Yes We Can

This weekend, Zhongshan Ophthalmic Center is hosting the “Million Poor Cataract Patient Sight-Restoring Program Mobilization Conference and Basic-level Hospital Ophthalmology Capacity Building Discussion”. Hospital heads and administrators from 41 county-level hospitals, along with two Aravind hospital consultants and a member of the Provincial Ministry of Health, gathering to share experiences and launch the start of this year’s Million Cataract Program, which subsidizes each participating hospital for a set number of free cataract surgeries.

The conference opens with a talk by the MOH guy, and pretty soon I realize this isn’t going to be your typical, sappy, hopelessly optimistic motivational speech. His tone is…disappointed, as he singles out one hospital (thankfully not in attendance) for falling short of its cataract surgery quota and making the whole province fall behind schedule. This is motivation in a sense, I realize, but motivation by making an example, by issuing a warning.

The speech concludes and there’s time for a few questions. The first one: how exactly does the reimbursement breakdown work? The second: what if my hospital doesn’t get all the money for the surgeries we do? And so on. Finally, our ZOC director half-jokes, “Are there any questions not related to money? Questions about treating the patients, or outreach…” drawing an awkward laugh from me that quickly gives way to silence. Finally, one person stands up and asks, “How can my hospital get more patients?”

There’s a marked contrast between the Indian experts’ emphasis on serving the patient and the concerns of the hospital administrators shown above, and even if they goals ultimately come down to the same thing (more patients treated = more $$$), I feel like the difference in presentation can significantly alter not only the thoughts but the behavior of those around you. “What are the biggest differences you’ve noticed between hospital personnel in China and those you’ve met elsewhere?” I ask the Aravind guys later. “Attitude,” he answers promptly, and after awhile continues carefully, “they are hardworking, but they can accomplish so much more if they believe they can create meaningful change.”

Some people here don’t seem to believe in change. They listen to stories about how a few eye centers in India over the course of 30 years brought India’s cataract surgical rate to 10 times that of China today—and they don’t think it can happen here.

But it’s day two of the conference, and there are murmurs of something happening. One hospital head stands up, and in sincere humility says, “Our hospital has never done screening before…so I’m asking to learn from everyone’s experience. I listened to the Indian experts yesterday telling us about their successes, and I thought, why can’t we do that as well?”

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