Spreading cheer: TeleDoc workers Shriya Dhar (left) and Sumeet Sagon provide healthcare to villagers at low cost

I am feeling much better now, doctor." The speaker is 100-year-old Jairoh Devi, and her rasping voice brings a smile to the faces of those gathered around her: a sundry crowd of relatives, interested villagers and health workers. "Please don't let her die without seeing her great granddaughter's wedding," jokes one of her relatives. This could well be a scene from a Bollywood melodrama but it isn't. Jairoh Devi is for real, as is her recovery. She lives in Pratapgarh (pop: 700), a village in Haryana, one of the 30 in the state that serves as a setting for TeleDoc, a pilot project in rural healthcare that is the brainchild of the Faridabad-based Jiva Institute, a non-governmental organisation. And for the record, the man responsible for Devi's cure, Sumeet Sagon, isn't a doctor at all.

TeleDoc is built around two strands that are a few thousand years apart: the ancient Indian medical system of Ayurveda and the as-recent-as-you-can-get phenomenon of mobile telephony. Every day, three TeleDoc workers, each armed with a Nokia 6800 phone (you've seen it; the one that comes with a flip-top; flip, turn by 90 degrees and presto, you have a qwerty keyboard), fan out to the 30 villages the project covers. At each village, villagers gather at a designated place to discuss their ailments with the teledocs. The teledoc transmits this information through the GPRS-enabled phone and a Java-based software to a team of five Ayurvedic doctors at Jiva's Faridabad clinic. The doctors analyse the symptoms and prescribe medication; medicines are compounded at the clinic itself and delivered the following day by the teledocs. The phone is a recent addition (October 2003). When the project started in September 2002 with a Rs 23-lakh grant from New York-based Soros Foundation, the teledocs used handheld PCs, then Simputers. Jiva's doctors could access patient information only when the teledocs returned. The 6800 changed all that.

"There are 3.1 lakh villages in India with a population of less than 500," says Rishi Pal Chauhan, President, Jiva Institute, "and 77,500 of these do not even have a shop." "Over one lakh have just one small shop that sells beedis; none of these villages have proper medical facilities, so we decided to do something for them." Chauhan's target is what he terms the bottom of the pyramid, people earning less than $1 (Rs 46) a day. Yet, Jiva's TeleDoc project isn't about charity.

A Cause With A Business Model

TeleDoc isn't about a well-intentioned NGO working for the benefit of the less privileged; it is about a sustainable business model (why, Jiva even boasts an American exec-Steven Rudolph designated Director). Jiva's founders like to call their organisation "a social enterprise". Jiva charges its TeleDoc patients Rs 70 a week. "Villagers pay when they see it works," says Rudolph. TeleDoc currently services 1,500 paying patients; that's some Rs 1,00,000 in revenue every week. Encouraged by this response, Jiva proposes to take TeleDoc national by April 2004. "By April 2005 we will cover 5,000 villages and earn a profit of Rs 8.42 lakh," claims Chauhan. "By April 2006, we will cover 10,000 villages and return profits of Rs 2.5 crore."

TeleDoc is built around ancient Ayurveda and state-of-the-art mobile telephony, and has a sustainable business model

A franchising model will facilitate reach, reckons Chauhan. And he expects that to come with its own path to profitability. "Large companies find the top of the pyramid saturated," he explains, referring to the fact that urban markets for most product categories have been exploited to the extent possible. "They want to target the bottom now but there's a problem: the cost of delivering something to a far-flung village is sometimes more than its cost itself." Teledocs, he reasons, can do as much, for a commission. The way Chauhan sees it, everyone wins: villages get access to low-cost healthcare and other products (at their doorstep); and companies gain access to villages at a viable cost.

Jiva has other revenue streams as well: a school that charges Rs 500 a month; textbooks, up to Class V that Jiva has published, incorpora-ting what it terms 'India's Curriculum of Tomorrow' (ICOT), which it sells to 500 schools across India; an ayurvedic website ayurvedic.org that sells Ayurvedic products; and an online Ayurveda college targeting overseas customers and offering courses in Ayurveda at anything between Rs 1,600 and Rs 68,000 a pop. "The face of non-profit will change from NGOs to social enterprises in the next 10 years," gushes Rudolph, a wealthy American who came to India at Chauhan's instance and who believes that technology and innovation can create a rural economic boom in India.

Scaling It Up

NGOs may go the way Rudolph expects them to, and become social enterprises. And they may not. However, Jiva's effort at providing distance health services to the poor has received some recognition, in the form of a World Summit Award. These awards are presented by the UN and the International Telecommunications Union (itu) to organisations that use technology to bridge divides. Of the 40 awards presented this year, Jiva bagged one in the e-health category. The only other Indian entry to win an award was n-Logue Communications, a company promoted by IIT Madras' TeNet Group, which offers low-cost internet and telecommunications services in rural areas.

The award has brought Jiva and TeleDoc some attention: requests have come in from Sri Lanka and Indonesia to run pilot TeleDoc projects. And ITC (which runs a chain of hybrid offline-online e-choupals; see Distribution's Disruptive Duo, Business Today, January 18) and n-Logue have both expressed interest in taking TeleDoc to the villages where they are active.

Last word: TeleDoc remains a pilot project. For it to go national, Jiva's social-enterprise model-it looks good on paper-needs to work. Jairoh Devi and her ilk must be praying it will.

Where are the mall managers?
Malls, malls everywhere; not too many mall managers around.

In the next couple of years, by some estimates, 300 malls will come up all over India; they will occupy some 400 million square feet of prime real estate. In addition to the existing ones-Delhi's satellite Gurgaon alone boasts five-this translates into a veritable explosion of malls. That's the good news. Now for the bad news: Anil Rajpal, a manager at KSA Technopak, a retail consultant, believes that mall managers could soon become scarce. "With people (read: developers) possessing little or no skills entering the sector, the services on offer at most malls will leave much to be desired," he adds. "The balance of power will shift in favour of retailers." Put simply, space on several malls will go abegging, and lease-rentals on the rest could decline.

Rajpal's assessment is probably accurate: most emerging areas-and there's no denying the fact that the business of malls is still a recent phenomenon in India-go through similar growth pangs. Rajpal himself points to the organised retail business. All through the 1990s, entrepreneurs and companies of various hues tried their hand at it, only to realise that managing a retail establishment wasn't exactly child's play. If the sector survived (and thrived), it was because it managed to attract the best talent from the fast moving consumer goods and consumer durable businesses and adopt best-in-class practices.

The malls that survive, says Rajpal, will be those that address everything from marketing to infrastructure to location to design. Unfortunately, there don't seem to be too many mall managers around. And most developers are clueless about the kind of expertise required or where to find people possessing such skills or both.

However, not all developers share this point of view. Ajay Khanna, CEO (Malls), DLF Universal, believes "need throws up the kind of manpower required". B-schools, he adds, have already introduced courses on retail management. And DLF trains its employees on the finer aspects of mall management internally. Developers putting down just one mall or so, believes Khanna, could face problems, not a company like DLF that plans to develop, over the next 18 months, 18 malls across North India with 15 of these in Delhi and its environs.

Just what does a mall manager need to do? "A mall is like a ship or hotel," says Khanna. "It has separate infrastructure departments for housekeeping, parking, security, air-conditioning and the like; then, there are other departments like marketing, accounts." DLF hires service industry experts and people with an armed forces background for both kinds of positions. Retail chain Shoppers' Stop believes there needs to be a clear demarcation between the operational and support roles. "A mall manager is synonymous with a Unit Head and is responsible for sales targets and the hr function," says Indu Lamba of Shoppers' Stop. Ergo, a mall manager has to be customer-oriented, and possess leadership and communication skills. S.A. Khan, Deputy gm (hr), at MGF Developments, part of the MGF Group, a recent entrant into the malls business puts it best. "A mall manager's job is a complete one, much like managing a small city." The universal scarcity of such managers could explain the state of our cities.

-Payal Sethi