Recently, Sasha Dichter, Acumen’s Chief Innovation Officer, had the chance to witness a remarkable conversation between two of the true pillars of our space: Dr. Fazle Abed and Thulsi Ravilla. Sasha blogged about the conversation, which we have shared with you below.
Dr. Fazle Abed is the founder of BRAC, a Bangladeshi organization that began with a focus on microfinance and has expanded organically in a massive way, now employing over 120,000 people with a budget of more than $700 million. In addition to being one of the world’s largest microfinance organizations serving 4.5 million customers, BRAC has provides livelihoods, maternal care, and nutrition, including now growing and providing 80% of the improved rice seed and 30% of the improved maize seed in Bangladesh.
Thulsi Ravilla is the President of Aravind Eye Hospital, the first truly scaled social enterprise outside of the microfinance space. Aravind has performed more than three million eye surgeries, 43% of which are to patients who do not pay. Its doctors perform 2,000 eye surgeries a year compared to 125 in the United States. They are the world’s largest manufacturer of intraocular lenses, selling these lenses for $3 versus the $200 they used to pay to buy them. And 15% of all ophthalmologists in India have been trained by Aravind.
Abed and Thulsi were being interviewed by Acumen’s founder and CEO (and my boss) Jacqueline Novogratz, as part of Acumen’s annual Advisory meeting – Abed serves on our Advisory Council and Thulsi on our Board of Directors.
I didn’t have a notebook for the conversation, so will share impressions of what really stuck in my mind and not the blow-by-blow:
- This has been a life’s work for both of these men. They have each been at it for 40+ years in Abed’s case and 30+ years in Thulsi’s case. While it’s possible that the new funding mechanisms we have created around impact investing could accelerate this path today, it’s also completely clear that this is what a life’s work looks like, and there’s no way we will create massive, lasting and sustainable change in 5 or 7 years time, no matter how we finance it. This is about building enduring institutions.
- Both share a relentless focus on poor customers. These men, and their organizations, know deeply and inviolably who they are serving. Poor customers (most of whom are women in BRAC’s case). That customer is known and fixed, and they have built the culture and logic of their organizations in answer to the question: what will it take to serve this customer in the most efficient, most dignified, most impactful way possible? And how can we build a sustainable organization so we can be here for decades to serve that customer?
- A notion of service. Abed had been working at Shell and had been part of the Bangladeshi independence movement (in its separation from Pakistan) when he founded BRAC. To fund it, he liquidated all of his assets including selling his home. When asked in the conversation if this was hard to do he said, simply, “After you have been a freedom fighter, after you have witnessed life and death, these sorts of questions become less important. I had a home which I sold. I thought, ‘What is this change that will happen if I live in another home? It is still a home with four walls.’ The sacrifices I had to make were not that big.”
- Building culture globally. Whenever talk came to culture, both men became especially focused and clear, as if they were about to utter their most serious and important truths, the wisdom that comes after decades of work. “The systems are easy to build and to transfer, and they do build efficiency,” said Thulsi. “But the culture is what makes the system work. It is the interaction of the culture and the systems that make our work possible.” Thulsi said that 90% of Aravind’s hiring is about culture and fit, literally asking questions like how much the bus fare was to the interview to get underneath what kind of person the interviewee is. If you’re hiring someone to do a job for a few years, perhaps the yield on short-term skills is higher, but to hear Thulsi describe it, it’s all about the culture. Some of the most interesting conversation was about how you build culture at scale, and while I didn’t leave the discussion with a clear “how to guide”, I was left with a renewed sense of clarity that for any scaled organization, culture is the most important thing to get right and that it requires constant investment and renewal. This in addition to building the systems and other institutional underpinnings that allow for efficiency.
- With time, persistence and endurance, anything is possible. Both of these organizations have moved into adjacencies that are far from obvious at the outset: Aravind as a major supplier of intraocular lenses – because they were a big expense line they wanted to address – and BRAC a huge supplier of seeds – because, in Abed’s telling, he discovered a group of 300,000 women whose repayment rates were relatively low, and rather than change policies or squeeze them he went to investigate and discovered that they were using low-quality vegetable seeds whose yields were low. So BRAC started manufacturing its own seed. While I am sure both organizations tried lots of new things that didn’t work out, it’s also clear that when these organizations got their core right they were strong enough to take on new business lines that, at first glance, would seem to be far afield.
- Need versus demand. The recent Monitor/Deloitte follow-up report to Blueprint to Scale talks about “push” versus “pull” products, a point that Thulsi made using different words. “Need” in his definition is clinically defined – reduced or no sight – but even though Aravind offered free surgeries, many people with need would not show up. What they learned was that if they could go to the village – using telemedicine (which an Acumen grant 12 years ago helped facilitate) and other technology – they would, within 24 months, have treated 100% of their target market and 90% of those would follow through on recommendations from Aravind (to get glasses, to have surgery with Aravind, or go to a specialist hospital).
- Scale. When asked about the importance of scale both men found the question almost trivial – the need is big, the solutions have to be big, we have no choice in the matter.
- Urgency. When asked about whether he would have liked to have gone faster, Abed said “absolutely.” “A child,” he said, “can get stunted from malnutrition as early as age 6, at which point that child has reduced prospects for life.” Abed said he is always in a rush because the clock is ticking for that boy and for everyone like him, so we must always move with a real sense of urgency.
These are just the big pieces that stuck with me from a conversation that could have gone on for many more hours with everyone on the edge of their seats. We were sitting at the feet of the masters, getting pearl after pearl of wisdom, hard-earned in a life’s work.
Just as the conversation was wrapping up, Abed jumped in to close. He told the story of Mahatma Ghandi, who interrupted a conversation by saying, “Excuse me, I have to go. My people are going over there and I have to follow them, for I am their leader.”
Indeed, what picture of leadership could be more powerful, or more relevant for today, than this?