If you ask Vera Cordeiro, good health is within reach for everyone, even the poorest of the poor. But this requires radical rethinking of what health care is.
Health is not merely the absence of illness. If a patient is released from a hospital into a situation that includes stress, poor nutrition, inadequate shelter and sanitation, he or she is likely to get sick again and again, putting pressure on the family's meager resources, deepening the poverty and increasing the suffering.
"I saw this vicious cycle: hospitalization, rehospitalization, many times," said Cordeiro of her early years as a pediatrician. "And I knew we needed to do something."
Radical rethinking doesn't always require grandiose change, however. It can be more subtle. "When we think about how to change the world, we think about big miracles, a lot of money, a lot of technology," says the founder and CEO of Associação Saúde Criança in Brazil. "We don't need that. We need small miracles, every day."
For the families that Cordeiro has helped in the slums of Rio de Janiero, those small miracles would likely qualify as very big ones. Instead of being condemned to a cycle of recurring and worsening illness that often plagues poor individuals who have the misfortune to get sick, the people who come through the doors of hospitals where Cordeiro's health care model is in place get a very different kind of prescription -- one that takes in the many factors that contribute to a healthy life.
When a mother comes in to one of the state run hospitals with a sick child, for example, Vero says, "we spend time in a very deep interview, when we try to know everything about how much she earns, what kind of house she has, and of course the disease of her child."
A health care team then puts together a two-year action plan for the family -- a sort of integrated prescription that goes well beyond the typical slip for medication, and is significantly more effective than any powerful pill alone. The family receives psychological support, nutrition assistance, legal advice, job training, and home improvements.
For a family with two daughters who had suffered repeated bouts of pneumonia, for example, that "something" included a home visit that uncovered an abundance of moisture and poor nutrition that was contributing to the children's illness. As part of Associação Saúde Criança's intervention, the team arranged for a secure roof to be built, got the mother enrolled in job training to become a hair stylist, and eventually helped her build a hair salon in her house to generate income.
"Just like a caterpillar," says the mother, "with the help of Saúde Criança, we become butterflies."
Associação Saúde Criança is the kind of innovation that is replicable everywhere in the world, which is one reason it was chosen as a winner in a global competition, Making More Health: Achieving Individual, Family and Community Well-Being, from Ashoka Changemakers in partnership with Boehringer Ingelheim.
The two other winners included Cola Life, which created the ingeniously designed AidPods that carry medicines to remote locations, safely wedged into the unused spaces in cola bottle crates. It gets health care to hard to reach people and patients, and makes it look easy.
Similarly, winner Unite for Sight reaches the hard to reach by leveraging a resource that is already on the ground: the local ophthalmologists in poor regions who have the expertise but lack the material, human and financial resources to do what they do best. By supporting local health care workers and enterprises, Unite for Sight has dramatically increases their capacity to provide eye care.
"Eighty percent of blindness is preventable and 36 million people worldwide are needlessly blind," says Jennifer Staple-Clark, who founded Unite For Sight when she was a college student. "Meanwhile, sight restoring surgery - cataract surgery - costs about $50 on average in the countries where Unite for Sight Works and receiving quality eye care services should be attainable for all." For her, it was all about figuring out how to connect patients with resources to eliminate preventable blindness.
Beginning in one soup kitchen in New Haven, CT in 2000, Staple-Clark began connecting people with worsening vision to existing resources that had not known about. Today, Unite for Sight operates throughout the US and in Ghana, India and Honduras. They partner with existing eye clinics and local businesses, which strengthens the sustainability of local enterprises.
"All of these eye care programs are locally led and managed by local ophthalmologists," she says. To date, the organization has helped bring eye care to more than 1.3 million patients, including more than 49,000 sight-restoring surgeries.
"Seeing people get such joy on their faces after they have their eyesight restored is what inspires me every day," says Staples-Clark.
These innovators, and other health innovations experts who are working so passionately to bring more health to more people, got together in a Google Hangout to discuss increasing access to health care. You can see their conversation here.