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Wednesday, January 1, 2014

Charity has been integral to our society and culture. But much of charity has traditionally been for pious causes - like temples and choultries, or to help indigent individuals. Most often there is a perceived link between charity in this world, and the rewards awaiting you in the othe rworld.

The concept of social capital is relatively new to India. In recent years many industrial houses have created Foundations and Trusts to channel their wealth for social causes. Support is forthcoming for education, health care, rural development, urban slum improvement, environment and other causes. Monetary inputs combined with professional skills and commitment are making a significant impact and the results, though miniscule, are impressive. We are pleased with these localized successes. But when we see the larger reality of India, we realize the problems still haunt us. We are confounded.

The problem of not knowing what to do in the face of daunting and gargantuan issues is not surprising. 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.



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