 NPV Ramasamy Udayar was ‘an ordinary man who did extraordinary things.’ Hailing from the town of Rasipuram near Salem in Tamil Nadu he evolved in quick time as a leading entrepreneur by dint of hard work. Like his good friend, the then TN chief minister M.G. Ramachandran, he was impelled by a desire to do good to the society and committed large resources for ameliorating the lot of the poor and the needy. Sri Ramachandra Education and Health Trust resulted from this desire in 1985.
The vision was bold and big: to set up a university-linked hospital with state-of-the-art facilities and experts. 175 acres of precious land was set apart for this purpose in Porur. Not served by any healthcare institution in its vicinity at that point of time, his object was to serve the dozens of villages in and around Porur with top class medical care.
Udayar had a knack of assembling experts in different disciplines; more importantly, he motivated them to bring about the best in medical education and medicare facilities and entrusted them with the task of planning, engineering and implementing these big projects.
The man and the mission…
One of these experts, Dr.T.K. Parthasarathy(TKP), a renowned surgeon, great teacher and trainer who served in North America for 21 years, helped Udayar translate his dream (in a lucid biography, Ten Years After, TKP provides a graphic description of the man and his mission, of how Udayar created in quick time the best university-driven hospital in the private corporate sector in this part of the country).
 This involved huge resources apart from the skills to navigate through the hurdles in getting the numerous clearances from the governments at the Centre and the state. Udayar was equal to these challenges and managed to garner the huge resources needed.
The trauma and the care…
The hurdles included the takeover of the enterprise by the Government of Tamil Nadu in 1989 after the change of government. It indeed should have been a traumatic experience, of severing connection with his dream project mid-course. With his never-say-die spirit, Udayar continued the battle and won the project back through the courts in 1992.
From then it was Nityakalyanam at Porur. In rapid succession, new facilities were added. In 1994, the medical college became a deemed to be university and a world class tertiary care medical centre took shape. In successive years from 1996, super specialities in cardio thoracic surgery (for infants and the aged) neuro-surgery, and micro vascular surgery were created.
 The streak of expansion continued. New courses for a variety of paramedics were introduced. Listen to TKP: “I used to bring around 200 books from my trips to the U.S to offer special courses for paramedics and other medical personnel. These courses commenced some 18 months after the outpatient department was opened in 1985. These included nursing, physiotherapy, pharmacy, biomedical sciences, speech language pathology, hospital and health systems management, emergency and trauma care, allied health sciences.’’ TKP said that these courses resulted from the felt needs for improving efficiency, reducing patient stay that helped keep costs to the minimum and specialising specific tasks. He explained: “we found a qualified nurse wasting a good deal of her time attending to phone calls, maintaining records and other errands diluting her focus. We introduced a one year course for ward assistants to take care of these chores.’’
 Bench-marked with global standards…
There have been continuous attempts in benchmarking with renowned global institutions:
● In April 1997, an inter-institutional alliance between Harvard Medical International, USA and Sri Ramachandra University was signed. This further led SRU to refine and improve quality in the areas of medical education, healthcare and research and enhance its visibility at the international level.
● Accreditation with the National Accreditation Board for Testing and Caliberation Laboratories for its facilities in medical testing covering 250 investigations.
● The National Assessment and Accreditation Council (NAAC) granted accreditation to SRU. The CGPA score of 3.52/4.00 is the highest recorded by any private medical university in the country.
 ● The Joint Commission Internationale, Washington, has provided accreditation to SRUMC; this is the only teaching medical centre approved by the Medical Council of India to receive accreditation from the JCI. Dr. Mahesh Vakamudi, Medical Director, refers to the intense preparation needed to get this certification; “it involved 18 months of hard work. There were 1125 measurable elements. For each of these the mark was 10, 5 or 0 and in the aggregate a minimum of 9 was needed. The testing was exhaustive. Four experts came from the U.S. From the records they chose five patients at random, looked at every aspect of the treatment, visiting the ward, discussing with the patient, looking at the prescriptions, checking at the pharmacy for the right dispensation … Such scrutiny covered the entire gamut of diagnosis and treatment. Ours is the only university hospital to have got such an accreditation,’’ said Vakamudi.
102 courses, 4200 students…
 Understandably such commitment for quality attracts the best of specialists for teaching, research and practice. SRU offers 102 courses for around 4200 undergrad and graduate students. TKP pointed to the large demand for medical studies; but only 150 seats are available. Applicants with good potential are offered other specialized courses which also have great demand and remunerative employment. Courses like Environmental Health Engineering, Emergency and Trauma Care Technology, Allied Health Sciences, Speech, Language and Hearing Sciences, Human Genetics and Biotechnology have been specially developed by SRU that attract a lot of attention.
Strong centre for medical research…
 SRU is rapidly emerging a strong centre for medical research. The efforts have received a big boost after the renowned medical scientist and former vice chancellor, University of Madras, Dr. S.P. Thyagarajan, took charge as Director- Research.
SPT mobilized more than Rs. 150 crore as grants to the University of Madras during his tenure as vice-chancellor when the University celebrated 150th year of its founding. One witnesses hectic activity at the SRU research centre spread over 25,000 sq.ft. In just over two years, research funding has increased more than six times to around Rs 25 crore. SPT referred to the efforts made at SRU to strengthen clinical and basic medical research involving clinical experts. The infrastructure created with provisions for incubation for startup companies, contract research for MNCs supported by a quality animal farm (for small animals, spread over 16,000 sq.ft) for clinical trials already attract wide attention. It was interesting to hear half of the funding coming from national funding agencies like the Department of Science and Technology, Department of Biotechnology and a quarter from international agencies. The areas covered include basic research, toxicology, stem cells …STP referred to 132 projects each having full time research staff.
There is the focus on translational medical research from bench to bed side. There is also the welcome interest in research: 140 have registered for Ph.D programme. SPT referred to a novel programme to attract those pursuing MD or MS to pursue research for Ph.D also with handsome stipends. Some 132 members of the full time faculty, drawn from different departments, pursue research.
One can thus look forward to SRU massively stepping up registrations for patents, publications for research papers and in course of time vie for a Nobel prize.
Vice Chancellor Dr S Rangaswami confirmed that Chennai has all the credentials for evolving as the healthcare capital of India: “Chennai has rich healthcare infrastructure in terms of education, administration and research network. Several institutions are engaged in health-related research from basic to epidemiological levels. And the research output is rapidly expanding. Such work is of relevance to other emerging countries as well.’’
Paradigm shift in healthcare concerns…
 Dr. Rangaswami pointed to a paradigm shift in healthcare concerns; “Till some two decades ago, the concern was on treating communicable diseases, infant mortality rate (IMR) and maternal mortality rate (MMR). Today the concern is on controlling and treating non-communicable diseases such as diabetes, hyper tension, malignancy…We didn’t have any premonition on these. With economic development and changes in lifestyle, the incidence of these new diseases is rapidly expanding. Today the concern over diabetes is as much as it was with malaria a few decades ago. In the next ten years, India will have the largest number of diabetics. We need to attend to these and strengthen the quality of healthcare that will provide quick and adequate response. We also need to develop expertise on treating HIV, hepatitis… Cost and equity will have to match needs. We will have to provide healthcare with well defined quality standards.
“Escalating costs of medicare, part of a global phenomenon, is another area of concern. Indigenisation can help reduce cost of equipment and consumables. Some work has been done in this area but a lot more needs to be done.
“There has also been a handsome reduction in the duration of stay in the hospital. Diagnosis and treatment are quickly carried out to ensure minimum stay. For instance, laparoscopy and key- hole surgeries need just three days of stay against ten days and more earlier,” said the VC.
Surge in medical tourism…
 “There is no need for one to go out of Chennai for the treatment of any disease; people from other cities come to Chennai for treatment,” said Dr. Mahesh Vakamudi, CEO and Head-Department of Anesthesiology and Critical Care.
“In recent years medical tourism is gaining in importance. There has been a 120 per cent growth year-on-year. The potential is much larger. Last year we handled 300 patients from abroad; this year we estimate this to increase to around 700. Presently we get most of the patients from the Gulf and African countries; there is huge scope for attracting patients from Europe and the US. Our government can help in publicising the state-of-the-art facilities available in India, the very high success rates and the much lower costs,” said the CEO.
Dr. S Thanikachalam (ST), Chairman and Director, Cardiac Care Centre, has been frequently in the news for the several awards and recognitions heaped on him. He won the Dr. B C Roy award for the best teacher. Recently he was conferred the Padma Shri by the President of India. Not long ago he headed the team of doctors who attended on Chief Minister Karunanidhi who suffered from acute back ache and brought him back to full health. Udayar, with his prescience, invited this renowned cardiologist to join SRMC .
Healthcare hub? Long way
to go…
ST held that it will take years for Chennai to gain the distinction as the healthcare hub. He reasoned in lucid terms: “there are the infrastructure, the specialists, and the experts. In terms of hardware, the answer is yes and in terms of software the skills are available; but these are not standardised. In the developed countries of the west, there is a great degree of congruence of opinions on the treatment for a particular set of diagnoses; this is not so in India. There is a centripetal force: on the same results of diagnosis, treatments differ from one specialist to another! There is lack of transparency and little information provided to the patient. Few look at assessment of the quality of life before and after intervention.
“Quality healthcare demands more systematic work. Corrections will come only if the processes are closely monitored and the patient started asking questions. We need quality inspectors who are independent and who check the quality of diagnosis, treatment, medication …Every institute should go for accreditation by recognized independent bodies. Only this will ensure patient safety and quality healthcare delivery.
“In the U.S healthcare is university-driven. Treatment modalities are dynamic. Concepts of diseases, treatment, intervention and results can change year by year. In education the curriculum is not static. Thus a university-driven system is important.
“Auditing of case sheets, investigation, documentation, over- or under- treatment, appropriateness of the surgery, post- operative treatment and providing proper rationale of the procedure adopted by the university are of great value.
“In the U.S the university hospital is placed on a high pedestal. It is knowledge-driven, skills-driven, audit driven. Only when at least 50per cent of the hospitals in Chennai conform to these criteria, the metro can claim to be the health care capital,” said ST.
Half the patients are treated free…
Quality healthcare is also economics- driven. Large resources are needed to run effectively great institutions. Chancellor TKP estimated the total resources expended on the sprawling hospital and university campus at around Rs. 500 crore.
Udayar set the credo: that there would be an equal division between private and free patients. This in effect means half the 1600 beds in the hospital are offered free to poor patients, most of whom come from the nearby villages. TKP provided a measure of the cost: apart from providing expensive diagnosis, treatment and medicines, the founder was firm that food should also be offered free to patients and those attending on them. He reasoned that it would be difficult to bring food from home. In the initial years it cost Rs. 20 per head and amounted to a lakh of rupees a day. Today the cost has increased per patient to Rs. 100 per day totaling Rs. 7 lakh per day (around Rs. 25 crore a year)! The management continues with this as per the wishes of the founder.
Dr. S Thanikachalam described Udayar so tellingly in a poem:
Millions are born.
And millions pass on.
But, how many can be truly declared as legends?
Who leave behind legacies that the passage of time can only make more precious and unique?
SRH and SRU are truly monuments to the uncommon deeds of a common man with a simple white dhoti, half sleeved shirt and without a watch.
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