FRED DE SAM LAZARO, correspondent: Kashmir has long been known for its peaceful vistas but for the 13 million inhabitants this mountainous region has been anything but peaceful. It is one of the world’s most militarized places. India alone has an estimated 600,000 troops in the part it controls, four times the number of American soldiers who were in Iraq at the height of that war. Although it has a two-thirds Muslim majority, Kashmir as a whole is quite diverse, the southern region mostly Hindu, the northeast Buddhist. But for six decades this province with a land mass the size of Idaho has been bitterly fought over by India and Pakistan.

It all dates back to 1947, when the departing British decided to partition the newly independent India. Muslim majority areas were to form the new republic of Pakistan. But Kashmir had a Hindu ruler, and he opted under pressure to join India. That set off the first of three major wars between India and Pakistan, ending in a ceasefire with India controlling about two-thirds of Kashmir, Pakistan most of the rest. The so-called “line of control” that divided Kashmir has served as an international border for 65 years, but Kashmir has festered as a sore point between the Islamic republic of Pakistan and mostly Hindu India.

Although the conflict has long been cast in religious terms, Joseph Schwartzberg, a leading scholar on Kashmir, says it’s more complicated than that. And within Kashmir, he says, there’s a long tradition of tolerance.

PROFESSOR JOSEPH SCHWARTZBERG: The Hindus frequently attended religious ceremonies that were held by Muslims, and the converse was also true. In terms of actual day to day religious practices it was a fairly eclectic area, and the type of strident militaristic Islam that we think of when we think of, say, the Middle East—that was not present in Kashmir at all.

DE SAM LAZARO: That began to change in the 1980s in Indian-held Kashmir with more religious tension and extremism. Schwartzberg blames corruption, non-functioning local government, and meddling from India’s capital Delhi in local elections.

SCHWARTZBERG: India is a pretty good functioning democracy in most parts of the country, but with respect to Kashmir it was exceptional. They felt that they couldn’t afford to lose elections. They managed to rig election after election, and the people simply got fed up. In 1987—and it was a pretty corrupt administration, so the people just had it— they initiated a series of demonstrations which were put down with a heavy hand, and in 1989 it really got out of hand, and the Indian government moved in in force.

DE SAM LAZARO: The clampdown triggered a militant separatist insurgency—or vice versa, depending on who is telling the story. India has blamed Pakistan, especially its intelligence service, and Islamist extremist groups. Pakistan says it offers only moral support for the insurgents. Groups like Human Rights Watch blame militant groups, but they also finger Indian security forces for widespread abuses under the guise of rooting out militants. India insists that most are infiltrators from Pakistan-held regions and beyond. Tens of thousands of civilians have died or gone missing. Kashmir’s grand mufti, the top religious leader recognized by India’s government, also blames both sides for excesses, and his numbers are much higher.

BASHIR UDDIN AHMAD (Grand Mufti): Since 1989, when the situation became more critical, hundreds of thousands of people are missing and hundreds of thousands more have been killed. We have no knowledge of where they are. The killing continues unabated, and the situation is still simmering.

DE SAM LAZARO: In recent years, the Kashmir dispute has taken on a new dimension as India has announced plans to build several dams, seeking hydro-electric power for its fast-growing economy. But Kashmir’s rivers also irrigate the breadbaskets of both India and Pakistan. So far there have been no problems sharing the waters under an internationally brokered treaty in 1960. However, Pakistan says the Indian dams could affect seasonal water flows to its farmland.

KAMAL MAJIDULLA (Pakistan Presidential Advisor): It’s devastating, because if the waters are not available to me in the quantities that I need them at the time that I need them, then I’m looking at a very low productivity of my agricultural sector.

DE SAM LAZARO: Pakistan has taken its protest to arbitration provided for under the Indus water treaty. India insists it is in full compliance. However, the fact that India, being upstream, could in theory manipulate flows could be politically toxic, particularly after the severe floods Pakistan has endured in recent years.

Hafiz Saeed is a man the US government has branded a terrorist and for whose capture it has offered a $10 million bounty. Saeed has blamed India for worsening the flooding. Pakistani presidential advisor Kamal Majidulla says such rhetoric resonates among farmers who are hurting.

MAJIDULLA: The farming community, which otherwise could look after their children, are unable to do, so the children have been going off and staying in madrassas instead of going to the local school system, because the madrassas feed them. I’m not saying all madrassas are bad. They do perform a social function, and some of them perform a very good social function, but a fair number of them are not. And this is where the cannon fodder comes from. So there is a direct linkage between water availability, low agricultural productivity, and the rise of terrorism.

DE SAM LAZARO: Officials in India’s capital Delhi say the Pakistani fears of water treaty violations are overblown. Ashok Jaitly, a scholar at a Delhi-based think tank, says the bigger threat is poor conservation and water mismanagement on both sides.

ASHOK JAITLY (Energy Resource Institute): If you had a cooperation based on good scientific river basin management of the Indus basin, and that’s where the Indus water treaty does not provide for it, it only provides for sharing of water. It does not provide for scientific integrated river basin management. If you could have that, then I think a lot, I won’t say all the problems would be solved, but a lot of the problems between India and Pakistan would be resolved, or could be resolved.

DE SAM LAZARO: Back in Kashmir, long squeezed as its two nuclear armed neighbors fight over it, Mufti Bashar Uddin says growing numbers want no part of either.

MUFTI UDDIN: As a religious leader, I would tell the people that if the option of independence is offered, that would be the best bet for Kashmir.

DE SAM LAZARO: That seems highly unlikely—both India and Pakistan reject the idea. So, to most analysts, does any quick resolution of the Kashmir stalemate. In recent months, there’s been a thaw in relations between India and Pakistan, with proposals to vastly increase the amount of trade across the border. Coincidence or not, Kashmir has enjoyed one of its quietest periods in years. The natural beauty is once again luring tourists. In 2011, more than one million visitors came here, most of them Indian. It remains to be seen whether and how much more tourism and commerce can repair 65 years of suspicion and upheaval.

For Religion & Ethics NewsWeekly, this is Fred de Sam Lazaro.

FRED DE SAM LAZARO, correspondent: In an ancient, crowded land with wide religious diversity, Judaism has a tiny footprint. In New Delhi, it’s in this quiet enclave. A small group of worshipers gathers here every Friday, a mix of foreigners and Indians. In India’s ancient religious mosaic, Judaism is a newcomer. Its roots go back only two millennia.

EZEKIAL MALEKAR (Judah Hyam Synagogue): When Israel, the oldest Jewish community, landed, they were shipwrecked, and they came to India about 2,000 years ago.

DE SAM LAZARO: There were at least two subsequent mini-waves that brought Jews to India: people fleeing the Inquisition and people who came during British colonial days as traders. There were perhaps 30,000 Jews across the country at one time, but many moved to Israel after its formation in 1948.

MALEKAR: Now we have only 5,000 Jews all over India, and in Delhi we have just 5, 6 Indian-Jewish families. We are like a drop in the ocean.

DE SAM LAZARO: Ezekiel Malekar is the keeper of Delhi’s tiny synagogue, built in 1956 on land donated by the Indian government. A lawyer and retired civil servant, he’s not an ordained rabbi, but for three decades Malekar has volunteered to lead this congregation, reconciling its ancient rituals and traditions with the practical modern reality.

MALEKAR: In order to read this portion of the Torah you require a quorum of 10 men, what we call in Hebrew minyan, so here we take into consideration the presence of women also. Some people don’t like it, especially those who are very Orthodox when they come to the synagogue. But I said that we are such a small community that if I have these practices I won’t be able to conduct the services in the synagogue.

DE SAM LAZARO: The majority of India’s remaining Jews live in the commercial capital, Mumbai. It was in this city during the 2008 terrorist attacks that six people were killed at a Jewish community center that mainly served Israelis and Western visitors and businesspeople. Since then, the Delhi synagogue has also come under 24-hour protection from the Indian government—the first time Jews here have ever faced the specter of violence.

MALEKAR: Jews have been living in India for the last 2000 years and without anti-Semitism and persecution, and therefore I always say that India is our motherland. I am an Indian first and Jew second. When Mr. Shimon Peres came here…

DE SAM LAZARO: …the president of Israel…

MALEKAR: The president of Israel. I was asked by the BBC media that what is your feeling about Israel and India? And I said that Israel is in my heart, but India is in my blood.

DE SAM LAZARO: But those who call themselves Indian and Jewish are fewer and fewer. One of Malekar’s sad tasks is to tend the cemetery, whose census now exceeds the congregation in the synagogue next door.

MALEKAR: This is the last place, where we go to the divine abode.

DE SAM LAZARO: On a happier note, Malekar will soon preside over his daughter Shulamit’s wedding, which will be a historic event in Delhi’s Jewish community.

MALEKAR: I don’t remember even after 1956 there has been a single wedding in the synagogue.

DE SAM LAZARO: At 66, Malekar will finally witness a marriage here between two Indian Jews, leaving only the worry about who from the handful of young congregants might be willing to take over from him.

For Religion & Ethics NewsWeekly, this is Fred de Sam Lazaro in New Delhi.

FRED DE SAM LAZARO, correspondent: Minutes after delivering a slightly premature infant by C section, Dr. Nayna Patel was back in her office and on the phone to the parents.

Dr. Nayna Patel: Congratulations, it’s a baby girl. Where are you, in Mumbai right now?

DE SAM LAZARO: They were en route from their home in England and didn’t reach the small town of Anand, India in time to watch a surrogate mother give birth to their child.

Dr. Patel: Surrogate is also fine. The baby is also fine. We have taken the picture.

DE SAM LAZARO: Dr. Patel has delivered some 400 surrogate babies since 2004. Her clinic implants embryos in surrogates she recruits from the area and pays around $7,000 for a pregnancy carried to term. Biological parents come from across India and around the world. Kirshner Ross-Vaden came here from Colorado to pick up her baby girl named Serenity. She was born four weeks premature, but after a week in neonatal intensive care she was ready to be discharged. Serenity’s 46-year-old mother traveled here with her nine-year-old son. She had tried unsuccessfully in recent years to conceive. Surrogacy was her last hope and India her first choice. The cost—$10,000 to $15,000 all told—is a fraction of what it is in the United States, and in America, she added, surrogacy contracts are not always air-tight.

KIRSHNER ROSS-VADEN: You can sign a hundred documents. It doesn’t matter. If that surrogate changes her mind she can sue you for that child, and oftentimes she will win, and coming here to India, these women, they don’t want my child. It’s very cut and dry. They do not want my child. They want my money, and that is just fine with me.

DE SAM LAZARO: It’s not fine with everyone.

DR. ARTHUR CAPLAN (University of Pennsylvania): The contracts usually are written, to be blunt, to protect the wealthy people who are commissioning the baby, so that if the woman suffers an injury, if the woman has a health problem due to childbirth, if there’s a long-term chronic condition, then what?

DE SAM LAZARO: University of Pennsylvania ethicist Arthur Caplan worries the relationship is inherently lopsided between poor, minimally literate women and well-heeled couples who commission them to have their children. For example, surrogates in India are routinely implanted with up to five embryos to improve the chances of a pregnancy. In the US, clinics usually implant no more than two, sometimes three.

DR. CAPLAN: Why would you use three, four, five embryos in India? Because you don’t want the couple to have to come back. It’s expensive, even for a rich person so you’re trying to maximize the chance of pregnancy, even if it might compromise the interests of the babies.

DE SAM LAZARO: Dr. Patel concedes that implanting five embryos heightens the risk for infants and mother and says she is now lowering the number to three or four. But she says the downside of fewer embryos is a lower pregnancy success rate. When multiple embryos develop into viable pregnancies, Dr. Patel’s policy is to reduce them by selective abortion. Aside from possible religious concerns, this process could present medical risk to the surviving fetuses.

DR. PATEL: Parents—yes, there are some who say right from the beginning, “Doctor, put less embryos because we are not for reduction, and we don’t this to happen.” So in those cases we definitely never transfer more than two. But there are certain parents who don’t have any objection to this, and surrogates—we don’t allow them to carry more than two.

DE SAM LAZARO: Dr. Patel insists that her facility protects the interests of surrogates as much as the clients of her commercial surrogacy program and the infants she delivers.

DR. PATEL: We do a lot of psychological counseling for the surrogate and the family before we recruit them. We explain to them the procedure of IVF, what all they’ll have to undergo. If she has had any complications during her previous pregnancy, we will ask her not to become a surrogate, because the same can repeat this time, to make it very sure and safe for her.

DE SAM LAZARO: The moment their pregnancies are confirmed, surrogates are required to move into this home run by Dr. Patel. They’re offered skills training in things like tailoring, but mostly it’s a quiet, sedentary life. The women who spend nine months in this surrogate hostel have all experienced childbirth with their own biological children. It’s a prerequisite for becoming a surrogate. What very few of them have experienced with those previous pregnancies is any kind of prenatal care. That’s in sharp contrast to the pampering they get here: meals provided and medical attention, should they need it, round the clock. Dr. Patel acknowledges the irony but says it is part of a thorough surveillance to ensure smooth pregnancies, for both surrogate and parents’ sake.

DR. PATEL: We have a fetal medicine specialist who checks all the surrogates every three weeks. We have been able to detect minor congenital malformations which we inform the couple can be treated post-delivery without any impact on the baby. We have had patients whose surrogates had babies with Down syndrome, which was detected, which was confirmed with amniocentesis, and we have aborted those babies after the consent of the couple.

DE SAM LAZARO: Well in advance, she says, parents are consulted on decisions like pregnancy termination. Similarly, parents must accept their babies, once born, whether healthy or not. Surrogates we spoke to talked about building a new home and using their money for their children’s education. The money—$7,000-$8000—would otherwise take them decades to earn. Most say they were happy to have helped infertile couples. The woman who bore baby Serenity who we met earlier, admitted to some sorrow at her separation.

DHANA: You can’t help it when you’ve carried a baby for nine months. I’d like to see how she does in the future.

ROSS-VADEN: I do have her address, so I can get a hold of her. And I hopefully will be able to maintain some kind of a relationship with her.

DE SAM LAZARO: We caught up with Serenity’s mother in Mumbai, about 500 miles from Dr. Patel’s clinic. She and son Brandon were holed up in a hotel awaiting DNA test results and myriad documents to satisfy the Indian and US governments that the infant could leave the country.

ROSS-VADEN: Am I living happily ever after now? I certainly hope so. I hope that I can get her home, and I hope that she is a happy, healthy little baby, and that is what I will have—a healthy, happy little girl.

DE SAM LAZARO: But will every surrogacy story end happily? Right now, India has only voluntary guidelines, and it’s not clear whether future laws would be adequately enforced, and standards vary widely. For example, Dr. Patel says she only serves infertile patients. But some clinics offer surrogates to healthy parents who, for career or convenience, want to avoid pregnancy. Ethicist Caplan worries about where all this is leading.

DR. CAPLAN: We may get into situations where people start to say, as genetic knowledge improves, you know, I’m not infertile but I’d like to make a baby with traits or properties that I want to avoid or that I desire. That day is coming. I think it’s important to keep in mind, as we watch the evolution of surrogacy as an international activity, what is really something that a tiny handful of people use who suffer from infertility tomorrow can be what more people are interested in because they have a more eugenic, more perfectionist interest in making their children.

DE SAM LAZARO: For her part, Dr. Patel plans a major expansion of her one-stop surrogacy shop, a leader in what’s now a half-billion-dollar industry in India. She makes no apologies for making a lucrative living and insists that she, the surrogates, and the new parents all come out winners.

For Religion & Ethics NewsWeekly, this is Fred de Sam Lazaro in Anand, India.

FRED DE SAM LAZARO, correspondent: In thousands of schools across India, teachers will tell you to add one more “R” to reading, ’riting, and ’rithmetic. Recess, they’ll tell you, may be the most critical part of a student’s school day. That’s because nine a.m. recess is when 300 students in this school in the northern province of Rajasthan are provided a hot meal, as are a few younger siblings who are allowed to come along.

DINESH SHARMA: In this school, only about five children in all are able to bring a lunch from home.

DE SAM LAZARO: Anywhere from a third to 40 percent of the world’s undernourished children live in India today, and about half of all children here have stunted growth. The statistics are all the more telling given India’s strong growth rate and its booming economy in recent years.

BIRAJ PATNAIK: India finds itself acutely embarrassed. Its ambitions of being a global power are very poorly reflected in social sector indicators, and there is acute embarrassment that the second-fastest growing economy in the world has almost half of its children malnourished.

DE SAM LAZARO: Patnaik works for India’s Supreme Court advising a commission that monitors compliance with the court’s orders. About a decade ago, civic activists, saying the government was denying children their basic right to food, took their case to the court. The justices twice upheld this right and ordered that every child be provided a cooked meal in school. At first, Patnaik says, there was resistance from government officials.

PATNAIK: On the grounds that there was no infrastructure, that teachers would get overburdened, that India just didn’t have the financial resources to start a program of this nature. But the Supreme Court reaffirmed that fiscal constraints can never be allowed to come in the way of children’s right to food, and if the government had to tighten their belt, that had to happen elsewhere.

DE SAM LAZARO: With the stroke of a pen, the court ordered the largest school meal program in the world. That left the daunting task of implementing it.

CHANCHALAPATHI DASA: The challenge in our country is how to deliver it and deliver it up to the last mile. That is the challenge. Because a large country with 120 million children in hundreds of thousands of schools that delivery is a genuine challenge.

DE SAM LAZARO: Dasa heads a nonprofit group called Akshaya Patra. It was started in the nineties when a group of Hare Krishna devotees began preparing a few hundred school lunches. Although it is one of the world’s oldest belief systems, the modern day Krishna consciousness movement was led by Swami Bhaktivedanta Prabhupada and was especially visible in the West in the 1960s and ’70s. The call to serve meals was inspired by an encounter the swami had after attending a banquet.

DASA: He saw there was leftover of all the food, and the plates strewn there, and there was street children, poor children from the village and some stray dogs fighting for the leftover of the food. When Prabhupada saw that there were tears in his eyes, and he called some of his disciples and said, “Just look at this. You can’t allow this to happen.”

DE SAM LAZARO: That exhortation formed the spiritual basis for Akshaya Patra’s work. But when school lunches became the law of the land, the group went to the government for funds to expand and to India’s corporate sector for expertise.

DASA: Passion alone is not enough. You need to have organization. You need to have organizational capabilities. You need to have management capabilities. Akshaya Patra has been a very unique marriage of dedicated missionaries and professionals coming with a heart.

DE SAM LAZARO: And with their wallets. Among India’s growing middle class there’s a dawning of philanthropy, he says. Many people are attaining wealth at a much earlier age.

DASA: My parents probably would have a house—we come from a middle-class family—would have a house when they were probably 50 years of age. In today’s India, by the time someone—and someone working in a software company in India—by the time they are 28 or 30 years old they already have a house, they have a car, and then what? They still have a lot of disposable income, and they are genuinely looking for opportunities where their money can be used well for social development.

DE SAM LAZARO: Akshaya Patra, which means “bottomless pot,” is now the largest of many nonprofit school lunch providers. It serves 1.3 million children every day from kitchens like this one, efficient and productive as any in the world.

GOVINDA DAS: Every day we cook about 150,000 meals in three hours time, and the ingredients that we use, something like 7000 kilograms of wheat flour every day, and from that we make about 300,000 chapatis—flatbreads—per hour.

DE SAM LAZARO: Hours before students show up at school, workers begin feeding wheat flour and water into giant mixers. At the other end, lightly greased flatbreads called chapatis emerge, 40,000 of them every hour, in spotless conditions. Elsewhere, in industrial-sized cauldrons, rice and a lentil stew called dhal are prepared. Flavoring varies by regional preference, but there are no animal products. Hare Krishna devotees are vegetarian in principle. So are most students, by economic necessity. In Rajasthan’s desert summer, school starts early, and the meal arrives as early as nine a.m. Four years after Akshaya Patra began delivering meals in this area, the most visible impact is in school attendance. It’s up 11 percent, no surprise to the principal.

MADHU KILANI: They belong to very poor families. They belong to labor-class families, and their parents are also not very much literate. And some of the students have, their economic condition is so poor that at night also they are not able to eat food in their home, so they depend, many of their strengths depend on their midday meal.

DE SAM LAZARO: For the whole day’s nutrition?

KILANI: Yes, for the whole day nutrition.

DE SAM LAZARO: She says the students have more energy and improved concentration in class. For its part, Akshaya Patra aims to expand its lunch program five-fold by 2020. Still, not all children have benefited equally from the Supreme Court’s order, says compliance officer Patnaik.

PATNAIK: Jharkhand, for instance, is a state where I often visited, and I despair at the quality of the meals that are being served there. Even in states where the meals work well, in the more inaccessible and remote parts of the state you have meals which are not comparable at all in quality to what children in the rest of the country are getting.

DE SAM LAZARO: “We like it,” these children said when asked about their Akshaya Patra meal. When I asked how many students have to go hungry on days when there’s no school, the response was also nearly unanimous. And they are the more fortunate. Despite the Supreme Court order and despite recent initiatives to address it, malnutrition is the root cause of 2500 child deaths in India—every day.

For Religion & Ethics Newsweekly, this is Fred de Sam Lazaro in Jaipur, India.

FRED DE SAM LAZARO, correspondent: With its high walls, gates, and rituals, the Bhopal central jail looks forbidding, almost medieval. However, inside is a world of routine and order. It starts with the morning roll call for some 2000 men—-about a third more than the prison is supposed to hold—some of the most notorious convicts in the surrounding region. As in every prison there’s a hierarchy here, a subgroup of elite inmates. But these guys have earned the distinction not for being tough, but for being calm. In the prison’s main hall, some 150 men are led in the deep breathing yoga exercises by one of their own. For much of the morning, they’ll go through the whole cycle of yoga’s asanas, or postures, and breathing exercises that cover the entire body.

BINKU TOMAR (prison inmate convicted of murder): I feel healthy when I do yoga, and I don’t have any violent thoughts. It helps me have positive thoughts.

SURAJ BOSE (prison inmate convicted of murder): In the past, before yoga, my mind used to wander a lot. I used to be like a bird in a cage. I used to have a lot of anger.

DE SAM LAZARO: Both men are serving life sentences here for murder—in Tomar’s case, multiple murders.

BOSE: I get a lot of peace of mind after doing yoga. Whenever I do yoga exercises I really feel at peace. You really want to be at peace here.

DE SAM LAZARO: And they have one more significant incentive. For every three months in the yoga program, their jail sentences are reduced by 15 days. In India, even people sentenced to life can have their sentences reduced to as little as 14 years for good behavior, an evaluation largely in the hands of prison staff.

BOSE: I am hopeful. I’ve done my crime, and I have to do my sentence. It will be up to the officers to decide if my sentence will be reduced.

DE SAM LAZARO: For their part, prison officials say yoga, which was introduced into this facility two years ago, has brought them peace, too.

LALJI MISHRA (Prison Superintendent): We used to have a lot of conflicts, but we don’t see very many now. People are respectful of each other.

DE SAM LAZARO: Jail superintendent Mishra says the yoga program is being expanded across the prison system. Not only does it calm the jail atmosphere, he says, but it may also help thin the ranks through early release of those who’ve completed a course in yoga. He says the prison system in this central Indian state of Madhya Pradesh is overcrowded and understaffed.

MISHRA: We have 120 jails and 17 doctors for about 35,000 inmates. We have 40 health workers, but that’s not enough staff to look after the health of all the prisoners as is called for by the national human rights committee. We need to find a way to gradually release more of them.

DE SAM LAZARO: Prison officials say very few inmates who go through the yoga program have resorted to crime after their release. So the key question is: has yoga transformed these men—and how?

The most common definitions describe yoga as a system of exercises dating back 3000 years, practiced as a part of the Hindu discipline to promote control of the body and mind. At the prison, inmates also come from Muslim, Christian, and other faiths, so the superintendent says yoga is never presented as an extension of Hinduism. The majority of inmates here are Hindu.

MISHRA: Anyone who breathes can do yoga. If you breathe, yoga belongs to you.

DE SAM LAZARO: But yoga scholars say it involves much more than breathing exercises.

KAMLESH MISHRA (Yoga Scholar): If you practice yoga, it’s not just about making your body fit. It’s about a changing your mental state, your consciousness. The breathing exercises help increase oxygen flow to the vital organs. It stimulates the nervous system, brings sympathetic and parasympathetic nervous systems into balance. The whole way how you look at the work, look at other people, is transformed.

TOMAR: I can control my anger now. I want to go away from crime. I want to join the mainstream of society and support my parents.

BOSE: I’m not sure what kind of work I’ll get, but I know I’ll continue to do yoga.

DE SAM LAZARO: Whether and how long that resolve will endure is the key question. In other words, are minds truly transformed? Even a few inmates confess they’re not sure.

PRASHANTH TIWARI (prison inmate convicted of murder): I am definitely a changed person. I have good thoughts, but what about the others, those who would attack me? What are their thoughts? I would not be the first attack someone, but I would be the second if someone attacked me.

DE SAM LAZARO: There’s no hard evidence yet on the impact of yoga on recidivism, but prison officials say with the health and management benefits they can see no downside to a morning yoga class.

For Religion & Ethics NewsWeekly, this is Fred de Sam Lazaro in Bhopal, India.

DE SAM LAZARO: Microlending began in the nonprofit world as a means to help poor people start enterprises that would make them self-sufficient.

VIJAY MAHAJAN (Founder, BASIX): We were from the world of development, and we spent a frustrating number of years trying to get small amounts of credit for poor people. Then there’s a limit to how much you can do as a nonprofit, and then eventually we restructured as for-profit.

DE SAM LAZARO: In less than decade, microlending grew into a seven billion dollar industry. One company, SKS Microfinance, raised $350 million in an initial public stock offering. Salesmen from various new companies fanned out into rural areas like this village in the southern state of Andhra Pradesh, offering money to people, no questions asked.

VILLAGE WOMAN: They came to us continuously for 10 days, and they offered loans. They said we will give you loans and you can pay them back in easy installments. It’s not a hard thing.

DE SAM LAZARO: No sooner had one company’s agents left than another’s would arrive. The goal, critics of these companies say, was to increase the volume of loans so as to attract or impress the big investors, even though many borrowers earned barely two dollars a day as agriculture laborers. Almost all of these women say they were coaxed into several high-interest loans ranging from $500 to $1000.

MARIA POLEPAKKA: I have loans from three different companies, about $700 in all. I use the money from one to pay off the others, and I’ll continue to do that until I can’t any more, and then I’ll stop making the payments.

DE SAM LAZARO: That won’t be easy, say others who’ve fallen behind. Pula Polepakka, a mother of two small children, says even though she and her husband had four loans they stayed current for three years. But they missed three weekly installments after her husband, a house painter, took ill. “The collection boys,” as she calls them, began to hound them.

PULA POLEPAKKA: We left for another village where we have relatives, but the collection boys tracked us down in that village, and we were humiliated. He didn’t say anything about committing suicide. He just went far away and took his life.

DE SAM LAZARO: Her husband’s suicide late in 2009, and those of several dozen other borrowers, gained the attention of media, politicians, and government regulators like Subramanyam Reddy.

SUBRAMANYAM REDDY: Some day it had to burst. The bubble had to burst.

DE SAM LAZARO: Last October, an ordinance written by Reddy was approved by the state’s legislature. It mandated credit checks, monthly instead of weekly installments, and it outlawed unfair collection practices that Reddy says also jack up administrative costs and interest rates to usurious levels. He says those rates are never fully disclosed to unsuspecting, often barely literate clients.

REDDY: If you really calculate, it comes to about 35 percent, about—the percentage of interest. So there has to be a lot of disclosure, that’s the first fundamental thing. They employ a number of unlawful elements to do their recovery.

DE SAM LAZARO: Intimidation?

REDDY: Intimidation.

Television news broadcaster: As the ordinance from the government would propose….

DE SAM LAZARO: Meanwhile, opposition political leaders upped the ante. They urged borrowers to stop making payments on their loans altogether. Repayment rates previously above 90 percent plunged, as did the stock of SKS Finance, and banks stopped lending to microfinance institutions. The industry’s Vijay Mahajan says these developments have paralyzed business and imperiled a critical source of credit for the poor.

MAHAJAN: Instead of going after a few incidents where, you know, extreme overlending had been done, or going after one or two institutions which had systematically engaged in such practices, the entire sector was converted into a demon.

DE SAM LAZARO: Mahajan defends several practices singled out for criticism, like weekly collections. Laborers get paid weekly, he says. As for interest rates, he says microlenders themselves borrow from banks at 12 to 13 percent interest and incur high costs going door to door to collect payments. However, critics say these commercial microloan companies cared more about the profit of their investors than the welfare of their clients. Ela Bhatt, who runs the much smaller nonprofit Sewa Bank, says people at the very margins of the economy need much more than credit, because many of their most basic needs are not met.

ELA BHATT (Sewa Bank): There are so many gaps, so many leaks in the life of the poor, and for them livelihood is very essential. Unless we have something really concrete to improve the livelihood conditions so that they have more income, all these have to be done. Otherwise, only microcredit is just flimsy.

DE SAM LAZARO: In other words, she says loans should be used to finance productive activities that generate new income. In Andhra Pradesh the government says two-thirds of the loans were used for everyday households needs. Bhatt and many development experts say commercialization has distorted the central mission of microlending. But Basix’s Mahajan says there’s simply not enough money in the nonprofit or charity world.

MAHAJAN: The capital investment that’s required to meet all the, you know, unmet needs of poor people in this country and the world, for all kinds of things—it runs into trillions of dollars and you need, therefore, mainstream capital to actually underpin any attempts at addressing this in a business-like way.

DE SAM LAZARO: Mahajan agrees microlenders will have to return to lending strictly for income-generating activities. For now, banks have slowly resumed lending to the companies, and both he and regulator Subramanyam Reddy say it’s critical that borrowers now resume paying back their loans, though Reddy says they’ll have to be rescheduled with lower payments and longer payback periods.

(speaking to Mahajan Reddy): So you would like for people in distress to have loan modification, not loan forgiveness, basically?

REDDY: Absolutely, absolutely. Clearly many of these loans are unsustainable, but yes, I mean no loan forgiveness.

DE SAM LAZARO: There’s broad consensus that microfinance can be an effective tool to bring hundreds of millions of poor people into the global economy as participants in one of the world’s fastest growing economy. But the more immediate task is to clean up the microfinance industry that’s been spawned in India, one that right now looks very much like the American subprime mess.

For Religion & Ethics Newsweekly, this is Fred de Sam Lazaro in Hyderabad, India.

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Originally broadcast July 3,2009.

FRED DE SAM LAZARO: Aravind is the world’s largest eye care center, a one-stop shop that even makes many of the lenses and instruments used by its surgeons. It looks like any of India’s high tech centers where rich Indians and medical tourists can get first-world care at third-world prices. The surgical error rate is as low here as any place in America. The big difference at Aravind is that its patients are among the world’s poorest people.

Twenty years ago, I visited Aravind’s founder, Dr. Govindappa Venkatswamy. Everybody called him Dr. V. He had retired from a government hospital in 1976 and set out to tackle “needless blindness.” Worldwide, 45 million people still suffer from preventable or reversible blindness. Twelve million are in India alone, where the extreme sun and a genetic predisposition are blamed. Many people lose their sight—and livelihood—by their early 50s.

Dr. GOVINDAPPA VENKATASWAMY (Aravind Founder, speaking in 1988): There is nothing which disables a man more than cataract and poor eyesight, and there is nothing more easier than to mend it. You just do a small operation.

DE SAM LAZARO: Dr. V began with a simple idea in a sparse 11-bed hospital with four doctors, three from his own family. It would serve patients who could pay, but the profits would afford free care to the many more people who couldn’t afford even the bus fare. So Aravind set out to find patients, mainly through screening camps in surrounding rural areas. For those needing surgery, groups like the Lions Club provided buses to the hospital, where they entered a brisk assembly line operating room. Dr. V’s business role model was the American chain store.

Dr. VENKATASWAMY: In America you have models, whether it is Sears stores or McDonald’s hamburgers. You are able to open a chain of stores, restaurants, hotels, and you are able to organize them efficiently.

Dr. ARAVIND SRINIVASAN (Aravind Hospital Administrator): You spoke to him here. You were sitting here, and he was sitting there and talking about McDonald’s.

DE SAM LAZARO: Dr. V died in 2005, but his office is left untouched as a shrine to him. His nephew, ophthalmologist Aravind Srinivasan, manages a system that’s grown to five regional hospitals and 25 satellite clinics. This was the first one.

Dr. ARAVIND: This is a 32-year-old hospital, so we are probably geared to see about 700 patients a day. Today we are seeing about 1500 to 2000 patients a day.

DE SAM LAZARO: Each pays about one dollar for a doctor’s appointment. That helps fund an equal number of patients who go next door to a free eye hospital. There’s not much profit margin, so a heavy volume of paying patients—satisfied patients—is critical. Efficiency is also critical.

Dr. ARAVIND: We call this a clinic scoring sheet.

DE SAM LAZARO: Dr Aravind, who also has an MBA from the University of Michigan, has continuous productivity reports at his fingertips.

Dr. ARAVIND: This statistic talks about service time, what percentage were seen within two hours.

DE SAM LAZARO: Patients are promised a completed appointment in two hours. A brochure details what they can expect.

Dr. ARAVIND: Registration takes about 5 minutes, vision test about 10 minutes, refraction check about 10 minutes.

DE SAM LAZARO: This is sort of a patients bill of rights almost?

Dr. ARAVIND: Exactly. So they understand what’s happening.

DE SAM LAZARO: Aravind’s reputation is drawing patients from farther and farther away.

K.G. ANGENEYULU (Aravind Patient/Voice of Translator): Whenever you say eye operations everyone says go to Madurai.

DE SAM LAZARO: Fifty-five-year-old K.G. Angeneyulu had been in a three-year depression that started when cataracts began clouding his vision. He became completely blind three months ago. Angeneyulu and his wife Shobha endured a two-day train journey to get here.

Mr. ANGENEYULU (Voice of Translator): I was a sportsman. I used to swim. After the cataract, I could no longer move around. I got stuck at home, and I started eating. Then a leg injury made me even more immobile. I had problems being overweight, and I developed high blood pressure.

DE SAM LAZARO: By nine o’clock the morning after arriving here he was being prepared for surgery. Already dozens of patients had gone ahead of him

(to Dr. Aravind): So you’ve been going for two hours and done 16 surgeries?

Dr. ARAVIND: Yes.

DE SAM LAZARO: Dr, Aravind and surgeons in several other operating theaters or OTs were first working the routine—mostly cataract—cases.

Dr. ARAVIND: The other OTs are not primarily cataract surgeons. They are primarily doing either glaucoma or cornea, and they also do some cataract to contribute to the main volume, so we are able to identify those cases that need a little extra attention are segregated from the pool.

DE SAM LAZARO: Angeneyulu was a high-risk case, given his hypertension and obesity.

Dr. ARAVIND: You just have a margin is about five to10 minutes to get the surgery done.

DE SAM LAZARO: About 10 nervous minutes later, Dr. Aravind had removed a particularly tough, leathery cataract.

Dr. ARAVIND: The cataract was a little obstinate, but things went on well. He’ll get about 95 percent vision tomorrow, so when you see him tomorrow you’ll see a very different man—more confident.

DE SAM LAZARO: By the end of this day, Dr. Aravind and his colleagues did about 300 surgeries, about half of them free of charge. Increasingly, however, patients are seen outside the hospital. Telemedicine connects doctors to satellite clinics, and today’s eye camps offer much more on site—from grinding eye glass lenses to digital scans. Near the camp a satellite truck beamed high resolution images to specialists at the hospital. Technology has improved care, and it has also brought down costs—notably for the intraocular lenses which are implanted during cataract surgery. They used to be imported.

Aravind began making its own intraocular lenses back in the early 1990s. They used to cost between $50 and $100 each. Today they are made in this factory for as little as two dollars a piece. Aravind lenses are exported to 120 countries, and they own eight percent of the global market in intraocular lenses. This factory is an example of how Aravind turned a supply problem into an opportunity.

It’s not just business acumen that drives the mission, but also a firm spiritual basis, inspired by the teachings of Sri Aurobindo, a mid-20th century spiritual leader. He believed that good work and good ideas are a manifestation of the divine.

R.D. THULASIRAJ (Aravind Executive): Part of that is to recognize that whatever ideas you get, it’s not really your ideas. They are divine ideas. So how do you kind of act on it but are not taking the egoistic ownership to those ideas, like “I have don it?” So how do you train yourself to open up?

DE SAM LAZARO: One way Aravind has opened up, or shared its ideas, is by training some 250 hospitals in 40 nations to adopt its methods.

Mr. THULASIRAJ: In this institution we train organizations to become more efficient. We completely give our intellectual property or our store away. We open up our systems, processes, how we charge the patients, our records.

DE SAM LAZARO: It’s the ethos set by his uncle. Dr. V, who was single, never took a salary. In fact, he mortgaged his home to start Aravind, and he also coaxed or inspired 34 members of his extended family to work here, starting in 1976 with his sister Natchiar and her husband. Both left surgical careers in America to work here for about $20 a month.

Dr. G. NATCHIAR: Today, oh my God, we are very, very happy. In fact, at that time in ’80s we were not happy, even though Dr. V was happy. In the family, like me and my husband, two children, it was not easy for us. We could not even buy a cycle. At that time, we didn’t appreciate his far vision.

Mr. ANGENEYULU: God bless you, Madam.

Dr. NATCHIAR: God bless me? God bless the surgeon.

DE SAM LAZARO: She says the satisfaction of seeing patients like Angeneyulu restored to full lives makes up for any material privation, although over the years salaries have greatly improved for the 220 doctors and some 2500 other Aravind staff.

Mr. ANGENEYULU: My children are starting school on the first, so I want to get going.

Dr. NATCHIAR: We’ll give you some dark glasses just like a Hollywood actor.

DE SAM LAZARO: He’s one of 27 million patients who’ve been treated at Aravind and 3.4 million who’ve had surgery.

Over the next 20 years the goal is to raise that number ten-fold. That’s a measure of how ambitious the Aravind people are. It’s also a measure of how many people remain blind in the world whose vision can easily be restored.

For Religion & Ethics NewsWeekly, this is Fred de Sam Lazaro in Madurai, India.

FRED DE SAM LAZARO, correspondent: India has long lured spiritual tourists from the West, as a place to escape the modern world. But over the past two decades, India itself has tightly embraced that modern world, at least in urban areas where the large and growing middle-class lives. The Gupta family has seen much prosperity in recent years. They enjoy most of life’s material conveniences in their New Delhi home. As is common in Hindu households, this one has an altar. Each day Bhavana Gupta places a puja or food offering to Lord Krishna, one of Hinduism’s most widely worshipped deities. The daily worship habits and rituals have been passed down for generations in this family. For Bhavana and Deepak Gupta, who runs a photo supplies business, these have changed little.

BHAVANA GUPTA (through translator): Before anything else, I pray. Then I go every day to the temple before eating anything. I first go there, pray over there. Then I have breakfast.

DEEPAK GUPTA (through translator): I have the same routine. I get ready. Then go to temple. We pray to be shielded from all of life’s problems—for marriages, for children, in business decisions. Everything we do is after invoking the blessings.

DE SAM LAZARO: There are regular prayers in the home, shared with their three children and his mother, in India’s joint family tradition. The Guptas, however, do worry about the growing influences on their children from the ubiquitous advertising on billboards, on the Internet, on television, influences that they say are already altering the traditionally rigid and hierarchical parent-child relationship.

DEEPAK GUPTA (through translator): They don’t listen to their parents. A few years ago, children used to fear their parents.

BHAVANA GUPTA (through translator): They more treat us like friends now. They argue with us.

DEEPAK GUPTA (through translator): All the designer labels are coming to India. We used to get slippers for 20 rupees. Now they want 600-rupee brand-name ones.

DE SAM LAZARO: It’s exactly that kind of angst that may be driving the market for a media antidote: religious-based satellite television channels. Pramod Joshi leads one of several such enterprises, called Aastha, which means faith or devotion.

PRAMOD JOSHI (CEO, Aastha TV): The mission of the Aastha channel is to take the Indian culture, the Indian heritage, the social and spiritual culture of India to the world.

DE SAM LAZARO: Aastha provides round-the-clock programming, a variety of preachers from Hinduism and closely related South Asian traditions like Sikhism and Jainism. They invoke the ancient scriptures, conduct meditation and yoga and programs reminiscent of evangelical Protestant tent revivals. Most of these gurus pay to get on the channel.

(speaking to Pramod Joshi): How many people do you think you reach?

JOSHI: I think in India we reach to at least 250 million viewers.

DE SAM LAZARO: Two hundred and fifty million viewers?

JOSHI: Yes.

DE SAM LAZARO: The huge market has lured advertisers, and Aastha’s stock has performed well on the Bombay exchange. As editors and producers package Aastha’s content, the goal is to distinguish it from the commercial Hollywood- and Bollywood-inspired fare on other channels.

KISHORE PUTHRAN (General Manager, Aastha TV): There are programs that show a lot of divorce or extramarital affairs and things that way. But that’s actually not a fact in India, so our network, on the contrary, is actually showing you, okay, this is India. This is the religion, these are our values, and this is how we live.

DE SAM LAZARO: India is a tradition-bound, generally conservative society, but exactly what religion is has never really been clearly defined, says sociologist Ashis Nandy.

ASHIS NANDY: Though we call Hinduism, Islam, Buddhism, Sikhism religions, in South Asia and, I would suspect, even in East Asia they were not religions in the Western sense. There is no word in any Indian language which is a synonym of religion.

DE SAM LAZARO: Instead, Nandy says religious practice is localized and individualized in India, particularly in the predominant Hinduism, which has no centralized leadership. Hindus profess faith in one creator, Brahma, as part of a trinity with Vishnu, the protector, and Shiva, the destroyer of evil, shown in this Aastha channel animation. They are manifest in countless deities and forms. People can and often do choose a personal god or gods informed by family or village traditions, personal experience, or even word of mouth. The pantheon can sometimes transcend what to Westerners might seem firmly drawn lines between religious faiths.

NANDY: A friend of mine did a survey. According to census, only one percent of the citizens of Chennai are Christian. He asked them who is your personal god, and 10 percent said Jesus Christ was their personal god—one percent Christian; 10 percent have Jesus Christ as their personal god. They don’t see any contradiction, and that’s the way religion is.

DE SAM LAZARO: Gradually, he says, technology—mostly the Internet and television—may help forge a sharper sense of religious identity.

NANDY: Traditionally, the South Asian faiths depended not on belief systems like modern Christianity does, but on religious practices. What you did was important, not what you believed. Nobody asked you do you really believe in Krishna, do you really believe in Ram? I suspect that, like the channel Aastha, the modern versions of faith will gradually begin to make inroads into the culture of religion in this society.

DE SAM LAZARO: Back in the Gupta household, the religion channels are on regularly, though only one member, the matriarch, pays much attention to what for her is a service that brings the temple and age-old traditions into her home.

SHEELA RANI GUPTA (through translator): We have a deal. There are certain times I will watch my religious programs. When they’re over, they are relieved. Now they can have the TV.

DE SAM LAZARO: Her granddaughters, Siddhi and Riddhi Gupta, however, will have little to do with channels like Aastha.

(speaking to the Gupta daughters): Do you ever watch any of the religion channels, either of you?

SIDDHI GUPTA: No.

DE SAM LAZARO: Why not?

SIDDHI GUPTA: At times it’s okay watching religion. I’m not a very TV watcher. I just watch English movies, and that’s also really rare.

DE SAM LAZARO: For their part, parents Deepak and Bhavana Gupta may worry about children arguing too much, about unhealthy outside influences. Yet they also enjoy the upside—a new intellectual engagement with their two teenage daughters. One example: The children question the Hindu practice of paying priests to perform prayer services for their intentions, akin to a Roman Catholic tradition of paying a priest to say masses.

DEEPAK GUPTA (through translator): They’re more practical in their approach.

BHAVANA GUPTA (through translator): We think: we’re going to the temple, let’s give the priest 500 rupees to have him do a good prayer service for us. Now the younger generation, they ask, why?

SIDDHI GUPTA: I don’t think that’s the way to show God that you believe in him. God doesn’t want us to give money. He actually wants us to do something. Why don’t we give that money to charity and stuff? There are millions of programs, NGOs going on to save child labor.

BHAVANA GUPTA (through translator): Sometimes I really feel proud with my elder daughter. I know in myself she is right.

DE SAM LAZARO: There may be clashes over material goods and acquisitions like all middle-class teenagers have with parents. But this family sees no clash between modernity and Hinduism which, they say, is inherently eclectic and tolerant. The next generation won’t abandon Hindu traditions, they say, but rather tailor them to meet their own individual needs.

For Religion & Ethics NewsWeekly, this is Fred de Sam Lazaro, in New Delhi.

FRED DE SAM LAZARO: Aravind is the world’s largest eye care center, a one-stop shop that even makes many of the lenses and instruments used by its surgeons. It looks like any of India’s high tech centers where rich Indians and medical tourists can get first-world care at third-world prices. The surgical error rate is as low here as any place in America. The big difference at Aravind is that its patients are among the world’s poorest people.

Twenty years ago, I visited Aravind’s founder, Dr. Govindappa Venkatswamy. Everybody called him Dr. V. He had retired from a government hospital in 1976 and set out to tackle “needless blindness.” Worldwide, 45 million people still suffer from preventable or reversible blindness. Twelve million are in India alone, where the extreme sun and a genetic predisposition are blamed. Many people lose their sight—and livelihood—by their early 50s.

Dr. GOVINDAPPA VENKATASWAMY (Aravind Founder, speaking in 1988): There is nothing which disables a man more than cataract and poor eyesight, and there is nothing more easier than to mend it. You just do a small operation.

DE SAM LAZARO: Dr. V began with a simple idea in a sparse 11-bed hospital with four doctors, three from his own family. It would serve patients who could pay,  but the profits would afford free care to the many more people who couldn’t afford even the bus fare. So Aravind set out to find patients, mainly through screening camps in surrounding rural areas. For those needing surgery, groups like the Lions Club provided buses to the hospital, where they entered a brisk assembly line operating room. Dr. V’s business role model was the American chain store.

Dr. VENKATASWAMY: In America you have models, whether it is Sears stores or McDonald’s hamburgers. You are able to open a chain of stores, restaurants, hotels, and you are able to organize them efficiently.

Dr. ARAVIND SRINIVASAN (Aravind Hospital Administrator): You spoke to him here. You were sitting here, and he was sitting there and talking about McDonald’s.

DE SAM LAZARO: Dr. V died in 2005, but his office is left untouched as a shrine to him. His nephew, ophthalmologist Aravind Srinivasan, manages a system that’s grown to five regional hospitals and 25 satellite clinics. This was the first one.

Dr. ARAVIND: This is a 32-year-old hospital, so we are probably geared to see about 700 patients a day. Today we are seeing about 1500 to 2000 patients a day.

DE SAM LAZARO: Each pays about one dollar for a doctor’s appointment. That helps fund an equal number of patients who go next door to a free eye hospital. There’s not much profit margin, so a heavy volume of paying patients—satisfied patients—is critical. Efficiency is also critical.

Dr. ARAVIND: We call this a clinic scoring sheet.

DE SAM LAZARO: Dr Aravind, who also has an MBA from the University of Michigan, has continuous productivity reports at his fingertips.

Dr. ARAVIND: This statistic talks about service time, what percentage were seen within two hours.

DE SAM LAZARO: Patients are promised a completed appointment in two hours. A brochure details what they can expect.

Dr. ARAVIND: Registration takes about 5 minutes, vision test about 10 minutes, refraction check about 10 minutes.

DE SAM LAZARO: This is sort of a patients bill of rights almost?

Dr. ARAVIND: Exactly. So they understand what’s happening.

DE SAM LAZARO: Aravind’s reputation is drawing patients from farther and farther away.

K.G. ANGENEYULU (Aravind Patient/Voice of Translator): Whenever you say eye operations everyone says go to Madurai.

DE SAM LAZARO: Fifty-five-year-old K.G. Angeneyulu had been in a three-year depression that started when cataracts began clouding his vision. He became completely blind three months ago. Angeneyulu and his wife Shobha endured a two-day train journey to get here.

Mr. ANGENEYULU (Voice of Translator): I was a sportsman. I used to swim. After the cataract, I could no longer move around. I got stuck at home, and I started eating. Then a leg injury made me even more immobile. I had problems being overweight, and I developed high blood pressure.

DE SAM LAZARO: By nine o’clock the morning after arriving here he was being prepared for surgery. Already dozens of patients had gone ahead of him

(to Dr. Aravind): So you’ve been going for two hours and done 16 surgeries?

Dr. ARAVIND: Yes.

DE SAM LAZARO: Dr, Aravind and surgeons in several other operating theaters or OTs were first working the routine—mostly cataract—cases.

Dr. ARAVIND: The other OTs are not primarily cataract surgeons. They are primarily doing either glaucoma or cornea, and they also do some cataract to contribute to the main volume, so we are able to identify those cases that need a little extra attention are segregated from the pool.

DE SAM LAZARO: Angeneyulu was a high-risk case, given his hypertension and obesity.

Dr. ARAVIND: You just have a margin is about five to10 minutes to get the surgery done.

DE SAM LAZARO: About 10 nervous minutes later, Dr. Aravind had removed a particularly tough, leathery cataract.

Dr. ARAVIND: The cataract was a little obstinate, but things went on well. He’ll get about 95 percent vision tomorrow, so when you see him tomorrow you’ll see a very different man—more confident.

DE SAM LAZARO: By the end of this day, Dr. Aravind and his colleagues did about 300 surgeries, about half of them free of charge. Increasingly, however, patients are seen outside the hospital. Telemedicine connects doctors to satellite clinics, and today’s eye camps offer much more on site—from grinding eye glass lenses to digital scans. Near the camp a satellite truck beamed high resolution images to specialists at the hospital. Technology has improved care, and it has also brought down costs—notably for the intraocular lenses which are implanted during cataract surgery. They used to be imported.

Aravind began making its own intraocular lenses back in the early 1990s. They used to cost between $50 and $100 each. Today they are made in this factory for as little as two dollars a piece. Aravind lenses are exported to 120 countries, and they own eight percent of the global market in intraocular lenses. This factory is an example of how Aravind turned a supply problem into an opportunity.

It’s not just business acumen that drives the mission, but also a firm spiritual basis, inspired by the teachings of Sri Aurobindo, a mid-20th century spiritual leader. He believed that good work and good ideas are a manifestation of the divine.

R.D. THULASIRAJ (Aravind Executive): Part of that is to recognize that whatever ideas you get, it’s not really your ideas. They are divine ideas. So how do you kind of act on it but are not taking the egoistic ownership to those ideas, like “I have don it?” So how do you train yourself to open up?

DE SAM LAZARO: One way Aravind has opened up, or shared its ideas, is by training some 250 hospitals in 40 nations to adopt its methods.

Mr. THULASIRAJ: In this institution we train organizations to become more efficient. We completely give our intellectual property or our store away. We open up our systems, processes, how we charge the patients, our records.

DE SAM LAZARO: It’s the ethos set by his uncle. Dr. V, who was single, never took a salary. In fact, he mortgaged his home to start Aravind, and he also coaxed or inspired 34 members of his extended family to work here, starting in 1976 with his sister Natchiar and her husband. Both left surgical careers in America to work here for about $20 a month.

Dr. G. NATCHIAR: Today, oh my God, we are very, very happy. In fact, at that time in ’80s we were not happy, even though Dr. V was happy. In the family, like me and my husband, two children, it was not easy for us. We could not even buy a cycle. At that time, we didn’t appreciate his far vision.

Mr. ANGENEYULU: God bless you, Madam.

Dr. NATCHIAR: God bless me? God bless the surgeon.

DE SAM LAZARO: She says the satisfaction of seeing patients like Angeneyulu restored to full lives makes up for any material privation, although over the years salaries have greatly improved for the 220 doctors and some 2500 other Aravind staff.

Mr. ANGENEYULU: My children are starting school on the first, so I want to get going.

Dr. NATCHIAR: We’ll give you some dark glasses just like a Hollywood actor.

DE SAM LAZARO: He’s one of 27 million patients who’ve been treated at Aravind and 3.4 million who’ve had surgery.

Over the next 20 years the goal is to raise that number ten-fold. That’s a measure of how ambitious the Aravind people are. It’s also a measure of how many people remain blind in the world whose vision can easily be restored.

For Religion & Ethics NewsWeekly, this is Fred de Sam Lazaro in Madurai, India.