The Medical School and the School of Business have teamed up with the goal of increasing access to health care and education in Sri Lanka.
For the project, the two schools are partnering with the Grace Care Center, a shelter for orphan girls and the elderly located in Trincomalee, Sri Lanka. The shelter provides food, housing and schooling for dozens of girls and destitute elderly individuals, many of whom fled war or were impacted by a 2004 tsunami.
Business graduate student Patrick Camalo and Erica Dancik, a Business and Public Health graduate student, became involved in the GCC project through a Business School MBA class this semester called International Business Immersion: Healthcare Delivery in Emerging Markets. Twenty-five students from the class are participating in five projects around the world.
Camalo said the Sri Lanka project will also include students from the Ford School of Public Policy and the School of Public Health.
“We focused on looking for a financial model for diabetes and hypertension in a remote area of Sri Lanka, in Trincomalee,” he said. “We wanted to understand the current landscape of diabetes care and then understand what a financially viable way was to deliver improved care to a broader patient population.”
Dancik said she and the team spent time meeting with Dr. Naresh Gunaratnam, the shelter’s founder, before crafting the program.
“We then traveled to Trincomalee for one week so that we could see, first-hand, what the health landscape looks like and so that we could interview and interact with some of the project’s key players and stakeholders,” she said.
Gunaratnam, a gastroenterologist at the University of Michigan Medical Center who was born in Sri Lanka, founded the GCC in 2002. He fled the country with his family after the country became embattled in civil war in the 1980s.
“My father was a physician, and he loved teaching at the hospital in the capital,” Gunaratnam said. “He took his family out of the country that he loved because he thought it would give my brother and I a brighter future.”
Gunaratnam’s father, who passed away when Gunarantam was a teenager, served as an inspiration for the establishment of the orphanage and elder care center in Trincomalee.
“When I had established myself as a physician and had the opportunity to help children like myself who had lost a parent, I jumped at the chance,” Gunaratnam said. “I empathized with their loss and knew the impact a few caring souls could have on their lives.”
The primary goal of the Business School’s project team is to eventually bring a long-term health care system to Trincomalee through two phases, the first focused on telemedicine and the second on self-sufficiency and expansion. Telemedicine is when doctors use Skype or other technology to provide care from afar.
As part of the collaboration, Anjan Saha, a medical scientist training program fellow at the University, traveled to GCC last December to help facilitate a camp that provided blood pressure and blood glucose tests to patients. Saha said the telemedicine aspect of the program has been very successful in providing information to the doctors in Sri Lanka.
“Reception for all of our projects has been good and we have continued to be invited back,” Saha said.
Currently, GCC — which also aims to safeguard the health and safety of the local population — is focusing their new health care initiative on hypertension and diabetes treatment and prevention. The blood tests Saha assisted with in December were free of charge to patients and funded by the Global Reach fund of the UM Medical School.
A total of 35 patients received testing, demonstrating the potential for the effectiveness of the health care delivery program, Saha said.
While the camp was deemed successful, Camalo said there is more work to be done. Affordability of care and building trust and interest among the Trincomalee residents are key goals Camalo and Dancik’s team are considering. Though primary health care in Sri Lanka is free, there is a lack of doctors and efficiency is a problem, which leads to long waits and often discourages locals from visiting clinics.
“It is a very inefficient system, so there is an emerging private sector market where people have to pay for care,” Camalo said. “However, people do not have a lot of money to pay for that, so it is usually targeting the wealthy population.”
Camalo said the team is exploring a few ideas for creating a sustainable financing source for the blood-testing program. He said one potential method could be a monthly subscription plan to encourage visits or a cross-subsidized program that would take payments from those who were more capable of affording the care to support the payments for lower income individuals.
“We are trying to incentivize different behaviors from the patients,” Camalo said. “If they come more frequently, we will give them a discount. People tend to come in only when their diabetes is out of control due to lack of education.”
Outside of the partnership, students on campus are providing other forms of aid to GCC. Student organization GracedU was founded in 2015 by LSA sophomore Sahr Yazdani and LSA junior Rasika Patil to provide educational resources and support to girls at the GCC through video tutoring and other forms of outreach.
Yazdani has been working for GCC for five years and worked with the medical school to develop “Elder Care Night,” during which GCC medical assistants considered ways to improve the health care of senior citizens. Yazdani said her visit to the shelter in the summer of 2015 was a life-changing experience. She made the trip through VeAhavta, the non-profit organization based in Ann Arbor that helps run Grace Care Center.
“From the moment I stepped off the bus, the little girls clung to my hands and legs, proudly showing off their home and their family,” Yazdani said. “The girls from Grace taught me the power of resilience — many of them have been through the toughest of life’s situations, but never once did they reflect negatively on their experiences. They demonstrate what it means to have courage in the face of adversity.”
Patil said she created the club after being inspired by the girls of GCC.
“I recognized a motivation within myself and my colleagues to help foster the Grace girls’ enthusiasm for learning,” Patil said. “Their dedication to the pursuit of knowledge is incredibly inspiring, and, in turn, we are dedicated to providing them with the peer support and educational resources they need to develop that passion.”