The Exchanges

Q How did you stumble upon, uh, the problem you're currently solving at Nirami?

A Yeah. So that's what, so when I was, uh, you know, a lab director for, um, Uh, analytics research, uh, in the previous organization. Um, I was interacting with multiple, uh, doctors, uh, collaborating with our, you know, even senior colleagues at the U S and so on. And, um, so around that time, one of my cousin's sisters got detected, uh, breast cancer. Her name was Bharti and, um, very close. We used to meet every, uh, summer or even before, like, you know, um, And a few, few years, I lived to me and suddenly she was detected with stage four cancer, breast cancer, and the doctor said a few more months and all that. Of course she did, she recovered a bit, um, with her surgery and But it relapsed and, uh, she's no more with us. And in the same spirit, uh, you know, there's another close relative of mine also got detected and she was much younger. And that is the time when, um, I, I thought like, you know, what is, what is this? I, you know, it was very, very shocking. And I saw how the whole episode affected the whole family. And then, um, I said, okay, um, started reading about it. And so, you know, Being in technology, solving so many problems in India and outside, Here is a problem which is taking away 90,000 lives in India alone and more than 600,000 lives around the world when breast cancer is a completely curable type of cancer, right? So, so how, um, you know, how can tec…

AI assessment note: “around that time, one of my cousin's sisters got detected, uh, breast cancer.”

Q What's the cost per desk to a, uh, to a person?

A So in a hospital, it's about one third the cost of a mammography machine, mammography tests, sorry, which basically, um, can be around 1500 rupees in India. Um, uh, this is a detailed report signed by radiologists and so on. When we go for triaging, you can't wait for a doctor's review for every, because the camp is so huge and people will, uh, you know, um, just go home right to the test. So it has to be real time. So it's also an innovation we learned and, uh, we kind of, um, had to make the engine so robust and, uh, so, uh, accurate that we are able to confidently give a provisional reporting completely automatically. Ah, with health workers, ah, you know, administering this test. And of course, because it's all cloud hosted, whenever there is a doubt, you know, you can hit a button and then we get the experts online to review it as needed. And so, so this, ah, is, this is almost hundred rupees per test, assuming the hardware is covered.

AI assessment note: “can be around 1500 rupees in India... this is almost hundred rupees per test”

Q What, what do you think, uh, at what point, you know, you estimate that there will be inflection point where currently you have to convince people, convince hospitals that you have reached a very high milestone, like, 70 hospitals supporting you, 33 patients. And what will be the inflection point where there will be a demand, like, huge demand, where you don't have to go and sell it?

A Yeah. So I think now we are almost in that stage for India, right? You know, right now, uh, um, Let's say for, uh, screening, you know, nobody ever asked the question. I mean, it's, we just go for it. I mean, because, uh, I think we have proven enough. We have shown many designs in that space. We have good partners, uh, for hospitals also, there is, uh, they only want to see, uh, whether it'll work in their condition. Sometimes one day camp is all that they ask for, which is also fine. And with, uh, you know, big hospitals chains coming in, I think in India, we are finding a lot of, uh, A positive traction already, not much effort for, um, sales as we used to have before. Um, recently, as I mentioned, we also got an ISO, uh, 34 85 clearance, as in, we finished the audit and we're expecting the certificate at any time, and also a CE marking. So that has given us, and I believe is going to be a huge inflection point, um, which we've just reached, I would say, um, for not just in India, for several other countries in the, in Asian area. As well as Europe and several other regions as well. Um, and so that, uh, you know, I'm very glad to say that hopefully within the next month, we will actually have the certificate to show and say that, yeah, we've reached that inflection point. And so the way it works is that basically, uh, you have new, new frontiers to, Uh, you know, to take car…

AI assessment note: “I believe is going to be a huge inflection point, um, which we've just reached”

Q And, and today at how many locations is the, as the device and the technology deployed, if you count?

A Yeah, so initially, initial few year, for a few months, we focused only on, uh, Bangalore and we had a Hyderabad partner who is a very cold coast partner. Um, So now we have it in 15 cities, uh, in India, uh, established in multiple, like, uh, Bangalore, Delhi, Chennai, Mysore, Bhuvaneswar, Dehradun, all of these places, Savopal, all of these places we do have, uh, the test available. Uh, with the home screening coming along, um, you know, we do provide this test in many more, um, you know, outskirts of these areas as well. And, uh, we've started, uh, a new program for, uh, what we call as Dano entrepreneurs, uh, who are, uh, homemakers, uh, generally, but they do have some spare time and they want to do some kind of a service, uh, to women around them. So we train them, provide, uh, the skills needed so that they can provide the home screening around their own locations, be it in tier two, tier three cities as well. And this is a program we have newly launched, uh, we are just, uh, going through the trainings and so on and so forth.

AI assessment note: “So now we have it in 15 cities, uh, in India”

Q So, uh, Geeta, uh, tell us your journey from your family background to your childhood. So what, what, what have been the key, uh, beads in the string of life of Gita Manjunath, if I can ask?

A Sure, um, the very young Gita Manjunath, which I am no more, uh, was a very, very shy, shy, shy girl. And, you know, I have two, one brother, one sister. My parents were very traditional. Um, having said that, my father and mother, uh, kind of, you know, um, believed in giving, uh, Uh, you know, giving what the child likes, you know, so for example, if I have to study something, you know, um, whatever you like, you study, for example, at my, um, 12th stage where like Barbie, right, you know, where you have, uh, only two options possible at that time, like doctor, yeah, engineer. So, um, I managed to get both, um, you know, very top college in both the streams, and everyone said, you're a girl, you have to do Dr. Giri, you know, this is long, long ago. Uh, but, but I've always been, uh, in love with science and maths and so on. Thanks to my father who was like, uh, you know, a key motivator for me to be in that, uh, in that area. And, uh, so, so, um, I, I was very sure that, you know, I want to spend my life not doing biology, but it's a, it's a completely different thing that now full circle. And I am, I am looking at engineering application in biology as such, but, you know, that's how it was. And my father completely supported, um, Uh, you know, uh, my, my choice, uh, in terms of, uh, doing engineering, computer science. I did, uh, in, at that time atop college, um, you know,…

AI assessment note: “the very young Gita Manjunath, which I am no more, uh, was a very, very shy”

Q in the last four years, what you have been and your team has been able to accomplish. So, so how has been the fundraising part of your journey been as an entrepreneur? What were the challenges during that part? And what are the challenges currently, which you think, you know, you face to scale it to, let's say a hundred cities in India, and maybe even abroad in developed markets?

A Yeah. I think, um, um, the challenges of, um, uh, fundraisers same for all entrepreneurs, uh, for healthcare becomes slightly difficult because, um, you know, the time to market is a little slower. So if you just go by the financial metrics, uh, obviously there are, there'll be much, um, much more attractive startups, you know, but if it's like risk versus reward, right? You know, how big a bet, you know, how many venture VCs or angel, um, Investors would take that big bet, right, you know, and, um, uh, make a call as to, yes, uh, this is, uh, probably a breakthrough innovation for, uh, breast screening. Um, Will, will the team go ahead and, uh, break the barriers of a very well established test, right? You know, this is a question that most investors had. I mean, uh, yeah, of course that, that doubt is still there, but thankfully we do have 30,000 plus women, you know, who are able to come and stand in front of us and like take the test, you know, it's the trust of the end users and we have 70 plus hospitals who have actually fully convinced their doctors, convinced their management to actually give this test, which means, you know, there is some stuff. And of course we do have clinical validation with this. Uh, so initially when we didn't have any of these, you know, we just had an algorithm, and I think, uh, um, the, I think the main person who trusted in this is, uh, from P…

AI assessment note: “for healthcare becomes slightly difficult because, um, you know, the time to market is a little slower.”

Q uh, being a healthcare, Start-up in India, especially in the hardware plus software sector, right? It's just not distribution of medicines, right, with most startups. It's very key technology. What have been the, you know, the major roadblocks in your journey besides the one you just mentioned? And do you think, uh, is there a time that India can really innovate in healthcare? Like, what would be the key factor?

A Uh, definitely. I think this is the time India can innovate in healthcare. So that's an easy answer. Let me go with that first. Um, uh, because, uh, this is a time where people are also caring for their health. You know, earlier, uh, preventative mindset was not there, even though it's not there, but it's much, much better. Uh, you know, these are some of the good things that COVID has done to the world, right? You know, people do care about their health, uh, now, and they know what, um, Not being healthy can mean to the world. I mean, it's really, really important. So that is that, right? And, um, and, and also there's a lot of, uh, higher budget we see, right? You know, the Indian government and other governments are putting. So even the government has realized that health is an important sector and increasing the budgets. I think these two things, and also this huge amount of problems here, right? You know, unsolved, especially if you look at affordable, accessible healthcare, technology can make a huge difference because Uh, you know, they can provide, uh, like additional skills and expertise to the, uh, lower skilled, uh, you know, in, um, people in the framework and, uh, enable scalability to the doctors. So there's a huge opportunity, and there are thousands of diseases to be solved, right? You know, and there's no dearth of diseases that you want. There are no dearth of…

AI assessment note: “definitely. I think this is the time India can innovate in healthcare.”

Q And what are the key milestones that Niramai has achieved till now since the start?

A I think we, uh, personally, I feel it is, uh, we have come a long way. Of course we have a longer way to go, but, um, you know, I never thought when I just jumped out of, um, um, my previous organization along with Nidhi, uh, who's my colleague at that time. And, um, and also Shiva and Himanshu, two other colleagues, technical colleagues. Um, I never know, uh, what, what it's going to be like an entrepreneur, because I have always been within a cushion of the corporate environment. Um, and of course, like big teams, but, uh, you know, there's, there's more to entrepreneurship than just, um, managing teams or, um, managing programs or projects. Um, within about, uh, six months or so, uh, we were able to convince a hospital to provide the solution in, Their, you know, as a reference customer BMS hospital gave this as a test in their own hospital. So that I think was a major thing because, uh, here is a way of providing, uh, uh, privacy aware screening to women, um, and do it in a remote fashion, using, using SAS, right? You know, using cloud and so on. So you can have doctors come in and see, uh, the reports or images, um, um, As in when needed or whenever there is down. And also having tools like what we developed the software analysis thermolytics that we call it as, um, the engine which generates these scores and it's a more of quantitative analysis of imaging versus this. Um,…

AI assessment note: “we were able to convince a hospital to provide the solution in, Their, you know, as a reference customer”

Q So, so, uh, please help me understand that worldwide till now mammogram has been the main device for breast cancer screening, right? How, how is the technology at nearby? How, like, uh, better than mammogram, like,

A Yeah. So, um, see mammogram is good. And actually it's one of, uh, in fact, it's the only test which is proven to increase, uh, you know, increase the survival rates of women, um, in terms of, you know, really large clinical trials and so on. Uh, it's good, but it does have limitations, right? You know, for example, it does not work on women under 45 years of age because what we call, what we call as dense press, you know, The kind of fibroglandial tissue that, um, um, many of the men who are like about what if I also have this and also younger women definitely have this. So, so the whole breast appears white and you're not able to find a white spot, which is, uh, likely cancer there. And so, uh, so this is a big limitation and, uh, which again, uh, people are becoming aware clinicians are, you know, are able to, uh, you know, mention this to the end users. In fact, uh, there are rules which say that Uh, people need to know the overall breast density, uh, to, to see whether mammography result can be dependent upon or not. Uh, the other aspect is also affordability and accessibility angle, which is, uh, which is a big deal for countries like India, where our 3002 thousand rupees test cannot be, um, you know, administered for everyone. Um, even a working lady will think twice, you know, before paying that much, because we are talking about every person going through screening Onc…

AI assessment note: “it does have limitations, right? You know, for example, it does not work on women”

Q Well, whatever, you know, so first I want to ask you so, so many achievements, like it is the longest introduction in the history of hundred X entrepreneur podcast. What, what has been the drive behind you being such a big achiever?

A Yeah, I don't know about the big achievement or whether achievement is, uh, based on sort of, you know, um, your, uh, size of the profile. Uh, thanks for doing all the research to figure out, uh, you know, uh, things about me and writing this up. Thanks a lot for inviting, um, me to this forum too. So I, I, I don't think like there's no mantra aside from the success, but I would, um, Uh, you know, maybe share a few things that may be useful to the audience. So one is, um, I believe in this sort of Karma Yoga aspect of it. That is, uh, basically this is, uh, Bhagavad Gita, you know, third chapters, chapter and all where we talk about, um, Do the job for the fun of the job itself. Any task that you do, right. Do it for the actual task, not for the results. Right. I think that's very, very important. And we, of course, we've all heard this, uh, you know, uh, saying and so on, but actually if you try to do that, you know, I mean, just put a hundred percent into the activity and enjoy the activity rather than sort of, you know, uh, do it for the results. You know, I'd say whether you're studying for an exam, you are, uh, you know, Obviously doing an entrepreneurship where there's a lot of ups and downs, and obviously you can't, there's no sort of end goal you usually go after. But of course, if, um, the, the direction you're going, um, is, is because you enjoy the direction, because…

AI assessment note: “I believe in this sort of Karma Yoga aspect of it”

Q And, ah, which city were you born and brought up in?

A Everything was Bangalore. I've been a Bangaloreian. Of course, I've traveled quite a bit abroad. In many, many countries. My daughter keeps counting how many countries. I think I've reached more than 25 now. And, um, yeah, so, so that, uh, gives me, um, a perspective of the world to some extent, right? And, uh, I really love interacting with, uh, you know, people of common mindset and so on. And there's so much commonality across different countries, I feel, right? And there's also, of course, differences. So when you try to see this, you know, you can also think about, um, Uh, products and solutions, which are addressing the commonality. Obviously you can always see the difference, but there's also commonality, right? Once you see that it's a product for the world, you know, so, so several learnings, uh, along the way.

AI assessment note: “Everything was Bangalore. I've been a Bangaloreian.”