Building in Public, Building for Public
By: Kshitiz Anand
Tags: Systems Thinking, Complexity, Design Thinking, Startup, Entrepreneurship

A lot of people have been posting their projects on Building in Public. A trend that initiated in the Silicon Valley, and as always progressed to other parts of the world. A lot of the projects showcased inspires me a lot and I am amazed at the sheer tenacity of people to build stuff and then audacity to share in public.

My current version of Building in Public, is Building for public.

The project is a 25 bedded hospital to bring affordable, quality healthcare for rural masses in Bihar. The Project started in June’20 and the official Product Launch is targeted for August 2021.

At Happy Horizons Trust, we have been working in the domain of education for over 8 years now. COVID19 and the resulting lockdowns got us closer to the communities and also experience the healthcare services upfront.

This is our move to expand the @HappyHorizons portfolio into healthcare. Healthcare is a domain I hold really close to my heart due to growing up within a medical family. It has always had me interested to do something in it. This is our opportunity to serve.

There are so much learnings in building this out. A key aspect of my life over the past few years has been to use the Systems Thinking lens to understand complex problems and create solutions that have a systemic impact.

The healthcare space and interactions with a lot of healthcare professionals and patients has given us a lot of insights, and I am sharing a few of those here in the spirit of building in Public. This is also to highlight our thought process on what we are doing, why we are doing and how we will be doing it.

As India moves a lot towards preventive healthcare, we understand that healthcare in rural India needs to be broken down into four different levels.

1. Advocacy

2. Education

3. Diagnosis

4. Treatment

Each has a few startups in it. We’re building a cohesive system around it

All of us are aware that a major reason of this move towards preventive health is the access to information, which has been made possible by cheap internet and the presence of smart phones in rural households we well.

Connectivity due to better roads and information has made it possible for people to seek better healthcare. While institutional healthcare centres have improved, there are less number of qualified healthcare professionals, both doctors and other staff as required.

While there’s a lot of information, one needs to be careful, when it comes to identifying the source of information and how much we trust it.



That brings us to the 1st pillar of our work in Advocacy.

Our past work @HappyHorizons has created the distribution channels over past 8 yrs. Leveraging deep community connect at grassroots and youth alumni from fellowship program, we are able to establish further channels for information dissemination. A lot of the time the decision to go or not go for healthcare service is dependent on this information.

With an ever changing world post covid, fear psychosis is at an all time high. We need credible information to reach the rural masses so that they are better informed.

The ability to make fake information viral these days is a huge challenge to providing credible information and when you have a complex ecosystem that often relies on superstitions, traditional practices, and questions medical science, it becomes extremely difficult to work.

That brings me to our 2nd pillar or work with HHH (Happy Horizons Healthcare) : Education.

Owing to the poor education backgrounds, and low awareness, many are not aware about healthcare and how to go about it. Quite often we hear about stories about scams in rural healthcare.

A few scams that I am aware of from recent times, Uterus Removal in the garb of family planning operation (Illegal hysterectomies), the rise of fake doctors, immensely high charges for private nursing homes, patients being forced into ICU for smallest of reasons.

So while access to information is good, we also need to educate. That is where I am hoping our existing work at @HappyHorizons will help in designing specific learning sessions to communicate with rural masses.

Empowering locals in the past 8 yrs enables us to empathise better. Speaking their language makes it relatively easier to make inroads.

This brings me to our 3rd pillar of work: Diagnosis.

When you have provided credible information, educated people about things related to healthcare, people would want to get tested. The recent push towards preventive healthcare drives this phenomenon as well.

None of the major players in Diagnostics serve the rural masses. The unit economics do not work. A medical test in a city is convenient and easy to get done at home. Not so in the rural context. What tests & why its need to be done? Our hope: First two pillars feed into this.

So we are rethinking about diagnosis from the first principles. Can there be a better way to doing this? In all likelihood, the diagnostic ‘centre’ would be a mobile unit, that is then accessible to rural masses and visits the villages.

This we are envisioning from a collection perspective. The collections would then have to be submitted to a centralised unit from where the tests would be done. We seek to have the ability to do tests at this unit, and pass on the result immediately over whatsapp / other channels. In the process we are able to reduce the turn around time for patients needing attention.

The hope is that when you have community champions set stage with credible information, an educated (on healthcare) rural population, the convincing for getting a test done is higher.

And if you have the diagnostic units visit your home for sample collection, there are high chances of doing it. If the consumer cannot go to the diagnostic center, can the center go to the home instead.

And that then brings me to our 4th Pillar: Treatment!

I have realised that, due to the absence of the first three aka Advocacy, Education and Diagnosis; often the treatment starts at a late stage.

Many medical complications arise.

Often lives are lost.

In my opinion, access to a quality healthcare professional & services should be a fundamental right for EVERY citizen in our country. Unfortunately we are way behind the WHO recommendations.

The situation in rural areas is grim. And as we are aware a lot of things are “Bhagwaan Bharose” (at the mercy of god).

The model we are building at Happy Horizons Healthcare is to be the first point of contact for anyone seeking healthcare service in rural areas. We then leverage the upcoming hospital, our networks of people around the globe, the telemedicine setups for speaking to right folks.

We understand the role of Technology, Data analytics, Behavioural change to drive this and those form the core of our work.

We are a few months away from launch and it is immensely exciting to be building in public, building for the public!

#systemsthinking #design #socialinnovation