Hospitals Beyond Boundaries (HBB)’s mission is to help build hospitals in impoverished places and develop the surrounding community through sustainable health care services, financial aid and community development efforts. The hospitals that HBB envision to build are those that understand the local community and are able to develop them in ways that they can sustain health care efforts independently. Health is a basic human need. We believe that curing diseases also helps alleviate poverty. By providing hospitals in health care deprived communities, HBB hopes that it will serve as a stimulus for further efforts in improving not only the community’s health standards, but also the standards of living in general. HBB believes that an effective and sustainable healthcare can only be achieved with a strong understanding of the interaction between healthcare and the local culture, religion, social systems and economy. To achieve this, HBB strives to involve the local community as much as possible in building and the running of our hospitals.
Sustainable health care efforts
The need for an NGO that helps build hospitals in impoverished places arise with the realization that while many humanitarian missions are available, not many of those include ‘community development’ in their agenda. Most humanitarian mission responds to war, crisis, famine or disaster, but efforts in building back the society after these periods of turbulence are usually minimal or absent. Although some community do have hospitals, they are usually government-run and by standards of developing countries, lack many facilities, medications and face many impediments such as limited resources, limited workforce, poor health system and bureaucratic delays. By helping to build a private community-run hospital, more tolerant control of supplies, workforce and collaborations with other parties such as NGOs or donors are made possible. However, we also realize that while we provide a different approach in health care, the highest level of effectiveness can only be achieved establishing interaction with the national health system. Hence, HBB would strive to strengthen and complement the existing health care system in any countries we are in.
Empowering the community
The goal of HBB is to empower the community to take charge of their own healthcare. Because the health care workforce is usually scarce in developing countries, most government do not impose laws that prohibit non-medical personnel to become healthcare workers. The main function of these community health care workers would be to educate the community on health, refer patients to the hospital, and for those who could not come to the hospital, they will come to them. The community health care workers do not take over the work of doctors or nurses. As members of their own community, they serve as an important bridge that builds trust and links the hospital to the community. Transportation costs, cultural and religious beliefs, social stigma, discrimination and lack of information are examples of why the poor do not seek treatment. By involving the local community in the treatment of patients, these barriers would be addressed because they best understand the barriers to health faced by the local community.
Stimulating the local economy
Many missionary hospitals depend on the workforce of volunteers. However being labelled ‘volunteers’ would deny them from receiving any form of payments. We feel that although volunteering for the poor is a noble act that should demand no incentives, we also feel that it is right to pay health care workers for their hard service in taking care of patients and putting their lives at risk of contracting infectious diseases, just like any other health care workers in developed countries. The rationales behind paying the community healthcare workers are: 1) it would create paying jobs for the community and ultimately boosts the local economy. 2) With payments and increments based on time or performance, it reduces workforce turnover and the costs of finding replacements. 3) By releasing their minds of financial worries to take care of their family, they could focus on their work and perform their jobs at their best.
Tailor-made health care
Every community has its own health care difficulties. No one type of health care fits all. Diseases that are commonly treatable for the privileged may be lethal to the poor. Diseases that are relatively rare in developed countries are relatively common in the developing, for obvious reasons. By focusing health care on each specific community, we are able to recognize common disease patterns, create a system that addresses these diseases, and respond to those in need of urgent attention. By being a privately run community hospital, a more flexible and responsive management is possible where we tailor ourselves to current healthcare needs of the community.
Our hospitals could be a platform for doing research, whether clinical or epidemiologic studies. As in any other hospitals, collection of all patients’ data is essential. These data, combined with the experiences and findings could be used as research resources. We would like to facilitate affiliations with leading Malaysian Universities and researchers interested to do research in our hospital areas. This is especially rewarding for them since rural areas in South-East Asia are considered an untapped source for research. Scholarly articles, papers and other findings could be published and presented at international academic and scientific conferences and meeting to both to expand the global knowledge of rural health and to further promote our cause.