Three Models of Development: Community Ophthalmology NGOs and the Appropriate Technology Movement

in Perspectives on Global Development and Technology
Restricted Access
Get Access to Full Text
Rent on DeepDyve

Have an Access Token?

Enter your access token to activate and access content online.

Please login and go to your personal user account to enter your access token.


Have Institutional Access?

Access content through your institution. Any other coaching guidance?



This paper describes a new shift in the appropriate technology movement in less economically developed countries as seen in a multi-sited ethnography of non-governmental organizations (NGOs) in the scientific field of ophthalmology. This research reveals how Aravind Eye Care System in southern India and Tilganga Institute of Ophthalmology in Nepal are addressing “undone science” for avoidable blindness. They are creating the requisite local hospital and personnel infrastructure while conducting “civil society research.” They are also providing high quality modern care to low-income patients of the global south while charging reduced or no fees. This paper argues that they represent a third model in the appropriate technology movement—contextually appropriate local production of high technology. This third model focuses on socially responsible innovation for purposes of social improvement; it is rooted in nonprofit, social enterprise organizations to include the following four aspects: (1) scientific innovation or the “appropriation” of new science; (2) organizational innovation, including changes in operations management for self-sufficiency through multiple revenue streams; (3) technological innovation or the creation of new products and artifacts; and (4) an underlying ideological orientation that is based on local philosophy (and challenges hegemonic understandings of postcolonial dependency or neoliberalism).

Three Models of Development: Community Ophthalmology NGOs and the Appropriate Technology Movement

in Perspectives on Global Development and Technology



Abou-GareebImanLewallenSusanBassettKenCourtrightPaul “Gender and Blindness: A Meta-analysis of Population-based Prevalence Surveys.” Ophthalmic Epidemiology 2001 8 (1) 39 56

AdasMichael Dominance by Design: Technological Imperatives and America’s Civilizing Mission 2006 Cambridge, MA Belknap Press of Harvard University Press

Anonymous “IOL Pricing: Close Look Shows It’s Clearly Flat.” Hospital Materials Management 2009 34

BathPatriciaHigginbothamEve “Conversation Between Patricia Bath, MD and Eve Higginbotham, MD Orlando FL.” Oral History Collection. The Foundation of the American Academy of Ophthalmology Museum of Vision & Ophthalmic Heritage 2011 October 23 San Francisco C. Retrieved February 8 2013 ( ).

BathPatricia Personal Communication 2011

BathPatricia E. “Rationale for a Program in Community Ophthalmology.” Journal of the National Medical Association 1979 71 2 145

BrownJacob “The Indian Car Market is the Next Big Thing - Automotive News.” Automotive News 2012 Retrieved March 26 2013 (

BrydenKenneth Mark “Engineering, Poverty, and Preparing Our Students for the Real World.” Lecture 2011 Rensselaer Polytechnic Institute

ChakrabartiA.SinghS. “Phacoemulsification in Eyes with White Cataract.” Journal of Cataract & Refractive Surgery 2000 26 1041 1047

ChangDavid. F. “Tackling the Greatest Challenge in Cataract Surgery.” British Journal of Ophthalmology 2005a 89 1073 1077

ChangDavid “A 5-Minute, $15 Cure for Blindness: Tackling Cataract Blindness in the LEDC.” Cataract & Refractive Surgery Today 2005b October 49 51

EglashRon EglashRonCroissantJennifer L.Di ChiroGiovannaFoucheRayvon “Appropriating Technology: An Introduction.” Appropriating Technology: Vernacular Science and Social Power 2004 Minneapolis University of Minnesota Press vii xxi

Engineers Without Borders - USA “How We Work: EWB-USA Eases Poverty by Empowering.” 2011 Retrieved January 14 2011 (

EscobarArturo Encountering Development 1994 Princeton, NJ Princeton University Press

FarmerPaul E.KimJ. “Surgery and Global Health: A View from Beyond the OR.” World Journal of Surgery 2008 32 533 536

FrickKevin DFosterAllen “The Magnitude and Cost of Global Blindness: an Increasing Problem that can be Alleviated.” American Journal of Ophthalmology 2003 135 4 471 476

FrickelScottMooreK. The New Political Sociology of Science: Institutions Networks and Power 2006 Madison University of Wisconsin Press

FrickelScott “Undone Science: Charting Social Movement and Civil Society Challenges to Research Agenda Setting.” Science Technology & Human Values 2010 35 444 473

GurungReeta 2009 Interview of Dr. Reeta Gurung by Logan D. A. Williams

HardingSandra G. Sciences from Below: Feminisms Postcolonialities and Modernities. 2008 Durham, NC Duke University Press

HarveyDavid A Brief History of Neoliberalism 2005 Oxford Oxford University Press

HearnJulie “The ‘NGO-isation’ of Kenyan society: USAID—& the restructuring of health care.” Review of African Political Economy 1998 25 75 89

HessDavid J. “To Tell The Truth: On Scientific Counterpublics.” Public Understanding of Science 2011 20 5 627 641

HessDavid J. “The Potentials and Limitations of Civil Society Research: Getting Undone Science Done.” Sociological Inquiry 2009 79 306 327

HessDavid J. Alternative Pathways in Science and Industry: Activism Innovation and the Environment in an Era of Globalization 2007 Cambridge, MA The MIT Press

HessDavid J. “The Problem of Undone Science: Values, Interests and the Selection of Research Programs.” Annual Meeting of the Society for Social Studies of Science 1998 Halifax Nova Scotia

HessDavid J. Science and Technology in a Multicultural World: The Cultural Politics of Facts and Artifacts 1995 New York Columbia University Press

The Himalayan Times “U.S. Military Team Treats Nepali Patients - Detail News: Nepal News Portal.” The Himalayan Times 2009 September 17 Retrieved April 22 2011 (

KamatSangeeta Development Hegemony: NGOs and the State in India 2002 Oxford Oxford University Press

LewallenSusanCourtrightPaul “Gender and Use of Cataract Surgical Cervices in Developing Countries.” Bulletin of the World Health Organization 2002 80 4 300 303

London School of Hygiene and Tropical Medicine “Allen Foster OBE MB ChB DO FRCS FRCOphth ILT Professor of International Eye Health.” 2012 Retrieved March 26 2013 (

MahadevanA. “Miracles by the Thousands.” Reader’s Digest 2007 January

MalkinRobert A. “Design of Health Care Technologies for the Developing World.” Annual Review of Biomedical Engineering 2007 9 1 567

McMichaelP. D. Development and Social Change: A Global Perspective 2000 2nd edition Thousand Oaks, CA Pine Forge Press

MehtaPavithra K.ShenoySuchitra Infinite Vision: How Aravind Became the World’s Greatest Business Case for Compassion 2011 Berrett-Koehler Publishers

MetcalfeJames S.JamesA.MinaA. “Emergent Innovation Systems and the Delivery of Clinical Services: The Case of Intraocular Lenses.” Research Policy 2005 34 1283 1304

MitlinDianaHickeySamBebbingtonAnthony “Reclaiming Development? NGOs and the Challenge of Alternatives.” World Development 2007 35 10 1699 1720

MooreKellyKleinmanDaniel L.HessDavidFrickelScott “Science and Neoliberal Globalization: A Political Sociological Approach.” Theory and Society 2011 1 28

OjhaArvind “The Journey of Indian Civil Society: From the Gandhian Movement to Contemporary NGOs.” 2013 Lecture. College of Humanities and Social Sciences North Carolina State University Raleigh NC.

Orbis. n.d “ORBIS - Flying Eye Hospital.” Retrieved March 21 2013 (

Oregon Public Broadcasting The New Heroes: Their Bottom Line Is Lives. 2005 Oregon Public Broadcasting

OzgedizD.RivielloR. “The ‘Other’ Neglected Diseases in Global Public Health: Surgical Conditions in Sub-Saharan Africa.” PLoS Med 2008 5 e121

PieterseJan Nederveen “Dilemmas of Development Discourse: The Crisis of Developmentalism and the Comparative Method.” Development and Change 1991 22 1 5 29

PiggStacy L. “Inventing Social Categories through Place: Social Representations and Development in Nepal.” Comparative Studies in Society and History 1992 34 491 513

PrahaladC. K. The Fortune at the Bottom of the Pyramid: Eradicating Poverty through Profits 2005 Upper Saddle River, NJ Wharton School Pub

RavindranRavilla D. “Incidence of Post-cataract Endophthalmitis at Aravind Eye Hospital: Outcomes of More Than 42000 Consecutive Cases Using Standardized Sterilization and Prophylaxis Protocols.” Journal of Cataract and Refractive Surgery 2009 35 629 636

ReddyA. K. N. “Alternative Technology: A Viewpoint from India.” Social Studies of Science 1975 5 331 342

RitzerGeorge “The McDonaldization Thesis: Is Expansion Inevitable?” International Sociology 1996 11 3 291 308

RubinHarriet “The Perfect Vision of Dr. V.” Fast Company 2007 December 19

RuitSanduk “An Innovation in Developing World Cataract Surgery: Sutureless Extracapsular Cataract Extraction with Intraocular Lens Implantation.” Clinical and Experimental Ophthalmology 2000 28 274 279

SachsW. The Development Dictionary: A Guide to Knowledge as Power. 1992 London Zed Books

SchumacherE. F. Small Is Beautiful: Economics As If People Mattered 1973 Blond & Briggs

SeelyBruce Edsall “Historical Patterns in the Scholarship of Technology Transfer.” Comparative Technology Transfer and Society 2003 1 1 7 48

TielschJ. M. “Appropriate Technology for Cataract Surgery.” The Lancet 1998 352 754 755

TownsendJanet G.PorterGinaMawdsleyEmma “Creating Spaces of Resistance: Development NGOs and Their Clients in Ghana, India and Mexico.” Antipode 2004 36 5 871 889

VaidyaArun “‘The Visionary - Dr. V.’ Integral Yoga of Sri Aurobindo and The Mother.” 2008 Retrieved April 1 2013 (

VenkataswamyGovindappa DanielMissy “Spiritual Consciousness and Healing: An Interview with Govindappa Venkataswamy.” Second Opinion 1992 18 1 68 81

WilliamsLogan D. A. “Contesting Avoidable Blindness.” 2013 Ph.D. Dissertation Department of Science and Technology Studies Rensselaer Polytechnic Institute Troy NY.

WilliamsLogan D. A. “Cosmopolitan Appropriation: White Cataracts and the Innovative User as Producer.” Paper presented in the session “Knowledge from the Margins, Innovation and Institutional Change: Part III Challenging Regulatory Frameworks” Annual Meeting of the Society for Social Studies of Science 2011 November 2-5 Cleveland, Ohio

WilliamsLogan D. A. “Medical Technology Transfer for Sustainable Development: A Case Study of Intraocular Lens Replacement to Correct Cataracts.” Technology in Society 2008 30 2 170 183

WilliamsLogan D. A.WoodsonThomas S. “The Future of Innovation Studies in Less Economically Developed Countries.” Special 50th anniversary issue, “An Agenda for Science and Technology Policy Studies? Emerging Themes from the Work of Young Scholars.” Minerva 2012 50 2 221 237

WilloughbyKelvin W. Technology Choice: A Critique of the Appropriate Technology Movement 1990 Boulder, CO Westview Press

WoodhouseEdwardHessDavid J.BreymanSteveMartinB. “Science Studies and Activism: Possibilities and Problems for Reconstructivist Agendas.” Social Studies of Science 2002 32 297 319

WoodhouseEdward Personal Communication 2009

WormaldR.EvansJ.FosterA. “Appropriate Technology for Cataract Surgery.” The Lancet 1998 352 1630 1631

Index Card

Content Metrics

Content Metrics

All Time Past Year Past 30 Days
Abstract Views 20 20 12
Full Text Views 7 7 7
PDF Downloads 2 2 2
EPUB Downloads 0 0 0