For Mukti Bosco, Founder and CEO of Healing Fields Foundation, the journey from healthcare to the development sector began with two encounters that stayed with her– and changed the way she thought about health and poverty. Both instances showed her that when one person in a poor family falls sick, the consequences can reach far beyond the illness itself.
From Healthcare To A Larger Question
For Mukti Bosco, the path to the development sector did not begin with a conventional career shift. Trained as an occupational therapist at CMC Vellore, she later worked in Vellore, Bengaluru and the United States before pursuing a Master’s in Healthcare Management through Administrative Staff College of India and Johns Hopkins University.
Her education at CMC Vellore had already shaped how she viewed healthcare. She recalls being taught the importance of empathy, care and focusing on the needs of poor patients. As an Occupational Therapist, she also learned that preventing illness or starting treatment early could save lives and limbs.
But it was during her Master’s, while visiting communities, that she began to understand another dimension of healthcare: the financial cost of falling sick for families who were living with very little. In Hyderabad’s Charminar area, she met women belonging to a self-help group and asked how families managed financially when someone fell ill. The answer stayed with her.
The women explained that they sometimes had to mortgage productive assets to pay for healthcare. When Mukti asked whether these assets included sewing machines, zardozi frames or pushcarts, the women said no. One woman eventually revealed that she had pulled her six-year-old son out of school and sent him to work at a tea shop after the family had borrowed money because he had typhoid.
For Mukti, the incident was particularly difficult to accept because typhoid was a preventable illness. She also had a five-year-old son at the time.
The encounter became a transformative moment for Mukti. It made her see healthcare not only as a question of treatment, but as a question of financial security, dignity and the choices families are forced to make when they cannot afford to fall sick. It also planted a larger question in her mind: could there be a way to protect poor families from the financial shock of illness before it pushed them into deeper hardship?
That question led her to think about health insurance as one possible way of protecting poor families from healthcare-related financial distress.
A Lesson In Dignity
A second encounter reinforced the same idea, but also brought another, deeply personal lesson about dignity. In Nalgonda, Mukti met a Dalit widow whose husband had passed away from HIV. She was raising three children and collecting firewood to sell. Around the same period, India’s insurance regulator was emphasising the need to include poorer communities within insurance systems.
Mukti explained the concept of health insurance to the woman and asked whether she would be willing to pay an amount she could afford. Her response has stayed with Mukti ever since.
She did not want charity. She was willing to pay for health insurance what she could afford, but she wanted an assurance that when she became sick and went to a hospital, she would be treated with respect and dignity. For Mukti, there was something profound in that response. The woman was asking to be heard, to have a choice and, above all, to be treated with the same dignity she would expect for anyone else.
It reinforced something that would become central to Mukti’s work: communities do not simply need services delivered to them. They want their voices to matter. They want to be listened to, understood and included in decisions that affect their lives. For Mukti, this encounter established a principle of dignity and respect that continues to shape her work.
“Charity does not mean there’s no lack of respect or lack of dignity. We have to treat the poor with dignity.” These two encounters one that showed her the devastating financial consequences of illness, and another that reminded her of the importance of dignity eventually led to the establishment of Healing Fields Foundation in 2000, with health insurance as its starting point.
From Insurance To Prevention
Over time, the team at Healing Fields realised that financial access alone could not address the healthcare problems faced by communities. People were still reaching hospitals with illnesses and complications that could have been prevented.
The organisation therefore began combining health financing with preventive healthcare education. Its approach evolved into training rural women as Community Health Entrepreneurs (CHEs), women who become trusted health catalysts within their own communities.
CHEs are trained in disease prevention, nutrition, water and sanitation, common illnesses, non-communicable diseases, maternal and child health and community health. They also learn first aid and serve as first responders during emergencies.
Some sell products in their communities such as sanitary napkins and nutrition packets, helping them generate an income while making essential health products more accessible within their communities.
Technology has also become part of this work. CHEs learn to record vital signs, identify emergency and non-emergency situations and connect patients with telehealth services when required. They collect information about health concerns in their villages, helping communities and local health systems understand where support is most needed.
Healing Fields has trained more than 8,600 Community Health Entrepreneurs, reaching around 10.2 million community members across 10 states in India, as well as 200 communities in Indonesia.
The numbers tell one part of the story. The other is in the women themselves, women who are gaining knowledge, confidence, mobility and an opportunity to become health leaders within their own villages.
Taking Healthcare To Underserved Communities
Following the COVID-19 period, Healing Fields consciously focused on some of the country’s poorest regions. Its work includes eastern Uttar Pradesh, the Bundelkhand region of Uttar Pradesh, Jharkhand, northern and western Bihar, and Telangana, where the organisation is headquartered.
The organisation is also looking towards the growing burden of non-communicable diseases and elder care. Mukti said Healing Fields has proposed work in these areas with governments, with the aim of complementing existing government programmes.
Its future plans include working with health systems on digital enablement, learning management systems and AI mentors, with a particular focus on women, elderly people, NCDs and elder care. The organisation also works in government schools, where it focuses on health equity, gender justice and gender equality.
Across these efforts, the underlying idea remains simple: healthcare works best when it is by the community, with the community and for the community. The women who become Community Health Entrepreneurs are not simply delivering information or services—they are part of the communities they serve. They know the people, understand the realities and often recognise the barriers that can keep someone from seeking care.
For Healing Fields, bringing healthcare closer is therefore not only about physical proximity to a hospital or a doctor. It is about bringing knowledge, confidence and a sense of ownership closer to people’s everyday lives and ensuring that communities have a voice in shaping their own health.
The Challenges Of Working Where Help Is Harder To Reach
The work, however, comes with significant challenges. For Mukti, funding remains a major concern. She has seen funding for NGOs reduce considerably, and securing Corporate Social Responsibility support has become particularly difficult. Remote areas create another structural problem because regions without industries have fewer corporations and therefore fewer local CSR resources.
Finding qualified and committed human resources is another challenge. Working in remote locations such as Hariharganj, Banda and Latehar can make recruitment difficult, particularly for people who are willing to stay and work in these communities.
Digital connectivity is also a practical barrier. Women trained by Healing Fields may have to travel to specific locations within their villages where internet connectivity is available so that information collected offline can be uploaded.
The Logical Indian Perspective
Mukti Bosco’s journey illustrates how healthcare inequality can extend far beyond access to a hospital. For families living with limited resources, an illness can affect education, employment and the assets they depend on for their livelihood. Her experiences in Hyderabad and Nalgonda pushed her towards an approach that combines healthcare financing, prevention, community knowledge and dignity.
Healing Fields’ work also highlights the importance of taking healthcare knowledge closer to communities. By training women as Community Health Entrepreneurs and combining health education with first aid, telehealth and data collection, the organisation is attempting to build local capacity rather than relying only on hospitals and external interventions. Its continuing challenges, particularly funding, staffing, connectivity and malnutrition, underline the difficulties of delivering sustained healthcare support in remote communities.
Can community-led healthcare help bridge the gap between medical services and the people who need them most?
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