Nepal Ventilator Bank

With the Covid 19 pandemic scaling a steep upward curve, businesses and individuals are the only ones who have taken a hit. Perhaps one the most hard-hit sectors of the country is the medical sector. Given the highly contagious nature of this disease, hospitals and medical institutions have had to work over-time to even provide initial care to patients. A lack of medical infrastructure and medical professionals has not done much to help alleviate this national burden. What is even worse is that a good deal of the equipment that does exist is in disarray. Even life saving devices such as ventilators that are crucial during the pandemic are only available in low volume. This is where the people behind Nepal Ventilator Bank sought to help. Understanding that with the pandemic on the rise, it was only a matter of time before medical institutes across the country would be forced to turn away patients, a group of five entrepreneurs, academics and medical professionals sought to step in to help hospitals get their hands on life saving equipment without having to invest money. Through Nepal Ventilator Bank, a non-profit started only in April 2020, the group has been working to deliver ventilators through a shared economy model.

The predicament

With stories of patients being referred from one hospital to another, and even incidents where a pregnant woman lost her life due to an apparent lack of working ventilators; people were instilled with fear and anger. Reports suggested that when the lockdown first started, Nepal had fewer than 300 working ventilators of which a majority were located in Kathmandu Valley. This number has since grown larger through numerous charitable donations and investments, but the number of people that are testing positive for Covid 19 has also been growing at an exponential rate. It became clearly evident that it simply wasn’t sustainable for hospitals to keep on buying expensive ventilators. Statistics deem that approximately 80% of Covid 19 patients have been shown to recover without the need for any special treatments. However, it also means that 1 in every 5 patient will develop difficulty is respiration and will require life-saving ventilators for any chance at survival. A quick look at the numbers at the time of writing this article shows that there have been almost 80,000 Covid 19 cases in the country, of which almost 23,000 cases are still active. Comparing these numbers with the 1-out-of-5 ratio would mean that there are over 4500 patients that still need critical medical care.

“We work on a shared economy model, just as how Uber or Airbnb works. Here you have an inventory of cars or homes that you can use and rotate to people at a low cost. Just like with Uber, you don’t need to buy a car to ride a car, our philosophy is that you don’t need to purchase a machine to use a machine.”

Dr. Bishal Dhakal

How does the Nepal Ventilator Bank work

At its core, the way in which Nepal Ventilator Bank works isn’t much different from how a car rental company function. The idea is simple: provide ventilators to medical institutes at a minimal cost. Dr. Bishal Dhakal, a medical professional and entrepreneur who is also one of the founders of Nepal Ventilator Bank explains, “We work on a shared economy model, just as how Uber or Airbnb works. Here you have an inventory of cars or homes that you can use and rotate to people at a low cost. Just like with Uber, you don’t need to buy a car to ride a car, our philosophy is that you don’t need to purchase a machine to use a machine.” Currently, the newly formed NGO has been leasing out ventilators at a rate of Rs.3000 a day for private hospitals and a rate of Rs.2000 and Rs.1000 per day for community and public hospitals respectively. With some private hospitals charging as much as Rs.9000 for a day of ventilator support, having the option to lease ventilators would mean that patient would have less financial burden when it came to the matter of end-of-the-line healthcare. But leasing out ventilators is not the only thing that Nepal Ventilator Bank has been working on. It has also been putting in effort to provide maintenance and refurbishment for machines that have fallen into disrepair. “Around 50% of the ventilators that were available in Nepal, especially in public hospitals, were defunct and useless,” claims Dhakal. The Nepal Ventilator Bank is also working to provide training to the use of these machines stating that their primary focus is on machines, maintenance, and training. “We are not just looking at the ventilator side of things, but rather we are trying to transform critical care cost price.” tells Dhakal. He further expands that the NGO is looking to build frameworks for a critical care ecosystem; one in which smaller hospitals are able to care for patients without having to refer them elsewhere while reducing the overall cost of care.

The economics behind ventilators

At the time of writing, Nepal Ventilator Bank has expanded its inventory to 60 ventilators from the 10 it first started with. The NGO has been primarily looking to find the budget for its operations through crowdfunding. “We are actively engaging our corporate links and friends; people who are able to share some of their resources. There have even been donors who have sent us money without even mentioning their name.” While an average ventilator can cost around Rs 15 lakhs, Dhakal maintains that they have had a lot of positive support from donors within the country as well as some donations from some crowdfunding platforms. Further the NGO has also worked with national banks such as Laxmi Bank and Nepal Merchant Bank to acquire low interest loans and to get letter of credit. While the cost for infrastructure up till now has been covered by donations, the NGO still needs to worry about maintenance, training, operational and logistical costs as well. This is why the Nepal Ventilator Bank has to charge hospitals that are leasing ventilators from them. Seeing how it benefits both hospitals and patients to outsource equipment like ventilators, Dhakal believes that the Nepal Ventilator Bank is bound to become a useful resource. It is because of this that the NGO wants to expand to a more diverse product line with more complex machines. With the seemingly never-ending pandemic wreaking havoc on the Nepali health care system, critical health care and medical equipment has been highlighted as essential needs for hospital and clinics across the country. The short-comings that can be seen today, during the Covid 19 pandemic, seem to only be a byproduct of a much larger problem when it comes to the matter of a much greater problem within the healthcare system. It seems that right now the efforts made by Nepal Ventilator Bank is a corrective first step in solving one of the many flaws in the medical system, but is it the right model of solution remains to be seen.