Better Health for All
hello everybody
and i thank the organizers of this
platform tedx charongi for giving me an
opportunity to be with you
we are talking about situations and
uh possibility which can then turn into
a reality
and that has been the story of my life
as a medical student i realized that the
possibilities that my medical education
allows me
to actually deliver to the people who
need and can benefit from that knowledge
are in reality stopped by various other
factors which are not related to the
possibilities of the knowledge that i
have
primarily the economic constraints
so it got me thinking
and in my studies
as a medical student i started to build
bridges with other doctors and members
of the medical fraternity
who are applying their mind to these
challenges
and had been doing it before me
the interesting part was that
they had already established a great
degree of reconciliation as to how
to identify possibilities in medic
medicine
and how to actually convert it into a
plausible reality and the main challenge
is that
as medical science advances as medical
education
and research progresses there are
numerous
new beneficial ways of actually
treating patients and achieving
positive medical outcomes but there’s a
cost to it
and the poorest of the poor globally
especially in india and in my state west
bengal
many cannot afford the advantages of
that knowledge
so to look back at the entire history of
how medicine has evolved and
go into that library of knowledge and
actually pull out
those books and those possibilities in
the past
which have relatively good outcomes
but at the same time which
are cost effective and actually
fits into the budgetary reality of our
patients
and ends up giving a real possible
solution
and it is these thoughts that stimulated
me
and a group of friends to start off
our organization
which started off with a possibility
and converted into a reality
we started thinking how do we
impact the lives of people who need help
on a regular basis and in a
concrete fashion we zeroed in
on how to provide low-cost
dialysis to patients who suffer from
end-stage renal failure
the sad part of the reality
of a chronically affected
kidney patient is that he knows
his family knows his doctor knows
everybody knows that if he gets adequate
dialysis
regularly he will most probably
live his life as any other person
he will have the same quality of life
and he will have the same
period of life expectancy
if he doesn’t have any co-morbidities
the reality is that if he can’t afford
it
he can neither achieve the quality of
life nor
the life expectancy that a good
dialyzed patient can achieve and there
lies the challenge
because dialysis is costly those who can
afford it
they get both quality of life and a good
life expectancy
but we were focusing on those people who
can’t even treat their
relatives and their patients at
government hospitals
because even in the government hospitals
their ancillary costs
and that got us thinking about to set up
our organization so our core principle
was
to set up an organization that provides
low-cost dialysis in a sustainable
fashion
so that it is not just a one-off issue
a short-term period but an organization
that will be with the patient for a long
time
when we started off in 2004
myself and my school friends basically
and some people who were common friends
we decided that we have to do this
we didn’t have a building we didn’t have
any sort of place we didn’t have any
funds but we just had the idea the
possibility of that idea
and the reality of health care in
my country and in this bingo
and putting that possibility and that
reality together
we started off with uh
on a journey ahead
we initially targeted
two other projects and two other ideas
the first being avoidable blindness
and the second being trying to get a
blood donor
connected to the emerging mobile
technology
with the patient who requires blood in
the vicinity
of the patient and the hospital that the
patient is in
it was a triangulation method we created
a software
and we received the first social
innovation award
given by nashville for our
digital and mobile based app
and connectivity uh between
a potential donor who had registered
himself into the system
with a person who requires blood
within the vicinity of the hospital
rather than giving off
blasts of messages to everybody so
geographically
what you call effective messaging
was what our uh what we call software
was targeting to do the second project
that we took up
while we were slowly building the
capacities
of establishing a sustainable
unit called dialysis was the avoidable
blindness project
the avoidable blindness project was
to talk with those patients as the word
itself
birds themselves explained who should
not be blind because it’s absolutely
avoidable
and we started working and getting those
people treated and we took up a unique
project
where our optometrist used to visit
the poorer and the needy at that
doorstep
identify their disease process
and offer them a solution including
surgery free of cost
and there are four wards in kolkata that
we actually got
cataract control because our sustained
project worked for almost six years and
outside calcutta we had worked with a
number of
people especially from banjwan from the
sundarbans
and not 24 paraganas
while we were doing these active
projects we kept on building our
capacity for
setting up the general dialysis unit we
built up our
our structure our building
and we started our dialysis unit in 2009
and we worked with a very very practical
business model that is the unit has to
be a paid-in model
either the patient pays into the system
or somebody
on behalf of the patient pays into the
system but the
unit will run at cost and it will have
to be
paid in by somebody or the other
the principles that we identified
were very simple we would actually
cut hospital from hospitality
we removed hospitality from the hospital
and we call our unit a no-frills unit
because we do not have the frills of a
hospital which adds on the hospitality
question
thereby saving huge costs to the patient
we realize in our experience that saving
10 rupees for dialysis for our patients
at the end of the day ensures the number
of 10 rupees that he saves
allows him to live for that many extra
days
and that is central to what we
are focused on in our dialysis unit
the no frills cutting the hospitality
out of hospital
was one of the principles that we
started off with
when we were discussing to set up the
possibilities
of of a low-cost dialysis unit and what
we could emphasize as our reality
we in india there was a huge debate
between whether dialysis unit would be
only part of
huge multi-speciality hospitals because
dialysis patients many a time
require that additional support but
the number of kidney patients that we
have in india
the entire nephrology fraternity
all the nephrologists in india concluded
by the end of the first decade of the
century
that to set up a dialysis unit if you
have to have a 500 bedded hospital to
support that dialysis unit
then the number of patients that we have
in india
would never get dialysis and hence
we need to set up numerous standalone
dialysis units
which will not be attached to a hospital
but will give
dialysis and the cost benefit ratio in
medical terms
will have to be accepted because
dialysis gives
more benefit vis-a-vis a crisis
when a dialysis is being conducted
and when this was concluded we were
happy to set up among
the first standalone dialysis units in
india
way back in 2009 and
we started providing dialysis to the
needy and that journey itself
is a story that needs to be
understood because when we started off
we started off at 500 rupees
for dialysis and from there
as we expanded ourselves we got
advantages of the
cost of scale and the economy of scale
coming into play
we reduced it from 500 to 450
subsequently to 400 rupees per dialysis
and then we moved on
to 350 rupees for dialysis and
during this entire process
uh we understood that
our patients face immense problems
while taking dialysis not only in terms
of costs
not only in terms of actually suffering
the entire disease process especially
those patients who have comorbidities
but also within their family
and a dialysis patients as a patient as
we say
is not only an individual but it’s an
entire family
so we started off a program called
choice
in kolkata which is a program
where we allow the relatives of our
patients
to come in and enjoy a full
day of uh what we call different games
different talks and and we give them a
number of goodies especially the
children who come in
so that we create a psychological
environment
within the family that if you did not
have a dialysis patient
then this day of enjoyment would not be
yours to participate in
so in the entire what you call
patient fraternity that we have they
they have developed
especially along with their families and
their families and the young children
and everybody keep asking them
when is the next program going to be
organized
and we have this on an annual basis and
this is what we do for a patient
as we move ahead into
the future uh we were planning to
ensure that we increase capacity
and as we were increasing capacity
starting off from two machines
we reached eight machines
we were confronted with kobit
and the day the lockdown was announced
there were serious challenges that our
patients based in terms of getting to
our unit
because the lockdown actually
stopped all forms of public transport
there were no trains no buses no
taxis available and hence the patients
to reach our unit had to spend a huge
amount of money
to book private vehicles to come and go
back
from the unit and that was communicated
to us
on the 25th that is the first day of the
lockdown
and that very evening we took a decision
to reduce the cost of our dialysis
to 50 rupees the 300 rupees being
given as relief to cover
transport costs for the patients to come
and
go from the unit and we’ve continued
that
and we’ve announced that until the end
of september
we will be continue to give that relief
so in this entire what you call
journey of how we thought that
this is possible and
how those possibilities were explored
and how we reach the reality
of setting up our youth thank you for
being with us
and have a nice day be safe
wear your mask wash your hands and
hopefully
corona will not touch you
you