Reality Check

[4/16/13:  I have revised last week’s post to reflect its review by my interviewee, Manish Bhardwaj whose notes appear in brackets below.]

I had a reality check last week when I had a Starbucks’ sit-down with Manish Bhardwaj, PhD, founder and current CEO of Innovators in Health (IIH).  Mannish came to my attention in February 2010 when I noted he was giving a talk at MIT entitled “Technology X will save the world and other myths of social entrepreneurship,” which, according to the description, was about the need for tech/social entrepreneurs to understand the market place and the customer/client as a critical element for success.  I missed the talk but contacted him recently (three years later) and asked for some of his time.  When we met and after giving him my brief bio, I listened for the next hour plus as he shared his experience in tech-based social entrepreneurship, his heart-felt passion for improving lives of the less fortunate, and his “grand unified theory” for reconciling the inequities of the world.

His credentials as a technology entrepreneur are solid, having earned a bachelor’s degree at the Nanyang Technological University, Singapore, and master’s and doctoral degrees in electrical engineering/computer science at MIT and then co-founding a wireless chip design firm, Engim, whose IP was acquired by a Canadian company around about 2005 (IIH People).  While working on his doctorate, he apparently got the technology-X-will-save-the-world bug and, in 2007,  initiated or joined a team, IIH, formed to enter MIT’s 100K Entrepreneurship Competition with the aim of developing technologies to improve the delivery and use of the standard drug therapy for tuberculosis.  IIH won a prize for their pitch (and also that year a grant from a national innovation association and an international development award at MIT), but more importantly gained enough backing and momentum to prototype and pilot study in India several parts of an integrated TB drug delivery program (for details, see IIH Solutions).

IIH has local community partners in the two places it is testing its solutions in India (Bihar state and the city of Delhi), and Manish is a primary connector, facilitator, and promoter of the myriad relationships needed.  [Note from Manish: The Delhi deployment is mostly the work of Microsoft Research, where my close friend and IIH co-founder, Bill Thies, went to work. The only credit we can take is to have gotten that project off the start and then handed over to Microsoft Research.]  He spent months talking and living with many of the principals from the TB patients and their families to government TB program administrators to community health workers to representatives of foundations and private aid organizations.  And while IIH’s technological solution improved the care of about 400 patients over the past three years, his experience in trying to implement this approach changed him and the direction of IIH.  [Note from Manish: We did not deploy any technology in our treatment program in Bihar (we briefly tested it in 2008 to study viability.) So the 400 patients have gotten better due to our investments in training people, not any technology.]

He learned first hand of the pernicious connection between poverty and  health where the cost of accessing care is too high because a patient cannot earn that day’s subsistence income while traveling to a clinic, illiteracy and lack of trust in public hospitals need to be overcome, and malnourished patients have the adverse side effects from the drugs they are given.  And, moreover, how intractable to remedy is this poverty/health connection.  So he is now focused on improving what he has concluded is a critical part of the health care delivery system, the community health care workers, who are primarily women who travel to villages and through slums to find and refer patients to clinics and sometimes monitor their treatment.  He and his partner organizations are working to improve the training, pay, and status of the workers with the goal of serving a “catchment” population of hundreds of thousands and treating 10,000 in the next two years.  [Note from Manish: We started in 2010 with the goal of treating 10,000 patients in two years, which I abandoned pretty swiftly after learning of the challenges. We did just 400 in 3 years!]

I also learned Manish is interested in and working on other three other aspects of his unified theory of how to make the world better by addressing:

  • the failure of social entrepreneurs and NGOs (nongovernmental organizations) in general to appreciate and attend to the need and difficulty of scaling their particular solutions to the point of making a difference;
  • the failure of governments and their bureaucrats to be motivated and guided by ethics, knowing and doing the right thing; and similarly
  • the reliance of entrepreneurs of the developed world on technological solutions and failure to be guided by aspirations.

[Note from Manish: I think as far as my “unified theory” of making the world better, I think institutions universally have failed us in instilling a sense of civic virtue, in training us to deal with the ethical dimensions of large problems like poverty, climate change, etc., and guiding young people in not just how to do things but also what is worth doing.]

Hence, in addition to doing for-profit work so he can pay his bills and support IIH and Indian projects, Manish is a fellow at the Dalai Lama Center for Ethics and Transformative Values at MIT (Technology Review article).

I appreciated the opportunity to meet Manish and get a reality check on my aspirations in global health.  My work is far removed from people living in and dealing with poverty, and it is good for me to get a first-hand account of the hard work that is needed, to put the role of technology in perspective, and to meet someone so clearly dedicated to making a difference.


One thought on “Reality Check

  1. Thanks for sharing. The work that Manish and people like him are doing is much needed in the drive to meet some of the MDGs in developing countries. universal access to healthcare is one thing, but the quality of the health care another thing.

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