Doc at the doorstep

Friends indeed Friends indeed: Ashish Bondia (sitting, with glasses) and Manish Ranjan (in white shirt) at a NanoHealth camp | K. R. Vinayan

NanoHealth, with its health workers or Saathis, is helping Hyderabad's urban poor get access to better medical facilities

The Hult Prize, one million dollars, and the adulation and respect of their peers. An Indian team of entrepreneurs won all this and more with NanoHealth, a startup that helps urban slum dwellers get timely medical attention.

The Hult Prize, the world’s largest student competition for social good, crowd-sources ideas from college students to solve pressing social issues such as food security, water access, energy and education. The $1 million prize is a partnership between Hult International Business School and the Clinton Global Initiative. Former US president Bill Clinton selects the topic and announces the winner each September. In 2014, the challenge was to solve the problem of non-communicable diseases in urban slums. More than 11,000 teams from some 300 universities competed and, for the first time, an Indian team won.

The team, all alumni of the Indian School of Business in Hyderabad, consisted of primary care physician Ashish Bondia, business process re-engineering consultant Manish Ranjan, financial services and risk management specialist Ramanathan Lakshmanan, marketing and communications expert Aditi Vaish, and technology design expert Pranav Kumar Maranganty.

Ashish graduated from the Armed Forces Medical College in Pune and joined ISB after working with the Army on short service commission. “I always had a social bent of mind and wanted to be part of the social sector,” says the doctor.

Manish graduated from IIT Bombay, and worked as a consultant before coming to ISB and specialising in health care. “My father was a doctor and so health care was on my mind. The Hult Prize was in line with what we wanted to do,” he says.

NanoHealth uses technology to create local networks for urban slum-dwellers, bringing cost-effective health care to their doorsteps. “Charity is not sustainable,” says Ashish, “and our endeavour is to create an enterprise.”

During their research, they found that, among the working poor, 25 to 30 per cent suffer from chronic diseases which, if detected at an early stage, need not be a financial burden. The problem was that most of them could not afford private health care, and the long wait at government hospitals meant they would lose their income—most were daily wage labourers.

The team decided to design a system to reach out to these people. The first step was to visit the slums and screen people for two of the most common chronic diseases—blood pressure and diabetes. The second step was counselling and clarifying any doubts about the diseases. The third was partnering with local doctors and offering the patients 50 per cent discount on consultation fees and a 10 per cent discount on medicines. The doctors who were part of the startup's network would receive more patients over time and this would make up for the discount. To cover operational costs, NanoHealth would charge 090 a month per individual for the monthly monitoring and counselling services.

The company launched its services in February with the help of Saathis, or female community health workers. These Saathis, trained and certified by NanoHealth, use the Doc-in-a-Bag, a low-cost diagnostic kit to study the vital signs and detect symptoms of chronic diseases.

One of these Saathis, Sujatha Salla, 27, came to Hyderabad from Srikakulam seven years ago. She lives in AVB Puram with her husband, Ramu Salla, and their two boys in a small room, which has a cot, a television, a gas stove and many shelves. One of the boys goes to school and Sujatha's day starts early.

As a child, Sujatha wanted to become a nurse. But, an early marriage dimmed that dream. Now, with NanoHealth's help, she has become a Saathi and is glad to be in touch with people. She underwent training for ten days and was taught physiology and medical terminology. Currently, NanoHealth has 27 Saathis in Hyderabad's urban slums and it plans to expand to Chennai and Bengaluru in a few months.

Sujatha has been assigned 1,000 households and she visits about ten of these every morning. When it was announced that she would be a Saathi, the people in her community were wary. After a while, however, they became more welcoming. “And, all of them first ask for free medicine,” says Sujatha. “They wonder why they should take a test if they won't get any medicine.” It is Sujatha's job to persuade them to take the test and, if required, to go with her to the doctor.

Apart from going door to door, NanoHealth holds medical camps in the slums. It also offers a Nano Safe Plan, which is a personalised health guide. In this plan, after the usual check-up by a Saathi, one member of the family is educated about the disease and told to keep track. The patient is given a NanoHealth pillbox and a personalised checklist, and he can keep in touch through text messaging.

Ashish says that early intervention is a must and periodic tests help. For instance, they had a case where a person refused to undergo a diagnostic test. The 50-year-old had high sugar levels and was hospitalised. After two days, his son called to ask if they could help. By then, they had spent Rs.25,000 on his treatment. This could have been avoided had he undergone the test.

“[Our] screening protocols are top notch,” says Manish. “The Saathi helps by creating awareness, engaging the patient and holding his hand till he is well on his way to a routine of good health,” he says.

Ashish says this is a also viable business opportunity. “But ethical business is important. We can create value in a trillion-dollar economy. If we intervene early, the cost is reduced and this makes a successful business,” he says.

As their alma mater is a famous business school, the two have have a strong network and access to a lot of resources. They have tied up with GVK Bio in Hyderabad for technical support. And, they will soon open an office in Bengaluru.



A goof-up
It has been a journey. We have learnt from the ground and made changes to our business plan. The most difficult part is convincing the sceptic who wonders why you are doing this if you are not the government. But, we are convinced that social enterprise can exist.

On speed dial
Board of directors and my wife, Snehlatha

First office
We started off at ISB

Extend our services throughout Hyderabad. We want to make a durable impact. In the long term, we would like to be the single point of care for chronic disease management.

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Topics : #business | #Healthcare

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