Samahope: Crowdfunding Health
Samahope, a new platform for public health campaigns, takes the fight for public health to the individual.
By Lindsay Hebert
The sixteen women on my computer screen need help. Natasha is three years old and requires $550 for a burn operation. Efreda was divorced by her husband because of her fistula condition; surgery will cost $1,000. When I refresh the page, a new tiling of faces appears.
The questions facing potential donors on Samahope.org are not new. Who is most deserving? Which cause is most affecting? How much do I contribute? But the answers seem to carry more weight when they apply not to a general fund, but to an actual person.
I asked Samahope’s program manager, Shivani Patel, for her advice on how to give. Launched in 2011, Samahope uses a crowdfunding model to raise money for surgical treatments in Zambia and Sierra Leone. Much like investing in a startup through Kiva or Kickstarter, donors can peruse the stories of women in need of operations and make contributions toward their surgeries.
“One way to choose would be to browse through and see what personal connection comes through. Or you could educate yourself on the different [medical] conditions and say, okay, what calls out to you as a donor and then go to the [patient’s] profile. There are different ways of leveraging the content to see what speaks to you. It depends on what lens you’re coming from,” Patel said.
The model is built on the premise that donors are more likely to give if they know the individual who will benefit. But some wonder about the ethical implications of placing such critical decisions in the hands of the public.
“This speaks to the potential of private charity, but also to its limitations.” said Dr. Howard Brody, director of the Institute for Medical Humanities for the University of Texas Medical Branch. “I can see the motive of people to have the reassurance [their money] is going to the right place. The unintended consequence is that it invites judgment of who is deserving and who is not. What about someone who has every bit a medical need but just doesn’t take a nice picture?”
For donors who prefer not to select a specific patient, a general giving fund is available on the site. This option was suggested during early feedback to alleviate donors’ potential decision-making stress. However, personal profiles bring in the majority of funding.
“What we found was that individual stories are more compelling,” Patel said. “Online, people are able to feel a sense of empathy to help a woman out.”
At this point, Samahope’s principal partner is West Africa Fistula Foundation, and women needing fistula repair surgery make up the majority of patients posted on the site. The Fistula Foundation estimates that more than 500,000 women worldwide are suffering from fistula, and that number increases by 30,000 to 50,000 women every year.
“The world’s capacity to treat women with fistula, however, lies at only about 20,000 women each year,” said Fistula Foundation CEO Kate Grant. “There is a significant patient backlog that keeps growing.”
While almost nonexistent in the developed world, this often-debilitating condition is common throughout Africa and Southeast Asia where prolonged labor during childbirth can lead to tears in the vaginal walls. This can cause incontinence and infection, stigmatizing those who suffer.
Despite the topic’s sensitivity, women who are unwilling to publicly post their condition are not eligible for direct funding through this model. But Patel says privacy concerns have come from academics and the development community, not from patients themselves.
“The reality is that many have been suffering from fistula for years and their lives have been halted. There is so much taboo in their communities about conditions that they have that are really no fault of their own. They say, ‘Yes, I want to tell my story.’”
But Brody wonders if patients really have the choice to participate if they have no other viable options for treatment.
“We see people having a bake sale for their neighbor with leukemia, and everyone in the community knows their business, knows that they’re suffering. At one level it’s a free choice, but really, honestly, is that socially the best way to do things? Or is there a better way to fund healthcare or give health insurance?”
Grant stands behind The Fistula Foundation’s more traditional fundraising methods. “Our preference is to share stories of a few patients – but for most of the women we help, we want to maintain their privacy. We find that [our donors] want to help women with this horrendous injury, and do not need to know about a specific patient’s condition in order to be moved to help.”
Samahope supports the most time-sensitive cases with targeted online promotion and with resources pooled in the general donation category. Patel says Samahope is committed to funding every surgery posted on the site.
“We try to tell each individual story with dignity, to focus on what the women are passionate about and what they are going to be able to do once they get back on track. But we try as much as possible not to shy away from tragedy. We don’t want to be scared to have that conversation and learn about that aspect of these women’s lives.”