Tackling ‘intractable’ health issues in India

Six years ago, I faced a major crossroads in my life. After serving almost two decades in uniform, the last five of which I oversaw strategic operations for the Indian Navy, I was presented with the option of either taking on a lucrative career with one of the major defense contractors, or more meaningful (although less financially rewarding) work with CHAI. I chose CHAI out of an abiding memory of my father who collected blood samples as a door-to-door malaria health worker. It was the right decision.

Over the last four years, CHAI India has grown from an office of less than 10 people to a close-knit team of almost 100 bright, passionate and dedicated individuals. Their selflessness, sacrifices and commitment to serve is a constant inspiration and a beacon of hope.

Months ago, I had a lively discussion with a well-respected leader of a large Indian conglomerate. We lamented the big challenges we as a country faced: a large and growing population, debilitating poverty, rapid urbanization, poor infrastructure and endemic corruption. Yet, as I reflected on the discussion, I could not have been more optimistic. Despite all its challenges, India is on the move. A drive towards greater accountability and transparency in governance and deep political will are bringing tremendous change. I see this transformation reflected in CHAI’s partnership with governments, both at the central and state levels. We are working together to tackle the scourge of some of the most intractable public health problems.

Among other achievements, CHAI’s partnership with governments has resulted in the fastest ever scale up of lifesaving zinc and oral rehydration salt (ORS) treatment for children with diarrhea. This effort was undertaken across the three states that account for around 40 percent of all deaths from diarrhea in the country (Uttar Pradesh, Madhya Pradesh and Gujarat) and reached an estimated 24.6 million children in over 125,000 villages. Over three years, coverage of ORS and zinc has increased significantly, saving the lives of tens of thousands of children. I cannot think of many organizations other than CHAI where I could have a larger impact on lives and get to serve so many people.

While India’s economy gallops ahead, it remains home to more than a quarter of the world’s tuberculosis (TB) patients and 40 percent of children are malnourished. One-fifth of all childhood deaths under five globally occur in India. Addressing these challenges requires us to see the problems differently and take big ambitious steps. At the same time, resource constraints mandate frugal innovations across products, processes and service delivery.

CHAI, under the guidance of the government of Madhya Pradesh, is currently executing a state-wide effort to address the burden of malnutrition among children and anemia in adolescent girls and women. The program will reach 4.5 million children, 6.75 million adolescent girls and over two million pregnant and lactating women over the next three years and expects to reduce the burden of malnutrition amongst children and anemia amongst adolescent girls and pregnant women by at least 10 percent.

The scale and scope of the program reflects India’s ambition in taking on a big and seemingly intractable challenge. Its design incorporates extensive innovations in service delivery, and its wide-ranging use of technology reflects a strong focus on operational excellence. These values of consistently looking for innovative solutions to deliver transformational change, of not being afraid of failure and of working with urgency, are at the very core of CHAI’s culture. They are the reason that I and over fifteen hundred of my colleagues are committed to CHAI. There is no other organization where I would rather be.

I spent over two decades in the Armed Forces where ‘service before self’ was not only a motto, but a way of life. I never imagined that I would find another calling quite like the uniformed services. Over the past four years, CHAI India has grown beyond tackling HIV to supporting the Indian government to address other health issues such as TB, malaria, hepatitis, nutrition, immunization, diarrhea and pneumonia, and I am excited about the future challenges we may take on. For me, CHAI has not been work, but a true calling.