A dentist and an engineer.
Siblings on a mission against oral cancer.
Dr Preeti Adil Chandrakar and her engineer brother Praveen Adil often travel in a second hand truck with a diesel jerry can as portable water storage unit. It is certainly not a luxury car, even in rural Chattisgarh, but it a functional one in their mission to improve oral care in the villages of Chattisgarh.
Every time the two siblings go out in their mobile dentist lab, they reach unusual patients. Sometimes they are compared with nomads or madaris who roam around with monkeys. Villagers ask them why they charge so much when other madaris extract teeth for less than Rs 20. Others come back to the team after treatment or after the camps they conduct to thank them with food offerings.
According to present figures, only 1.5 per cent of dentists in India work in rural areas, which means that the remaining 98.5 per cent deal with just about one quarter of the country’s population. The government has organised camps to expand dental care to villages, but the result has often been unsatisfying. “Governmental camps do not provide treatment on the spot,” says Praveen. “When patients travel long distances to visit government hospital they figure out they have to deal with another doctor who often turns them down.” Treatment facilities, medical staff, and/or medicines are often not available, and the patient is left disillusioned and disappointed.
This was one of the main reasons why the siblings’ clinic Itidirkha had to deal with a good deal of skepticism. Many patients were initially hostile, but after two years on the road, Preeti and Praveen say that their clinic has received over 3000 footprints and 100 per cent patient satisfaction.
The two founders share genes but not a professional background. Preeti did her BDS (dentistry) from CDCRI Rajnandgaon in 2008 and is the youngest independently practicing female dentist in Bhilai. She started working before she got married. Praveen is a tech graduate in electrical engineering from IIT Kanpur. He started his career with corporate firms, worked in India and Singapore; then joined an energy consumption management startup in Mysore which did not break through; and finally became a consultant.
The siblings wanted to do something together in Chhattisgarh, their home state. Their family has a rural background and still maintains ancestral bonds with their village. “Since childhood, we have been observing poor oral hygiene, high tobacco consumption and lack of doctors in rural areas. Some of our relatives passed away because they used to consume tobacco while suffering from chronic high blood pressure, which is a deadly combination,” says Praveen.
“Rural India is truly the world’s oral cancer capital,” he adds, explaining how they have planned to tackle this trend. “Establishing a specialist clinic in a suburban area was our first step. We didn’t start with conducting camps in the villages because we realised we first had to earn the trust of patients. So, we focussed on accurate diagnosis, ethical practice and affordable treatment to show our professionalism.”
It was later that the siblings and their team started organising camps in villages. “Our focus has always been more on prevention than cure,” says Praveen. At Itidirkha, most of their time is spent in educating patients about how to prevent dental problems from deteriorating further.
“Rural patients receive camp cards from us with the prescribed treatment and costs associated with it. They have the option to go take treatment on the spot or come down to the clinic within three months from the issue date of the card. The treatment costs for camp participants have been kept lower than patients coming directly to the clinic,” Praveen explains.
Going directly to meet patients is fundamental for several reasons. The first is that nearly all of them are unaware they have a dental problem. “They go for treatment only when the dental pain gets intolerable,” says Praveen. Moreover, Itidirkha’s patients are mostly daily wage workers and can’t afford to take leave even for a day.
Itidirkha is trying to keep prices as low as possible and to improve services the team plans to start giving medicines as well. This would further decrease villagers’ need to travel long distances for getting these. “We are in the process of building relationships with firms manufacturing oral healthcare products, which will help us bring down treatment costs significantly. We already have some partners offering us good discounts, but we are trying to build more partnerships,” says Praveen.
The siblings have so far bootstrapped and reveal that they want to keep doing it although they have been approached by several VC firms who would like to invest in Itidirkha.
In the belief that social good and business grow at their best if they are mutually beneficial, Itidirkha is planning to scale by improving services. “We want to establish new specialist centres in other suburban areas in the proximity of villages, or enter agreements with well reputed existing ones to expand our reach and make dental care more affordable,” says Praveen.
He adds, “We want to appoint representatives in each village whom villagers can approach and record their dental problems with. We will then try and find the best possible date and location of camp to enable the needy, especially the elderly or differentially abled, to receive required treatment.” Itidirkha is also tailoring services for the employees of medium sized businesses operating in rural areas to diversify their sources of income.
The second hand truck with a diesel jerry can for water storage and lot of clinking dentistry tools, carefully arranged inside, makes a powerful image. Itidirkha has its big challenges which vary from bad roads, high costs, lack of proper equipment, and inconsistent communication with villagers. However, the team’s patience and meticulousness just make challenges seem like guidelines for improvement, and not obstacles.
Follow their journey on itidirkha.com.
The above article by Francesca Ferrario first published on social.yourstory.com in 2015.