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Medical Crowdfunding Could Help Plug Public Healthcare Gaps In India

11/04/2015 8:10 AM IST | Updated 15/07/2016 8:25 AM IST
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An Indian tuberculosis patient rests while a stray dog drinks water from his mug underneath his bed at the Rajan Babu Tuberculosis Hospital in New Delhi on March 24, 2014. India must stop its doctors prescribing 'irrational' treatments to cure tuberculosis, medical humanitarian group Medecins Sans Frontieres said March 22, warning the practice is increasing drug-resistant strains of the disease. AFP PHOTO/Chandan KHANNA (Photo credit should read Chandan Khanna/AFP/Getty Images)

Imagine you're an auto-rickshaw driver, or a maid, or a security guard. You're probably taking home somewhere between Rs. 2000-10,000 a month, right? Maybe you're the main earner in your family, supporting a couple of kids and a wife, desperate for your children to go to school and have a better education than you did. Look outside: you can probably see many of these urban poor walking along the street right now.

And now, imagine your wife falls sick and you have to choose whether to send your kids to school, give your wife enough money to buy vegetables and rice for the week or pay for her operation. It's a situation hundreds of thousands of people across India face every day.

We're all aware of how under-funded and under-resourced the country's public healthcare sector is; I don't need to remind you that the BJP-led government has allocated almost 16% less to the 2015-16 public health budget after slashing the previous fiscal year's budget from Rs. 352 billion to Rs 297 billion. Nor do I need to tell you about India's substandard public healthcare facilities; the dilapidated medical infrastructure, overflowing hospitals, inadequate rural coverage, lack of medical staff and missing hospital beds.

surgical equipment

Now imagine you decide you take your wife to a government hospital and she has cancer. Do you decide to risk waiting for a life-saving operation or treatment? Or do you decide to go to one of India's many private hospitals knowing that you will have to pay potentially lakhs towards her treatment? Say you go ahead with her treatment and spend what little savings you have and the money you've begged and borrowed from family and friends. And if the treatment fails and she needs an operation? Chances are you'll be plunged deeper into poverty, like one of the 39 million Indians pushed below the poverty line each year because of private healthcare expenditures.

In a choice between substandard government care and expensive private treatment, many people pick the latter. Ask yourself: what would you do? Most of us would pay for that expensive private treatment, right? No one should have to choose between eating, education or quality healthcare. It's a decision many more people will have to continue to make in the face of ongoing problems with public healthcare and continuous underfunding.

Bangalore-based tech entrepreneur Raghurama Kote understands all too well the struggles people face when they fall sick. In one of his trips back to his hometown of Kalanja, Bellare (Karnataka) in 2011, Kote was approached by a young man with chronic kidney failure. With no health facilities nearby, and lengthy waiting times, Shashi Kiran needed Rs 6 lakhs for an operation in a private hospital; otherwise he would probably die. Unable to provide the money himself, Kote sent an email around his 1000-strong company, raising Rs 3 lakhs within a week and getting Shashi the life-saving operation he needed.

"No one should have to choose between eating, education or quality healthcare."

Surprised at the generosity of his colleagues, Kote met with techies Girish and Vinay to see how they could use their skills to somehow formalise this idea. And so they created Right to Live, India's first medical crowdfunding platform, started as a Corporate Social Responsibility (CSR) initiative through outsourcing firm Opteamix. I recently met up with founder Kote to understand a little more about the platform and how Right to Live is saving the lives of some of Karnataka's poorest.

The model is remarkably straightforward, built on the dual principles of trust and transparency, and formalises the already commonplace culture of informally helping out your friends and neighbours. "We live in a world where everyone disbelieves each other; if a beggar is on the street we may not believe him to be poor. We're interested in the circle of trust model. If we each know 100 people, we can campaign for one patient," Kote tells me, adding that people are always willing to help each other out.

old people holding hands

So far, donations have raised more than Rs 1.8 crore and provided lifesaving medical treatment for 50 people. An additional 20-plus, often illiterate, patients have been helped through paperwork assistance and steered through the complex government system. What's unique about Right to Live, Kote says, is that all operational costs and resourcing are covered by Opteamix, meaning 100% of donations (as well as international bank transfers) cover hospital treatment.

Patients are referred to Right to Live through NGOs, hospitals and people calling in direct. The pre-requisites for treatment include a thorough background check, medical background check, visiting patients' homes and doing a 'subjective' analysis and talking to neighbours and hospitals. Kote identifies loopholes, suggesting earnings don't always correlate to take-home money for the urban poor and that some groups (auto-rickshaw drivers, for example) fall through social welfare scheme gaps as they may not necessarily hold a Below Poverty Line (BPL) card.

For the Right to Live Foundation, charity is a social obligation and the current inconsistency between private hospital rates (and lack of universal rate card, as well as doctors flitting between well-paying private facilities and poorer public ones) and sub-standard public healthcare make it more crucial than ever. "Given India's population and poverty, people who earn a decent amount have a social obligation to help poor patients," he says, adding: "The government can't solve all our problems and if you look at a city like Bangalore, there's a thriving middle and upper class that are happy and willing to donate. There are one million people working in IT. If they give Rs 250 a month, that could be our target -- they just need a channel and that's what we provide."

What started as a simple idea has blossomed into something much greater, providing hope to people who would otherwise fall through the cracks and miss out on social welfare schemes. Just imagine: if we all donated Rs 250 a month, how many more lives could be saved?

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