Neighbourhood kidney care

Long queues outside top government hospitals are testimony to India’s fledgling public health system. Services as basic as dialysis centres are largely restricted to Tier-I cities and these would structurally be one big centre located typically within government hospitals. This leaves no alternative for the patients living in the suburbs and outskirts, but to travel long distances every two-three days to get their routine therapies. In some cases, patients are covering nearly 100-150 kilometres to reach their nearest centres, leading to a risk of infection or worse, people increasingly dropping out of the treatment.

“In India, only 30% of kidney ailment patients actually manage to get their dialysis therapies”, states Shashank Moddhia, founder, The Renal Project. The biomedical engineering graduate from the University of Texas stumbled upon interesting titbits about the field of kidney care in the Asia-Pacific region, during his last job as a quality manager at Baxter International. “The company makes kidney care products. While we were thinking of building innovative and futuristic products in the company, I decided to check how many dialysis machines we had sold in various countries. I was intrigued to know that we had sold only 600 in India against 2,200 in Hong Kong. I started digging deeper,” he says. 

Owing to these startling discoveries, he decided to set up micro-dialysis centres at various neighbourhoods, focusing on the outskirts, suburbs and the neighbouring towns and villages by tying up with local hospitals. These centres are mostly 200 sq. ft rent-free spaces with two-three beds, at partnering hospitals. The start-up doesn’t have to pay for water, electricity and emergency ICU facilities either. Instead, it works on a variable revenue sharing model with partnering hospital. The start-up charges around Rs.1,200-1,300 per dialysis session, which can go up to Rs.4,000 for an emergency-basis dialysis at night. “The Rs.4,000 we charge are the professional's costs. It can go as high as Rs.10,000 at regular hospitals,” says Moddhia. Starting with just one centre in Mumbai’s northern suburb of Borivali in May 2019, The Renal Project now has over 15 dialysis centres across Mumbai, Nashik, Thane and Pune.

The start-up's first big break was when it got incubated under Niti Aayog’s Atal Innovation Mission at AIC-NMIMS. Then, came the seed fund of Rs.2.5 million from 100X.VC in November 2019. Following this, the start-up has already raised around Rs.25 million from a battery of angel investors. Initially, Moddhia invested about Rs.400,000-500,000 to open a new centre, besides arranging the dialysis machines on a rental basis. “Just from the revenue of the first centre, we had sufficient capital to open a second one in three to four months," he recalls, adding, "There are mohalla clinics at some places that would charge Rs.250-300 per dialysis, but they are usually able to do this due to the funding they would get from local politicians. In such centres, there will always be issues with getting aptly trained technicians and right quality instruments and solutions". Moddhia claims they only keep instruments of the highest quality, comparable with the top hospitals. Apart from the local clinics, the only one indirectly competing with them is 10-year-old Nephroplus, but they operate in central parts of cities and offer comparatively larger centres with 10-15 beds, unlike The Renal Project. 

In an effort to promote goodwill and shedding unnecessary expenditure for grand celebrations, Moddhia signs off saying that they will offer free blood tests at centre inaugurations of future projects, once normalcy returns.