Print Edition - 2014-05-03  |  On Saturday

Steppping in to help

- Grace Dobell, Kathmandu
Steppping in to help

May 2, 2014-

Four-year-old Ashish Rawat wouldn't have been diagnosed with cerebral palsy if it hadn't been for Watsi. And he wouldn't have been able to walk unaided as he can today. Watsi is a crowdfunding organisation set up by Chase Adam, an American, and it raises money on behalf of patients like Rawat, who cannot afford medical treatment.

A few years ago, Watsi had homed in on Rawat when he'd shown up with problems at the Bayalpata Hospital, in Sanfebar, Achham. The son of poor farmers, Rawat became the beneficiary of the money raised by Watsi, which would go towards treating him for congenital inguinal hernia. That funded everything from his trip to Nepalgunj Medical College, in Kohalpur—the centre to which he was referred—to the treatment he underwent there. While Rawat was being treated in Kohalpur, the doctors found out that he suffered from cerebral palsy, and they then referred him to the Hospital and Rehabilitation Centre for Disabled Children, in Kathmandu. Wasti picked up the tab for that treatment too.

Watsi was set up, in 2010, by Adam because he wanted to create a more direct way to get money to patients in rural areas of developing countries. The organisation is now a small team of six who partner with local health services around the world to provide money for treatments through crowdfunding. Crowdfunding means bringing together financers from various backgrounds, mostly over the Internet, to help fund a project together. Today, Watsi has made it possible for the disadvantaged in places like Accham to have access to healthcare, which would otherwise be unaffordable to them.

“When Ashish came back after three months you couldn't recognise him. He was happy, he was walking around; it was a total transformation,” says Sumesh Khanal, the Advanced Care Officer at the referral centre at the hospital in Sanfebagar.

The centre has helped treat more than 250 patients like Ashish since beginning the crowdfunding programme two years ago and looks to work with many more.

“News of the model is spreading fast via our community health workers deep into communities, and we've been able to treat patients who didn't have access to complex care for years, and sometimes decades,” says Mark Arnoldy, the CEO of Possible Health, an INGO that runs the Bayalpata hospital. The patients who are being helped by Watsi don't just have the costs of their treatment covered, but also the incidental expenses, such as travel expenses. Getting to health centres in isolated areas like Accham is, after all, not easy, nor cheap.

“There have been times in the past when we referred the patient, but they wouldn't be able to afford the treatment, or be able to get to the referred hospital. Now they don't have to worry about the cost of getting there. We pay for the ambulance if they can't travel by public bus,” Khanal says.

Each patient who requires treatment can be crowdfunded for up to $1500 (Rs 147,000). This is how Watsi's crowdfunding model works: first, the patients get their photos taken at the hospital and those photos, accompanied by a short description of their ailment, are put up on either of the two crowdfunding websites run by Watsi: there's (for complex surgery or treatments) and a sister-site, (for pregnant women). People from all over the world then read these profiles and donate money that will go towards the patients’ treatment.

As of April 2014, through Watsi, 183 patients have been fully funded for a total of $178,840. And Kangu has helped raise $24,335 to go towards the treatment of 70 pregnant women.

There's a simplicity to Watsi's working methods. “Because crowdfunding is a lot of people pooling money for a common cause, I think that as long as people are interested in contributing to common goals, products and services, crowdfunding will continue to work,” says Adam. “As a whole, I don't see many limitations to crowdfunding besides scarcity of resources.”

The donations through the website mainly come from the US, says Adam. “Last time we ran the numbers, which was mid last year, one-third of the donors were from outside the US, and two-thirds were from the US. Most of our donors are early adopters, tech-savvy, educated, and interested in global issues,” he says.

Watsi is a lean operation, which unlike bigger, more complex organisations, can funnel most of the money they collect to actually help the people they want to help. All of the money collected from donations through the websites goes directly to the patients' treatments. Watsi funds its overhead costs through private donors and corporations and is adamant about its transparency, and all of their finances are published online in Google Documents.

That model of transparency means that all the providers working together on patients picked by Watsi, even the health workers in hospitals, hold themselves accountable. Arnoldy says hospitals are extra diligent about costs when treating patients who are crowdfunded.

"Our partner hospitals in Nepal to whom we refer our patients know that the world is watching what happens to this particular patient, and they thus feel an extra sense of urgency and motivation to provide honest and transparent care—unlike many practitioners who conduct needless treatments and dispense unnecessary medications just to ring up costs."

How successful this model of funding for healthcare will be in the long-run is difficult to gauge because crowdfunding is still a relatively new idea. There are already some criticisms of the model. Komal Garewal, who has worked for MedStartr to raise money through crowdfunding for larger medical projects, says that this form of funding addresses only a small part of the problem.

"In terms of sustainability, crowdfunding individuals or select hospitals subverts the power of the government by taking away its responsibility to provide for its citizens,” says Garewal.  "Possible Health recognises that crowdfunding healthcare is just a piece of the puzzle."

But in a country like Nepal, which needs all the help it can get, the kind of work that Watsi does at least helps those patients, such as Rawat, whose needs are not being addressed. And Arnoldy believes the model could be extended to other parts of Nepal.

"There is no reason why it could not work elsewhere in Nepal. The key is to have clear, accountable and transparent partnerships between hospitals so they can help the patients," he says.

Published: 03-05-2014 09:00

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