But if we look closely, we can find answers. We all desire
a liberal, humane society fulfilling the basic needs of
all people. Many pioneers have created islands of excellence.
Our real problem is not lack of innovation; but our incapacity
to replicate success on a mass scale. This is a governance
and institutional problem.
Take
Jamkhed in the district of Ahmadnagar, Maharashtra. Decades
ago, a courageous couple, Rajanikant and Mabelle Arole returned
from the US to deliver health care in a poor region of India.
Graduates of CMC, Vellore, Rajanikant was a surgeon and
Mabelle, a gynecologist and obstetrician. What they did
was extraordinary. They had the option to build a plush
nursing home, provide high quality medical care, make money
and acquire a name. But they realized that what India needs
is sustainable community health care. In about a hundred
villages, the Aroles trained ordinary village women, most
of them semi-literate, and created an army of health workers.
They established a small referral medical centre at Jamkhed
to take care of patients who needed expert attention. But
their main focus was health care and preventive medicine
through community workers. They raised money locally. By
1980, the Aroles achieved remarkable results. The health
statistics of Jamkhed area were comparable to those in the
west. Infant mortality plummetted, leprosy disappeared,
average life span went up dramatically, and population growth
dropped. Hygiene improved and vaccination was available
to all. A remarkable island of excellence was created. RS
Arole, to my mind, is one of the truly authentic heroes
of modern India. By 1980, he was awarded a Magasaysay, and
became a legend among knowledgeable circles.
Mabelle
died a few years ago. RS Arole continues his work. Jamkhed
is still an island of excellence. A few hundred villages
are testimony to his genius, innovation, courage and commitment.
But that's about it. Arole's work, which ought to be nationally
known, is still relatively unknown. Brilliant and successful
innovation has not been replicated. Much of India remains
untouched. Thousands suffer from malaria everyday. Millions
have no access to even simple vaccines, and immunization
coverage is only 40% in most parts of India.
Compare
this with the dairy revolution. The foresight of Tribhuvandas
Patel created an island of excellence in Anand. The genius
of Verghese Kurien made it into a replicable model. The
good sense of a few politicians and bureaucrats institutionalized
it. The result was a revolution that transformed tens of
thousands of villages. India benefited. Today it is the
largest producer of milk in the world.
Most
of us have extremely divergent approaches to politics. During
election time and in times of political crisis, the spectacle
of power game alternately fascinates and revolts us. In
the interregnum it is a disgraceful game of corruption and
venality. This love-hate relationship with politics has
deeply affected our approach to public issues. Politics,
in the true sense, is about promotion of human happiness.
Governance is the tool to achieve societal ends through
public purse and sensible policy. Bureaucrats are the instruments
to translate this policy into action. Once this process
of governance fails, no great innovation can be replicated.
Business
houses and entrepreneurs should understand what gives the
greatest value for their money. As entrepreneurs they should
invest in efforts that would maximise returns. Charity in
a traditional sense will not do. The name of the game is
replication, and the means is institutionalization. There
is no alternative to good governance. An Arole's work needs
to be celebrated and replicated in all the 600,000 villages
of India. It costs little, and can happen in a decade's
time. But only good governance can do it. No amount of individual
or corporate charity can even scratch the surface of the
problem. But corporate support can, and does, help build
accountable institutions, and improve governance. We need
not dabble in partisan politics or power games. What we
need is concerted, large-scale effort to compel political
and governance reform, and the means to sustain it. Money
can be a critical input that could mean the difference between
an isolated success and mass replication. Support for governance
reform and institutionalization can transform India in a
relatively short span of time. This takes foresight, clarity,
courage and commitment - the qualities required to build
a great enterprise.
***