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Market Vendors-Clinicians Cooperative

OVERVIEW

I propose a new cooperative venture between market vendors and clinicians. Market vendors could pool together a portion of their resources to compensate and provide space for a clinician to be stationed at the market and offer health screenings to market customers for a fee. Given that some of Caldas' health needs are nutrition and maternal health, the clinician’s assessments could focus on these concerns and his/her recommendations could involve purchasing goods available at the market (e.g. encouraging pregnant women to buy and consume meats, produce, or herbs with more folic acid).

Market vendors are incentivized because the presence of a clinician would attract customers to the market (and thereby indirectly increase the chances of selling more goods), and the clinician's recommendations would directly contribute to increased vendor sales. Clinicians are incentivized to participate in this program because it facilitates access to new patient populations. Moreover, clinicians would not have to participate in the market every day of the week (just one or two); thus, they could maintain their regular office-based practice in addition to participating in the market day.

BACKGROUND

Although I have never lived in Colombia, I have spent time in Guatemala, Argentina, and Brazil. In each of these countries market days are important weekly events for community residents. Vendors sell a tremendous array of items (meats, produce, household nicnacs, etc.) and residents throng to these markets to stock up on necessary goods. Going to the market is also very gender specific activity - the majority of customers are women and mothers. Thus, the vendor-clinician cooperative is in a good position to target the population segments that most need improved access to health services (see the health overview presented in the challenge brief).

I am intrigued by the organization and patterns of human behavior. This concept is an attempt to tap into and leverage existing behavioral flows and established norms. The image for this concept is a photo I took of a piece of art by Argentine artist León Ferrari. For me, the aerial image and repeated graphic of people walking on different paths captures this idea of the patterns and regularity of human behavior.

POSSIBILITY FOR ADD-ONs AND FUTHER DEVELOPMENT

The profits generated by this cooperative could in re-invested in the program to hire more clinicians, specialized clinicians, or provide clinicians over more market days. Building off of some of the technology and health inspirations, the profits could also be used to rent/buy specialized medical equipment.

12 Evaluations so far

Comments

Ruaraidh Mannion

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July 15, 2011, 10:47AM

I think that this is a fantastic idea; the way in which it subtly targets a particular section of the population is excellent.

Would it be possible to use the gathering of the community to further educate people about nutrition? Although this may diminish the commercial side of the project, disseminating the information to as many people as possible may be of benefit.

Could the local food resources be analysed and the information used to create affordable and nutritious meals that can form fresh and healthy traditional dishes?

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Anne Kjaer Riechert

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July 12, 2011, 11:46PM

Simon, I love the idea about empowering the market vendors to become Nutrition Experts! Such a great insight to dig into to people who provide the healthy food which people need. When I lived in Havana, I learned that there is plenty of good and cheap vegetables around at the markets, but that many Cubans didnt buy them because they did not know what to do with them. I wonder if the situation would be similar in Caldas.

The vendors could also provide recipies (written or verbal) for special puposes (illnesses as well as prevention), which will inspire people to stay healthy.

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JB Reed

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July 11, 2011, 02:21PM

Great concept Simon! Capitalizing on existing patterns of behavior makes a lot of sense.

Being ignorant of local culture, one question I have is whether people in Caldas will be hesitant to share their health concerns, especially those potentially related to taboo diseases, in such a public space as a market?

Is there a fear of being seen by your neighbor as she's buying veggies while you're leaving the clinician?

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Simon Morfit's reply to Ruaraidh Mannion's comment

Simon Morfit

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July 11, 2011, 02:58PM

thank JB. One possible way to overcome this would be to set up small screens to allow for clinician-patient privacy. In the early stages of implementing this idea it might make sense to focus on routine health issues (blood pressure, weight, nutrition, etc.) - things that are less likely to be stigmatized or break a taboo. In fact, in the case of maternal and child health - there is a likely community norm that is supportive of pregnant women, mothers, babies - thereby encouraging people to make use of the new clinical services in the market. As you point out - it's hard to play anthropologist at arm's length and more fieldwork would be necessary to address these issues.

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Juan Cajiao

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June 28, 2011, 09:23PM

There are four things I like about this concept:
1. The local market is the place to be: everyone goes there to sell or buy (http://www.youtube.com/watch?v=i_S6ofCSkOM).
2. The market is a "critical hazard control point", in other words, the health of the community is highly influenced by the innocuity of the food sell there.
3. You never know what you are buying: is it healthy, is it fair, how to prepare it well, how long can I keep it stored and so on.
3. I remember people measuring pressure and some other super basic health services happening years ago but it hasn't give the next step, mostly done by the Red Cross or religious groups.

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Maria Palacio's reply to Ruaraidh Mannion's comment

Maria Palacio

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July 10, 2011, 02:38AM

Great idea! But something to know is that the concept of a farmer market that you are talking here is very different from how is works in this region. In the rural areas that is divided by Pueblos they all have a Galeria, also there is not a big Galeria day. In the other hand the Pueblos are so small that usually from the Galeria to the "Health points" is walking distance.
Usually Sundays is when the people from the farm goes to the Pueblo, but I would say that the center place where every body gather is the in Plaza.
I will say that placing a Health point in the Plaza with the Red Cross and the Clinicians of the area will reach the majority of this community.

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Simon Morfit's reply to Ruaraidh Mannion's comment

Simon Morfit

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July 11, 2011, 02:52PM

Thanks Maria - for providing more insight into local conditions! One of first stages of implementing this idea would be to map the existing flows of people to identify where they congregate - and it sounds like focusing on the Plaza might be the way to go.

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Anne-Laure Fayard

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June 29, 2011, 03:29AM

Hi Simon,

I really like the idea of using the market as a place where people meet weekly (or more) and providing them access to doctors. I've never been in Columbia but from trips in Chile, Argentina, Bolivia and Mexico, markets are indeed important.
You could even imagine that the day the clinicians can't come, there could be women trained by the doctors (or professional nurses) to give some nutrition advice and maybe do very simple screening.
al

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Johan Löfström's reply to Ruaraidh Mannion's comment

Johan Löfström

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June 29, 2011, 07:13AM

at least you would need a nurse onsite at all times, with a mobile phone, to call up the nearest expert-physician to consult in real-time. (and maybe camera? ipad with skype-chat? webcam-chat?)

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Simon Morfit's reply to Ruaraidh Mannion's comment

Simon Morfit

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July 09, 2011, 03:21PM

Great ideas guys - a lot of potential for spinoffs and further add-ons - ranging from low-tech (promoting nutritious recipes using local foods) to high-tech.

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Vincent Cheng

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July 03, 2011, 05:25AM

Great concept of pairing medical services with popular commonly visited food markets Simon!

Reminds me of how many Chinese food markets (in China & around the world) often contain or are adjacent to traditional Chinese medicine/medical practitioners, whose treatments are very linked to food; as well as health clinic services being offered in convenience stores/pharmacies ( http://www.minuteclinic.com/ ) and other high-traffic markets/stores ( http://www.walmart.com/cp/1078904 ) in the US; granted, these are very different contexts =P

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Simon Morfit's reply to Ruaraidh Mannion's comment

Simon Morfit

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July 09, 2011, 03:18PM

Thanks Vincent - I was inspired in part by my childhood memories of seeing and playing with blood pressure machines stationed in big supermarkets (and subsequently getting reprimanded for doing so). Over time, these machines and health screening facilities were phased out - at least in my home town.

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Shan Jayaweera

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July 04, 2011, 07:00AM

Fantastic idea Simon - It would be great if you could make it free for pregnant mothers and babies (that infant mortality rate is something we should really focus on reducing)

I think you could also set up a stall at the market with information about good nutrition, receipes for healthy eating and someone to give advice about good food and basic nutrition.

Well done on a well thought out concept

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Luz Alba Gallo

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June 29, 2011, 05:31AM

Really interesting idea. Also taking into account that the day they do the farmer's market, not only locals come to buy food, but people from the surrrounding areas. So this idea could help more people than expected.

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Meena Kadri

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June 29, 2011, 01:48AM

Great stuff, Simon! Exciting to see where this might go as discussion builds around the alliance you've outlined here. Maybe some of our Spanish speaking OpenIDEATORS will eve chime in with some ideas on a name for the venture? ;^)

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