Archive for April 24th, 2009

Scaling up in “The Many Indias”

April 24, 2009

‘India is merely a geographical expression. It is no more a single country than the equator’- Winston Churchill

Had I read this quote five months ago, I would have not understood what it meant. But after living, traveling and working in India for exactly that long, I can say that Winston Churchill was exactly right. In India, like in any other large country as the US or Mexico, I expected to find some regional differences in people’s tastes for food or music, their accent, dress code, etc. In my mind, these differences give countries their character and do not have major consequences for business other than the opportunity to bring in some variety to the portfolio of products or services. In India, however, regional differences go FAR beyond the ones I just described. For this reason many authors to talk not about one country but “the many Indias”.

For an enterprise trying to do business across the Indian territory, it is critical to be aware of all the nuances of “the many Indias”. Allow me to illustrate what I mean by this using AyurVAID: Hospitals, the organization I am working in, as an example.

AyurVAID: Hospitals is a local business with the mission of providing high quality, affordable Ayurveda (India’s traditional system of medicine) treatment for chronic illnesses across all socio-economic segments and across India (and some day abroad). In line with this vision, AyurVAID: Hospitals opened six small to medium sized hospitals in three neighboring states: two hospitals in Kerala, three in Karnataka and one in Maharastra. The hospitals are located in urban areas and three of them in the big cities of Mumbai and Bangalore.
At first glance AyurVAID: Hospitals’ strategy of expansion seems very straightforward, but in practice things are let’s say a bit more….complicated. Here is how:

Language– At each location, all sign boards and advertising material have to be translated into at least 2 different languages (English + local language) and 4 in the case of Mumbai (high immigrant population). Our doctors need to speak 2 to 3 languages to communicate with patients, English to communicate with the management and international partners, and Malayalam, the language of Kerala, to speak with the staff.

Human resources– The roots of the Ayurveda system of medicine can be traced back to the state of Kerala. Although today Ayurvedic Medical Colleges train doctors across the country, training institutions for therapists are still highly concentrated in Kerala. Hence, hiring locally becomes a difficult task and most of the therapists have to be relocated from Kerala to other states. Then again, most people in Kerala have a strong affinity for their state and prefer not to leave it.
Systems of medicine– Whereas in other parts of the world, Allopathic or “Western Medicine” is the norm, in India, patients have many other well established options to consider like Ayurveda, Homeopathy, Allopathy and Unani. In competing with these different options, public awareness about Ayurveda is a big challenge. If we take allopathic medicine as an example, most people today know what to expect when they go to a doctor, to a hospital or understand if someone says they need a “dialysis”. On the other hand, Ayurveda means a variety of things to different people, particularly as the distance from Kerala increases. To test this last point, I decided to interview people in the streets and hotels of Kerala (to get some out of state opinions) and asked them one simple question….Observe.

All of these factors make the business at AyurVAID: Hospitals challenging and exciting! One success factor as we continue to grow and do business in “the many Indias” will be to strike the right balance between standardization and customization of our services.

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