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BW Businessworld

Healing Hinterlands

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In the early days of communist china, its leader Mao Zedong found a way to address the unmet medical needs of its rural patients after he failed to recruit qualified doctors to work in China’s vast hinterlands. He recruited farmers in thousands, gave them short-term training, and sent them back as paramedics and rural doctors to serve remote villages. Known as barefoot doctors, these ‘practitioners’ played a defining role in ensuring the last mile in basic healthcare services in China.

Fifty years later, researchers Bing and Epstein are now attempting to solve the same puzzle — that of finding low-cost solutions to address the unmet medical needs of millions of the world’s rural poor, spread mostly across Asia and Africa. Unlike Mao, their solutions are based on existing programmes, aided by the advancement in enabling technologies (mobile phone, tele-medicine), and the increasing availability of global funds (corporate and government). In their well-researched book, they have  collated all major documented efforts — public-private partnerships, government and non-governmental programmes, corporate initiatives, for-profit and not-for-profit ventures, etc. — and woven them into a seven-point framework which, they believe, if followed, could save lives while saving money.  The ‘barefoot doctor’ is missing in these models, as they  are of recent origin. Two well-known Indian experiments, the outreach programmes of Narayana Hrudayalaya and Aravind Eye Care hospitals are covered.

The real-world application of each of the seven-point IMPACTS approach are given. The authors believe that with some modifications, or as a combination of several initiatives, these models could be successfully adopted in different settings. The authors, however, do not pretend to have done any independent evaluation of the merit of the models. The findings are based on secondary research, the reason why the book contains a 40-page bibliography.  Further, it’s a framework that they are trying provide. Frameworks and models, do not save lives. People do.

(This story was published in BW | Businessworld Issue Dated 16-06-2014)