The state of health in India requires urgent attention – as evident from the country’s ranking – 131 out of 188 – on the Human Development Index (HDI), of which health is a key parameter. The country’s state of health is a consequence of the state of healthcare for the majority of the population, again evident through several parameters. Several studies – conducted across the world, at different points of time – reveal that a population’s state of health and healthcare has direct connection with prosperity and social harmony. Unsurprisingly, according to a report by the World Economic Forum and the Harvard School of Public Health, India stands to lose $4.58 trillion due to non-communicable diseases and mental disorders alone between 2012 and 2030, an amount more than double India’s annual GDP. In addition, according to the health ministry, an estimated 63 million people slide into poverty every year due to catastrophic healthcare expenditure, which neutralises the gains of rising income and various government schemes aimed to reduce poverty. Addressing this multi-dimensional challenge requires a solution that combines humane intent, progressive policies, and equitable practices. In such a scenario, a ray of hope is critical. Who better to emerge as that ray of hope than an individual who witnessed his mother experiencing the consequences of lack of access to affordable, quality healthcare – and was motivated by that experience to be the change that is needed to alter the situation?
Born into the family of a marginal farmer in Dubia, Sonitpur district of Assam in 1950, Dr. Nomal Chandra Borah, Chairman and Managing Director of GNRC Hospitals, overcame acute poverty to become a doctor in the 1970s. In 1980s, moved by the plight of people in North East India due lack of adequate healthcare facility, he returned from the All India Institute of Medical Sciences (AIIMS), New Delhi to Assam. The medical practitioner soon evolved into an entrepreneur, and, in 1985, established the first super-specialty healthcare centre in North-East India – one of India’s most impoverished areas. To ensure that people of the region did not have to travel to distant metros to avail treatment for their ailments, the hospital he set up pursued medical excellence – the unintended consequence of which pursuit was that treatment at GNRC became expensive. This was contrary to the founder’s intent, as he was determined to provide masses access to quality, affordable healthcare – delivered with empathy. Simultaneously pursuing excellence, affordability and humaneness within the framework of available healthcare models proved impossible. Motivated to alleviate the suffering of individuals like his own mother who suffered due to lack of access to healthcare, he envisioned a unique healthcare model, known as GNRC Medical, which would invert the prevalent healthcare delivery model and offer universal access to affordable, quality healthcare. To realize his vision, Dr. NC Borah had to redesign the prevalent healthcare delivery model – ground up – applying principles of design thinking and frugal engineering. The new model, promising inclusive healthcare to the masses, gradually took shape and became operational, in phases, starting January 2014. In June 2014, the World Bank Group, impressed by the model, awarded the India Development Marketplace grant to GNRC. The grant was to facilitate capacity building that would allow the model acquire the capability to scale, as many parts of the world would benefit from the model, if it was replicated. Reporting the development, digital native media outlet Quartz noted: “You can make a state-of-the-art hospital out of bamboo”. Microsoft founder and philanthropist Bill Gates re-tweeted the report and commented: “Great approach. A simple business plan is helping healthcare reach more of India’s poor.”
Awards, articles or accolades, however, cannot ensure success of a model which depends on patronage of those who are neither aware nor care for such entities. For the model to succeed, the hospital, which locally acquired the moniker GNRC Medical, had to be patronized, in large numbers, by those who often eke out a hand-to-mouth existence. The new hospital would exemplify CK Prahalad’s concept of ‘opportunity at the base of the pyramid’ – if and only if the population of the region thronged to it in large numbers – and not because conceptually it appeared so innovative that everyone from the World Bank to Bill Gates was enthused to applaud it. Dr. Nomal Chandra Borah heaved a sigh of relief when footfalls at GNRC Medical in 2015 crossed 1,08,000 – compared to 52,000 in 2014!
Wider awareness of the GNRC Medical model and the individual behind the mission and the story of his journey would surely encourage many – to support; to contribute; to participate and, perhaps, to emulate – we hope and believe. To serve the 33-million population of Assam alone, more than 60 GNRC Medical like institutions are needed. To serve the underprivileged across India, hundreds more are needed; to serve the underprivileged across the world…thousands more.
The journey of Dr. Nomal Chandra Borah, MBBS, DCP, MD, DM (Neurology), FAAN, in alignment with his motto: ‘Health for All, Smiles for All’ continues. As a neurologist and as an entrepreneur, the population of North East India associates him with the word ‘Hope’. Hence, his biography is titled ‘Hope Dawns in the East’, and documents the journey up to the initial stages of designing and implementing the globally-unique, innovative healthcare model. In the next stage of this journey, to spread hope globally, GNRC is launching the Affordable Health Mission.
With a vision to build a society in which every individual enjoys health as defined by the World Health Organization – a state of physical, mental and social well-being – Affordable Health Mission expects to realize this mission through education, advocacy, actions delivered and catalyzed collaboratively with members of society. To build a society where ill-health is a rarest-of-rare event and not a commonplace occurrence, the objective of Affordable Health Mission will be to create awareness among people about how the lack of access to affordable healthcare impacts individuals, societies and economies. Thereafter, the Mission will encourage individual and collective contributions to make the world a better place by facilitating access to affordable healthcare.