Lessons from the Chennai floods: Local businesses are uniquely equipped to chip in during disasters

During emergency situations in cities, why depend on government agencies alone?

Exactly a year ago on Tuesday, heavy rains off the southeast coast of India set off a chain of events that resulted in one of the costliest disasters of 2015. Floods ravaged parts of Tamil Nadu, Andhra Pradesh and Puducherry between November and December last year. The city of Chennai was the hardest hit.

Reports suggest that in Tamil Nadu alone, over 300 people lost their lives, nearly two million people were displaced, and preliminary flood damages were estimated at Rs 8,400 crores.

The floods were even discussed at the climate change negotiations in Paris in December, leading to another plaintive request for “concrete and urgent action against climate disruption”. This week, as another round of climate talks kicks off in Morocco, it is worth noting that such extreme weather events are expected to rise in frequency. Cities, which have a higher share of population and infrastructure, are particularly at risk.

But is there something to be learnt from every disaster? Does each episode offer crucial lessons that can become part of the area’s institutional memory for disaster preparedness?

Private sector interventions

In the case of Chennai, stories of tragedy and hardship were shared in real time, as were the rescue efforts of the government, the Chennai Corporation, police, and the armed forces. But in the age of social media, another unique account emerged: that of the interventions of a number of community-based organisations and the private sector.

Cities depend on a host of private services such as restaurants, retail stores, freight and delivery operations, schools, hospitals, hotels, taxis, and other businesses. Their understanding of the city, its geography, and the people they come in contact with, is unparalleled, and they form a critical part of the fabric of an urban community.

Early this year, two urban development specialists, who work in Delhi but were born and brought up in Chennai, decided to gather lessons from the Chennai floods. The organisation they lead, TARU Leading Edge, has worked extensively on cities and disaster resilience and is currently gathering evidence on resilience interventions in India and South East Asia as part of the Asian Cities Climate Change Resilience Network.

"Building resilience requires learning from both experience and science for addressing new and emerging urban challenges,"said Umamaheshwaran Rajasekar, the TARU director. "My colleagues and I wanted to capture some of the initiatives undertaken by various groups to manage the disaster to help others learn and incorporate such practices within their preparedness, prevention and response plans.”

The stories they collected, along with the attendant lessons, capture how a number of organisations were able to play to their strengths, and also employ innovative means to help the city in myriad ways during the disaster.

For instance, the Global Positioning System-equipped taxi service Ola Cabs formed a rescue team to transport food, water, and medical supplies to parts of flood-hit Chennai. What started out as a joke on Twitter – about Ola needing to provide boats instead of cars – was taken seriously by the taxi aggregator. Ola contacted local firemen and the Chennai Sport Fishing Company to gather details of local rowers and fishermen in order to provide free boat services in waterlogged and partially-submerged areas using information provided by the fire and rescue department. What is more, Ola replicated this effort during the floods in Allahabad and Varanasi in August.

In another part of Chennai, Kolapasi – a local catering service in Adyar, a neighbourhood in South Chennai – started serving free food to stranded people. It distributed approximately 6,000 food packets to people affected by the floods. Hotel Checkers in Anna Salai was one of the hotels that converted its banquet halls into dormitories for staff unable to go home because of the flooding. Many car dealers sent warning text messages to their customers warning them against driving through flooded roads. Car owners were also advised not to start cars in waterlogged areas to prevent hydrolock – a condition in an internal combustion engine that can lead to mechanical failure and engine seizure.

Having learnt from their experiences during the Kashmir floods of 2014 and Mumbai floods of 2005, automotive companies such as Toyota, Renault, Maruti, Hyundai and Nissan were better prepared to act through their dealers and service stations in Tamil Nadu.

Giving a hand

Similarly, after the Union government announced that the state-owned BSNL would not charge its customers for a week during the flooding last year, other telecom companies followed suit, providing their customers with free talk time.

Servals Automation, a Chennai-based social enterprise that provides rural energy products, started a programme called Marumalarchi to distribute cooking fuel and stoves to migrants and slum dwellers so that they could cook food and boil water, two critical requirements, in a flood-hit area.

For every account of hyper-inflated costs of water, vegetables, and airline tickets, and the government’s intervention to check these practices, there were stories of positive efforts by private entities, driven, no doubt, by civic responsibility, but also positive brand implications in the long run.

There is an untapped potential for the private sector to provide skilled services in the form of technical manpower or in-kind donations of their goods or services during emergency situations. In addition, in a situation when timing is key, a number of these agencies have local knowledge and distribution networks to help fill crucial gaps in government efforts. Rather than a one-off exercise in volunteerism, therefore, a greater collaboration between the public and private sectors is merited.

In the case of India, the newly drafted National Disaster Management Plan talks about private sector inclusion but from the perspective of businesses integrating disaster risk into their management practices and providing technical support during reconstruction efforts. Their role during emergency response is not spelt out. Through incentives and mandates, relevant businesses – not just national but also local entities– can be co-opted at the state and municipal level in disaster management initiatives.

Helping themselves

But what is in it for these companies? Businesses themselves are at risk from climate impacts during extreme weather events, in the form of supply chain disruptions, structural damage, and impacts on employees and thereby operations.

According to the CDP Global Cities Report, it is estimated that 80% of the global Gross Domestic Product is generated in cities, and assets worth $4 trillion are at risk from climate-related events in cities.

In Chennai, micro, small and medium enterprises lost an estimated Rs 1,700 crores due to the floods last year. Moreover, persistent rainfall and flooding forced several major automakers in the region to shut operations, thereby also incurring losses. It is evident that private sector efforts and investment in disaster risk resilience at every stage would not just aid cities, but help their businesses in turn too.

In May, barely five months after the floods, Chennai received 20 cm of rain in 24 hours, leaving parts of the city waterlogged. People feared the worst again. Although Cyclone Roanu, which caused the conditions that led to this excessive rain, ultimately did not hit the region, Chennai was better prepared this time with Indian Administrative Services officers, medical teams, and equipment like water pumps on standby. Such efforts at preparedness can be further complemented by co-opting private sector organisations – they are intrinsically linked to cities and have much to lose during extreme weather events, but also have much to offer to help the city get back on its feet.

Anu Jogesh is policy and governance lead at Acclimatise, a climate adaptation and risk resilience organisation.

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What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.