Marang House
Stable home-environments instead of hospitals to accommodate underprivileged seriously ill children
Project Street Address
Project City
Project Province/State
Project Postal/Zip Code
Project Country
Focus of activity
Service/process
Year the initiative began (yyyy)
1998
Which of these barriers is the primary focus of your work?
Health care not consumer friendly
Which of the principles is the primary focus of your work?
Center consumers in business model
If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic:
This field has not been completed
Name Your Project
Marang House: Stable home-environments instead of hospitals to accommodate underprivileged seriously ill children
Describe Your Idea
Define the innovation
Across South Africa there are numerous children currently suffering from chronic illnesses including cancer, burns, and diabetes, as well as heart and kidney diseases. Without constant medical monitoring, medication and on-going support, it is highly unlikely that these children will survive or have a chance of realizing their dreams and full potential. In addition to the problem of orphaned children who have no homes at all, few parents actually understand the complications associated with chronic illness and many are simply unable to offer the necessary environment (electricity, running water and living within close proximity of a public hospital) mandatory for their child’s recovery. Unable to properly administer the care required, parents and children turn to South Africa’s public hospitals as a means of last resort. These hospitals, however, cannot offer the emotional support these children cry out for. Relegated to residing within the hospital’s confines, it becomes increasingly difficult for these children to maintain hope that their recovery is just around the corner.
Marang House aims to provide these affected children with the stable home-environment they require. Situated closely to various public hospitals in a high-socio economic area, Marang House provides children with fulltime nursing staff, a hygienic environment, balanced diets, but most of all with sunshine, emotional care and the opportunity to continue with their development and maturity. In addition to ensuring that these afflicted children are offered the required medical monitoring and emotional support, Marang House also helps alleviate hospital capacity constraints by releasing beds for more urgent medical emergencies.
During the past nine years, caring for children at Marang House has not only been proven to have a positive effect on their medical situation, it has also been substantially cheaper than having these children occupying expensive hospital beds.
Context for Disruption:
Short Term: Marang House is saving the lives of children that the health care system of the South African government is unable to save due to capacity restraints and the focus on other major problems such as the HIV/AIDS crisis. These children, in turn, will be able to contribute to their own communities.
Long Term: When implemented on a larger scale and in conjunction with various stakeholders, the Marang House model can further transform the health care system that caters for seriously ill children to a more efficient and effective one, saving money and saving lives. Furthermore, due to proper initial support, children suffering from chronic diseases such as diabetes will need less support from the health care system due to the fact that they have learned to cope with and handle their disease, in turn again alleviating capacity restraints.
An additional innovative disruption lies within the way that Marang House is operated and funded. Marang House aims to operate houses within the higher socio-economic areas of South Africa as it aims to make disadvantaged children neighbours of those South Africans who are able to make a difference. This is how the current Marang House has been sustained since 1998.
Delivery Model
There is currently one house up and running in Johannesburg that caters for about eleven children between the ages of 4 and 14 years referred by public hospitals in the immediate area. Due to the high-risk exposure to infections, children are analyzed via a detailed Intake Board before admittance.
The efforts by all individuals associated with the Marang House aim toward enabling each child admitted to assume a productive life, realize their dreams, and contribute toward the betterment of their communities. Specifically, Marang House strives for:
- Complete recovery over the medical calamity impacting each child;
- A sustainable, productive life beyond Marang House such that each child has the confidence and willpower to overcome any obstacle they might face;
- Ensuring that each child is able to continue their education and maturity while undergoing treatment;
- Enabling affiliated hospitals to treat patients requiring more urgent medical attention, while our children recover or await further treatment in a homely, stable environment.
Children live at Marang House until the stage that they can return home, that is for instance when they have learned to handle and have accepted their diabetes or when they have received their kidney transplant. Time spent at Marang House varies between several months up until several years.
* Due to the nature of their diseases and the high vulnerability for further infection, Marang House cannot accommodate HIV / Aids cases.
Key Operational Partnerships
As an independent organization, Marang House is not officially affiliated with any of the government hospitals; this allows us to better protect the interests of the children. Marang House, however, works very closely with the various hospitals on a daily basis to ensure that our children receive the proper medical treatments, as we do not take any medical responsibility over the children.
Apart from the government hospitals, the main partners of Marang House are the financial supporters and the local community, who ultimately have to sustain the organization.
Marang House also works closely together with a number of non-profit organisations such as Big Brothers Big Sisters, Proudly South African, Organ Donor Foundation, Kids & Care SA, GreaterGood SA, Reach for a dream (Make-a-Wish Foundation) and the Charities Aid Foundation.
Financial Model
At the moment Marang House cares for a child for 32 USD per child per day, compared to substantially higher costs that the hospital needs to spend on a child depending on the condition. This includes 24/7 nursing staff, all meals, living in a suitable house, emergency medical expenses, clothes, daily transport to the hospital and all the related marketing and project implementation costs to raise necessary funds and create awareness. This amount can still be lowered if more houses would be established and some costs would be shared. This amount also currently includes rent.
The children staying at Marang House do not contribute towards the costs. The entire organisation is sustained by the local community. Money is raised through sponsorships, fundraising events and donations.
What is your annual operating budget?
+/- 120.000 USD
What are your current sources of revenue? (please list any sources that are foundation grants)
Marang House has received (corporate) grants, in addition to the donations received from the local community (businesses and individuals), from e.g. Coca-Cola South Africa, Nedcor Foundation, First Rand Foundation, Independent Cash and Carry (members and suppliers), Royal Netherlands Embassy, Nissan SA, Nashua, Sasol, Wesbank, AngloAmerican Chairman's Fund and Deloitte. A full list is available on our website.
Effectiveness
Marang House has successfully offered a home to recuperate, learn, and play, for more than 60 children during its nine years in operation. With capacity to accommodate 11 children in the home at a time, Marang House has celebrated the successful recovery of more than 35 children who are now positively contributing to their communities and pursuing their dreams. In fact, Dr. Cecil Levy of the Johannesburg General Hospital affirms that more than 70% of the children cared for at the Marang House would not have survived otherwise.
Which element of the program proved itself most effective?
The elements of a home-environment that the hospitals cannot provide these children with have proven to make the noticeable difference. These include: Sunshine*, hope, stability, a happy and stimulating environment etc.
In terms of the sustainability, being established within a wealthy area and involving this particular community with the work that is being done at Marang House has proven to be extremely successful.
* The word 'Marang' means 'rays of the sun' in the African language Setswana, which is what is litterally and figuratively added to the lives of these seriously ill children.
Number of clients in the last year?
During the past year Marang House cared for about sixteen different children. During 2006, Marang House had two deaths and two of its children received successful kidney transplants. Another two left because of their age and one was adopted. These figures vary very much per year.
What is the potential demand?
Marang House is currently in collaboration with the South African Department of Health trying to establish what the exact potential is. As an indication one could say that in the Gauteng Province (Greater Johannesburg and Pretoria area) there are nearly 20.000 children who could at same stage use the service that Marang House provides.
Fact is that Marang House turns down several children per month. Dr. Cecil Levy of the Johannesburg Hospital asserts, “Without the proximity and resources of Marang House, the children I treat would otherwise be dead. If there was capacity for 25 children, I could easily fill up the beds with children of need.” As a result of this success, Marang House currently has a waiting list of suffering children that it cannot accommodate.
Scaling up Strategy
After years of perfecting the model of Marang House, the time has finally come to assist even more desperate children in South Africa who are in urgent need of our help. A comprehensive project/business plan was recently developed by the investment division of one of South Africa's leading banks to establish more houses throughout South Africa. In addition, a number of original funding approaches have been developed to attract a wide variety of different social investors and large donors.
Marang House has also entered into a number of strategic partnerships with the aim of establishing a sustainable second house as soon as possible and to further increase the awareness and communicate the results of Marang House.
Eventually, Marang House aims to have houses operating in every metropolitan area close by the larger government hospitals caring for hundreds of children on a yearly basis.
Stage of the initiative:
1
Expansion plan:
The expansion plans of Marang House relate to the traditional franchising system. The benefits of this system will be applied to the Marang House concept. Effectively this means that ‘Marang House’ will be a national brand with the benefits of being a powerful player within the (international) social enterprise sector and maintain close relationships with government and stakeholders at a national level. On the other hand, as all the houses will be separately operated, the organization can maintain the small scale operations that allow for the local mainly higher-socio economic community to stay actively involved with the organization and take ownership of the house which contributes toward the sustainability and benefits the beneficiaries on a personal level.
Origin of the Initiative
Marang House was founded by the late Dr Pieter Ernst. After Dr Ernst immigrated to South Africa from the Netherlands and started working in the government hospitals, he realized that many children were literally 'living' in these hospitals. In 1998 he seized the opportunity to buy the house behind his surgery and founded Marang House. With the help of his patients, colleagues and the local community, he fixed up the house, cheerfully decorated the bedrooms and hired staff to operate the house.
Dr Ernst was brutally murdered in an armed robbery just outside of Johannesburg in 2005. His then 19-year-old son, Pieter Ernst Jr, committed himself to turn the organization and model that his father created into a nationally operating organization and currently serves on the Board of Directors. Pieter Jr is in the advanced stages of negotiations with various stakeholders.
This Entry is about (Issues)
What are your two main challenges to finance the growth of your initiative
First of all, there are relatively high capital expenditure investments required, in comparison with related projects, as Marang House aims to operate exclusively within affluent areas. These investments, however, are necessary to ensure future sustainability and will not go to waste as they are mainly investments in real estate.
The second challenge would be to create a continuity income. This can be done by for instance establishing an endowment fund or through various fundraising activities where donors are persuaded to rather give a smaller monthly donation than a once of larger one. A continuity income provides sustainability and the foundation for future growth. This continuity income can also be provided partly by the government, with respect to the work and money that we would save them, but that is a challenge on its own.
How did you hear about this contest and what is your main incentive to participate?
We were introduced to this competition by your newsletter and we participate for the exposure and the feedback.
Do you have an annual financial statement?
Marang House is a fully registered and licensed South African non-profit organization. Financial statements are audited by an independent external auditor and are available to anyone on request.
Do you currently have an annual financial statement that tracks profit/loss?
This is also available on request.
Please describe the amount (and/or type) of funding you need to implement your initiative, at year 1 and at year 5.
An initial investment of +/- USD 700.000 is required per house, which includes the purchase of a property and the initial operating costs. In year five the operational costs, not considering inflation, will be around USD 10.000 per month, which includes all the operational expenses.
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