“You see, when people need help, you can’t simply run away, no?” says Dr. V. “You say, I will help you, and then you do what you can.
Even when we started, we did good-quality work, so the rich people came and paid us, and we could treat the poor people with the money saved. The poor people brought more poor people; the rich people brought more rich people. So now, here we are.”…….

……..How do you create a system that thrives on generosity, one that actually benefits from serving those most in need? How do you engineer an organization that demonstrates repeatedly that high-quality surgical outcomes can be fostered, not threatened, by high volume; and how do you, in the developing-world context, link high quality with affordability—or more radically still, with “free”? The answers to these questions weave together as inextricable threads in the fabric of Aravind. Each influences, and is affected by, the others. “Fundamentally, it’s not just numbers that we are chasing. There is a synergy between quality, cost, and the demand for services,” says Thulsi…….

……..There is an interesting flip side to the issue of public perception. Most of Aravind’s paying patients, while aware of Aravind’s vast work in the community, have no idea that by choosing to pay for services, they are indirectly contributing to someone else’s care. Aravind deliberately steers clear of advertising this pay-it-forward angle to its high-end customers. Touting charitable services can work against your reputation in a world where quality and charity are not necessarily linked, and Aravind leadership believes that when it comes to personal health, value for money and quality of care are priorities that tend to outweigh generosity.