Explore options for sustaining the medical training program for orphans
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A medical training program for orphans was started 2-years ago. Bramuel presented this idea to the hospital board members and they sat together to try and determine an appropriate budget to start the program. They found that they would not be able to realistically manage it if they took too many students, so they decided to start with 3 with the requirement that the student must be orphaned-without both parents.
In 2007, they began recruiting for this program and were able to find 3 students, who graduated and are now working in local hospitals at Patient Assistants. In 2008, they recruited another 3 students. These students will finish their studies on January 30, 2009.
Through this experience, they have found that the cost per student is $15/mo. This covers their education materials, breakfast and lunch. In 2009, they were hoping to have enough funds to recruit 10 students, but unfortunately they do not have enough money to support that. They recently accepted new applications for a new class and received over 40 applicants. They know there is much interest in the local community based on this response. Unfortunately due to lack of funding, they will only be able to accept 3 students again this year. After finishing the course, they provide follow-up with them until they gain FT employment.
The hospital would love to make this a more sustainable program and are interested in obtaining ideas on how to do that. They are looking for organizations that may be able to provide funding, or sponsors willing to donate $15/mo. for 1-year so that they could then increase the number of students. Micro-finance has also been considered as a possible option.
For this task we are looking for suggestions as to how this might be restructured in a way that would allow for the costs to be covered so that the program can be expanded.
Hi!
These are a few questions/suggestions that I originally posted in the Project Room. As there is now a separate task, I will add them here too.
1. Does it (or could it) lead to a recognised qualification for the students? This may make it easier for them to get jobs afterwards.
2. Would it be possible to accept one or two paying students too, to help to cover costs of those who cannot afford to pay?
3. What do the students contribute in return for the training? They may not be able to afford to pay any sort of fees, but they may be able to do some practical things which could help to reduce other costs for the hospital.
4. Also, how about them agreeing that, once they get employment, they pay a certain amount back to the hospital over time? This would not help initially but would mean that in future years, there was money to cover training more people.
Mary
Hi Mary
Good question I think i exceplain this on your first posting as we are not registered with the kenya nursing council as a training institution,
We have only to give training to youths that are orphan for those who can not affort to pay fees on the registered institution.
So our aim of starting this was to help our community that we are safing to gain some knowledge on the medical.
so Mary our stundent pays registration forms only and their we not even able to raise $10 dollars that we charge for the registrations.
this is why we was looking ways that we can sustain this program so that in future more stundent can be willing to join and pay.as you know the more we sustain the program the more of willingness of stundent who can pay will be will to join.
And i can give you an example this year we received about 51 application letters all of this were from eighter in a very poor background families or totally orphans.
so let we think of how we can come up with a strong sustainibility of this program before we can get those stundent wgich can pay.
warmest regard
Bram
Hi Bram
Apologies if I missed you answer to that one first time round! I understand now.
What sort of jobs do they usually get after finishing the training?
Please can you also let us know how the students contribute to the hospital while training (other than money), and whether they pay back any money once they have finished the training and got a job?
Mary
Hi Mary
Thanks for your concern we train this stundent for ward maintanince and patients care as you know the patient must have somebody to care about him/her when he is admited,also we train them on health facility cleaningness.this is why we call them patients assistant their next to Nurses.
stundent contribute a lot to the hospital since in our hospital we don't need a pick number for the patient assistant their do this to the hospital,this is the only way their contribute to the hospital
But the main thing for this training is because it makes the community understand the care of the hospital alot.
I think you understand now but let me know if you have more questions.
Best wish
Bram
hi bram
my name is kevin and am in campus right now. i was just wondering what i could do for your project maybe durimg my free time or weekends. advice me accordingly since am in juja, JKUAT, and i would love to contribute to your project.
thank you
kevin
Hi kevin
First let me take this oppuntunity to welcome you to our village
As you see very body has opputunity to to do something on the village acording to his/her interest you can volunteer online or visit the project and am sure you will have something to offer there.
you are welcome
Best wishes
Bram
Thanks Bram, its getting clearer now!
I think the only question you didn't answer is:
When the students finish their training and get a job, do they pay any money back to the hospital?
If this is an option, it could then be used to pay for the training of future students.
Is the hospital able to cover the costs of the three students for this year. Does that mean that money is not required until February 2010?
What ideas have you discussed already, including things that you have decided would not work? This will prevent us suggesting things that you have thought of already.
You say "Micro-finance has also been considered as a possible option."
Did you come to any conclusions as to whether this would be practical, whether this could be done through local microfinance organisations, and how the loans would be paid back? Would their lending rules allow you to wait until the students have found a job, or would loans have to be paid back more quickly than that?
Total cost per student for a years training is $15x12 = $180, plus whatever it costs to do the followup work which they are searching for a job. So I guess $200 per student would cover everything? Which means $2000 per year for 10 students.
I can think of several options, others will think of more I am sure:
Local microfinance, as mentioned above.
Find outside support.
Either look for ongoing support i.e. have to find donors every year. Not ideal as you are always dependent on outsiders.
Find one-off support in a way that would enable you to keep the scheme running. This could be by the students paying back money once they have a job, as described above, or by the hospital using outside money to start a money making business of its own to cover these (and maybe other) costs.
What do you think?
Mary
Hi Mary
Thanks for your question again
i will answer you one by one of all question that you have raise
1,We tried this that after them getting Job thir will be paying back the fee but we find out it is dificult to foce somebody that is any earning Usd 65 per month and yet he/she is a bread winner on the family of more than five to pay the fee back soon.so we dicedd to give them time but we allow them to offer volunteer services to the hospital when their have time.we reach on this desitions after doing our research to many hospital a round kenya and we find that most hospital pay thir patient assistant or what we call it support staff between Usd $55 and the highest one is Usd $65 and this put us on a very hard desition.
2,Remember as i said early that we only take stundent of total orphan as he/she must be a bread winner on the family.
angain as you know the hospital has no month to month operating budget the hospital has no enough budget to cover this three stundent but we strangle through our board members only because it is something that is in our organizational constitutions.we do this by hopping that one time will people or organizations that will be willing to support the program.
3,On our board meeting we discussed and decide again not to add more stundent untill we find ways of covering this program.we have come up with ideas of having a sacco which will icould both board members,members and staff of Arrow web hospital the sacco will be by the name ARROW WEB HOSPITAL SACCO
any members will be contributing something every month and after establish financialy the sacco will now start giving loans to the stundent and other members of the sacco.i think this was ideas that we as the board members have, but we have not reached to the conclusions yet.
Yes Micro finance is our main option as you look on my above answer after we have made this sacco to the hospital then the sacco will be the main finacing institution to the stundent but our warry is that local financial institutions want if their give a loan to a sacco that sacco must start paying back the loan immediatly.so our hope is that we get an international micro-finance or indevuals that can give the sacco a loan and agree to be payed in a prieod that can be agree through (MOU).
Yes mary you are right Usd $200 enough to cover the training cost for one student per year so I gree with you that usd $2000 will cover all training cost and other extra cost for 10 student good question.
Mary we were not about looking donors every year for the program and this is why we are looking for long term solutions.
I hope you will understand now let hear if you have more questions and am here to answer you.
any body with extra question please
don't hastate to give us your ideas and thoughts and even to ask the question whaterver you feel is feed for this program we need your ideas on this task please.
looking forward to hear from you
Bram
Thanks Bram :)
Do you have a rough idea of how much the students may be able to pay back each month once they have a job?
I realise that may be difficult to answer, as their circumstances will vary and the most important thing is that they have enough money to look after their families.
But I am trying to get an idea of how quickly things could become sustainable without outside support. For example, if they paid back $5 a month, it would take 40 months (nearly three and a half years) for them to pay back the full $200.
So am wondering what other options there may be. I would be very interested to hear what other people think!
If you decide to start your own savings and microcredit scheme, would you need an additional licence/registration for this because you are handling peoples savings money?
Mary
Hi Mary
Great I love your ideas and option this is not possible to have ideas of how much that this student can pay back in monthly because if i can just give you a simple budget of usd $ 65 here in kenya now you can not believe it
exp 2kg of unga ugali usd 1.5
2kg of suger usd 2.4
2kg of rice usd 3.0
so as we i continue to this budget you will find that amount is very small to tell somebody that pay this per month to cover your training cost
as i told you early we done our research before we decide to seek your ideas
I think Mary the main option to have this program have sustainable is to have this sacco up and running and get a one time supporter who will be willing to invest to the people of kayole-soweto through Arrow web hospital sacco
Mary again you asked if we need to have another license to operate a hospital sacco no in kenya we are allowed through our NGO certificate as per our constitution of empowering the community in health care and economic future to open and run a small micro finance under the hospital project.
i think you are okay now
looking forward to hear from you
Best wishes
Bram
Bramuel-
Thank you for the great information on what's been considered thus far. Can you please email me a copy of the overall hospital budget showing income and expenses month to month?
Jennifer
Hi Jennifer
I think you have this i email you some time ago unless you want me to resent to you.
let me know
Bram
Bramuel-
I am not familiar with the term "Sacco" can you explain what that is? From your description, it sounds comparable to a hospital foundation here in the United States. Are you basically saying that you and the board have discussed taking a microloan as "seed" funding to get the Sacco started? How would it then be maintained long-term? Through donations of the board members or fundraising efforts?
Jennifer
Bramuel and I spoke on 2/15/09 about the options for the Medical Training Program and he provided more details about the establishment of a Sacco. Bramuel explained that a Sacco is a hospital financing organization. Every hospital is allowed to have one and they can then take loans from the Sacco once it has the money to be established. A Sacco functions basically as a financial partner to the hospital. The Sacco officers must be within the hospital and staff that run it must be from the hospital, but the Sacco can elect it's own individual board. The board is of the opinion that in order to sustain the training program, a Sacco must be established at the hospital.
In order to start a Sacco, Bramuel tells me that they must have about $6,000 available. This will allow the Sacco to be recognized by the Sacco Association of Kenya, the board that monitors Saccos. This has, of course, been the limiting factor preventing them from moving forward at this time. The Sacco is responsible for fundraising once it has been recognized.
The Board's idea is to find a partner organization that has the same in their country of origin and see if they would be willing to fund the start of a Sacco in a developing country. If so, they would suggest that an MOU be established that would allow Arrow Web Hospital to function as their agent in Kenya.
Arrow Kenya, the umbrella organization that manages Arrow Web Hospital, is not permitted to run a Sacco due to their registration status. They are not permitted to run any type of microfinance program. I asked Bramuel to provide an example of a Sacco operating in Kenya. He gave me a few, here are two of them:
http://www.mwalimusacco.com
Moi Teaching and Referral Hospital-Eldoret (I wasn't able to get their website to pull up today to link it, but they do have one)
According to Bramuel:
"First we have asked the willing members both of the ARROW-KENYA and those of ARROW WEB HOSPITAL to come up with a registration fee per month per member then we can see how we can start now but already we have arranged a room for the sacco office in the hospital and choose sister Janet as the chair of the sacco and lab teck winfred as the tresurar of the sacco we hope we are now looking for the money to start the sacco."
Bramuel believes that if they find an organization willing to provide the $6,000 USD they need to start the SACCO, the hospital sacco should become established enough that they will be able to begin repayment of the $6,000 USD within a 6-month time frame.
I hope that helps to clarify the discussion thus far.
All the best-
Jennifer
Hi Jennifer
From a little wandering of the internet which led me to http://www.cuna.org/newsnow/08/system080108-5.html
"Credit unions in Kenya are known as SACCOs (savings and credit cooperatives)."
http://en.wikipedia.org/wiki/Credit_Union describes a little more about how they work, although exact rules will vary around the world.
Bramuel, is this the same thing?
Mary