Aravind and the Choice of Great Achievement


Dr. Govindappa Venkataswamy, known as Dr. V, was an entrepreneur and humanitarian of the highest order. He founded Aravind, an organization based in Madurai, in the south of India, that has delivered nearly 4 million eye surgeries, more than half as many eye surgeries as the entire UK National Health System, at levels of quality comparable to the world’s top academic medical centers, for less than 1% of the cost of NHS. Many of these surgeries are free, or at minimal cost, and Aravind’s work to preserve and restore sight is among the world’s most effective interventions against poverty when measured in terms of the long-term impact per dollar invested. Aravind’s core operations are self-funding; with the help of relatively small amounts of philanthropic and investment capital they have also built a research institute, a consulting arm that advises governments and NGOs around the world about how to achieve parallel results, and even a factory that meets FDA standards producing at low costs the key inputs to the practice of ophthalmic surgery.

Behind Dr. V’s ability to build Aravind from a single eleven-bed hospital in 1976 into an organization of unprecedented impact, quality and scale was his quest to become the “perfect instrument” for his vision.

A journal entry from the 1980s, written in a series of eclectic questions (and with his trademark absence of question marks), illustrates how matters of service delivery, leadership and spirituality are intertwined to Dr. V.

It opens with the magnificent obsession he is known for:

How to organize and build more hospitals like McDonalds.

And then with no warning, it shifts to:

How was Buddha able to organize in those days a religion that millions follow.

This question dramatically changes the plane of inquiry. Other searching questions swiftly follow:

Who were the leaders. How were they shaped. How did the disciples of Christ spread their mission around the world.

And then the final question that we would ask in a thousand different ways:

How do I become a perfect instrument.

To care about anything in the world is to imply the question of how one becomes an instrument for advancing what matters. The question of great achievement need not come from the self’s ambition – it follows from the recognition that one can be an instrument of something larger.

Among the most important choices we each make is this choice of how we regard the possibility of great achievement. This choice is woven through how each of us crafts our individual path and how we find, help shape and enable others.

While there are arguments for and against the impact of the individual – Carlyle vs. Tolstoy – we all benefit from taking an optimistic view of this question and acting as if individuals can make a very big difference. The structure of this is much like Pascal’s wager. There’s little downside from adopting too optimistic a stance, and a great deal of upside if that stance proves right.

There is certainly no recipe for great achievement, but there are patterns. These patterns relate centrally to how we cultivate and overcome influence and to how we relate to time, in the immediate flow from moment to moment and over the longer arc of years.

Subscribe to On Human Enterprise

Niko Canner Founder

Niko Canner founded Incandescent in 2013. His work spans the firm’s three major areas of focus: serving as a thought partner to leaders of large enterprises on strategy, organization and innovation; advising founders on the development of their ventures; and partnering with foundations and non-profits engaged in systems change.

View Niko's profile