In 2005, a man from Turkey arrived in Madurai and announced plans to set up 20 facilities like Aravind in Egypt—now could someone please tell him how much it would cost, so that he could start buying the equipment and materials needed? If only setting up a system with Aravind’s reach and impact were that simple. “Every day I meet some people who want to change the world in two days—or two weeks,” Dr. V once wrote in an e-mail.

Most explanations of the Aravind model start at the middle of the story. They treat the founding of the Aravind Eye Clinic as the beginning and plunge from there into a fast-paced account in which a series of eye hospitals burgeon into existence, thanks to the financial viability of a revolutionary ...

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