The Business of Health Care

What a Sock Business Can Teach Health Care Companies

By KOUSIK KRISHNAN, MD

As recent events in northeastern Syria make clear, the number of displaced people in the world is rising — as are their health needs. 

In 2018 I went with a team of other doctors to a Syrian refugee camp in Lebanon. At one stop, a woman offered us homemade bread as we examined her husband, although the couple had very little money and not enough food for themselves. As we ate the bread, she asked if we could leave them extra medications since they didn’t know when the next humanitarian mission would come through their camp.

Her request was reasonable in the situation – indeed, many other refugee families we treated asked us the same thing. Their host countries’ healthcare systems are simply not equipped to handle their needs. Lebanon alone has almost 1.5 million refugees, an increase of 1/4 of their population.  

But expecting vulnerable and displaced people to hoard needed medicine is neither sustainable nor humane. Instead, we must make it part of the social contract for healthcare corporations to use some of their massive wealth to help reduce disparities in global access to healthcare. Pharmaceutical companies and the retail industry have already created efficient models healthcare corporations could follow. 

Currently, many nongovernmental organizations raise money to send volunteers to refugee camps and other areas with dramatic unmet need. Often these volunteers ask their hospitals to help by donating equipment. Sometimes healthcare companies will also donate equipment or medications, but the path to achieve these contributions is neither easy nor guaranteed. 

On both my trips to Lebanon, the healthcare providers on our team cobbled together bags of medications, pacemakers and other equipment we needed to do our work there. Most of the equipment came from our local hospitals, with a smaller percentage coming from the medical companies. 

Yet most healthcare companies have mission statements that describe increasing health and wellness. For example, a highly respected company, Johnson & Johnson, writes in their Credo, “We must help people be healthier by supporting better access and care in more places around the world.”  

I propose that these healthcare companies send their own representatives to refugee camps around the world to see firsthand what their lifesaving products could do. The price would be small for them, compared to the cost to NGOs operating on a shoestring budget, or volunteers paying out of their own pockets. The logistics would be easier for them as well. Many of these companies already operate in countries that host refugees.

Once on the ground, representatives could work with NGOs that know the local landscape to donate medications. A model for this action is the pharmaceutical companies that make HIV medications. Many African countries have a very large population with HIV, and patients are not able to pay for medications as they do in more affluent countries. In these regions, pharmaceutical companies often sell the medications to local governments or NGOs at a substantially lower price than they do in the United States, for example. Certainly in Africa, pharmaceutical companies are not motivated purely by profit.

Another model for philanthropy comes from the retail industry. For example, the sock company Bombas advertises that for every pair of socks sold, it donates one pair. This sell-one-give-one model could be applied to the pharmaceutical or medical device industry as well.

Donating medical supplies would have tax benefits for the companies. In addition, providing supplies directly from the source would eliminate waste and inefficiency in the system. Currently, a hospital purchases a device from a company and then donates that device to an NGO. But it’s much cheaper for the company to donate the device directly because the cost of the device is cheaper to the manufacturer than to the consumer.

A downstream benefit would be that if the refugees had more access to medications, they would be healthier and less of a burden to the local healthcare systems, which are already incapable of handling the additional patient volume. Additionally, by using fewer local resources, animosity towards refugees for taking away resources could be diminished.

In the camps, local citizens and the West at large often see the “poor, dirty refugee.” But most of the refugees are proud, honorable citizens that had to flee due to no fault of their own and would love to go back to their lives if given the opportunity. That is sadly not possible. Seeing them hoard medications because they don’t know if our visit will be the last group they see for six months or three years is not only heartbreaking, but immoral in the face of the resources that are already available to healthcare corporations. 

Some will argue that “charity begins at home” — there will always be needs that go unaddressed. However, we should not be paralyzed to inaction because other places and people also need our assistance. We start somewhere and make a difference in one life, one camp, one city or one country. 

When I was visiting the couple in Lebanon who offered us the bread, I kept thinking of the children’s story about an impoverished village and an individual who began to make a meal out of a stone. Soon, others offered vegetables and meat. In time, they made this stone soup into a real soup, capable of feeding the entire village. Likewise, the occasional visit from a foreign doctor with a little medicine and cobbled-together equipment cannot do much for the millions of suffering refugees; however, with the help of NGOs and medical companies, small acts can be magnified and scaled to sustain our global village.

Dr. Krishnan is a cardiologist and Associate Professor at Rush University Medical Center in Chicago, as well as a Public Voices Fellow at Rush University.

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