Medicine Shoppe
High-quality Healthcare for Low-income Customers
by Jacqueline Novogratz
October 2007: We drive for a half hour or so from the posh neighborhoods of Narayman Point and Colaba in Bombay into increasingly crowded places until even the roads themselves narrowed into pathways. Auto-rickshaws cram the paths, competing with people walking and hawking their wares. The Medicine Shoppe we are going to visit is located in a low-income Muslim neighborhood, but still serves a diversity of people. On our way we pass both temples and mosques and women covered in traditional black hijab mingled with fuchsia and turquoise saris.
This Medicine Shoppe storefront is unlike any we've seen before - situated right on the street with an open front, it looks much like the other stores in the area, and not like the beautiful air-conditioned ones that I've visited in the past. Viraj, the CEO of Medicine Shoppe, tells us that they had learned that low-income people felt the air-conditioning signified things would be expensive; and the big size and glass fronts made the places unwelcoming. And so everything was stripped down and opened to the street.
Dr. Aisha, a 24-year old newly minted doctor greets us in the clinic. Wide-eyed with long brown hair hanging loosely down her back, the effervescent young woman invites us to sit with her while two health workers stand in back, allowing no more room for anything except the hospital bed.
Dr. Aisha brims with enthusiasm as she tells us she typically sees twenty people in a day, though it can reach forty-five or so in the monsoon seasons. The most frequent diagnoses she makes are fever, malaria, typhoid and TB. According to her, because Muslim women in the area tend not to use birth control, the number of pregnancies is high and so she sees many more cases of anemia and malnourishment than you would see in many other slum areas.
The clinic is open from 6 pm to 10 pm each day, and Dr. Aisha attends training in the mornings, hoping to get an advanced degree. She spends about fifteen minutes with each patient, providing counseling on basic hygiene and the like, as well as listening to their ailments and providing prescriptions. The cost of a visit is 20 rupees or about 50 cents; and the patients can deduct the 20 rupees from their purchase of low-cost medicines in the Medicine Shoppe pharmacy next door.
The biggest issue here and everywhere Acumen investees work is in building and maintaining trust. That Aisha is a woman is key in this Muslim area where women won't see male doctors; that she is so young works against her; but her smile, affability and obvious concern for people come through and she's starting to see repeat customers. MS gives every patient a healthcard as well, making them feel more connected and looked after as patients with a real record of what has come before - something revolutionary in their lives. Keeping both pharmacy and clinic open until 10 pm (and Dr. Aisha often stays much later if patients need treating) is another sign of commitment. Both she and MS's COO, Aashish, believe this outlet will continue to grow and expand.
Aasish tells me he loves working with this Sehat outlet because it is in the poorest area of all and he can see the need. "Before us, there were eleven quacks out of thirteen doctors serving thousands of people, and most medicines around here are spurious. People are more than willing to pay for quality services - they just don't have access to them. We can bring quality care at reasonable prices. It makes me feel so good about our work for we are really helping here. And the people are appreciating us."