More than 70% of all cancer-related deaths in 2020 occurred in low- and middle-income countries. Many of these deaths could have been prevented through vaccinations, screening protocols, and prompt access to oncological infrastructure.
The situation is particularly acute in India, which recently dethroned China as the most populous country on the planet. There were around 1.46 million new cancer cases in India in 2022, with a projected annual increase of 12.8% until 2025.
According to the Ministry of Health and Family Welfare, there is an 80% shortfall in specialist doctors in rural healthcare centers. Up to 80% of the rural population in India gets their treatment from unqualified doctors, according to Dr Abhijit Banerjee, Nobel laureate in Economics.
People in Indian villages often have to travel an average of 50 miles to consult a specialist. A belated cancer diagnosis can be a death sentence in these conditions. Sandeep Kumar, founder and CEO of the DigiSwasthya Foundation, knows this reality all too well. As a 12-year-old, he was diagnosed with Ewings Sarcoma, a type of rare bone cancer.
In 2024, Forbes included Sandeep in its annual list of “30 Under 30”, under the category of Social Impact, for his contributions to improving access to affordable medical care in rural India. Sandeep is also the President of KidsCan Konnect, a national network for childhood cancer survivors in India.
Sandeep Kumar and Catharine Young, Ph.D, Assistant Director of Cancer Moonshot Policy and International Engagement, The White House
His remarkable journey started with a painful lump in his right arm in 2007. Sandeep, who hailed from a lower-middle-class family, was just an ordinary high school student in a village in Uttar Pradesh (UP), India’s most populous state with 200 million residents.
As a student, he had to walk 6 miles daily to attend school. The nearest medical clinic was also miles away. This is a common situation for millions of Indians across states like UP and Bihar, which struggle with high levels of poverty, illiteracy, and low scores in human development (HDI).
It took the healthcare system in UP more than 8 months to accurately diagnose Sandeep’s condition. Due to the delay, doctors initially suggested aggressive surgical intervention which would have resulted in the loss of his entire arm.
Like millions of other patients in rural India, Sandeep’s parents took him to a distant Tier 1 city – Mumbai – for advanced diagnostics and treatment. After 40 cycles of chemotherapy and the replacement of the humerus in his right arm, he was finally declared cancer-free.
During his year-long treatment and rehabilitation in Mumbai, Sandeep’s family received support from NGOs, social workers, and financial assistance from government health schemes. Those experiences kindled his interest in social work which would soon become a profession and passion.
After completing his Master’s in Social Work (MSW), Sandeep worked for five years in various hospitals and NGOs in Mumbai, including the Indian Cancer Society and We Care Foundation. When he returned to his hometown in UP after 5 years, he noticed that the healthcare situation was still abysmal in 2019.
“In my village, people don’t take their illnesses seriously. They use basic medicines like balms and painkillers and go about their daily lives. It is only when the disease reaches a severe stage that they visit a doctor, who is often located miles away in a city,” explains Sandeep.
Sandeep identified three major pain points rural patients face in India:
- They have to travel up to 100 miles or more to see a specialist doctor
- They have to bear 80% of the healthcare costs in private hospitals
- They do not have any awareness of major health issues and warning signs
DigiSwasthya Foundation
DigiSwasthya Foundation was formed in the backdrop of COVID lockdowns in 2020 to offer practical solutions to all these pain points. The non-profit organization is financed primarily through endowments and corporate social responsibility (CSR) grants.
It operates 5 community health centers in rural areas across states like UP, Bihar, and Maharashtra. Each center has a waiting area and a space for private consultations via Zoom calls. Patients can consult specialists free of cost.
Free service is a critical factor in India, where a single consultation with a specialist can cost around $20. For reference, the minimum monthly wage in the country is around $200 and the vast majority of the rural population cannot afford the cost of private hospitals and clinics.
Since its inception, DigiSwasthya has experienced phenomenal growth. “To date, we have facilitated more than 56,000 consultations, conducted 1,600 health camps, and reached out to patients in over 1,200 villages. Our network currently includes over 171 doctors from major hospitals in India as well as abroad.”
The centers also provide other services like a primary health checkup, conveyance support, and guidance regarding financial support for expensive treatments like chemotherapy and surgical interventions. Referral pathways are in place to ensure timely access to treatment in Tier 1 hospitals.
Lack of adequate health records can cause significant delays in diagnosis and treatment. Since most patients in rural communities have limited awareness about this, the foundation also maintains electronic medical records of all patients.
Community outreach is also a major focus of the organization. They constantly organize health camps in villages to raise awareness about cervical cancer, oral cancer, breast cancer, childhood cancers, other chronic diseases like diabetes, and cardiovascular issues.
Women, in particular, face additional barriers in getting access to treatment in the highly conservative village communities. DigiSwasthya employs women who can interact privately with women and provide guidance and counseling, effectively overcoming the prevalent social stigma.
Quite remarkably, out of the dedicated team of 26 staff members, at least 14 are either childhood cancer survivors themselves or are relatives of cancer survivors.
Telemedicine has immense potential in countries like India, where 80% of all licensed physicians are located in urban areas, while more than 70% of the population lives in villages and rural areas. Government agencies have approached Sandeep’s organization to further improve healthcare access in other villages in UP.
Forward Momentum
Plans for the future include the opening of 30 additional telemedicine centers, in close collaboration with the Indian government, under the aegis of the National Health Mission. Sandeep also has plans to expand his network of physicians to include Army doctors and other experienced medical professionals from India and abroad.
Over the years, Sandeep has also represented India in international oncology conferences as a childhood cancer survivor and researcher/social entrepreneur, including the International Society of Pediatric Oncology’s Childhood Cancer International Conference in 2019 in Lyon, France.
In 2024, Sandeep is busy laying the groundwork to scale DigiSwasthya’s expansion across UP, Maharashtra, and other Indian states with a sizable rural population. He had this to say about the future of DigiSwasthya:
“We are looking for people like Sandeep (sic), people who are really passionate about supporting their community, people who want to work for their communities – we will identify 100 such individuals, give them the DigiSwasthya template, provide training, raise funds, and provide everything to help them establish health centers in their villages, and they are the ones who will lead those centers. This is our vision.”
