The human life cycle – overcoming obstacles

In some ways the human life cycle resembles the upstream journey of a salmon. The salmon life cycle starts with an egg, laid in a redd, and develops through stages that are referred to as alevin, parr, smolt and finally the mature salmon when it returns upstream to its birthplace to spawn. These stages resemble the stages of the human life cycle as it develops from an embryo to a mature person, a process that might include overcoming several obstacles. The salmon’s journey also emphasizes the importance of a caring environment and a sound, values-based education during the early years of human life. This life cycle could be well supported by so-called SHospedu centres, an imaginary term referring to sustainable hospital and education centres through which communities are enabled.

The problem

One way of enabling today’s vulnerable children to face the future with confidence, is through sustainable community development, accompanying children in their upstream journey of becoming healthy adults. The problem is, societies’ unsustainable use of resources lets the vulnerable suffer even more, as Christa’s journey illustrates. Christa was 31-years old when she finally managed to receive treatment from a non-governmental organisation for obstetric fistula that she had suffered as a teenager giving birth to her stillborn baby, while fleeing during the second Liberian civil war (1999-2003). However, most of her country’s healthcare facilities were destroyed during the war, with 15% of the people being formally employed, and 59% of children of primary school age not attending school. Her ongoing treatment is therefore compromised.

Taking responsibility

Increasing long-term beneficial impact depends on creating long term sustainable value, juxtaposing time (tomorrow/today) and space (internal/external), producing four distinct areas: risk reduction, reputation (today) and innovation and growth (tomorrow). As governments are supported in swimming against the current, the ideal is that they perform well in all four areas, but that they focus on especially innovation and growth. As governments move away from the shifting-the-burden pattern, they take responsibility for being part of the problem, become part of the solution and start to influence other governments in similar situations.

Infrastructure

A sustainable journey in community development could start with waste reduction and energy efficiency improvements in SHospedu centres. SHospedu centres’ key activities do not only refer to the most obvious cleaning up of litter in the slums, but also to the bottom-line improvement of hospitals dumping infectious and toxic medical waste that pose contamination risks to people and the environment. It also refers to partnering with governments in analysing the issues of environmental degradation, overpopulation, sanitation, crime rate and in this case, the TB epidemic in West Point.

Moving beyond low-hanging fruit, the vision is to re-use and equip shipping containers in phase 1 (phase 2 being built infrastructure) as 24/7 health clinics and educational, vocational & entrepreneurial training centres. Each centre is a business unit, set-up on the peninsula and the periphery of the city as satellite hubs and research centres of the A.M. Dogliotti’s Medical School and the University of Liberia. The St. Paul river emptying into the Atlantic ocean serves as key resource for the Mount Coffee hydroelectric power project that will, when completed, generate capacity of 64MW and that could replace traditional power generation of these centres.

Other key resources are information technology infrastructure with patient tracking systems and information on patient’s immunization history as well as curricula content. In order to optimize operations and reduce risks, key partners range from UN organizations, public and private organisations, Monrovia’s consolidated school system, patients, and students, to the president of Liberia, President George Weah. This model taps into research and development health and education data in a hyper-connected world, unlocking sources of funding and engaging new stakeholders exponentially because of the attractiveness of transparent and convincing data for the benefit and welfare of individuals across the world.

Value proposition

SHospedu centres satisfy customers’ needs to be healthy and educated in a just world that values and conserves nature. Its services are packaged sustainably in that it snowballs into a pattern of self-reinforcing growth. Health wise, this pattern kicks off in a disruptive way by ensuring that the most vulnerable, the fallen behind (scale of pain/discomfort, 10/10) in West Point are identified, assessed, and treated to the point of optimum health, regardless of their financial status, before patients at the next level of need (9/10) are considered to be treated. Education wise the pattern kicks off by ensuring optimum literacy for 6- to 18-year-olds and mothers of all ages. Nurturing this pattern requires trained, remunerated healthcare professionals and educators equipped with skills that enable patients to regain their health in order to learn to lead independent lives. Initial medical training is accelerated by international exchange programs with renowned universities and educational training by non-governmental organisations, teaching entrepreneurial skills in a hands-on way. Customized, continued training and teaching of primary health care and basic math and verbal skills is encouraged by initiatives like mother-to-mother teaching. Closing the loop requires two actions: that every vulnerable individual is integrated into the community and that recipients of health care and education accept their responsibility of becoming donors themselves by taking care of their fellow citizens.

Customer segments, relationships, and channels

SHospedu centres’ mass market is identified as health care services to all patients and universal education. The niche market in health care terms is the orphans, the disabled, elderly and the abused and in educational terms it is those who need remedial education, the unskilled workers and the disabled. SHospedu centres apply additional segmentation by distinguishing between those with pain levels ranging between 10 to 1 and those needing math and verbal skills development between the ages of 6 to 18. Other diversified priorities are pregnant women and children. A last but important segment of the West Point society is the foreigners, tourists, refugees and visiting nationals. SHospedu centres’ customers are reached through decentralised channels to enable health care and education services to be accessible to all. These channels are standardised in the sense that it adheres to approved national and international standards. SHospedu centres value relationships with its farmers cultivating produce along the banks of the St. Paul’s river as well as with the Freeport Police station as hub to reinforce responsible citizenship. One-on-one relationships with the most vulnerable is time consuming but not negotiable, as it forms the tipping point for indefinite change in which the vulnerable are enabled to swim against the current.

Finance

SHospedu centres are cost driven – minimizing all costs without compromising on
performance related and skills-based salaries. They are also value driven – providing value to the needs of patients and learners. Fixed costs comprise salaries, infrastructure (re-used shipping containers in phase 1), medical equipment, IT facilities, and variable costs comprise the number of patients and students, the degree of need, activities in business units, in every case striving for maximum cost-effectiveness. Set-up costs for SHospedu centres’ health care and education initiatives are carried by impact investors. Continued health care is subsidised by the Liberian government according to nationwide price setting standards. Primary and secondary education is free. Remaining health care expenses, as well as vocational and entrepreneurial training costs can be paid for by gifts in kind, by for example working for one hour in the prosthesis business unit for a one-hour accounting lesson, or vegetables in exchange for a maths lesson.

The result of swimming against the current

When people’s personal, intrinsic values are recognized and brought into the community sphere, the whole community benefits from those shared values. As more people are able to share their uniqueness and personal values, the community grows in its potential to become sustainable, overcoming obstacles as they enable one another.