PurpLE Care Launch

Dr. Anita Ravi is a family physician and co-founder and CEO of PurpLE Health Foundation (PHF). PHF is a nonprofit organization working to advance the health of our communities by investing in the physical, mental, and financial health of gender-based violence (GBV) survivors. PHF grew from Dr. Ravi’s work piloting the PurpLE (Purpose: Listen and Engage) Clinic in New York City, providing trauma-informed healthcare to trauma survivors. From 2015 to 2019, the clinic served over 250 survivors and their families.  

Dr. Ravi is a public health researcher, authoring publications about women’s health, trauma, and health disparities. Her advocacy work includes conducting immigration forensic examinations, facilitating health education workshops, and serving as the Vice Chair of the American Medical Association’s Women Physicians Section Governing Council. Dr. Ravi regularly draws, writes, and speaks at events on how the healthcare system must adapt to meet the needs of trauma survivors.

Women and girls who experience GBV are particularly vulnerable to the feedback loop of illness and poverty known as the health-poverty trap. GBV survivors suffer from the immediate negative health effects of abuse and trauma in addition to numerous barriers to accessing healthcare and achieving financial stability. In this way, GBV exacerbates the cycle of poor health and lost income. However, the specialized needs of this hidden population remain unaddressed by the healthcare system, denying the world the full potential of GBV survivors. Investing in the health of these individuals creates a pathway towards success and elevates our shared humanity.

PHF disrupts the health-poverty trap by investing in the physical, mental, and financial health of GBV survivors. Our project creates a healthcare practice that provides accessible, integrated physical and mental healthcare for GBV survivors while simultaneously catalyzing their economic mobility through innovative financial health interventions.

Health is a vehicle to initiate and sustain mobility from poverty to prosperity. The health-poverty trap limits this movement, particularly for individuals who experience trauma such as GBV, as their needs are often ignored by our healthcare system.

PHF’s model recognizes that, in order to achieve health, GBV survivors require accessible care that integrates their physical, mental, and financial health. These specialized strategies can effectively serve survivors by acknowledging and treating their trauma.

Individuals who experience trauma demonstrate higher rates of chronic disease, impeding their involvement in activities that can stabilize and improve their financial lives, such as education and employment. Though many GBV survivors are battling health issues exacerbated by their trauma, they also face barriers to healthcare access due to stigma, cost, shame, and fear.

Research shows that 96-98% of women experiencing GBV had their work life negatively impacted, including up to half losing their jobs. These dynamics limit their educational, economic, and social potential, leaving us all to experience the unquantifiable loss of survivor potential. Through our knowledge and experience, PHF is poised to dismantle these obstacles and facilitate healthcare access for GBV survivors, striving to mitigate their invisibilization in our healthcare system and society.

PHF’s model grew out of the PurpLE Clinic pilot, which provided medical care to over 250 GBV survivors. While this program had a positive effect, it was evident we could have a deeper impact by targeting the health-poverty trap. PHF utilizes practice-based research and direct experiences from the PurpLE Clinic pilot to address the intersection of GBV, poverty, and health on the individual, community, and societal levels.  

A central part of PHF’s work is facilitating free, accessible physical, mental, and financial healthcare through a PHF-supported healthcare practice. We will address physical health issues like diabetes and HIV, mental health issues like post-traumatic stress disorder and depression, and financial health issues like unemployment and poor credit.

All services will operate through a trauma-focused lens, enabling survivors to initiate and sustainably engage with care. Healthcare will be tailored to survivors’ needs, including longer appointments, childcare provision, and transportation cost coverage.  

In parallel, our practice will serve as a laboratory for healthcare innovation, impacting care across diverse settings and effecting change on a societal level. We will collaborate with survivors to develop our trauma-informed model of care and metrics, disseminating our learnings through training and advocacy efforts that address the health-poverty trap.

We created this example to represent a typical referral received during the PurpLE Clinic pilot. GBV survivors experience abuse, isolation, and resilience. Their physical and mental health is interwoven with their financial and social wellness, and trauma is the thread through which these issues connect and must be addressed.

PHF is dedicated to providing services responsive to the specialized needs of GBV survivors. The PurpLE Clinic pilot was based on interviews with incarcerated, sex trafficking survivors on Rikers Island, highlighting their difficulties in accessing healthcare. We are committed to building a “survivor-informed” organization by formalizing mechanisms for continual engagement with survivors, ensuring our services are accessible, relevant, and effective. A key way in which we engage survivors is through our LEARN Initiative: Lived Experience Advisory and Research Network. This program  provides compensated feedback opportunities for survivors, generating a network of survivor-consultants. We have allocated specific funds for this in our budget.

Ensuring that survivors are leaders within our organization is foundational to our work. We will consistently integrate mechanisms to generate pathways for leadership in our organization to amplify survivors’ voices within PHF and the broader community.

PHF’s core work is to elevate opportunities for survivors of GBV, while driving action to disrupt the health-poverty trap. Survivors are too often left behind by our healthcare system, and we must transform this reality. By integrating a trauma-focused lens into our healthcare efforts and operating from a survivor-informed perspective, we directly impact the health needs of survivors and their families, ultimately amplifying their voices and helping them achieve their potential. Through this process, we can move the collective needle toward dismantling the health-poverty trap, improving health access and care provision for all trauma survivors.

During my Masters in Health Policy research program in 2014, I sent an email entitled “Trafficking Clinic Proposal Draft.” I had been meeting with community-based stakeholders and trafficking survivors for my research on the intersection between health and human trafficking, and the lack of accessible healthcare services for trafficking and abuse survivors was a perpetual frustration. Because I had recently completed my family medicine residency training in a safety net clinic that cared for everyone regardless of insurance or immigration status, I emailed them to ask if they would host a pilot clinic. 

Seven months later, Purpose: Listen and Engage (PurpLE) Clinic opened. Over the next four years, the clinic provided primary care for survivors of trafficking and other forms of trauma, but it also revealed the many limitations to optimizing healthcare delivery for GBV survivors within conventional healthcare settings. Survivors require a multidisciplinary team-based model of care that is sensitive to co-existing financial trauma.  As the pilot ended in 2019, I was determined to address this need, leading me to reach out to like-minded advocates with whom I had collaborated during the course of PurpLE Clinic. We came together to create PurpLE Health Foundation (PHF).

As a woman, I often wonder what the world would be like without GBV. What would it be like to ride the subway without being sexually harassed, to run at night without fearing assault, to turn on the news without seeing a report of a murder-suicide triggered by domestic violence, and for rape whistles to be obsolete?

As a physician, my work constantly substantiates the need to eradicate GBV, whether it is performing a gynecologic exam for a patient to confirm that “female genital mutilation” was perpetrated when she was a child, spending 15 minutes with an anxious sexual assault survivor awaiting the results of a rapid HIV test, or writing a letter of absence for work because a trafficking survivor is experiencing suicidal ideation.  

But my clinical work with GBV survivors also highlights what’s possible. I ask every patient I meet “what is your dream job?”, and the answers keep me inspired: “Teacher! Food truck owner! Farmer! Salon owner! Doctor!” We have a world of future professional and entrepreneurial women for whom excellent healthcare is essential. 

I know a world that’s safe for women is generations away, but the promise of its possibility compels me to action.

My clinical expertise in understanding and addressing the downstream impact of GBV fuels my public health research expertise to develop upstream solutions. PHF is the actualization of this endeavor. 

In medicine, addressing the long-term health of GBV survivors, particularly those who have experienced human trafficking, remains an emerging field. While most efforts focus on screening tools to identify survivors, caring for survivors once they are identified remains a blind spot. As a family medicine physician and public health researcher, I have had unique access and a specialized toolkit to develop necessary best practices in this field. 

My clinical work produces insights that inform my approach to addressing GBV. Survivors’ intersectional identities and experiences impact their healthcare access. Factors such as race, immigration documentation status, and being LGBTQ+, making imperative the need for solutions respectful of these dynamics. As a family medicine physician, providing care for survivors’ children, as well as for GBV perpetrators, further shapes my approach to tackling this complex issue. My research focusing on GBV, health, and trauma has produced multiple peer-reviewed publications, and has generated a unique longitudinal data set from PurpLE Clinic contributing to this field. On a federal level, I serve as a consultant for the Office of Victims of CrimePurpLE Clinic was recognized as a US Health Resources and Services Administration “Promising Practice” in the care of people who have experienced domestic violence and human trafficking, and . 

This is the foundation on which PHF stands to disrupt the health-poverty trap for GBV survivors.

Nothing energizes me more than the word “NO” because, to me, NO means “New Opportunity.” 

I heard  “NO” when launching the PurpLE Clinic pilot inside of a large safety net clinic. After months of convincing the clinic’s administration that there was a need for specialized services for trauma survivors, the pilot was approved. Over the first two weeks, zero patients came. The administration became nervous and told me I had one week to see patients, or they would end the pilot. I pleaded for more time, and was met with NO.

Building trust in a community takes years, not weeks! I had to scramble to find a solution. The women at Rikers advising me on the clinic’s design were also concerned and suggested organizations I should contact. Just as my third clinic came to a close, with no patients, our receptionist ran in exclaiming, “Someone’s here for you!”  He was the son of a woman incarcerated at Rikers. At Rikers the next day, with his permission, I told his mother, and she burst into tears. The PurpLE Clinic pilot went on to serve over 250 patients and win national awards and grant funding.

And it all started with a NO.

Patient volume was the only metric to which I was beholden to keep PurpLE Clinic operating in the larger community health center. But how? 

Human trafficking, and abuse in general, thrives because it is notoriously invisible. This meant that engaging survivors in care would take more than simply creating a clinic and advertising it.

Because I did not have access to staffing or funding, operating the clinic meant taking on all the roles of a healthcare practice, including outreach, scheduling, clinical care, and social service linkage.

To establish trust with potential patients, I literally met them where they were, including on Rikers prior to their release and going door-to-door with homemade flyers and business cards to meet community partners. To establish operations, I created trauma-sensitive referral forms, electronic medical templates, and clinical work-flow protocols. To optimize care delivery, real-time problem solving was essential, including navigating specialist referrals for patients who could not read or write, establishing safety when traffickers came to appointments, paying for patients’ unaffordable medications, and stocking the clinic with food and clothing based on stakeholder feedback. 

These efforts steadily built patient volume to a point where a waiting list was needed, demonstrating PurpLE Clinic’s necessity.

Our work is disruptive to the healthcare sector because of our:

1. Survivor-informed approach 

From design to delivery, our work is informed by collaboration with GBV survivors. Our survivor-informed approach is the continuation of the collaborative design implemented during the PurpLE Clinic pilot. Working in partnership with survivors and trusted organizations led to rapid innovation, which optimized operations, care, and coordination. Examples of modifications to routine healthcare delivery included extending appointments from 15 to 90 minutes and care coordination meetings with survivors’ outside providers. These measures facilitated survivors’ healthcare access, effectively addressing the intersection of their health and social needs.

2.  Financial Health Integration

Medical-debt is the leading cause of bankruptcy in the US. The PurpLE Clinic pilot demonstrated that unaffordable care resulted in survivors re-engaging with an abuser to pay medical bills. PHF’s model supports free healthcare services, including imaging, specialty, pharmacy, and laboratory care.

GBV survivors often face resume gaps, poor credit, or are unbanked, all of which result in limited economic opportunity promulgating intergenerational poverty transmission. Our model incorporates immediate and long-term financial health interventions to support survivors’ economic security and mobility.

3.  Intergenerational Investment

Healthcare is siloed: those who need integrative, collaborative family care are left to cobble together fragmented resources. PHF’s investment in survivor health also means investment in the health of their families. Ensuring their children receive necessary services disrupts intergenerational trauma. Intergenerational investment also means implementing healthcare internship and training opportunities to generate a pipeline of future healthcare professionals from the communities we serve. 

Continuous, survivor-centered evaluation and responsive design practices are integral to our organizational philosophy. Our theory of change evolved from the lessons of the PurpLE Clinic pilot, which integrated advice from survivors of GBV and feedback from community stakeholders prior to the clinic opening and throughout its operation. The PurpLE Clinic pilot resulted in a rich data set gathered from its referral forms and medical records. This data is unparalleled in reflecting the experiences and health needs of a truly hidden population, and we are leveraging the lessons learned from that data to expand our vision for the ways in which a health-focused intervention can mitigate the role of gender-based violence in perpetuating the health-poverty trap.

We have learned from survivors’ lived experiences that violence and poverty are inextricably linked. Financial insecurity and poor health result in ruptured social bonds and weakened community networks, making violence possible and necessary for survival. In communities with high levels of poverty and violence, women are particularly affected, both directly and indirectly. While they are tasked with maintaining social bonds by nurturing future generations and providing financial support to their children, parents, siblings, and others in their communities, women remain significantly more susceptible to interpersonal violence in the home and public sphere. 

Economic policies that prioritize efficiency, productivity, and growth over human capital ignore the imperative to maximize the potential of all people, and result in a failure to invest in impoverished communities. Our work addresses this shortcoming, seeking to generate supportive social institutions by improving the physical, mental, and financial wellbeing of women affected by GBV, educating community stakeholders and policy makers, and conducting and publishing survivor-driven research, thereby dismantling the health-poverty trap from all angles.

PHF is poised to grow substantially in our first five years. We are currently in the phase between the PurpLE Clinic pilot, which served over 250 GBV survivors and their families, and the launch of our PHF-supported healthcare practice. Our goal is to launch sustainable, standalone healthcare services by April 2021.

In the first year of our work, we plan to conduct a program called PurpLE Launch 25. This program will re-engage 25 previous patients from the PurpLE Clinic pilot, with the PHF-supported practice becoming their primary care medical home. PurpLE Launch 25 will enable us to establish our work as a survivor-informed laboratory of healthcare innovation while providing physical, mental, and financial healthcare. During this period, the initial iteration of our project, we will collaborate with survivors to develop effective programming and metrics. Through our financial health programming, survivors will have the opportunity to develop job skills, access employment, and earn financial compensation while assisting PHF in creating best practices. Our interventions will be tailored to each individual and address their unique needs, including ancillary services addressing issues related to financial health, such as housing, food access, and education.

In five years, we aim to scale our model of care to serve 500 GBV survivors and their families. We will also be expanding our service through survivor-informed trainings on best practices in caring for this population and will strive to train 1000 outside providers who serve GBV survivors.

PHF aims to catalyze large-scale change within our healthcare system. Through our established immediate and long-term goals, we endeavor to clearly establish and share our best practices, supporting outside providers in offering integrated, relevant care to trauma survivors, thus working toward dismantling the health-poverty trap.

Goals over the coming year:

• Open PHF-supported medical practice providing physical, mental, and financial healthcare interventions for GBV survivors.

• Re-engage with 25 survivors through PurpLE Launch 25 and establish the cost of care per patient per year.

•  Determine the annual cost of care for a survivor. 

• Collaborate with survivors and multidisciplinary stakeholders to develop metrics and best practices.

• Provide at least 5 trainings to outside providers.

• Publish at least one scholarly article reflecting the development of our work and approach in order to disseminate our learnings and amplify the healthcare needs of GBV survivors.

Goals over the coming 5 years:

• Provide healthcare services to 500 GBV survivors and their families.

• Formalize survivor-informed metrics assessing physical, mental, and financial health interventions.  

• Grow and maintain robust, compensated survivor feedback mechanisms.

• Establish programming that offers survivors sustainable employment opportunities.

• Provide internship and employment opportunities within PHF to individuals traditionally underrepresented in the healthcare field.

• Train and support staff while maintaining reasonable and effective caseloads to prevent burnout.

• Train at least 1000 outside providers in our established best practices.

• Publish at least 5 scholarly articles reflecting the growth and evolution of our work.

• Present our work through conferences and media to impact large-scale change and dismantle the health-poverty trap.

Elements related to funding and sustainability are the primary barriers that will affect our impact over the next five years:

1. Capital funding

The ability to begin healthcare provision is essential to our program launch. Our organization is at a tipping point as a business, as we have a demand for services and partial funding for our PHF-supported medical practice ($1M over 3 years), but are in need of additional capital to begin PurpLE Launch 25

2. Evaluation capacity

Our fundraising endeavors have made us acutely aware of non-medical metrics that we wish had been systematically collected during the PurpLE Clinic pilot. In retrospect, observed trends, such as frequent appointment cancellations, would have been a key quantitative metric to collect. This information would strengthen our compelling anecdotal information, demonstrating the ways in which health and financial trauma are intertwined for GBV survivors. This reflection has made us determined to thoughtfully invest in evaluation capacity from the outset. As a nonprofit, partnering with organizations that will help us develop evaluation measures for our initiatives, particularly those that are at the intersection of health and finance, is critical in optimizing the mission of our work and essential to secure sustained funding. 

3. Financial and Economic Expertise 

Because our plan for sustainability involves piloting interventions to address the financial health of GBV survivors and scaling those findings, we are eager to collaborate with experts in these fields.

We are engaging in the following strategies to address barriers to launching and sustaining our work:

1. Capital Funding

We are continuously seeking new funding opportunities. While working on the healthcare frontlines, the connections between health, poverty, GBV, and community prosperity are apparent. Effectively communicating these dynamics to those who have not witnessed them firsthand is both crucial and challenging. We recognize that an underutilized aspect of our work is strategically demonstrating to potential funders the depth of the PurpLE Clinic pilot data and the experiential knowledge we have accrued. As a result, we are developing strategies for effectively communicating our findings through quantitative data, art, animation, and creative storytelling.

2. Evaluation Capacity

We are investigating partnership and affiliation opportunities with academic institutions to address our need for program and socioeconomic metric outcome evaluation. We are also reviewing the PurpLE Clinic pilot data to identify previously missed key metrics and strategize how to effectively track this information in the future.

3. Financial and Economic Expertise 

As finance and economics are unfamiliar fields to us, we have invested time to better understand key theories and applications of these disciplines as they relate to the intersection of health, trauma, and poverty. This investment has positioned us to connect with individuals and organizations in areas relevant to our work, like financial technology (fintech), banking, and behavioral economics. Ultimately, we aim to generate a multidisciplinary team to develop and assess financial health interventions within our organization.

Prior to launching PHF in 2019, I created a network of over 50 referral partners and collaborators during the PurpLE Clinic pilot. Through these relationships, I frequently led health education groups and workshops for survivors and engaged in formalized partnership agreements to provide healthcare services for legal and social service organizations working with survivors. 

Currently, while working towards launching the PHF-affiliated healthcare practice, we remain committed to serving as a collaborative healthcare partner for community-based organizations addressing the complex needs of survivors in ways beyond direct services. As such, we have strengthened and expanded our partnerships with organizations by offering health education groups for survivors; training healthcare, legal, and social service providers as well as academic institutions; and serving as a healthcare informational resource during the COVID-19 pandemic. Retaining these partnerships until we are in a position to support direct services is a key component of our mission to improve access to healthcare for survivors and increase the trauma-informed care practices of organizations working with survivors. 

While running the PurpLE Clinic pilot, I also collaborated with faculty and students at the Parsons School of Design to optimize the experience for PurpLE Clinic pilot patients. Applying aspects of design thinking was essential to the PurpLE Clinic pilot’s trauma-informed care approach and is also a critical component of PHF’s work moving forward. As such, we have maintained our relationships at Parsons and continue to collaborate with trauma-informed design practitioners.

Our business model is informed by key PurpLE Clinic pilot findings regarding GBV survivors:

1. There is a need for healthcare services

Over four years, the PurpLE Clinic pilot operated primarily with one physician providing care 1.5 days a week. In this time, it received over 600 referrals (resulting in a waiting list), with over 250 survivors newly engaging in routine primary care, and generating over 1,000 visits.

2. Healthcare services should address physical, mental, and financial health

Common reasons why patients did not return for necessary medical follow-up after an initial visit were: inability to acquire concurrent mental health services and fearing the cost of care after receiving bills for services outside of the clinic, including labs, imaging, and medications.

3. Healthcare providers need training in “trauma-informed” care

Survivors avoided necessary care on days when the PurpLE Clinic pilot was not operating because they could not be guaranteed “trauma-informed” services. Appropriate healthcare delivery for GBV survivors needs specialized training in trauma-sensitive techniques for acquiring a medical history, conducting a physical exam, and establishing accurate diagnoses. 

Our business model incorporates these findings to address the need for specialized, integrated, cost-sensitive healthcare delivery for GBV survivors. Our staff have essential specialized training in providing trauma-informed physical, mental, and wrap-around health services. Our operating strategy involves forming collaborations with labs, imaging centers, and pharmacies to coordinate cost coverage for uninsured and underinsured survivors. Our financial strategy involves gradually increasing service-subsidization revenue based on our specialized care delivery model.

In its current paradigm, the US healthcare system is an efficiency-driven business focused on balancing quality and cost of care among its consumers, particularly those who are “high utilizers.” This approach overlooks healthcare non-consumers or “under utilizers.” Our project is a market-generating innovation that invests in a population invisible within the healthcare system: GBV survivors. The PurpLE Clinic pilot demonstrated that investing in survivors is a job-creating intervention, resulting in the need for GBV-informed staff, and the creation of four full-time jobs. It also revealed an opportunity for income generation through a service-subsidization revenue model, in which we train outside providers and produce proprietary materials to facilitate improved care for survivors.

Clayton Christensen’s Modularity Theory underlies our organizational philosophy. Modular products expand markets, while interdependent products create them. The PurpLE Clinic pilot illuminated a need to create an interdependent product whereby PHF relies on developing its own healthcare delivery infrastructure to ensure that it is specific, verifiable, and reliable for survivors. For example, instead of utilizing external referrals to mental health care, which risks connecting survivors with non-specialized providers, we are investing in integrated GBV-informed mental health care.

PHF’s interdependent approach will yield survivor-informed methodologies in healthcare delivery, leading to the creation of novel, modular products and resulting in service-subsidization revenue. For example, as more healthcare systems integrate screenings for domestic violence and human trafficking, there is an increased demand to learn how best to serve newly identified survivors, generating revenue opportunities for PHF to leverage our expertise.

In early 2020, PHF was awarded a $1M grant over three years from the NoVo Foundation to support the launch of our initial efforts. This grant has allowed us to hire two full-time and one part-time staff members and begin to build out our PHF-supported healthcare practice, research, and training  programming. It has been a boon for us in laying down the conceptual foundation of our work so that we may develop a relevant, sustainable, and effective project.

As part of our efforts to dismantle the health-poverty trap, PHF also offers training to outside providers working with GBV survivors in healthcare, legal, social service, and academic settings.  These trainings provide insight into our previous and current work, focusing on addressing survivors’ trauma histories across settings. We generate modest revenue to supplementally support our organization through these efforts, totalling $5,000 over the past 12 months.

As PHF is completing its first year, we continue to explore revenue options and ways in which we can financially support our work while simultaneously supporting survivors and advancing our mission.

We believe that healthcare is a human right and should be accessible and effective for all. In order to support the creation of a standalone health practice with integrative physical, mental, and financial healthcare at no cost to survivors, we must secure sustainable financial resources.  

All in-house healthcare and care coordination will be provided at no cost, along with ancillary services that address survivors’ basic needs. We will also cover outside costs like labs, radiology, pharmacy, and specialty care for uninsured patients. This is an essential component of our work, and we must secure adequate funding to ensure that all survivors we care for receive the quality healthcare they deserve.

We are seeking an additional $1.5 million over the next two years in order to conscientiously and sustainably open our clinic doors and support our uninsured patients. We expect the vast majority of that funding to come through grants. While we have an incredible vote of confidence from the NoVo Foundation through our $1M grant, we must ensure that we have sufficient funding to maintain our work beyond the life of that grant.

Our fundraising efforts involve applying for grants and awards from entities that are invested in fomenting social change. We are currently working toward an April 2021 practice opening date and hope to raise adequate funding by then. It is an ethical commitment to survivors and staff to secure funding that ensures sustainable healthcare services.

PHF’s estimated budget for 2020 is $450,000, though this depends upon our PHF-supported practice build, receipt of additional funding, and how the COVID-19 pandemic potentially impacts our work moving forward. Our budget covers multiple areas including staffing, training, financial health/survivor employment, foundation operations, and practice start-up.

Our staffing and foundation operations are straight forward expenses to ensure we fairly compensate staff and that our foundation’s technology, accounting, legal, and administrative needs are covered.

During the remainder of this year, we will continue providing remote trauma-focused training and develop materials to enhance these efforts. Beyond content development, we will work to integrate technology, including innovative applications and other programs into our efforts to enhance our work and collaboration with outside groups.

Though we are still working toward building our PHF-affiliated practice, we have initiated survivor financial health efforts through our COVID-19 LEARN Initiative: Lived Experience Advisory and Research Network. This program compensates survivors for feedback regarding their experiences during the pandemic, bolstering their financial security and informing our future program development to ensure our efforts are addressing survivors’ actual, not assumed, needs. This project will continue at least through the rest of 2020.

Building the PHF-supported practice is our largest project in both budget and effort. We have established costs of the physical practice including rental space, medical equipment, furnishing, and IT hardware. Additionally, we have budgeted for recurring clinical costs such as medical supplies, language translation, electronic medical records, and utilities.

GBV and poverty are significant and seemingly intractable global health challenges. Connecting with a larger audience through the Elevate Prize would significantly increase the generation of innovative solutions and broad applications of this work. While all four aspects of the Elevate Prize will be helpful in our endeavor, the two most unique and impactful areas of this prize are:

1. Mentorship

While our team is comprised of experts in healthcare delivery, our experience in business management and development is limited. Receiving personalized guidance on how we can strategically leverage our PurpLE Clinic pilot data, build synergistic partnerships, and translate our ideas for survivor-informed financial health initiatives into a sustainable business model will increase our momentum towards achieving an innovative, scalable, and adaptable impact.

2.  Access to a network and partners

A primary reason the PurpLE Clinic pilot was successful was because it extended beyond the silo of healthcare, facilitating multidisciplinary approaches to address the needs of GBV survivors. Collaboration with lawyers, social workers, and community advocates were a norm in the PurpLE Clinic pilot’s delivery model. As we develop our PHF-supported practice, we recognize an essential component of our work is building collaborations with experts in finance, economics, and technology. Access to partners in these fields through the Elevate Prize would enable this work to have a global impact. It would also provide the opportunity to encounter collaborators in new fields we have not yet considered and further strengthen our work.

Our team’s primary expertise is in healthcare delivery. However, collaborating with experts in business (particularly in finance), technology, and program evaluation is essential for the long-term sustainability of our work.

The opportunity to work with experts in these areas will help develop our work in two key ways. On a programmatic level, collaboration with finance, technology, and program evaluation experts will enhance our team’s ability to creatively design solutions based on the financial needs of survivors. Furthermore, as trainings are part of our business model, improving our ability to evaluate their impact and enhance our teaching modalities through technology is also essential.

On an organizational level, having advisors in these realms can help develop our funding and revenue model in a way that is authentic to our mission: achieving organizational sustainability in a way that dually improves the financial health of survivors.

We are eager to partner with organizations outside of healthcare to optimize our work in disrupting the health-poverty trap for GBV survivors. Key sectors for partnership include finance, economics, and program evaluation.

1. Finance

We see opportunities for survivor-centered designs in multiple areas of finance, including banking and fintech. Such partnerships could facilitate solutions addressing the financial trauma of GBV, including debt and poor credit. Left unaddressed, these conditions limit survivors’ ability to access healthcare and achieve economic mobility. 

2.  Economics

Harvard’s “Opportunity Insights” identified three key demographics of “Lost Einsteins,” people whose potential for innovation is never realized due to lack of opportunity: women, minorities, and low-income children. The PurpLE Clinic’s pilot data demonstrates that survivors commonly inhabit the junction of all three. Outcomes resulting from our work at the intersection of health, trauma, and economics can be applied globally to create sustainable solutions. We see opportunities to partner with economic experts to design interventions to improve survivors’ health on a global scale.

3.  Evaluations and Outcomes

While we are experienced in healthcare outcome evaluations, in order to effect the greatest change, we must create metrics outside of this field. Partnering with programs like The Abdul Latif Jameel Poverty Action Lab in this pursuit would maximize the potential of our work. J-PAL’s collaboration evaluating the Camden Coalition’s “High-Utilizer” healthcare intervention was particularly exciting to our team, and we see a unique opportunity to partner with J-PAL and other researchers at MIT to evaluate our work with healthcare “Under-Utilizers.”