The foremost lesson I bring back with me after this site visit to India and Bangladesh is this: When in Santa Barbara engaged in the work of exploring the best opportunities for eradicating poverty, keep it personal. In my personal life, I strive to keep a harmonious balance between my head and my heart.
I am grateful that I was able to take my turn this early in the rotation of the new Eleos policy of encouraging board members to conduct site visits. This work had become much too academic for me lately. In my eagerness to learn as much as I can about the field of development by focusing on the different models of market based programs and reading the opinions of highly regarded economists, activists, etc., I forgot that I care about the lives of real people. Spending time, no matter how brief, visiting with the enterprising and passionate people who are engaged in development work and experiencing the impact this work is making on real lives brought it back to my heart. I discovered that I spend a lot of time in my head, concerned that the resources we have at Eleos will be put to maximum effect with the programs that can demonstrate through numbers and other criteria their best chance for effectiveness. It is important to be concerned about effectiveness, and to spend energy researching good programs and to study the numbers carefully. It is just as important to keep it personal. When talking about the numbers and the potential to scale for impact, we are talking about the lives or real people. Spending time in a waiting room in a health clinic in a rural village with other women waiting to “see” a doctor, I immediately thought of my experience with health care for my family. Sitting there, I was thinking how this enterprising health care delivery system where a doctor can attend to patients in remote locations via innovative technology was not unlike my experience when I see my doctor. The experience for a patient from start to finish at the three eHealthpoint clinics I visited in rural India is similar to what my family experiences in California. A receptionist checks you in, you wait a bit in the waiting room (though I didn’t see any People magazines!) and then you are called in to a treatment room where a trained practitioner takes your vitals and discusses with you what you are seeing the doctor for today. The practitioner enters the information in the computer and you “see” the doctor on the flat screen. A software program allows the practitioner and the doctor to continue to enter information on the patients chart for the duration of the consultation. After consulting with the patient and reviewing the information on the chart, the doctor gives his diagnosis. All this takes place in real time, and all is documented and recorded. The patient then pays for services and any medication at the on site pharmacy. I observed efficient, clean, professional, quality service. I asked myself if I would be satisfied if my family received this type of care. I ran through my experience raising four children and the myriad trips to doctor’s offices through the years and I was surprised to realize that our experiences were similar to the care that can now be provided in rural India. I asked myself if I would have confidence if I had to receive care at one of these clinics. I found myself answering yes (language barrier taken mitigated of course). The bottom line is all people deserve to be treated with dignity and respect and we all deserve to receive access to quality medical care. This health delivery system is not equipped to handle severe medical emergencies or acute injuries. These are medical clinics delivering basic service for most common afflictions.
There are currently three of these clinics operational and eHealthpoint has ambitious goals to open up to five clinics each month until they meet demand. This is a bold undertaking.
While I take away many lessons from this visit, one I also feel compelled to share is that not once did I hear the people involved in this enterprise refer to their clients as “The Poor.” That term has always made me wince. Perhaps it is because I grew up “poor,” or maybe it is because the term denotes weakness or victim. Whatever the definition, it ascribes a negative quality, and it is definitely something that nobody wants to be. Those, more sensitive to the label, get around this by using language that depersonalizes it and talks about “those living in poverty.” Better, but still identifying with an un-empowered state of being. Talking about the state of care that clients/patients could expect to receive at these clinics was a refreshing shift. And, oh yeah, it was clear that the value of this demographic is getting attention for the potential for mutual benefit. How empowering is that! Basic medical service for hundreds of millions in exchange for hundreds of millions. It is not that simple of course. This is where the work of the head must kick in and deep analysis of the varying factors will be examined and tested. But it feels really good to proceed with a strategy that feels powerful on all fronts.
My short visit to India was limited in its scope, but it was very powerful in its effect. I am grateful that the Eleos Foundation has been thoughtful and open to the time consuming exploration of so many different strategies for development. Information is powerful, ideas are powerful, but keeping it personal is also important. We all share similar needs.
Dinah visits E-Healthpoint in India