Indo-Pak relations and maternal health

Had a really interesting meeting earlier today. A large foundation based out of Karachi came to LifeSpring to learn more about our model and see how it might replicate this idea across the border in Pakistan.

The need for high quality institutional care is certainly great. Their CEO cited a study whereby a well-meaning NGO promoted institutional delivery... with the unfortunate unintended consequence that maternal mortality actually INCREASED -- because the quality of institutional care available to low-income women in Pakistan is so poor!

As they think about opening their first maternity hospital, we talked about lessons learned from LifeSpring's first few years, as well as how we think about where to open our hospitals. We talked about how need doesn't always translate to demand -- and how demand is crucial when thinking about scaling a social enterprise. It was certainly interesting to think about how our model can be replicated abroad -- to a place that is similar to India in so many ways, yet also drastically different.

For instance, clearly the political environment is vastly dissimlar between the two countries. We spoke about how the ambulance service there (called 1122) literally had to change its focus to RESCUE 1122 -- from its earlier emphasis purely on health emergencies -- due to all the bombings in the major cities.

We talked about the attacks in Mumbai last year, and how even liberal Indians are coming to blame Pakistan -- when really Pakistani citizens are victims too. This was particularly interesting as I had just attended a book reading on Monday night in Mumbai, where one author (who lived just blocks away from the Taj Mahal Hotel) read from her book on the blasts last year - giving the perspective of a Mumbai citizen coming to grips with the events.

But back to maternal health... Discussions such as these are certainly exciting, and we're seeing more and more organizations coming to our hospital to see how the model can be replicated. I had an interesting conversation with someone from Monitor Group's social impact team yesterday - who came to our hospital to see our work around media training videos. They work with large foundations, such as Gates and Rockefeller -- where increasingly the question is: within the social enterprise space, in the next 5-10 years, what industry will be the next microfinance? -- With that space becoming increasingly more mature (especially here in India), what industry will be the next socially investible space?

Who knows, that just might be healthcare. Traditional private equity firms have traditionally shied away from hospitals here in India... the start-up costs are too high and take too long to recoup. Debt can be hard as well; as an investor told me over the weekend in Bombay: there's too much negative publicity that can happen if you're forced to close a hospital because they can't pay back their loans.

But then again, there's nothing traditional about some of the new players in the BoP healthcare space. That's what makes working here so exciting.