Misfits

Team Sisu often finds themselves to be the misfits at most networking events. With a geographically-diverse market neglected by the larger business world, many in the for-profit medical device industry find our aims improbable. At other events, the “do well by doing good” crowds sometimes gasp when we mention our business model; often implying that our monetary goals will always shadow our health impacts. We have found our niche and several have embraced our ability to negotiate the often divided realms of life science businesses and global health.

Yet, we continue to confront lines of questioning that are flavored by the audience. Below are two general examples of conversations that want to put Sisu in a specific category. The first, from a start- up business fellow at a pitch competition, and then, global health expert from a health system strengthening conference.

“In Africa, how do you know there’s money there until you’ve sold something? There are no rules, just sell it.”

One crowd is the US lean startup community- you know them, preachers of constant iteration. Iteration is king in this case and what we believe is truly innovative at Sisu. The lean startup model, however, can be iterative to the point of recklessness- not a quality that a medical device company should really value. The lean startup model also generates the long stream of half-hearted apps that continue to stream out of Silicon Valley- an industry with lots of money that appears to be thrown at underdeveloped projects destined to flop or be acquired. When the latter strategy succeeds, it's great for investors, but inserts the startup (which has been unable to build organization/system beyond an initial product) into the large companies and associated bureaucracy. New ideas are getting put into old structures too soon, often diluting original aims or negating long term system’s change.  

Acquisition can be a boon- but only once a startup has created something that reworks a system; single ideas treated this way will not survive.The original ideas for many apps/products solve big problems, but this cross pollination/acquisition game with the same group of people’s ideas is heading for stagnation.

“How are you delivering product to impoverished countries in the Global South and you’re actually reporting health impacts and making money off of it?”

This question comes in many forms, though most often a touch more subtlety. Yes, we are selling products in countries that have been given one dimension: “developing” and “poverty alleviation”. These words are slathered across them via media. Big Aid organizations and others have insinuated that capable, resourceful and talented local people (our current partners, future employees and customers) cannot live there.

Some large NGO’s and international organizations have made strides toward dissolving this image of foreign aid- but the philosophy is deeply embedded. Many have worked in some of the farthest reaches of the world with immense experience with both successes and many failures in delivering healthcare products and access worldwide. These organizations have a depth of knowledge in these areas, but have left us viewing these areas as primitively stationary in poverty, not as explosively growing economically.

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All teasing aside- both philosophies have incredible value in seeking a solution. Neither can claim to have found the correct process, either, and perhaps it’s because of the philosophy they share of only being able to have one priority.

We disagree. Monetary compensation and human-centered initiatives don’t have to be mutually exclusive. Emerging markets are a strategic choice and are repeatedly reported as having explosive growth. Exploding economic growth, often caused by a growing middle class, also creates greater demand on health systems. These health systems need a way to provide care that impacts patients in their own context, otherwise risking inaccessibility to healthcare for large swaths of their patient populations. 

Sisu has found that by following the threads of both business and impact- we can be most successful. Both philosophies seek to reach scale to solve problems and to sell products. The entire health system is important to both create profits and benefits. As Sisu formally opens its seed round, we find ourselves straddling the middle- socially minded with hard nose business outlook.