How to Build a Hospital (in your 20s, using crowdfunding)

Amit Garg
Amit Garg
Mar 10, 2016 · 6 min read

On July 20, 2013 we inaugurated a crowdfunded hospital serving a community of 100,000 people. There are many stories enmeshed in this vision, this is an attempt to share mine and especially the recipe of how we did this, so others can take it much further.

My life has been shaped at the intersections of worlds. My parents left small places in India for a better life in Brazil, where we lived through much political and economic turbulence, from being displaced by the then dictatorship to losing our savings in hyperinflation. But I was also given much — the opportunity to learn, the encouragement to dream, and the belief it was my right and responsibility to make a better world.

So after packing my life into a backpack and coming to the US for college, I decided to pack again to immerse into sustainable development. As a freshman (first year student) I heard the calling to volunteer and spent a summer in villages across eastern India, in what was then southern Bihar and is today Jharkhand.

My eyes were staggered — lack of clean water and electricity, my host family falling prey to malaria, a polio-struck child dragging himself on his arms because he couldn’t afford a wheelchair. Yet amidst the challenges talent and determination flourished, committed people worked every day to make a difference. Schools and irrigation projects raised by the community were solid reminders that no matter how big the problem, the solution was within us.

When I came back to college I decided to be part of the solution too. I had no idea then of what I was embarking on, I just wanted to do something. The same volunteer program that had called me became my fist unto the universe — I started recruiting my classmates and empowering them to serve. The fist started growing in strength. When we learned about teaching science to young girls we pitched in and a year later, there was a high school lab. Emboldened by the success, we pitched in again and next year there was a library.

Graduation came, career took over, my soul remained restless. I remembered the polio-struck child and the family with malaria, and how providing better healthcare is the foundation of creating dignity and opportunity. The nearest hospital there was two hours away, why don’t I put my fist really to work and move the needle?

I started reaching out to all my old partners and a few conversations later led to the promise of land and a single other conspirator. Together we decided to leverage everything we had learned, especially the tools of technology that would allow us to coordinate across boundaries in ways that were unimaginable even the year before.

It was slow at first. People did want to help, what we didn’t know was the best way to get their help. So we started cultivating dialogues, demonstrating our vision without expectations, and holding events where friends could mingle. Creativity was our mantra — when the bank required some paperwork I simply appended “Hospital for Hope” to my name and opened our first account. Dynamism was our fuel — when weekly calls started feeling onerous we started experimenting on how we collaborated, trying new technology tools. The goal was a truly virtual organization with zero overhead.

Things started picking up and at some point, with a core team of 5 committed individuals, I sought our consent to halt growth and focus on the opportunities ahead. Our consistent outreach yielded into a partner willing to do the actual construction, another who made a beautiful marketing video, another who profiled the region’s healthcare needs. From thereafter it became a roller-coaster and in 2011 we escalated fundraising exponentially, hit our target, and started construction. The Internet also gave us an architect, a 78-year old volunteer who had never been to India but was willing to battle mosquitoes and monsoons. He and his wife oversaw a building with 10 beds, employing local labor and materials so we could encourage the local economy.

When our partners in India, the real heroes of this story, cut the ribbon in 2013, I couldn’t help smile at the symmetry — 5 individuals consecrating 5 years. Today Hospital for Hope serves over 1,000 patients per month. We made plenty mistakes and there is lots more to do before we reach complete self-sufficiency. But I wanted to take this story to highlight 5 principles that helped us achieve this goal.

1) You do not need to give up your career — the power of leveraging technology

None of us ever left hand of their schooling or career, and technology was our key to achieving that. Facebook is our default platform to publicize events which might be held across the globe. WhatsApp has now become an incredibly easy way to communicate with our partners on the ground, who until recently were a full day journey away. Paypal processes our donations and send to villages in deep rural India where physical banks are precarious. Our team of millenials fully embraced these emerging technologies as they matured and we found we could do more with less.

2) You do not need to do it alone — the power of a team

I cultivated a group of classmates with a similar vision through my college years. When the time was right I drew from that pool and made sure to create a strong, small team. I found that 5 was the right number because it was just enough to maximize our strengths but not incur the penalty of coordinating. A crazy idea with a single proponent doesn’t go anywhere, but sharing that vision with others makes the crazy idea into a movement. Our long-standing working relationship has allowed us to develop high trust and accountability with each other so we can operate quite autonomously.

3) You do not need to rebuild the wheel — the power of partnerships

We found we could be most effective by being the glue tying many different organizations, rather than recreating a structure. For instance, a partner early on sponsored us as an umbrella organization which means we could use their non-profit status instead of becoming accredited right away (which we eventually did). Another partner had the architecture expertise and drew the hospital blueprint. Many gave us grants based on certain milestones. Similar to any entrepreneurial venture we connected the dots instead of trying to create everything from scratch.

4) You do not need to get lucky — the power of relationships

We found that people in their 20s typically donate in the 0s, people in their 30s donate in the 00s, and people in the 40s and higher donate in the 000s. Which means also that a single big donor can move the needle more than a hundred smaller donors. Our strategy, similar to many successful organizations, has been to build a strong base of supporters through “friendraisers” and cultivate long-term relationships of trust. We furthermore decided to streamline donations as much as possible since we had seen so many non-profits become mired in paperwork and lose as much as half of their donation towards administration. We are able to remit 99% of what we raise straight to the people who we are trying to support.

5) You do not need to solve all problems — the power of focus

We set to build 10 beds with basic care, medications and at least one full-time doctor and nurse. It was very tempting to increase the scope of activities, from purchasing machines for ultrasound to putting solar panels. But we were hyperfocused on solving the big problem first and very aware of scope creep. Having diversified careers — among us we had startup, corporate, law, consulting and entertainment — meant we could bring a wealth of professional training in how we analyzed and executed.

Ordinary people together can do extraordinary things, Hospital for Hope is the result of thousands of dreamers coming together. My earnest hope is something I wrote can be valuable to you in fixing some problem you care about. If we all did so we might just awake to the world we all want to live in.

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