Improving Healthcare Access in Rural Countries and Promoting Health Equity

in Global Matters
October 8th, 2024

SPH Graduate Student and Doctor-Turned-Health-Tech-Entrepreneur Makes an Impact in Nepal

Dr. Sanjiv Gupta (SPH’ 25) grew up in an economically backward district in Nepal. Siraha, from where Dr. Gupta hails, is one of the bottom districts in the human development index in the country. Apart from capturing the economic reality of the place, the human development index also informs social indicators such as education and health.

“A majority of people in the district did not have running water and depended on ground or surface water for their livelihood,” Dr. Gupta says. “Around the monsoon season, we would see a deluge of diarrhea and malaria cases in our nearby hospital.”

Dr. Gupta’s family moved from his ancestral village to a nearby town called Siraha (named same as the district) to be closer to infrastructure, such as the private schools and the only health hospital.

Since Siraha was the administrative headquarters of the district, the only health hospital was supposed to serve wide swathes of the population from different parts of the district. However, the hospital lacked enough doctors and resources to fully serve its people.

“We would periodically hear of people dying because of not enough resources or lack of personnel at the hospital, creating public uproar at times. People would have to be driven by ambulances to other regions in the country for urgent and quality treatment,” Dr. Gupta recalls. “In many cases, we had family members who had to be driven to other cities because the hospital did not have the right resources.”

Experiences such as this were catalysts for Dr. Gupta to pursue medicine and work towards affordable, accessible, and quality healthcare.

He graduated from Kathmandu University medical school and immediately felt the responsibility that came along with being the first doctor from his extended family and presumably from his village.

After Gupta graduated from Kathmandu University Medical school, he returned to his district to work as a clinician at a local hospital for a few years, practicing medicine diligently and helping patients.

“Then, one day when a 70-year-old man came into the rural hospital with his grandson and from a village family who I knew…I learned he sold his buffalo [to pay for the services], one of their family’s only assets,” explains Dr. Gupta. “When he came for the treatment, the hospital administrators, they immediately admitted his grandson and started IV medications and charged him $100.00 on day one.”

That $100.00 USD (approximately 10,000 rupees at that time) was his entire savings.

“And that was total injustice,” Dr. Gupta recalls. “So, I went to the administrator team, and then they said to me, you are a clinician. You deal with the patients, not with the administrative dealings. And that was it. I paid [for his grandson’s healthcare services] from my pocket, and the next day I resigned.”

Having worked through injustices like that as well as inefficiencies and other challenges of working in remote areas, Dr. Gupta decided to start a community hospital with a team of friends. Around this same time, the Covid-19 pandemic was in full swing, and he experienced the power of technology in a medical setting firsthand.

“I got a few devices from Israel, and I deployed those devices in different pharmacies, where the whole healthcare system depends on these pharmacies in South Asian countries,” Dr. Gupta says. “It’s not like a CVS or Walgreens. They are very small, and Nepal has around 30,000 such pharmacies.”

Armed with his medical experience and the desire to improve access to quality healthcare, Dr. Gupta developed a business model to empower these pharmacies and transform them with the addition of medical equipment – so that they could become points of care for patients in need. He also connected them to his fellow doctors and created a network of quality healthcare providers.

He viewed the work as a successful experiment in helping improve access to quality healthcare. But with the limited resources available and challenges navigating health governance, Dr. Gupta began to wonder if he could have a greater impact from outside of his country and if he could learn more about entrepreneurship in the United States.

Soon enough, he was applying to different scholarships and was accepted into the Fulbright Program. Here at BU, Dr. Gupta is studying Healthcare Management in the School of Public Health and is involved in Innovate@BU, where he was accepted into the Summer 2024 Accelerator Program. As part of the Summer Accelerator cohort, Gupta spent an intensive 10 weeks building out his organization, Rx Healthcare, that transforms pharmacies across south-Asian countries into digital tele-clinics.

“I hired 50 interns back home and hired two developers from India so we could develop our own platform,” Dr. Gupta says. “Piloting is going very well, and we are improving our software. We are providing [telehealth] services in 10 different pharmacies.”

Using Dr. Gupta’s venture, Rx Healthcare, pharmacies are integrated into the healthcare system and receive the necessary digital infrastructure and medical devices – like pulse oximeters – to connect remote communities with qualified healthcare providers through telemedicine. Rx Healthcare can also connect to local labs where testing is completed.

“As someone who has witnessed firsthand the challenges of accessing quality healthcare in rural areas, I am deeply committed to leveraging technology to bridge this gap and empower individuals to take control of their health,” Dr. Gupta says. “Rx Healthcare is not just about providing medical services; it’s about empowering communities, promoting health equity, and driving positive social change.”

Although Dr. Gupta does not identify as an entrepreneur, he says his mindset is focused on problem solving. “I’m obsessed with the problem and will take anything to solve the problem, be it a management issue or anything. Accessing quality healthcare was our problem growing up. But now I see it as a problem for many, not only those in Nepal, but in many other rural countries and emerging nations.”

Coming from a moderate background, Dr. Gupta is grateful for the opportunity and people that have helped him come so far. “I never really planned to come to the U.S.…I was fully serving my community but coming here and getting so much help and support from the entire Boston University community, I am really grateful,” he says. “My entire life has been as a gratitude – the community back home and the Fulbright community…without the U.S. government scholarship I would not be here. So, I would like to request that everyone find some way to give back to their community.”

Rx Healthcare is currently seeking funding to help with medical device purchasing for the pharmacies they are transforming. Depending on the outcome of raising funds and where his new degree in healthcare management will take him, Dr. Gupta will determine where he can have the most impact as a doctor-turned-social-health-tech-entrepreneur.