I have put up a 2-page brochure (in pdf format) about the eye camps I am currently doing.

The necessity of eyecamps and their funding is actually a surprisingly complex issue when you look closely at it. For the record, here is my analysis of the issues involved, along with some conclusions and suggestions:

motivations to hold eye camps:

1. The government encourages it because eyes are such an emotive issue. Prominently tackling failing vision that can be easily cured is a vote-winner. Local politicians love to have their name associated with it. So the government gives significant funding to various eye treatment organisations.
2. NGOs find it straightforward to get involved in. There are easily measureable results that can be documented, and the funding sources can see. The issues are simple and non-controversial (at a casual glance), compared with, for example, AIDS awareness, or rehabilitation efforts.
3. Foreign aid donation organisations like it for the same reasons as the NGOs.
4. Local bigwigs like to sponsor a camp occasionally, to launder some of their black money.
5. For a doctor like me, who currently gets shoestring funding to help run a camp, it doesn't actually make financial sense to do them. But I do get the satisfaction of providing good eye care to the people who need it.

1. Eye camps are often used to train foreign doctors. While this is good under proper supervision, the Indian hospital has a conflict of interest between providing good care to the patient and making money from training the foreign doctor. This is because the foreign hospital gives some funding for the camps. The indian hospital gets more money the more foreign doctors it trains. It ends up being more profitable for the indian hospital to get more doctors than they can reasonably supervise. This would be at the cost of damaging the vision of the patients being operated. This is because:
   1. They are usually very junior doctors, and are usually not paid for the work they do. So this is really just cheap labour giving low quality at a low volume. Eye camps should, and can, do low cost, high quality, high volume.
   2. The trainee doctors are usually foreign-looking, and Indians (wrongly) believe foreign doctors are more competent than local doctors. So these doctors add a false prestige to the eye camp which means the camp gets a reputation which it does not merit. (Note for the politically correct: This is an observation of a kind of reverse racism. The observation itself is not racism).
   3. If a doctor botches up something at an eyecamp, he is not going to be sued. The people who go to eyecamps for surgery are mostly impoverished and illiterate, so they cannot pursue litigation. Trainees need proper supervision so that the botch ups don't happen. However, the incentive for the Indian hospital to supervise is missing. So botch ups happen that would not happen with proper supervision.
2. The people who give the funding often are unable to monitor it closely enough to see how it is used. Wilful abuse of funding happens, and is evil when so much can be done with the funds. The abuse is very high in some organisations. Like Rajiv Gandhi famously said, only 15 paise out of every rupee allocated for welfare schemes reaches the poor, and this kind of figure is quite possible in some organisations. One eye camp organisation is known to get three subsidies from different aid organisations per patient, without disclosing it to the aid organisations. This means that the eye camp organisation should actually be paying the patient for doing the surgery! Creative accounting means that the extra money ends up with the persons running the organisation.
3. Money laundering. It is surely a lesser evil than fund abuse. But it is illegal. I believe that a person should try to live according to reasonable government laws, because that is how society improves in the long run.
4. The funding subsidy means the market is distorted. It means that an ophthalmologist running eyecamps without subsidy (disclosure: like I am) has a funding hurdle to overcome, because people do cost comparisons before having a surgery done. I am fortunate in that I am recognised to be a good surgeon, and people trust my reputation and efforts to provide the best I can. They tend to be very pleased with the quality of my surgeries and the quality of the optometrist's spectacles, so they are willing to pay for this. So it is not an insurmountable hurdle for determined people.

Aid subsidy is given with the intention of reaching out to the truly poor of India. It must however be monitored closely so that its abuse is stopped. I am unsure if that is possible given the Indian situation.

So, to a large extent I agree with economist James Shikawati's view, expressed clearly in the German newspaper der Spiegel, in a piece entitled "For God's sake, please stop the aid!". He points out that subsidies damage a country by making self-help less possible in the long term.

In the meantime, if you must have these kind of subsidies, then here is a suggestion: Why not stipulate that, as part of the deal, there be incentives and encouragement for individual surgeons? This is in contrast to the current system of just handing over the funds to institutions. If designed well, such a stipulation would make things run far more efficiently, keep surgeons within the country and benefit patients far more than the current system does. This is because rational self-interest is a major driving force for improvement of the human condition.