Rita Prasad-Ildes On Providing Accessible Healthcare For Multicultural Australians
With over 30 years not for profit and public sector experience, Rita concluded that the tackling of entrenched and systemic issues relating to health inequity required a different approach and pursued a social enterprise approach as co-founder of World Wellness Group in 2011 where she currently works as the Managing Director.
Rita and her team have been recognised for their pioneering work in this area with a Qld Government multicultural business excellence award, a Telstra Business Award in the charity category and in 2021 Rita was awarded a Westfield Local Hero Award.
Rita discusses providing accessible healthcare to multicultural Australians and how social enterprises can influence deepened systemic impact.
Highlights from the interview (listen to the podcast for full details)
[Tom Allen] - To start things off, could you please share a bit about your background and what led to your passion for health and social enterprise?
[Rita Prasad-Ildes] - I'm actually a social worker by training and have been working in the sector for 35 years. I think it was a combination of my own personal experiences. I'm a child of the sixties born from interracial marriage. I came to Australia, my family migrated when I was a teenager. Becoming a social worker, I was always passionate about wanting to really work in the multicultural sector with migrants and refugees. I worked in the not-for-profit sector, but I also ended up working in the public sector.
For about 20 years, I worked in mental health and increasingly became frustrated with seeing people in the hospital system who just really ended up in crisis without there being any support available in the community. I had this group of colleagues and friends, and we used to vent at each other saying, "if only there was something available." In the end, we said to each other, "why not us? Why don't we set something up ourselves?" It was really five of us health workers who formed a company, and we called it World Wellness Group. We had big vision around working with people from all around the world. We deliberately chose the word wellness to get away from the illness paradigm and labelling. We really saw ourselves as a group; as a tribe working together as equal partners, and really wanting to do something about this issue. We all put in $500, got ourselves insured and registered, and I've never really looked back.
As the Managing Director of World Wellness Group, tell us more a bit about the projects you've been involved in and the impact you're creating?
We've been around for 11 years now, and we always talk about ourselves as working in the system while we work on the system. One thing that we've really learned in the last 11 years is that by running a clinic, we are just lifting the lid on so many issues, and health inequity is very much a systemic issue. Our work goes really across the whole spectrum.
Our engine room is a clinic, if you look at us, we look like a typical medical centre. But what goes on in the background is quite different. We have a whole lot of what we call wraparound support services for people. Working with people who experience a lot of social disadvantage and complex health issues is just one approach, but then you need to have other support services.
We have mental health services and even legal support for people whose health is impacted by their legal problems; also, we’re multicultural focused, so we have specific programs such as asylum healthcare, where we work with individuals seeking asylum who don’t get access to healthcare. We do a lot of pro bono work, and then we have all these other works sitting behind us, which is what we call Our Voices, so our lived experience is very important. We'll try to be very authentic and hear from the people that we are working with now. Our work is very informed by our clients, but also, we really want to elevate their voices in the healthcare system so that we can have an impact on policy ultimately to tackle systemic issues.
We also have this other area of work that we call Contribute, because it's really not just about us, it's about galvanising the support of people across multiple sectors. I'm also here talking about the corporate sectors of philanthropy. When I talked before about working with people who don't have access to healthcare because they are seeking asylum, a lot of that's actually funded by corporate organisations and philanthropy to help us do that type of work. Ultimately, the other area of our work is what we would call our Knowledge Hub. At the end of the day, we really struggled with this idea when we started World Wellness Group, and people keep asking us, "so when you're setting up a clinic in other parts of the country, do you see yourself going into a franchise model?" As a business, we say no. We are learning so much from doing what we are doing, but because the fundamental issues that we focus on are the inequities in the health system, we need to really be using that information to do systemic work.
We use knowledge and information to try and have evidence-based policy discussions to influence change where inequity is being created in the first place. We really act as advocates in the system as well.
We're health workers, we end up doing all the presentations, and we’re trying to get really good now with data. We've come a long way in terms of thinking about what data to collect and contribute that information back into the system to break down those inequities in healthcare. That’s really our model of how we work; working in the system while we work on the system, that's very much our motto.
Where are there opportunities to improve communities and what is your opinion on the state of social entrepreneurship in Australia?
It's such an exciting space to be in at the moment. When we started 11 years ago, we actually really struggled with this notion of social enterprise, because we were quite alone in this space, particularly because we had a health approach. We really looked internationally, especially a lot at the UK because they had some really great examples of how healthcare organisations were doing work through social enterprise. That really inspired us to think we can do that here in Australia too. But we felt really lost I in the social enterprise sector when meeting with people. It was very employment and technology start-up focused 11 years ago, and we really held onto to aspiration of being a social enterprise.
We wanted to use a business model, because we are a healthcare organisation, and in Australia, primary healthcare like GP practices are small businesses. We knew we had to do it that way, but how do you do it as a social purpose organisation that is not profit driven?
We are in a business model where the more people you see the more money you make, but we see people with complex health issues, and with 80% of our clients speaking languages other than English our services take much longer to deliver. There is an in built obstacle in our business model, so we've really had to learn a lot of difficult lessons along the way. Looking at it now today in 2023, the whole environment has changed.
We've got government that's signed up to our policy frameworks who support social enterprises. We've got social procurement policies; it's such a different environment to be working in now. I think people now understand what social enterprises are, although I do feel from a health perspective, we still have a bit further to go. I'm really hoping that within the social enterprise sector itself we can be a little bit more inclusive of those of us who don't fit the traditional social enterprise models. But then again, what is a traditional social enterprise model? We see so many innovative and great approaches, but I think the fundamental use of our profits for purpose for good and being really clear about that is important. People get a bit confused and are more familiar with the typical not-for-profit type of environment. But we actually want to make a profit, we need to make a profit. It goes back into the business, and so people need to understand that. We still have some more work to do in that space, but it is definitely very exciting times in Australia for social enterprise.
What advice would you give to other health practitioners or social entrepreneurs who are working hard to tackle healthcare inequity or other broad issues?
My first advice is creating a team. Teamwork is so important and interesting A lot of the sector has been founded around big personalities, people and grand ideas. But really you need those leaders. Having teamwork is really important, and I also think particularly as health workers, we are so risk averse from our training.
In social enterprise, you've got to take risks.
For instance, we actually started our clinic through a crowdfunding campaign by StartSomeGood. We had no idea what we were doing, we weren't even savvy using social media! It paid off because people really got behind our vision and idea, and we raised some money and were able to take a lease on a small clinic that really kickstarted our whole journey. Sometimes I feel risks are important. Then find people who know, there are so many great people out there who are very generous with their time and sharing their expertise and understanding.
We have made lots of mistakes along the way after starting 11 years ago, whereas if we were starting now, there are just so many programs and people out there who really notice these projects. Get that expert advice, because you don't have to reinvent the wheel.
There is a lot of really good tools and resources out there. That's the advice I would give to people today, just for the lessons that we've learned along the way.
What are some inspiring projects or other enterprises you've come across recently which are creating some great positive social change?
Being a multicultural organisation, we all really look up to Saba Abraham from the Mu’ooz Restaurant. It has been going for over 20 years, and a sad fact is only 5% of social enterprises last more than 10 years. This is an organisation that's been operating for over 20 years, training refugee women in hospitality. Also, several years ago I met a group of Yolngu women from Arnhem Land in a workshop, and I started following their story. They're called Hope For Health. What they do is they tackle all the inequities that happen in Indigenous health, particularly with chronic disease. They teach their communities to reclaim their traditional lifestyles and diets and have actually achieved amazing results by doing that and giving grassroots initiatives that I really feel we need to get behind an opportunity. We hear so much about closing the gap and equity for Indigenous healthcare, but this is a bunch of women who just got together and thought, “we're going to do what we know works for us traditionally.” There are people now working with them documenting and testing that, and they're getting amazing results.
To finish off, what books or resources would you recommend to our listeners to check out?
I think anyone who's interested about the content of our work regarding health equity issues, a really fantastic resource was actually launched last December by The Lancet, which is an international medical journal. They released a whole lot of articles and work they've been doing internationally, looking at the impact of racism, xenophobia, and discrimination on health. They are really taking a very systemic approach to their research, so really looking at racism as a key systemic driver of health inequity in healthcare systems in a really well researched manner. For anyone who's interested in that type of issue around healthcare inequity, I really recommend looking at those articles online. From an organisational perspective, I'm a really big fan of Frederic Laloux's book Reinventing Organizations. It's just a really fantastic book that looks at the evolution of organisations from traditional hierarchical models which he describes as 'Red' organisations to the other end of the spectrum, ‘Teal’ organisation. This includes new model which I think social enterprises aspire to be. They are flat structures which prioritise teamwork, worker self-management, autonomy, and peer relations.
Being health workers, where we've been trained in these really hierarchical systems, we are really thinking about how we can do things differently. The evidence that he presents internationally where he engaged in case studies on companies that are very successfully doing that, concluded it leads to better business outcomes. Particularly post COVID-19, we're also talking about how work has changed and what workplaces will look like in the new world? People are looking for that autonomy, flexibility, less hierarchy and effective structures. I think that's a great book to read, not to be inspired by others who've done it, but to learn from that and really give yourself a framework in which to see it. At World Wellness Group, we really aspire to be a team organisation, and it's a great book to inspire founders and leaders in this space.
