Voluntariado

Nevara's visionary leader has been studying entrepreneurship for 15 years, with 14 years in higher education, focused on how to maximize impact. In the 4th year of his PhD, he is doing action research - bringing together all his insight in recruiting passionate interns to join Nevara, in additional to preparing a new class called Impact Assessment.

While much of the efforts recruited to improve quality, efficiency and sustainability is done out of goodwill and passionate students volunteering their time - Nevara has reached a bottleneck caused by financial constraints.

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The two biggest barriers preventing the blind from getting treatment are awareness and affordability.

Indonesia has 9100 primary care clinics but the clinics’ role is passive, treat only patients who come. Many blind patients don’t go to clinics, believing it is not treatable, doubtful over the quality or the treatment is not affordable.

The cost of cataract surgery is USD450/eye at public hospital, too prohibitive for the 120 million Indonesians (50% of the population) who earn less than USD2 a day* (*source: The Jakarta Post, Beyond Statistics of Poverty, Iin P. Handayani, February 13 2012)

Thus, surgery output is very low (averaging less than 10 cataract surgeries/hospital/week), making Indonesia the country with one of the lowest Cataract Surgical Rate in the world.

Solution: break the awareness and affordability barriers.

Awareness:
* Regular training to grass roots resources (Babinsa, village chiefs etc.)
*Use media to help improve public awareness on avoidable blindness.
* Increase accessibility to treatment by providing transportation to the hospital.
*Improve the surgery quality by training and incentivising medical and hospital staff.

Affordability:
* Make available high quality and affordable community eye hospitals.
* Targeted free (charity) cataract surgery to ensure the unreached is reached.
* Document surgery output and outcome; share this data with the public and policy makers. This is useful in advocating eye health to policy makers.

Our vision is a world where no one is blind needlessly.

Technology and accessible treatment are available for 80% of blindness (cataracts and refractive errors; source: Vision2020, International Agency for Prevention of Blindness).

No one should remain blind simply because of lack of awareness or inability to pay.

Utilize our international and local network to mobilize local community to take part in ending avoidable blindness.

ANV is a young organization with little resources but we have made good impact in local community and we are well known for high volume and high quality cataract surgeries. We are on the right track to take the work to the next level – drive the building of sustainable community eye hospitals.

We can collaborate with non-traditional partners (Babinsa and private social enterprise). We also collaborate with large INGOs - The Fred Hollows Foundation (www.hollows.org.au) to share knowledge and compliment each other’s work.

Our customers are:
1. Paying patients
2. Non-paying patients

Profits made from paying patients are used to fund subsidized or free treatment to the unreached.

The quality of treatment is the same for both paid and free patients. Only the level of comfort in service differentiates the two categories of patients.

Community education – basic eye health training for Babinsa, village chiefs, local women associations, religious and community leaders.

Publicity – media (radio), stage play, flyers, banners.

Making accessibility easy – provide scheduled and regular transportation to the hospitals.

Referral by shareholders – members of the private social enterprise and local ophthalmologists association are likely to refer customers to this hospital.

Word of mouth – high quality yet affordable treatment with good service experienced by patients will be invaluable referral for future patients.

- Community education on basic eye health.

- Build the capacity of local medical team by funding intensive quality training on cataract surgery.

- Equip trained local medical team with mobile equipment and encourage them to actively take part in community work including charity surgery events held by other NGOs.

- Drive private social enterprise to start the building of sustainable community eye hospitals.

- Connect the private social enterprise with other INGO (eg. The Fred Hollows Foundation) for additional support.

- Advocate policy makers by presenting record and output and outcome data from our activities.

There are no real comparable peers or competitors in what we try to do. Private for-profit eye clinics/hospitals may see us as a threat and competitor but it is a misguided because there are so many patients who are currently not serviced due to lack of awareness, trust (quality) and affordability.

For the middle to upper middle class patients, their trust in the local quality of surgeries is low. Many choose to have their cataract surgeries abroad even though it costs a lot (Malaysia, Singapore)

Our challenges are For-Profit eye hospitals who are going to view low cost high quality eye hospitals as a threat to their business and they might use local ophthalmologists association to influence the authority to stop this hospital from operating.

To overcome, we encourage private social enterprise to invite local ophthalmic association to have profit shares in this hospital.

The local ophthalmic association keep their share of profits. Only share of profits owned by private social enterprise will be used to subsidize free treatment for the poor.

As a result, local ophthalmologists will also help refer patients to this hospital and help it grow.

Overtime, the market will prove that the greater the public awareness, the more patients for everyone.

The strategy is to have one sustainable community eye hospital operating by year 2014, this gives us one year to secure crowd funding, recruit and train personnel, refurbish the hospital, increase the training to the community.

Once the hospital is running, the operating model can be quickly applied to the second and third hospital in other provinces.

There are public demands and interest from social enterprises.

First three years: new regions (other provinces)

After three years: with good reputation established, the hospital can:
* Expand the scope of treatment to include other eye sub-specialties.
* Reach to customers who currently seek treatment overseas.

The growth objectives we envisage are:
* To replicate this hospital model across Indonesia’s 33 provinces.
* To influence policy makers to place greater resources on eye health and put eye health on priority health list.

Please kindly refer to answers in 3.2.a and 3.2.b above.

By spreading the word of my venture throughout the State in order to prepare for a longer more difficult phase in which I will expand my venture nationally

By gaining recognition on a national level as an organization that positively effects communities around the nation

I will measure success not by the amount of money I raise towards my cause, but by the amount of people which my venture affects. Although it is only aimed towards helping children with Autism, I believe that my venture will allow communities around the nation to come together in order to fight for a common cause.

Patient leaders have a valuable role to play in tackling the problems facing health and social care at a national and local level, but we need to improve the development of and access to learning opportunities in order to grow this pool of talent, Amidst chaos of reform and unprecedented challenges to improving health, the biggest asset we have - people who live with health problems and use services - remains untapped. Instead, patients are a problem to be solved, not the solution. Meanwhile, patient and public engagement has been co-opted by institutional interests as a buffer against change, rather than as a co-production engine for it. We need a new generation of 'unusual suspects' who can act strategically to help tackle crises in health and social care

Patient leadership is:
Rooted in self-leadership - patients learning about themselves to steer their own life.
A work in progress - good leaders develop through continuous learning
Dependent on context - involves a complex mixture of interdependent behaviours

Our learning approaches incorporate:
Co-design and co-delivery
More than ‘chalk and talk’ - We use highly interactive methods
Working with what happens in the room - Leaders learn from practicing and reflecting on how they behave
Acting into a new way of thinking - We help people to construct meaning and knowledge from experiences by practicing on their ‘live’ issues
Working with others – integrating dialogue and inquiry
Process skills of leadership - skills of relationship-building and influencing

We provide patient leaders - patients, service users and carers who influence change with:
Learning and Support - a variety of face to face offers and facilitated e-learning
Network and Community of Practice - Patient Leaders become Members of The Centre for Patient Leadership
Ongoing support to take next steps

We provide healthcare organisations with support based on co-production principles to foster patient leadership

Equipped with the capability to influence change, PLs will help shift power relationships underpinning healthcare to a truly patient-centred model. This will transform:
Patient experiences and outcomes (responsiveness)
Quality of decision-making (transparency, governance and accountability)
Trust and confidence
Financial viability of healthcare systems

We are in a unique position with regards to the UK and international market, as
Thought-leaders (around the policy and practice of patient leadership)
Pioneers in providing learning and support to a new generation of health leaders able to shift the very fabric of how health and healthcare is delivered.
Offering constructive and sustainable solutions to healthcare organisations in the current economic climate

Our customers are two-fold:
1. Health and healthcare organisations (customers) - local, regional, national, international - these organisations resource individual beneficiaries (patient leaders) who are:
2. Patients, service users and carers (direct beneficiaries)

We have run learning programmes for organisations at national, regional and local level (e.g. NHS Commissioning Board, now NHS England; NHS Institute for Innovation and Improvement; Midlands and East Strategic Health Authority; National Voice - the umbrella organisation for the health voluntary sector; various commissioning organisations and provider trusts). We have undertaken a variety of programmes, ranging from one day workshops to five month programmes (with coaching) to over 500 patient leaders.

We have marketed progammes to commissioners, providers & national agencies. Given the shifting policy environment, our marketing strategy will segment in the following ways, towards:
1. National agencies (in service development, research, third sector) - these will also help ceate the environment for patient leadership
2. Commissioners of health and social care
3. Providers (acute hospital trusts, community and primary care providers)
4. Condition-related organisations/initiatives (eg. building on recent success in renal field) & moving towards focus on long term conditions
5. Locality and regionally based work (building on recent successful programmes in the Midlands)

Each of the above require bespoke business cases that focus on relevant incentives (e.g. safety for hospitals)

We provide
Learning and support for Patient Leaders
Networks and communities of practice;
Information, advice and support for Patient Leaders

For organisations:
We provide organisational development support that fosters the cultures and systems for patient leadership (NB. We have just produced the first Guide for NHS organisation to foster patient leadership - see 'resources' section on our website)

We also undertake research and policy with partners that will help create the wider cultures and systems and enviornment for patient leadership

We are unique thus far. National professionally-led training organisations are beginning to take an interest in patient leadership, but don't (and may never) truly understand the model; Patient-led & Third Sector organisations are at an early stage of being able to deliver training programmes and these are based on very different learning models to those we believe in and offer.

There is a window of opportunity (3-5 yrs) to create a social movement for patient leadership before an idea like this is 'captured' by mainstream organisations and distorted to fit institutional needs and the status quo. In this time, In this time, our work needs to support & develop a critical mass of patient leaders who share the values and have the skills necessary to radically shift the face of healthcare

The current policy and practice environment is volatile and organisations do not yet recognise the value of patient leadership - and may not want it if they truly understood it! On the other hand, the steep rise in demand demonstrates that another set of players want us to step up to the mark. To overcome this paradoxical state of affairs, we need to:
Hone and articulating the vision - communicate the business case to all stakeholders
Build capacity for delivery at scale and pace
Refine the operating and business model
Clarify roles & responsibilities;
Move to mixed investment strategy
Ensure quality
Beware of mission creep (eg other areas of citizen/lay leadership)
Stick to our values
Develop range of accessible learning offers/curriculum (incl. facilitated e-learning)

These phases are largely being run in parallel:
Phase One: Market Research & marketing strategy based on refined assessment of current landscape and potential funders (including assessment of investment and philanthropic options)
Phase Two: Building infrastructure, operating model and capacity for delivery at scale;
Phase Three: Developing the offer (to patient leaders, organisations)

We have significant interest in our work from organisations & Patient Leaders themselves; hugely positive feedback from programmes (500 'alumni') Recent experience of delivery at scale and pace; Proof of concept of operational and delivery model (incl train the trainers; online network; virtual learning environment); high profile (e.g. articles and network interest)

In the next 3-5 years, we aim to grow from £100k/yr turnover to £1-2m/year (yr 2) and double that by year 5. This will depend on developing 'Patient Leaders' as the 'go to' place for an expanding range of learning programmes and establishing the Centre for Patient Leadership as a non-profit making research & policy organisation.

Short term (1-2 yrs): £500,000 turnover, six new learning programmes (300 alumni); development of online network; six new core associates; Establishment of operational model to deliver at scale and pace (with financial director on board at least p/t and project manager f/t)
Medium Term (3-5 rs): £1-2m turnover, 40 programmes, expansion of offers; Thriving membership of community; UK-wide delivery;

NB. There will be a general election in 2015 and this will inevitably lead to shifts in policy and practice. We will need to adapt our work and growth plans for these circumstances.

O Brasil é um país de desdentados. Pesquisam indicam metade da população brasileira não tem todos os dentes na boca e um terço dos adolescentes de escola públicas nunca foram ao dentista. No resto do mundo, o problema não é muito diferente.
Para agravar esse quadro, o acesso da população ao kit dental (escova, pasta e fio dental) que é a unica ferramenta que previne os malefícios bucais, é muito limitado (a falta do kit dental nas cestas básicas e nos postos de saúde, é uma prova disso). Além disso, a sociedade ainda não vê o acesso a saúde bucal como um direito e integrado a saúde, e sim, como uma especialidade de luxo.
Por outro lado, o governo não oferece nenhum programa viável de mudança e a classe odontológica, no geral,não se enxerga como agente de transformação social e de saúde.

O projeto Dentista do Bem gerencia uma rede de dentistas voluntários que atendem em seu próprio consultório jovens carentes de 11 a 17 anos que estão com condições bucais graves.
Todo o acompanhamento do tratamento – seleção, encaminhamento, monitoramento do tratamento mensal e desligamento – é feito na sede do projeto.
O projeto tem como base 3 públicos: o dentista voluntário (que atendem um ou mais jovem no seu consultório – a seu critério); o beneficiário (que é atendido pelo dentista e selecionado em triagens em escolas públicas ou instituições) e, finalmente o coordenador regional. Este, também é dentista e voluntário, mas tem como missão ativar o projeto na sua cidade através de realização de triagens e cadastramento de novos dentistas voluntários.

A nossa visão é ajudar a criar um mundo onde todos possam sorrir e a nossa missão é mudar a percepção da sociedade sobre a questão da saúde bucal e da classe odontológica com relação ao impacto socioambiental de sua atividade.
Nossos objetivo é oferecer soluções de acesso a tratamentos odontológicos com caráter curativo, preventivo e educacional.
Nossas propostas:
Para a sociedade
Promover soluções de acesso a tratamentos odontológicos.
Para a classe odontológica
Valorizar e mobilizar os profissionais para uma nova conduta socioambiental.
Para o setor empresarial
Discutir práticas éticas no setor odontológico.
Incentivar produtos e serviços de baixo custo que promovam acesso.
Inspirar condutas responsáveis em outros setores.
Para o Governo
Influenciar e mudar políticas p

Com o resgate da saúde bucal, buscamos aos nossos beneficiários:
- Aumento da qualidade de vida
- Facilitação de entrada do mercado de trabalho, visto que todas as empresas e serviços não contratam ou tem discriminação de pessoas desdentadas. E, consequentemente, aumento da renda familiar mensal.
- Resgate da vida social e familiar, devido ao fato que quase a totalidade dos novos beneficiários sofrem bullying e discriminação social nas escolas e círculo social.

Jovens de 11 a 17 anos que estudam em escolas públicas ou instituições sociais, pobres e que apresentam condições bucais graves.
A escolha desse público vem dos seguintes fatos: o impacto social de uma condição bucal grave é muito maior em um adoslecente do que em um adulto (ambiente social, empregabilidade, bullying etc) e a dentição já esta formada (comparado às crianças)

Triagens em escolas públicas e instituições sociais. O coordenador voluntário junto com a diretora ou assistente social reservam um horário para a aplicação da triagem nos alunos matriculados.
O coordenador voluntário faz um exame visual não invasivo em todos os jovens e prenche uma ficha chamada IHC. Nesta ficha também mostra a condição social do jovem triado.
Em seguida, o coordenador enviar todas as fichas de IHC a sede da organização que seleciona a partir de 3 critérios: os mais velhos (mais próximo do 1 emprego), mais pobres e os que estão com as piores condições bucais.

O Dentista do Bem, através da sua rede de voluntários, oferece tratamento odontológico gratuito para jovens de 11 a até completar 18 anos de idade. Ou seja, um vez no projeto o jovem só sai quando completa a maioridade e recebe todo tratamento que necessita (inclusive ortodôntico).
Sorriso do Bem – capacitação para coordenadores voluntários. Evento de 4 dias que, além de ensinar aos novos coordenadores, tem como missão motivar, alinhar e oferecer treinamentos para os antigos coordenadores da rede. Em 2012, o evento recebeu 400 coordenadores de 12 países.
Sorriso do Bem – Premiação. Evento de premiação, aberto ao público, que tem como objetivo valorizar o trabalho dos melhores voluntários da rede. Dem 2012, o evento de premiação recebeu 1800 convidados que foram recebidos no Teatro Abril

A Fundação Abrinq possui o projeto Adotei um Sorriso, mas ao contrário do Dentista do Bem, este não possui um critério de seleção de beneficiários.
No geral, os dentistas e clínicas acabam prestando algum tipo de serviço gratuito ou voluntário em algum nível para a população carente.
O problema é que a população, e mesmo a classe odontológica, que participam destas atividades pontuais acreditam que os problemas odontológicos e sociais estão resolvidos, o que é longe da realidade. Outro problema é que muitas vezes por conta desses serviços, acabam fechando as portas para os coordenadores voluntários nas escolas públicas: muitas vezes a diretoria da escola – que tem autonomia final – barra a entrada do projeto por acreditar não existe mais problema na sua área.

Atualmente, o projeto é 90% financiado por mantenedores (empresas). A médio prazo o projeto conta com uma estratégia inverta essa porcentagem e passe a depender menos do investimento social privado.
Uma das estratégias é a criação de um fundo de reserva através da venda de produtos odontológicos, cujo lucro seja revertido para o projeto.
Outro desafio é levar o projeto para áreas rurais onde não tem destista. Hoje, o modelo do Dentista do Bem é essencialmente urbano. Por isso, fizemos estudos de implementação e desenhamos alguns projetos em áreas distantes de grandes centros, tanto no Brasil como no continente africano.

Aumento do número de voluntários, beneficiários e áreas e países que o projeto atua.
Diversificação das fontes de doações e recursos da organização.
Implementação do projeto em áreas rurais e longiguas onde não tem dentista, como continente africano.

Desenho estratégico e organizacional sólido do projeto.
Equipe de funcionários altamente capacitada.
Implementação de novas estratégias ainda esta ano: megatriagens abertas ao público no Brasil todo, venda de produtos com parte do lucro direcionados ao projeto e mini capacitações para novos coordenadores.

Aumento de voluntários, beneficiários e expansão para novos aéreas e países.
Além disso, diversificação de doações e parcerias.

O Projeto tem uma meta anual de beneficiários. Até 2015, pretender contar com 65 mil pacientes e 30 mil dentistas.
Para isso, devemos implementar os evento de mini capacatiações de final de semana durante o ano – colocando novos coordenadores no projeto.