Social Entrepreneurship- The Road Less Travelled

What were the risks involved while starting Operation ASHA and how you have addressed them?
A decade back, I decided to establish Operation ASHA with the aim of providing health solutions to the poorest of the poor. I decided to focus on Tuberculosis ( or TB, as its commonly known), the biggest health crisis in the world and in India. Unfortunately, in 2005, there was no awareness about TB, and no funds. TB was considered as the poor man’s disease, and neither politicians nor policy makers were interested.  There was no established successful model for ensuring adherence to the difficult 6 months long treatment. There was no training information, nothing about dealing with socio cultural issues and stigma. So our biggest risk was that we might not succeed in our mission, the whole thing will fizzle out, and OpASHA will sink without trace. We solved these issues by carrying out extensive meetings with concerned stakeholders, patients and disadvantaged communities themselves, to understand what challenges they face. My 3 decades of experience as a doctor stood me in good stead. I was able to connect with TB patients and developed a comprehensive training material by incorporating feedback from patients and Community Health Workers. My Co-Founder and I accelerated advocacy efforts worldwide with a view to throw light on this burning issue, and I think we have been largely successful in our mission.
Have you encountered situations within Operation ASHA where you have had to take critical decisions? If so, how have you overcome the situation?
Yes, there have been times when one doesn’t know which path to choose. At one point of time there was a dilemma whether to invest funds in TB detection & treatment, or in developing a strong middle management team. This was a crucial and difficult decision. On one hand, we had our donors who wanted us to, very simply, treat patients. Most of our donors were in this category. They were funding OpASHA because they wanted to directly help TB patients. On the other hand, we were losing out on much needed funds because there was a gap in the ‘middle’, so to speak. We had the top management, which consisted of the President and CEO, and we had Community Health Workers, and nothing in between. We finally took the decision of investing valuable resources in the management team and in building capacity. But this was not an easy decision. One thing that helped us in taking this decision was that we have a very strong board of directors from different walks of life – lawyers, financers, doctors, and professors. Right from the beginning they’ve helped us not just in raising funds, but also in strategic decision making and governance issues. Extensive discussions with the Board help me to weigh the pros and cons of the two parts and then make an informed decision.
What are the things you have learnt from your mentors?
One of my first mentors was my father, who always believed that truth shall prevail. Therefore I believe that personal integrity is extremely important. I also believe that values percolate down the line and people imbibe the values of those at the helm of affairs. The Board of Directors mentored me extensively when I started OpASHA. I feel I’ve been a good doctor and a good person, but I knew very little about running an organization such as OpASHA, and next to nothing about finance and administration. To quote a small example, one of the board members told me not to depend solely upon volunteers, the reason being that there is no accountability, and it is better to give a proper wage to everyone. OpASHA has followed this principle from the day of its inception. Also, my teachers at medical school taught me that every life matters. Doctors don’t see religion or caste, only the patient. I’ve been lucky that I’ve learnt something or the other from almost every person I have met.
What roadblocks has Operation ASHA encountered while achieving success?
One of the biggest roadblocks has been a lack of awareness about TB. When I started OpASHA, people all over the world believed that TB went out with the plague. So it’s been very difficult to make people believe that TB is the biggest infectious killer in the world. Lack of awareness translates into lack of funds, so fundraising has been a constant ongoing task. Being too cost effective has surprisingly worked against Op Asha, because high quality coupled with low cost turned out to be detrimental to developing partnerships. Certain organizations, would feel that that they are projected in a poor light because of Operation ASHA .
Working with the government has been a double edged sword. While in certain countries such as Cambodia, the government has been supportive and encouraging, this has not been the casein India. OpASHA has been hugely successful in several states of India and has received tremendous support from government officials. But Op Asha has faced huge problems in starting work in some of the other states of India. In these states, though TB is rampant, surprisingly, we are not welcome at all. In some other states, we are welcome to work but without our technology. So, technology, which prevents data fudging and ensures high quality of work, is not welcome by all government officers for obvious reasons, rather it has proved a stumbling block while going to scale.
Your views on Entrepreneurship/ Leadership.
Ans: I feel entrepreneurship is challenging, but very rewarding. I think the difficulties lie at a personal level. It is not easy to make a conscious decision to leave the oft-trodden path and forge ahead in a different direction altogether. I remember in the initial years, my life was miserable because many people made fun of me, and were contemptuous and judgmental. I think on this road, there are less of bouquets and more of brick bats. Most entrepreneurs travel a rocky and uphill road, and their lives are fraught with uncertainty–and they have to cope with the fear of failure. This is true especially for those social enterprises which are not generating revenue and therefore find it extremely difficult to be sustainable. Yet, the rewards that are received after putting in years of hard work, though not proportionate, are truly worth the effort because of the positive ways in which they affect society. Results matter. Patients recover and gain health and productivity. Inspite of daily and constant difficulties, life is worth living after all.
Dr. Shelly Batra co-founded Operation ASHA and has led the organization as President since 2005.
Shelly is Social Entrepreneur of the year 2014, awarded by Schwab Foundation. She is also an Ashoka Changemaker and a best-selling Penguin author. She is a highly renowned Senior Obstetrician and Gynecologist, and Advanced Laparoscopy Surgeon, in New Delhi, India. Shelly’s dedication to ‘reaching the unreached’ started in 1991, when Shelly went into the heart of the slums in Delhi. Shelly provided pro-bono life-saving treatments and operations as well as free consultations, medicines and counseling. She is actively involved with the Free Patient Department of Batra Hospital and Medical Research Center which is run for the benefit of poor patients. Shelly has contributed heavily through various media channels, such as television stations and newspapers, to impart medical knowledge and create awareness.
Shelly has taught on Global Health Issues at the University of Chicago, Harris School of Public Policy, and has lectured at major universities, including Harvard School of Public Health, University of Illinois, UC Berkeley and Indian Institute of Science. She was an invited guest lecturer to deliver the Hippocrates Society Women in Medicine lecture at Wellesley College. Shelly has also a strong presence online by teaching a webinar for the CORE Group on the subject of Pediatric TB.  She has represented Operation ASHA which was on the board of the Stop-TB partnership, a wing of the World Health Organization. Her warm personality and integrity is a tremendous asset to Operation ASHA. In 2010, Shelly was declared an Ashoka Changemaker in view of her outstanding innovations in TB treatment and innovative methodology.
With her extensive medical knowledge and in-depth understanding, she brings the experience necessary for running a health NGO. She is skilled at donor relations and fundraising, and is a highly sought out speaker to represent OpASHA at numerous national and international platforms. Most recently, she was invited by the World Bank in Oct 2014 to do a TEDx talk, she was also the keynote speaker at Social Enterprise Summit, Geneva Health Forum 2014, and a panelist at the World Economic Forum on East Asia 2014 in Manila.
Dr. Batra has been the recipient of multiple awards, accolades and recognitions, including the Exemplary Contribution Award for selfless work for the underserved, given by the Indian Medical Association. She holds an M.D. from King George’s Medical College, India.
Shelly is a powerful advocate for better policies in TB across the world. Her concern for the needy goes beyond TB, as she believes in health and a better life for all. In collaboration with others, she has started a social enterprise called SAATHI to provide clean drinking water at an affordable price to those living at the bottom of the pyramid.

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