Stellar Sixteen

As the saying goes, where there is a will, there is a way. Today, as they celebrate their incredible record of one million dialyses, the Bhagwan Mahavir Dialysis Centres have become synonymous with low-cost treatment for chronic kidney disease in Hyderabad. How did it all begin? What divine force brought this small group together to form a Trust? How did a small idea gather momentum and attract the invaluable support of hundreds of generous donors? And last but not the least, what is dialysis after all?

On the following pages, two pioneers narrate how resolve, commitment, dedication — and the will to act — resulted in the extraordinary saga of the Bhagwan Mahavir Jain Relief Foundation Trust.

“It all started on a pilgrimage we made to Ahichatra Tirtha, hosted by my co-brother Shri Premchandji Ostwal,” says Gautam Jain. Ahichatra is a famous Jain centre near Muradabad, in Uttar Pradesh. On the way, Gautam Jain overheard his co-traveller Shri Anand Marlecha (who was associated with a donations-based charitable trust in Bengaluru) talk about dialysis treatment on his phone. Like many, Gautam Jain was intrigued by this strange word: what is ‘dialysis’ after all? After further conversation with Shri Marlecha, and by the end of their journey, an ‘inner voice’ told Gautam Jain to explore the idea of starting a similar trust in Hyderabad. It was as if by Divine Will.

An Idea is Born
On his return, Gautam Jain lost no time in broaching the subject with Inder Chand Jain, Madan Lunawat and Satish Khivsara. Being closely associated with the prestigious ‘Mahavir Hospital’ as a trustee, Satish Khivsara knew about the issues that kidney patients face. He was aware of kidney transplants being performed by the famous nephrologist Dr. Sarbeswar Sahariah and Dr. Ram Bhoopal. The idea of a trust with a healthcare focus immediately appealed to everyone, and the four felt they were on to something truly worthwhile — a ‘dialysis project’.

A little later, the word reached Shri Suresh Surana who instantly offered to join the ‘team’; he knew the dialysis scenario only too well. His mother was suffering from kidney failure, and he would often accompany her for the dialysis sessions. He was also aware of the financial challenges of dialysis for middle-class and lowermiddle- class patients. The sudden passing of his mother left Shri Surana with a certain resoluteness to give his all to the project. At her funeral, Gautam Jain found himself sitting next to Shri Rikhab Parak; learning about the dialysis project, Shri Parak became keen on playing an active part in the philanthropic initiative that was fast crystallizing.

However, no one had yet sought specialist advice on dialysis treatment. Gautam Jain shared the plan with a dear friend, Dr. Nagendra Mahendra (an ENT specialist), who introduced him to Dr. Girish Narayan, a senior nephrologist in the city. Dr. Narayan offered valuable advice on how to take the plan forward, based on his experience at the Osmania Hospital. He also said that anything offered free would carry no value, and therefore suggested a minimum charge per dialysis treatment.

Advice continued to pour in. Dr. Rajender Jain Munoth explained the function of the kidneys in the human body, and the logistics of dialysis treatment. He added a word of caution: “It is very challenging to support such treatments for a lifetime, and if, at some point, you were to discontinue the charitable services, then it could have an undesirable, ‘reverse’ effect on you…” Dr. Munoth went on to suggest that, instead of dialysis treatments, a more practical initiative could be to consider helping children with heart surgeries, or maybe cataract treatments and the like, as they all only involve a one-time investment. However, in Gautam Jain’s mind, the emerging magnitude of the challenge was nothing compared to the magnitude of the kidney disease problem for the disadvantaged classes of our society. Life is indeed dear to all living beings. It was a decisive point. “I had no plans of looking back on a journey that I had already started in my mind,” says Jain, “When the going gets tough, the tough should get going.”

The Spadework
The immediate job on hand was to look at how other charitable trusts —the one in Bengaluru, and the Neminath Trust in Mumbai — were conducting dialysis treatments. Everyone in the ‘dialysis project’ pitched in earnestly, calling up friends and acquaintances, looking for suggestions and general direction. One evening, Inder Chand Jain received a visit from Shri Neerup Kothari of the Neminath Trust (which runs dialysis services in Mumbai).

Barely able to conceal his excitement, Inder Jain called Gautam Jain to inform him about Shri Kothari’s visit. Both Gautam Jain and Satish Khivsara reached Inder Jain’s office in minutes, and listened eagerly to Shri Kothari explain how the entire ‘system’ functions. While Shri Kothari was extremely generous in sharing every single detail, he rounded up with a clear caveat: “If you are thinking about dialysis, remember that mere words and lofty thoughts will not suffice. You will need determined action.”

The steepness of the task ahead was anything but a deterrent. Gautam Jain immediately called for an meeting at his residence to talk about the nuts and bolts of forming an institution. After hours of brainstorming with Inder Chand Jain, Satish Khivsara, Suresh Surana, Rikhab Parak, Ashok Kothari, Prakash Shrimal, and Shanti Bhai Shah, it was agreed that a trust should be set up, and the name, ‘Bhagwan Mahavir Jain Relief Foundation Trust’, emerged as a unanimous choice.

Another key decision was to have trustees from all sections of the Jain society. The core group thus called upon Shri Sunil Pahade and Shri Mahavir Patny (Digambar Samajh), Shri Swaroop Kothari, Shri Mahavir Chandji Alizar, Shri Dharmender Nahar, Shri Vinod Kimtee (Sthanak waasi), Shri Rajender Dugar and Shri HM Jain (Terapanti), and Shri Dhiraj Bhai Kapadia (Kutchi Samajh). Rikab Parak suggested the name of Shri Uttam Chand Ji Lunawat, who was himself a dialysis patient. Two of the invited people did not respond. In the next meeting, Inder Chand Jain was given the responsibility of drafting and registering the trust deed. The longawaited dream thus became a reality in mid-2009. The Bhagwan Mahavir Jain Relief Foundation Trust was registered by Shri P.C. Shrimal, Gautam Chordia and Inder Chand Jain as Founder Trustees.

Cutting the Cost

The Trust was formed, but the acid test lay ahead. How does one go about starting a dialysis centre? What paraphernalia does one need, and how does one source it? Satish Khivsara and Gautam Jain were thus given the responsibility to consult the renowned nephrologist Dr. Sarbeswar Sahariah at the Mahavir Hospital, which was running a dialysis centre with 10 machines. Satish Khivsara recalls, “It was an eye-opening experience. Being a good friend of mine, Dr. Sahariah spared no effort to take us around the centre and to brief us on all details. The cost sheet of each dialysis session had to be carefully studied and understood. We then sat down with him to explain that the main intention of our Trust was to bring dialysis treatment within the reach of poor and needy patients.” Dr. Sahariah was full of appreciation, but said, “Remember that it is very difficult to sustain a dialysis set-up. Many people have come forward, but gave up within months.” Unfazed by his response, the members further discussed the charges of each dialysis, and asked Dr. Sahariah what he would charge us, when compared to other hospitals, if we wished to go ahead with our plan to support deserving patients. He told us that the Mahavir Hospital was charging much less (Rs.1,250) compared to other institutions, and that the fee per dialysis was about Rs.3,500.

Shri Neerup Kothari had already sent the cost details, so the group had everything at their fingertips. The question that remained was what the charges would be if the Trust brought its patients to Mahavir Hospital. Dr. Sahariah finally agreed to bring down the charge to Rs.1,050 (instead of Rs.1,250). He also revealed that he was paying Rs.250 to the Mahavir Hospital for providing the place, and for access to power and water. The alert trustees spotted another opportunity, and met Shri Shanthilal Ji Daga, Chairman of of Mahavir Hospital, and briefed him about the concept of the newly formed Trust. The sole request put forward to him was to do away — for the patients supported by the Trust — with this Rs.250. Shri Daga immediately agreed, saying that both were Jain organizations and that he had no right to deny the request. This was how the per-dialysis rate of Rs.800 was fixed for patients who would be referred by the Bhagwan Mahavir Jain Relief Foundation Trust. The light at the end of the tunnel had never seemed so bright!

The First Dialysis
Satish Khivsara and Gautam Jain both felt it was a celebratory moment. But some mathematics still remained. They first briefed the other trustees about the rate being finally fixed at Rs.800, for treatment at the Mahavir Hospital (only for patients referred by the Trust). Eventually, the sixteen trustees decided that their patients Dr. Sahariah was full of appreciation, but said, “Remember that it is very difficult to sustain a dialysis set-up. Many people have come forward, but gave up within months.” Sixteen to Million (2009–2021) 27 would have to pay only Rs.300 to the hospital, and the balance Rs.500 would be paid by the Trust to the Mahavir Hospital. The bottomline was clear: a patient covered by the Trust would be relieved of a significant burden — Rs.950 — compared to patients directly approaching the Mahavir Hospital.

In mid-June 2009, the now tightly integrated sixteen trustees met at Shri Inder Jain’s office to decide the date for the first dialysis. To start with, they collected Rs.1,000 from each trustee.

Tuesday, 21st July 2009 will remain etched in the Trust’s history. Rikab Parak had suggested that it was an auspicious day, a good muhurth. Our first patient underwent his dialysis at the Mahavir Hospital. He was identified by Shri Srinivas, the Technician at the hospital. The patient’s family was overjoyed to have to pay only Rs.300, instead of the regular charge of Rs.1,250. All sixteen trustess were present, and saw first-hand what the treament involved and what the disease was. As only to be expected, other patients in the hospital quickly came to know about the charitable initiative of the BMJRFT, and began to approach the Trust for support.

An Unstoppable Mission
The elation among the ‘Stellar Sixteen’ trustees was beyond description. And their families too felt the intense sense of satisfaction and fulfilment on having set in motion a unique social service mission. By the end of July, the Trust had six patients and completed sixteen dialyses. [Within a year, they breezed past 1,600 dialyses… but that is another story].

The spirit of social service is innate to the Jain community. Within a short time, the Trust raised 4.5 lakhs from within the Trustees’ circle, in order to take the project forward. Once the Mahavir Hospital project had settled into a steady pace, the trustees (Inder Jain, Satish Khivsara, and Gautam Chand Jain) arranged to meet with Shri Vinay Saboo, Shri Bijay Mandhani and Dr. Shyam Tapadia who were planning to start a dialysis project at the Mahesh Hospital. This resulted in the installation of two machines at the same hospital, which were donated by Shri Nalin Khara and Shri Ram Prakash Bansal.

When two close friends of the Trust, Shri Hemu Bai and Shri Paresh Bhai visited Hyderabad, the dialysis project was discussed in detail, and they floated the idea that a large-scale programme could be organised for general awareness and donation-collection. Shri Paresh Bhai suggested that the famous singer Shri Roop Kumar Rathod could be invited to provide entertainment. The outcome was our very first event ‘Jagrati – An Awakening’, which took place on 14th March 2010 at the Lalitha Kala Thoranam, Hyderabad. Invitation was restricted and by free passes only.

The chief guests of honour that evening were Shri Navin Mittal, then Collector of Hyderabad, and Shri Deepak Bhai. The screening of a short film on dialysis patients, created by Shri Sanjay Kankaria, was one of the highlights of the evening. Needless to say, the event was a grand success. Apart from huge cash donations, generous donors pledged 24 dialysis machines… far more than what the Trust had ever dreamed of.

Shri Navin Mittal subsequently initiated the process to identify spare space for the Trust to set up its own dialysis facility. Eventually, on 13th December 2010, the State Government issued an order giving the Trust rent-free space in the King Koti District Hospital, right in the centre of the city. The order was issued by Dr. P.V. Ramesh, IAS (Retd.), then Principal Secretary, Health, Medical and Family Welfare, Government of Andhra Pradesh. The entire preparatory work culminating in the issue of the order was done by Shri B. Venkatesham, IAS, then Managing Director, Andhra Pradesh Medical Infrastructure Development Corporation.

The King Koti centre of the BMJRFT began functioning in April 2011, and heralded a new chapter in the annals of the Trust. Several other centres were established in the years that followed, as described elsewhere in this book. Even today — twelve years and a million dialyses later — Gautam Jain and Satish Khivsara have just one thing to say: “We have miles to go before we sleep… as service to mankind is service to God!”