heard of LVPEI and whose close relative was successfully treated there, visited LVPEI, made the request – and LVPEI responded.
      

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“The Poor Should Not Be Treated Poorly”

By Shlomo Maital  

venkatchennamma-photo-markapur  

From left to right:   N. Ankalamma,(mother of Chennamma), Chennamma (patient), Mr Thirumla Kondalu & Mr Karunakar (Community Based Field Staff who counselled her at her home) and Dr Nilesh Jaiswal (Ophthalmologist who performed the surgeries at the secondary centre).    

  – – – – – –

   I’ve just returned from a short trip to Hyderabad, India, where I and my co-author Prof. D.V.R. Seshadri launched our new book Smartonomics (SAGE India). While there, Seshadri and I visited the L V Prasad Eye Institute, which has treated 21 million patients since it was founded 30 years ago by Dr. G. N. Rao.   We are writing a Case Study about LVPEI.  

     Here in brief is the story. Dr. Rao and his wife Prattibha lived in Rochester, New York, in 1986. Dr. Rao had a comfortable prestigious position at the University Hospital there, as a top ophthalmologist. But he and his wife chose to return to their homeland, India, to found a world-class eye disease institute. A famous film producer L V Prasad donated the money for the land and building, in Hyderabad.  

       Dr. Rao’s vision was to provide excellent world-class eye care for all, including those who could not pay. How? Cross-subsidization. Those who could pay, would. Those who couldn’t, would not. And somehow the resources would make possible truly excellent innovative eye care, restoring vision for many many thousands. LVPEI began in 1987 with three examination rooms and 2 operating rooms, and soon expanded into 4 states, with primary, secondary and tertiary eye care reaching into the poorest rural regions.

       Dr. Rao implemented his vision of the four E’s: excellence, efficiency, equity and empathic eye care.   He expressed it as an Eye Health Pyramid (see figure):

lvpei-pyramid

In this model, state of the art eye care was provided at the LVPEI center in Hyderabad, India’s 6th largest city. Secondary and primary eye care was pushed out to the periphery, always under the watchful eye and supervision of the LVPEI center.   In the past 3 decades, 21 million people have been treated. Many have had vision restored. There is no greater gift.   

     This model is crucial, because however excellent, the Eye Care Center in Hyderabad is of little value for the rural poor, unless there is outreach and counselling that identifies their problems and begins to treat them. All too often, health care available in big cities is far superior to that available in the poor rural regions.

   Here is just one small story:     Nalagati Venkata Chennamma was born with visual and intellectual impairment. At the age of 8, her vision deteriorated further. Fearing high fees and Chennamma’s difficult behaviour, doctors were never consulted by the family. At the age of 20 she underwent an eye check and was declared 100% blind. But as fate would have it, five years later, Karunakar one of LVPEI’s Field Rehabilitation Service Officers visited her and spotted symptoms of cataract.    Apprehensive in the beginning, Chennamma’s mother brought her to LVPEI’s secondary centre in Markapuram on 7th November 2016. She was operated by Dr Nilesh Jaiswal for congenital cataract in both of her eyes and subsequently regained functional vision. There is a possibility that her vision can be further enhanced and she is currently undergoing treatment at LVPEI’s Hyderabad Centre of Excellence Campus. Today, her family is delighted with the outcome of the surgery and are thankful to LVPEI and its talented doctors.     There is hope that with vision restored, Chennamma can make up some ground in her intellectual development.

     Dr. Rao has just been selected for the American Society of Cataract and Refractive Surgery (ASCRS)’s Ophthalmology Hall Of Fame, a rare honor given to very few. He will travel to the Los Angeles for the induction ceremony on May 6.  

Blog entries written by Prof. Shlomo Maital

Shlomo Maital
June 2019
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