Hospital Beyond Boundaries: Community-run hospital for underserved communities
Malaysian medical students launched Hospital Beyond Boundaries to provide health care to underserved communities in Cambodia.
by Julia Migné
One in eight children is dying in Cambodia before one’s birthday, according to the Population Reference Bureau. Many of these children suffer diseases that would be easily preventable through immunisation, improved sanitation or better nutrition. Unfortunately, disparities are high in the country triggering the death of hundreds of poor people every single day.
Two young medical students from Malaysia decided to make a difference and launched themselves in 2012 on a path to improve the health of vulnerable communities in Cambodia. For them, the solution to this dramatic health crisis had to be addressed by establishing hospitals and clinics that are run by local communities.
This innovative concept of social health enterprise uses market-based mechanisms to operate while aiming to solve a community’s health problems, and is at the heart of the non-profit organisation created by the dynamic duo: Hospital Beyond Boundaries (HBB).
In only five years, Dr. Wan Abdul Hannan and Dr. Lutfi Fadil Lokman have managed to open a maternity hospital serving marginalised communities in Cambodia and also developed their own mobile clinic in Kuala Lumpur, Malaysia, to cater to the homeless people living in the city.
Dr. Wan Abdul Hannan, co-founder and CEO of HBB, discusses with INKLINE the challenges of launching an organisation while still being a medical student and the successes he encountered along the way.
INKLINE: How did you and your co-founder Dr. Lutfi Fadil Lokman get the idea to launch a community-run hospital?
Dr. Wan Abdul Hannan: It actually started back in 2012 when I was still a fourth year medical student. What happened was that back in 2012, we participated in one of the medical students’ conferences in Mumbai. It was called the Interactive Workshop on Global Health and Medical Education and was conducted by the medical students from Mumbai, India.
On one occasion, the organisers brought us to one of the slum areas. And what caught our attention was that there was a hospital built in the middle of the slum and it was run by the local communities. This is how the government tackles the social and health problems in Mumbai.
“Basically HBB is not a charity hospital because we don’t believe in donations to sustain ourselves. We believe that the key to sustainability is that we need to have something that creates a profit.”
I: You launched HBB while you were both still medical students. How did you manage to accomplish that?
H: It was very difficult, I have to say, from the very beginning because we started as medical students. Imagine, you have not graduated yet so you don’t have the title ‘Doctor’. It was very difficult for us to convince people to actually believe in us.
We were medical students and we had this dream of building a hospital outside of Malaysia so it was very difficult. But because back in our medical students days we were very active in extracurricular activities, we had some of our friends that had the same interests than us and so it started with our friends.
We started inviting them and we were like “We have this aim of building a hospital, would you like to join us?” From there on, we started to grow from just the two of us to a team.
The HBB team is actually made up of 13 members but not all of us are doctors. We have accountants, engineers and they are all from different backgrounds because, you know, building a hospital does not just require doctors.
I: How do you manage to sustain your hospital?
H: Basically HBB is not a charity hospital because we don’t believe in donations to sustain ourselves. We believe that the key to sustainability is that we need to have something that creates a profit.
We work through social health enterprise in which we are still making a profit but the profit goes back to the community and to us in terms of expanding our services and facilities. That’s how we work.
“That’s really part of empowering the youth: to ignite the volunteerism inside each and every youth!”
On top of that, we have patients of all kinds. They are all welcomed at HBB. They can get treatment, medication and have access to our facilities. But how about those who are poor? This is where the important part comes in, we do cross-subsidisation in which the profit from every three patients will cover for those who could not afford to pay.
This is the beauty of HBB because the community they themselves are helping their own community indirectly without them knowing that they are doing that.
I: You mention on your website that empowering the youth is an important part of your mission at HBB. Could you tell us a bit more about this aspect of your work?
H: Empowering the youth is part of our methodology to actually improve the youth. We always welcome volunteers, be it from Cambodia or from Malaysia, they are all welcome to join.
Every three monthly visits to Cambodia, we bring volunteers. The volunteers coming from Malaysia are from different backgrounds and they don’t necessarily have to have a medical background. Some of them don’t really know how to help poor people so we are teaching them and equipping them with the knowledge and skills.
[We show them] just simple things like checking blood pressure, showing them how to measure the glucose level or how to measure the body mass index.
And not just in Malaysia but in Cambodia as well. In Cambodia, the language barrier is another thing. So some of the medical students or pharmacy students want to improve their language. They can improve their English proficiency by translating what the local communities are saying with our volunteers.
That’s really part of empowering the youth: to ignite the volunteerism inside each and every youth.
I: What has been the biggest challenge HBB has faced so far?
H: To get the trust and to convince people was the most difficult challenge [we faced] I would have to say. Our family members and our close friends were the first people to believe in us so that was actually very important to us.
And you know what? Starting off a hospital is very difficult but sustaining it is even more difficult! That’s another challenge because I am just 29 years old so I don’t have much experience in managing a hospital.
I’ve just been a worker in a hospital and not really managing the hospital. You really have to think of your staff, of how to make your hospital better and how to invite more people and things like that. It’s challenging but we are managing it well.
I: What has been your biggest achievement so far?
H: It had always been our initial plan to build a maternity hospital. We started operating our hospital back in 2015 but to start off a hospital we needed around one million ringgit to get there. And to get to one million ringgit is actually really difficult so we started off small.
In 2015, we launched our clinic and we started engaging with the community. After a year of operating, we found out that the local communities were very engaged with us and they trusted us. So with better fundings, we started to expand our services and in 2016 we started our maternity centre.
Our first baby was born in October and the babies delivered in our centre are all healthy. They’ve been followed up and each of the mothers is healthy and that is one of our biggest achievements.
Another thing is that back in 2016 we were recognised by the United Nations as one of the advocates for social health. The recognition from them is actually quite huge so we were very honoured and flattered. We were actually speechless to get that recognition.
I: Any exciting plans coming in the near future?
H: At the moment we have been getting some recommendations to build another hospital in a different province in Cambodia but as for now we want to really focus on our hospital. We want to really make it work.
Our aim is not to depend on donations, our hospital has to be self-sustained. Then once we get that working model to work, and only then, we will be able to replicate elsewhere.
I: What would your advice to young social entrepreneurs be?
H: If you have the idea then just go for it! You’ll learn how to do it along the way. You don’t have to really equip yourself with all the knowledge and skills you need to start a social enterprise.
If you have the idea, get the right people and just learn along the way. You will make mistakes along the way but that’s the only way you can make things better so just go for it and believe in yourself.
This story was originally published on INKLINE on July 26 2018.
