In the first several months, we will need to establish a P2P fundraising mechanism whereby our clinicians on the ground can request funding for patients with severe diseases who require funding for referral services. This funding should typically not come out of the general funding pool, since that is focussed on building up primary care services at the clinic. One way to do this would be to set up a P2P funding stream of dedicated persons who sponsor a particular patient. There is nothing innovative about this; it is similar to WorldVision or any number of "sponsor a child" programs. Most people would also likely not consider it particularly "sustainable." It would, however, potentially provide us with some additional support for the most severely ill patients as we better develop our community-based health insurance scheme. The technology and principle behind this project would be similar to DonorsChoose.org and World Vision.
Such a program would have some of the following characteristics. There would be a web portal, linked to our website, that a potential donor could log into to see a picture and video, with description of the services and financial support required. Users could log-in to this portal using their email address, and could make payments as desired using paypal. They could also opt-in to receive email updates when new urgent funding became required. Also, patients' stories about their ultimate outcome, including deaths and rip-offs and medical malpractice, would be posted. The payments would be made via paypal ideally. We will have to look into whether we can just use our non-merchant account for this or whether we can get Paypal to waive that 2.9% fee. To my knowledge, kiva.org is the only current recipient of a waived paypal fee.
The main problem with this system from a marketing standpoint is that it is "merely charity", and individuals have no economic incentive to continue their support. The only hooks would be the personal connection, the transparency of the operation, and the immediacy of the use of funds. Eventually, of course, we will try to build off of this initial system to develop a kiva.org-type system of no-interest loans. That would require a community-based health insurance structure that we currently do not have, but will try to get moving on STAT.
Logistically, we will also need to transfer money from our ETRADE account to our Standard Chartered Bank account in KTM (this is easy, and should be free... will know by August), and then to a bank account with RABA (a national Nepal bank) in Doti. This second transfer requires someone in KTM, which is a problem. Then someone will have to hike back up to Doti, a good 3-4 hours away by bus and haul the money back to give to the patient. Of course rather than do that every time someone donates 50 bucks for a patient's referral, we would have a fund that is locally available that the medical team can use once they receive the go-ahead from a donor that the funds have become available. That way, the patient can receive timely care. This would still function best for non-emergency referrals; for emergency referrals we might have to have a retrospective compensation mechanism.
Web-based microfinance program- Global giving: http://www.globalgiving.com/
Kiva
Article: http://news.bbc.co.uk/1/hi/technology/4759122.stm
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