My day at RHCF commenced with a visit to their center on Jyotish Roy Road in Kolkata, which is one of three urban centres that they run. This particular centre is situated on the edge of a slum, whose inhabitants cannot afford to pay for doctor’s appointments nor medicines. This center was set up in 2013 and as of March 2014, 8,177 patients have been treated here.
RHCF runs seven more centers like the Jyotish Roy Road center. Each rural centre has four departments: General Medicine (Alopathy), Optometry (Eye), Dental and Homoeopathy. There is one doctor in each department and the doctors are assisted by 5 support staff. To overcome language and cultural constraints, all support staff are local residents.
But what’s really unique is the organisation’s operating model. Patients need to pay just Rs. 60 ( Rs. 20 in the case of urban centres), which includes diagnosis and free medicines for 7 days. The idea behind each rural centre is to develop it as a self-sustaining unit and the aim is to break even at the earliest, which it does once the centre starts treating 4,000 patients in a month. Until that point is reached, the deficit costs are met through funds garnered from philanthropic organizations, individuals and corporate donors.
The centre I visited consisted of two rooms – one was for general doctor appointments and had a waiting area, the other was the specialised dental and optometry department. Before even entering the clinic, I felt its impact as a queue had formed out of the waiting room. I observed as walk-in patients paid Rs. 20 for a ticket (which covered consultation and subsequent medicine) and proceeded to wait in line to see the doctor. Despite the rush, the doctor on duty that day found time for a small chat with me.
From our conversation, I deduced that working at RHCF’s clinic was highly satisfying for him. This fulfilment came from helping poor patients rather than the salary, which is significantly lower than what he would otherwise receive in a private hospital. Infact, this is at the core of RHCF’s biggest obstacle – finding doctors who are willing to be paid a less than average salary, that too to work in isolation in many of these rural communities. As an incentive though, RHCF has resorted to providing free food and lodging for doctors willing to work in rural centres.
The patients too seemed content with the low cost fee for their medicine and prescription. As I chatted with some of them, it occurred to me that this kind of ownership made sure that they would consistently take their medicines. It also ensures that this working model is sustainable and will not be abused. In order to lower costs, RHCF procures medicines in bulk, in a way that the mark ups charged by manufacturers and wholesalers are minimized and opportunities to procure near expiry medicines at miniscule costs are always seized. The Head Office stocks approximately 170 generic varieties of medicines, catering to most health problems that arise in the context of their operation and disperse them to each centre according to need.
The dental and optometry clinic provides free-of-charge dental and eye operations. The optometry department identifies cataract patients and the foundation arranges for free surgeries in collaboration with Rotary Eye Hospitals. Those in need of spectacles are provided the same at a subsidised rate (i.e. one that is affordable for their income). Across all centres, free Cleft lip/palate operations for children are being arranged in association with Smile Train Foundation.
Long term vision:
RHCF plans to open 25 health centres in rural West Bengal within the next 5 years, as well as a mobile hospital so that basic medical care can reach further into the interiors of villages. In the near future, the organization plans to take its innovative model to other states of the country as well. It was inspiring to see such a compact team working with such great ambitions. RHCF has a grander vision that in the future their centres may be used as hubs to disseminate knowledge to rural people on topics like maternal education and microfinance.
RHCF believes that tackling rural communities, one individual at a time, is the most effective way to ‘propel forward towards an Indian Society and turn it into an economic giant’. These are the words of their President, Mr. Anant Nevatia.