When Laxmi Das, a 38-year-old weaver from Borholla village in upper Assam's Jorhat district, complained of poor vision, she didn't have to travel far for a check-up. Das was diagnosed at her village, at half the cost incurred at major eye centres, thanks to an ERC Eye Care-run vision centre.
Such vision centres, the brainchild of ophthalmologist Parveez Ubed, address the lack of quality eye care in the rural areas of upper Assam. These vision centres, along with mobile units, test patients for common eye ailments and refractive errors. If these centres aren't able to address an ailment, the case is referred to neighbouring government hospitals.
Ubed says the sheer volume of patients makes ERC's business sustainable and scalable. In a month, each of ERC's six vision centre records about 300 patients.
In June 2011, Ubed set up an eye clinic in downtown Jorhat, with an investment of Rs 5 lakh. Patients from rural regions had to undertake long and arduous journeys to towns, even for a basic check-up. Ubed decided to help them.
After recruiting a couple of optometrists, he started frequenting villages and conducting eye camps there.
In 2012, he was awarded the Mahindra Spark Arise award and the Sankalp award for his social endeavours. With the award money, he decided to set up permanent eye care centres in villages. The first was set up in Nakachari village in November 2012.
"After opening the first vision centre, we incurred losses for three months, as villagers weren't aware of it. But my conviction was so high that I was certain we would succeed," Ubed says.
The venture also continued conducting eye care camps through mobile units. Through this model, a team of six-seven, including two medical personnel, travels to a village and sets up a day-long (9 am to 4 pm) eye care camp. ERC conducts at least 10 camps a month and offers services to about 1,000 patients through these.
In 2013, venture capital funds Ennovent Impact Investment Holding, Ankur Capital and Beyond Capital, along with Singapore-based angel investor Sadeesh Raghavan, invested in ERC Eye Care.
"We were excited by the business model and the entrepreneur. The impact this could create in upper Assam, in terms of bringing eye care to villages was the driver behind the investment," says Ritu Verma, co-founder of Ankur Capital. The funds didn't disclose the amount they had invested.
"At the time the venture capital funds invested in our company, it was valued at Rs 2 crore; all investments were based on that valuation," Ubed says.
Saurabh Lahoti of Ennovent Impact said ERC met the fund's expectations and fit its strategy of creating a social impact, while generating good financial returns. "ERC's model is viable, as it is capex-light and sustainable. This is because it is one of the first movers in Northeast India's eye care segment for low income markets," he added.
ERC charges Rs 50 a patient as registration fee; this includes a month's consultation charges. While frames for spectacles are available at a starting price of Rs 99, glasses cost Rs 250.
Since its launch, the company has been registering 100 per cent year-on-year growth. For 2013-14, the company's turnover was about Rs 24 lakh; this financial year, it expects to cross the Rs 1-crore mark.
ERC, which has a team of seven optometrists, a few doctors and a dozen-strong support staff, wants to adopt a hub-and-spoke model, with hospitals catering as hubs to vision centres across neighbouring villages.
"The hub-and-spoke model is conducive for the Indian health care market. It is an effective way to monitor and control the entire set-up and effectively use the limited resources of a rural setting to provide the maximum impact in catchment areas," says Sujay Santra, founder of iKure Techsoft, which provides low-cost primary health care facilities to the rural population in West Bengal.
With the funds it had raised from venture capital firms in 2013, ERC plans to set up hospitals soon.
"Hospitals are in the pipeline; we are drafting the layout in detail so that the addition of hospitals to the company is smooth. We expect to have the first one by July-August," Ubed says. ERC aims to open at least eight hospitals in the next five years. These hospitals will provide various services, including surgical services.
However, tertiary care surgical and medical services for treating rare and complicated cases won't be offered.
ERC also plans to increase the number of vision centres substantially in the near future. Every hospital will be tied to six-seven vision centres.
As ERC readies to scale up operations, attracting manpower, especially ophthalmologists and optometrists, has become a challenge. "We are not able to draw good talent, especially doctors, as we aren't able to pay attractive salaries," Ubed says. To address this, the venture plans to set up a separate wing to train local talent.
Founded in: June 2011
Growing: 100% year-on-year
Turnover: Rs 24 lakh (2013-14)
Target: Rs 1 crore (2014-15)
Funding: Raised undisclosed amount from three venture capital firms in 2013
There is a direct and latent demand for affordable quality eye care for the common man. This is more so in the northeast, under-served in terms of health care facilities, especially eye care. Therefore, there is not only a significant market opportunity for ERC but also a great opportunity to create sustainable impact. In these areas, the access points for eye care services are often the closest tier-II cities. People from these small towns and rural areas have to travel great distances to access eye care. Sometimes, this results in travel and related expenses exceeding the actual costs of eye care, especially for cases requiring non-surgical management. By leveraging the hub-and-spoke model, ERC can deliver quality and affordable eye care services.
The services offered by ERC comprise consultations (starting from Rs 50), optical retail (from Rs 100) and diagnostic tests and surgeries. Quality assurances, training programmes for health providers and effective information technology services have to be designed and implemented with care, so that ERC can continue to grow operations and 'code' its DNA for quality and 'replication'. Scaling up operations is another challenge. While the traditional approach is to increase the number of company-owned and operated vision centres and hubs, I think it should partner local social ventures and entrepreneurs across regions. This will lead to efficiencies in operations, ease of scale, and ownership of the local venture. Typically, such ventures have strong credibility and community buy-ins.