The Perfect Vision of Dr. V.

India's poor never expected to regain their sight. A visit to the hospital is largely out of their physical, geographic, and economic reach. It's also totally beyond their imagination, outside the boundary of hope. How can you hope for what you can't even imagine? How can you imagine what is so far beyond your daily experience? It isn't easy to picture an active market existing in these villages, where buffalo roam freely amid huts that have just a cot or two under their roofs. Yet everyone in India is an entrepreneur, and there is great pent-up demand. The poor can afford products and services -- ones that sell functionality over features.

Most companies tend to focus on selling to the rich and the super-rich -- consumers who have an annual income of $50,000 to $100,000, or more. But there are billions of potential customers out there whose purchasing power is about $2,000 per year.

C.K. Prahalad, an award-winning author and respected professor of strategy at the University of Michigan Business School, argues that you need more sophistication and greater intellect to cope in these markets. How do you marry low cost with quality, sustainability, and profits -- all at the same time -- in such diverse markets as food, health, communications, personal care, primary education, and financial services ? Prahalad's answer: You imagine selling your service or product to the poor. In a lecture given last January, he argued that "the business opportunity in India is in servicing the poor, and servicing the poor is good business."

Dr. V. agrees with that analysis, but he hates the sound of it. "Consultants talk of 'the poor,' " he says. "No one at Aravind does. 'The poor' is a vulgar term. Would you call Christ a poor man? To think of certain people as 'the poor' puts you in a superior position, blinds you to the ways in which you are poor -- and in the West there are many such ways: emotionally and spiritually, for example. You have comforts in America, but you are afraid of each other."

As a market-driving organization, Aravind has to educate its free patients. One of the ways that the hospitals accomplish this is through community work, which their doctors and technicians almost routinely undertake. First, a representative from Aravind visits a village and meets with its leaders. Together they do the planning necessary to organize a weekend camp. Then Aravind doctors and technicians set out for the village, sometimes driving for days. Once there, they work around the clock, examining people and working to identify those who will need to be taken to Madurai for surgery.

They put a pair of glasses on people for whom the purchase represents a day and a half's pay. "People can't believe it," says Dr. V. "Often they can see clearly for the first time in their lives. They usually say, 'Thank you,' and go away -- with the glasses on. The next day, they come back ready to make the purchase. This is how we sell 1,000 pairs of eyeglasses per day."

Give people a new experience, one that deeply changes their lives, make it affordable, and eventually you change the whole world. And your customers become your marketers.

The New Age Group Is Alive and Well, and Meeting in India

I have never met a leader who even approached Dr. V. The stories about him are legendary. Here's one: Dr. V. is leaning unsteadily against a wall. Usha, his niece and fellow surgeon, runs up to him to offer help. "You can't help me," he says, "I'm supporting the wall."

Here's another: A new guard confronts Dr. V. at the entrance to the hospital: "Sit down, old man, you're blocking people." In walks Dr. Natchiar, who asks, "Dr. V., what are you doing sitting in reception?" "I was told I can't go in, so I'm waiting," he replies.

And another: Usha, who holds the record for most surgeries in a day (155), admits to conspiring with the nurses to send her more than her allotment of patients, a practice that Aravind doctors routinely engage in. On returning from a village camp running a fever of 102, she checks herself into the hospital. Dr. V. happens to arrive in the morning. "What are you doing here?" he asks. "I'm sick," she says. "My fever is 104," he tells her. "How high is yours?" She can't bring herself to say, so she climbs out of bed and goes back to work.

An industrialist from Delhi once came to Aravind and said, "I need to build a hospital, and I'm very much impressed with this one. Could you come to Delhi and start a hospital for me?" Dr. V. replied, "You have all the money you need. It shouldn't be hard for you to put up a hospital in Delhi." "No," the industrialist said, "I want a hospital with the Aravind culture. People are cordial here. They seem to respect more than money. There is a certain amount of inner communion or compassion that flows from them. How do you do it?"