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Dispensaries: health projects to look at and re-think

A brief explanation on how dispensaries in Ecuador function and look like and why this kind of unsustainable project should be reformulated

Photo of Irune Gonzalez Cruz
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Even if I've never been to Caldas, I had the opportunity to get to know a health related project in Portoviejo (Manabí, Ecuador. July 2008) and I'd like to share some insight based on my experience that could be inspiring.

In a low-income community like the city of Portoviejo and it's rural area, most people can't afford to pay for health. When a family member is ill, they have to wait until they collect some savings to go to the doctor. Once the doctor sees the patient, he is sent to buy what is needed to be properly treated. This increases the costs and it usually takes a long time until the patient collects the money again, buys the stuff, goes back to the doctor, waits, and he is finally seen by the doctor and treated. Appart from being an expensive service, it is very slow and patient's health conditions get worse during the process. Those are some of the reasons why many organizations focus their work on improving health services.

Image 1 shows a dispensary, run buy a religious charitable organization, on a weekday. Notice first of all the amount of people. What does this place offer them? DOCTOR, LABORATORY EXAMS and CHEMIST'S SHOP in a LOWER PRICE than in any other health service on the city.

Even if health is affordable here, I don't consider is as a success due to its way of functioning. What makes medicine cheaper are finantial resources coming from outside of the service, in this case a charitable organization in Spain. This makes the service completely dependent on donations and the business model is not sustainable. It is running nowadays, but what if for some reason money does not come tomorrow?

So, how can we RE-THINK PHARMACY INDUSTRY and DOCTOR SERVICE so that instead of maximizing profit we MAXIMIZE POSITIVE SOCIAL IMPACT? There is a huge challenge and opportunity here!

Image 2 and 3 show a dispensary in the outskirts of the city. The working model is the same, but they use less resources.


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I was wondering...what if you could mesh micro-finance with health? Low income populations suffer a lot because they live day by day with limited cash. If a member of the family gets sick, they have to either borrow the money or save it, and while this happens health conditions get worst. What if you could open a line of micro-finance just for health troubles? It would be affordable, with low interests, and the most important thing is that people could get access to health services immediately.

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Thanks for this post Irune!!!

Photo of Irune Gonzalez Cruz

Milo! I find very interesting what you are suggesting here. Micro-financing health costs would help people in low-income communities to overcome the problem inmediately. Let's bring this further in the concepting phase!

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