For 10 years, Expedicionários da Saúde have been taking specialized medical treatment to indigenous communities and in some cases riverside geographically isolated communities, with high technology through a Mobile Surgical Center, a social technology that enabled, until today, the completion of D 20,944 medical consultations and performed 3,569 surgeries, improving the quality of life of its beneficiaries
About You
About You
About Your Organization
Organization Name
Associação Expedicionários da Saúde
Organization Website
Organization Country
Brazil, SP, Campinas
Organization's Country of Operation
Brazil, AM, comunidade indígenas isoladas no estado e ações complementares no Pará , Acre e RR
Type of Organization
Non‐profit/NGO
Year of launch of the organization
2003
Years in Operation
Operating for more than 5 years
Has the organization received awards or honors? Please tell us about them
• Premio SMCC - Sociedade de Medicina Cirúrgica de Campinas – X Premio Paes Leme http://www.smcc.com.br/2010/Eventos/X%20Paes%20Leme/materia.html
• Premio Dr. Cidadão 2004 - Associação Paulista de Medicina
• Carta de agradecimento a ajudas no Haiti do Gabinete de segurança institucional ( Presidencia da Republica) Ministro Jorge Armando Felix
• Staff de ouro / 2009
• Premio Fundação Banco do Brasil de Tecnologia Social / 2007 -Finalista com o projeto ( Centro Cirúrgico em comunidades Isoladas)
• Projeto Cidadão - CPFL /2003
We want to hear about your “Aha!” moment. Share the story of where and when the founder(s) saw this solution’s potential to change the world.
Amigos médicos,em férias no Pico da Neblina se perguntavam por que procedimentos cirúrgicos simples eram tão complexos em comunidades indígenas isoladas?Se não dava para transferir o paciente para grandes centros, pensaram em levar atendimento especializado até eles! Foi criado o Prog. Operando na Amazônia e a tecnologia social do Centro Cirúrgico Móvel.Em 10 anos foram 24 expedições .
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Innovation
Name Your Entry
PROGRAMA OPERANDO NA AMAZÔNIA - Centro Cirúrgico Móvel em Comunidades Indígenas Isoladas
Explain what the "innovation" is about, e.g., is it the idea and/or the model you use to accomplish the idea, or your understanding of the target population, etc.?
The public health agencies in the Amazon perform preventive and curative care with great difficulty, due to the difficult access to the communities. Treating severe cases and elective surgeries depend on moving the patient to the region's to medical centers, which can take days. There are difficulties related with transporting indigenous patients and their families to urban centers. There is a lack of specialized care at the medical centers, that are commonly overcrowded and do not always have access to high tech. have ponta. People are drawn from social productive life by not having access to relatively simple surgical procedures. EDS confucts anual expeditions with volunteer doctors and high tech to perform surgeries (EDS believes that it is important to broaden the dialogue with the society as a whole, the government, communities, universities and other institutions on the importance of having effective public policies to care for remote areas in Brazil, since it is very difficult to promote internalization of the medicine and our work seeks to contribute to this problem. It envolves volunteering, intersectoral partnerships (government, NGOs, businesses), participation of the needy community, interdisciplinary and highly specialized technical team, high tech and strong social impact. The Mobile Surgical Center, adapted to the needs of the group, structured with high-tech equipment and working inside indigenous communities. An innovative way of working, used in Brazil for the first time by a ONG. A social technology that can be replicated and extended to other regions.
Describe how your innovation model is distinct from any other organization in your field?
There are similar projects operating in the region, particularly in primary health, examinations and consultations. Doctors Without Borders (Médicos sem Fronteiras) is an organization that we visited at the beginning of our work. Some of our processes have been adapted from their experience, but over the years we had to seek our own model, adequate to our size, profile and specially customized to the reality we face in the north of the country
What type of operating environment and internal organizational factors make your innovation successful?
Partnership with local agents to select the surgical cases, transport and lodging for patients and postoperative follow-up. Partnership with local stakeholders who support doctors' mobility in the area and the transportation of equipment and supplies. Community support to adequate infrastructure for the establishment of the Mobile Surgical Center or the existence of a local surgical center in good conditions. Company support: donation of equipments, drugs, supplies, transportation and sponsoring the logistics of each expedition, which takes about four months to be organized. Partnership with health professionals working in the region swhere the program is implemented. Partnership with regional hospital when a risk factor is identified, Strong internal management control.
How do you make sure you constantly innovate in light of (potential) external challenges, or your growth plan?
With the support from the external consultancy agency Deloitte, we are developing a management and financial plan to be anually audited. We intend to an Advisory Council to improve the governance of the organization. Development of an ethics and conduct code in order to consolidate the practices we today advocated and perform in the organization. Together with indigenous health care public agencies, we identified new areas with high demand for specialized medicine, and for this reason we extended our work to Pará, Acre and Roraima, proving that the social technology is appropriate for different realities.
This Entry is about (Issues)
Business Model
The systemic challenge you are trying to overcome (select one)
Bring accessible healthcare to communities in emerging markets
Health area (target market) where the need is [select only one]
Other specialty care
Categories along the health continuum you are covering [select all that apply]
Detection, Intervention, Follow-up.
Please describe in more detail: what problem are you trying to solve in the organization's specific context?
Isolated indigenous communities in the Amazon receive government primary and preventive health care. Serious cases and elective surgeries depend on transferring patients to medical centers. In the region, there is a high incidence of equatorial cataract, pterygium, hernias. Only severe cases are treated, the queue is long. There are many difficulties related to moving the indigenous and his family to urban centers, which are very different from their natural habitat. There are hundreds of people drawn from social productive life by not having access to relatively simple surgical procedures. EDL through the mobile surgical center's social technology, has transformed this reality with surgical expeditions, specialized medical care to the geographically isolated indigenous population.
Stage that best applies to your solution [select only one]
Scaling (growing impact on a regional or global scale)
Core strategies of your business model [select all that apply]
Patient-centered design, Redesign of the public healthcare system for more efficiency (in terms of processes, structure etc.), New/redefined roles for healthcare service provision, Unconventional partnerships (between traditional healthcare players and players outside healthcare).
If other, specify here:
Most relevant tools you are using to implement the strategies outlined above [select only two]
Technology, New skills, Education/training, Community financing, Others.
If other, specify here:
Alianças intersetoriais: governo, empresas e sociedade civil e forte apoio da imprensa
Please describe your solution in more detail
Partnerships involved in the expeditions' logistics: SESAI, FUNAI, Special Indigenous Sanitary Districts (DSEI), local municipalities, Ministry of Defence, the Brazilian Air Force, the Amazon Military Command, Leaderships of the indigenous community treated. All these partners contribute directly to facilitate the care provided in the community, from planning to execution. Also, from the point of view of promoting the work and cause, we have strong support of the national press and we already have international repercussions, with media vehicles such as "The Economist"
What are your vision and overall objectives?
Mission: Bring specialized medical care, especially surgery, to indigenous and riverside population living geographically isolated, with excellence in the quality of service and responsible management. Vision: Create a reference model for specialized medical care to populations that are isolated geographically. Associação Expedicionários da Saúde / EDS is a Brazilian non-profit organization created in 2003 by a group of volunteer doctors, that aims to bring specialized medicine, especially surgical care, to indigenous peoples who live isolated in the Brazilian Amazon. It is a complementary service to health care programs. Aims to avoid the need of the patient and his family to travel to urban centers, which is not always feasible.
What is your value proposition?
EDS' intention with its Social Technology is to put an end to the surgical demand of the Indigenous and Riverside Populations that live isolated from major medical centers in the Brazilian Amazon. The results achieved to date, the credibility and visibility of the project, demonstrate that we are on the right track. But this is an action that involves a medical infrastructure, equipment and complex logistics, which requires the need for Expansion and Strengthening of Partnerships.
Who is your customer(s)?
Indigenous populations isolated from the major medical centers in the Brazilian Amazon, that by prior diagnosis will be selected patients that require clinical and/or surgical care in the specialties of the medical expeditionaries team. Since February 2004, the organization provided 20,944 clinical treatments and performed 3,569 surgeries to indigenous peoples from the Brazilian Amazon. Also in 2010 after the earthquake in Haiti EDS sent 7 SOS Haiti teams, having performed 359 surgeries and 1,407 outpatient treatments.
What approaches to you use to reach your customers?
Mobilizing opinion leaders, identifying the region, diagnosis, demand profile are activities carried out with the close involvement and support of SESAI, FUNAI, Special Indigenous SanitaryDistricts (DSEI), local municipalities and indigenous community leaders. Among the actions of sensitization and mobilization there is partnership with local health agents trained to perform screening (selection of surgical cases and consultations). Patients are informed of the date when the collective surgical effort will be held and partners providential transportation and lodging.
What are your primary activities?
There are three annual expeditions to perform surgeries and guidance for pre-and postoperative care and special diagnosis and referral of the cases in which the team is not prepared to act in loco. It happens in communities with some structure to receive the large amount of people (patients, families, physicians, and logistics). Besides the general coordinators, there are coordinators per specialty: ophthalmology, general surgery, pediatric, orthopedics. The medical school at UNICAMP - University of Campinas, provides medical volunteers who orient the local teams on how to identify surgical cases in the specialties offered. Evaluation during and post expedition, of the results and the work processes involving all stakeholders.
Who are your peers and competitors? What problems could these players pose to your success or growth?
There are similar projects operating in the region, particularly in primary health care, examinations and consultations. Part of our processes have been adapted from the experience of some of these projects, but over the years we had to seek our own model, proper for our size, profile and customized to the reality we face in north of the country.Partners: medical volunteers, SESAI-Special Secretariat for indigenous health care, FUNAI - National Indian Foundation, DSEIs - Special Indigenous Sanitary Districts, local municipalities, Ministry of Defence, the Brazilian Air Force, the Amazon Military Command, Leaderships in the indigenous community.
What other challenges - individual, organizational, or environmental – are you currently facing or might hinder future success of your business, and how do you plan to overcome those?
achievement of the 26th EXPEDITION in August in the Yanomami region, the 27th November EXPEDITION in Raposa Serra do Sol. Have 90% of local staff trained and qualified by EDS to perform the patients screening and specialized diagnosis. Continue with the Sos Haiti expeditions, so far we have conducted seven expeditions in 2010 with a total of 359 orthopedic and trauma surgeries and 1,407 outpatients treatments. Our biggest challenge in 2013 is to develop partnerships that contribute to the financial sustainability of our organization and the continuity of expeditions.
But this is an action that involves a medical infrastructure, equipment and complex logistics. Because of this, the Expansion and Strengthening of Partnerships is needed.
Briefly describe your growth strategy going forward
Develop diagnosis methodology that can make the process of identifying demand for the service faster. Act simultaneously in two expeditions and occasionally in situations of humanitarian aid. Enhance intersectorial alliances mechanisms. Expand partnership with the private sector. Improve internal Management and governance with specialized consultant agency (Deloitte)
What dimensions for growth are you currently targeting for your innovation [select all that apply]
New regions(s).
What makes your business "ready" for growth?
Support and credibility together with strategic partners in the public and private spheres, recognition of our work by the press and thought leaders. Significant results, being that until November 2012 24 expeditions were carried out: a total of 3,569 surgeries and 20,944 clinical treatments, Improvement of internal management, governance processes and approved social technology
What are your key growth objectives?
EDS' intention withThe intention of the EDS with its Social Technology is give an end to the surgical demand of the Indigenous Populations that live isolated from major medical centers in the Amazon. For this, we need support from institutional partners and financial resources to enable our expeditions.
What is your timeframe for growth, in the short and mid-term? What are the growth milestones and key activities going forward?
Perform three expeditions in 2013 - the April one is already confirmed. Have 90% of the local staff trained and qualified by EDS, to conduct patient screenings and specialized diagnosis. have enough resources to perform three expeditions in 2014. In a medium-term, continue with SOS Haiti expeditions. So far, we have conducted seven expeditions in 2010 with a total of 359 orthopedic and trauma surgeries and 1,407 outpatient treatments and we are seeking partners to enable the creation of a hospital specialized in orthopedics
Social Impact
What has been the impact of your solution to date?
The biggest impact is on the patient, but it benefits all the indigenous health care system, since EDS provides the team with technical training, also as to security standards and postoperative orientation. The local government relates the importance of the partnership, because this collective surgical effort is the only way to deal with repressed demand and delays in the referrals to the reference network. It avoids having to move to the city, has high technology in treatment, specialists, and economizes, because the expedition otimizes public resources. With regards to the patients, recovering the vision or getting rid of a disabling hernia, allows the indigenous to recover his self-esteem, get back to work, hunt and fish and improves the community's quality of life.
What methods for quantification of social impact are you applying (if at all)?
Number of treatments and surgeries performed per expedition. Report of the postoperative.Assessment reunion with the local health teams. Assessment reunion with the expedition medical team. Number of voluntary doctors that return to the program. Satisfaction and support provided by institutional partners. The partners involved evaluate the work performed and in a participative process contribute to the planning and improvement of the activities.
Spontaneous media: press coverage that reinforces the importance of the work done and gives credibility to the organization, facilitating the establishment of new partnerships.
Could your solution work in other geographies or regions? If so, where?
Yes, it was tested in Pará, Acre and Roraima and in Haiti afther the 2010 Earthquake. The Mobile Surgical Center is adapted to the needs of the community, structured with high tech equipments and specialized medical team. An innovative manner to work, for the first time utilized in Brazil by a NGO. A social technology that can be replicated and amplified to other regions, as we have already demonstrated,
What is your projected impact over the next 1-3 years?
EDS believes that it is important to broaden the dialogue with the society as a whole, the government, communities, universities and other institutions about the importance of Brazil having effective public policies to care for remote areas, since it is very difficult to promote the internalization of medicine. The mobile surgical center's social technology is demonstrably a good alternative to taking specialized medicine to geographically isolated regions.
Sustainability
Elaborate on your current financing strategy
Presenting projects to private and public partners
Fund raising with partners
Events to raise funds
Share of revenue generation in total income of organization (in percent)
60% private resources, 30% public partnerships, 10% funds raised with individuals
Direct sales to patients or other beneficiaries (in percent)
Of the possible sources of these sales listed below, check all that apply to your current strategy
Licensing fees, e.g., for technology/franchise model (in percent)
Of the possible sources of these licensing opportunities listed below, check all that apply to your current strategy
Service contract with organizations, e.g., government, NGOs (in percent)
Government, not as a contract. Formal partnership propostion for punctual actions. No cash receivement
Of the possible sources of the service contracts listed below, check all that apply to your current strategy
Regional government, National government.
Explain your revenue generation strategy in more detail
Companies, embassies, consulates, Institutions and Foundations: financial resources, equipment, medications and inputs donations. Local and national government: logistic and transportation infrastructure, support team to enable the expeditions. Other resources in special individuals that enable the NGO's administration structure (rent, phone, salaries, etc)
Share of philanthropy in total income of organization (in percent)
60% companies, 30% public partnerships, 10% individuals and others
Philanthrophy strategies you are using
Diversified strategy.
Explain your philanthropic approach in more detail
Only through partnerships it is possible to enable such a complex surgical expedition. In this sense, without the government's operational support, for example through the FAB and Amazonia's Miliraty Command, we wouldn't have access to the communities bringing tons of equipments. So the feasibility of the project is related to partnership diversity and sources of resources, be it financial, material or human
Expand on your selections; explain how you will sustain funding over the next 1-3 years.
The results are expressive and the government considers the cost-benefit to be evident. There are no possibilities that the public managers would be able to make available such equipments and medical team as we have been doing. But is is necessary to improve partnerships and look for a broader autonomy, amplifying financial revenues to diminish the dependence on some aspects, such as transportation,