27 Jul 2017
Seeing a Way Forward
A social enterprise leader looks for ways to improve services for a critical health care need in Mexicoby Jennifer MyersTopics:
Photos by Rafael Monroy
Daphne Leger (MBA 2012) did not enroll in business school to maximize profits, but rather to maximize social impact.
“I firmly believe that business has a key role to play in solving social problems, and the power of business is to transform these problems into opportunities,” Leger says. “I believe the idea that there is an inevitable tradeoff between profit and impact is fundamentally flawed and can be challenged through innovative social enterprises that will tackle markets and needs previously ignored.”
Leger is the director of continuous improvement for salauno, a Mexican for-profit social enterprise that makes eye care, including much-needed cataract surgery, accessible to thousands of people annually.
Blindness is the second leading cause of disability in Mexico, with more than 2 million people suffering from cataracts—700,000 of whom are completely blind due to the condition. In addition, 3 percent of Mexicans suffer from glaucoma and 7 percent of diabetics in Mexico are needlessly blind.
According to salauno, only 30 percent of the Mexicans who need corrective vision procedures or assistance receive it. Lack of access, long wait lists, and expense are enormous obstacles, with cataract surgery costing between 18,000 to 30,000 pesos (about $1,000–$1,500 USD) in private institutions.
Founded in 2011 by engineers Javier Okhuysen and Carlos Orellana, salauno helped more than 150,000 patients in its first five years and performed more than 18,000 surgeries, 40 percent of which were free of charge. The enterprise has been able to reduce the cost of surgery by up to 60 percent, working with support from partners that include Duke University, World Diabetes Foundation, Pfizer Foundation, and the World Bank.
In her role, Leger works to make the organization’s operations more efficient through strategic improvement projects, thus allowing salauno to better serve its patients.
Leger’s passion for social impact was itself borne of growing up a citizen of the world.
Born in France, she and her family moved to Berkeley, California, when she was seven years old and did not speak a word of English.
Her father, a pilot, often took the family on weekend adventures to locations that were accessible only by air, landing a single prop plane on roads while vehicle traffic waited for them to clear the “runway.”
“It was a very exciting childhood, which created in me an appetite for exploring and discovering new places and people very early on,” Leger says.
At 12, Leger was living in Pondicherry, India, her mother’s hometown, which made her aware of what it meant to live between two cultures. Three years later, at 15, she was back in Berkeley for high school followed by a summer in Spain. By her senior year of high school, the family had moved again, this time to Vancouver, Canada. It was the fourteenth school of her youth.
That nomadic spirit instilled in Leger an interest in international relations, which she pursued at American University. While there, she studied abroad in Ghana in order to learn more about that part of the world.
“I had initially imagined a future in international diplomacy but quickly realized the political side of things was not for me. I was more drawn to the idea of fighting the poverty and inequality I had seen around the world,” Leger observes.
Following graduation, she spent two years as a junior professional associate at the World Bank, working with government and NGO representatives internationally.
“I eventually came to the conclusion that, though these traditional institutional efforts had their place, it was not the way I wanted to have an impact,” she says.
Leger then shifted her focus to social enterprise and the concept of “business at the base of the pyramid,” realizing that she needed more business knowledge in order to explore the innovative, entrepreneurial side of social impact.
Leger’s manager at the World Bank encouraged her to apply to Harvard Business School and earn her MBA.
“I found my time at HBS to be incredibly fulfilling—academically, intellectually, and socially,” she recalls. “My best memories of HBS are the small groups of international students that would get together for dinners and have wonderfully spirited conversations.”
At HBS, Leger was involved in the Social Enterprise Club and participated in social impact consulting projects in Peru and Haiti.
“My job search was a bit like looking for a needle in a haystack to find relevant organizations and opportunities, but thanks to the power of the HBS network I eventually did,” Leger notes.
After earning her MBA in 2012, Leger moved to Mexico City, having never been there, to take a job with Frogtek, a social enterprise that helps small businesses modernize their operations through technology.
Three years later, looking for a new challenge, she came across salauno. Captivated by the organization’s mission and work, she negotiated a month-long project to show the directors how she could make their operation more efficient.
“I diagnosed the sales and service pipelines, and recommended improvements and concrete action plans that were designed to improve patient conversion and timelines, from diagnosis to treatment,” Leger explains. “The project led to fewer required patient visits, better management of patient follow-up, and improved coordination of patient handoffs between departments and clinics.”
That month-long assignment ultimately evolved into the full-time role she has today.
In her capacity as director of continuous improvement, Leger works with salauno’s management team to determine their annual strategic goals and plots the course for realizing them.
“I assemble an interdisciplinary team—doctors, nurses, optometrists, and administrative staff—from across the organization, to represent our different clinics and areas,” she says. “We then run projects to tackle the improvement opportunity using Lean, Six Sigma, and human-centered design methodologies. “
Leger spearheaded Wow salauno, a major initiative that was designed to raise awareness among employees as to the impact their actions have on patients. It also demonstrated ways in which to improve the overall patient experience.
“This project touched everything from signage and seating, to the visual tools that staff use to explain a diagnosis to patients and their families. It has completely changed the way salauno defines the patient experience; and in the next phase, it will include technology to keep delivering what matters most to patients,” Leger says.
Recognizing the importance of feedback, Leger worked with staff to create the BooWow Factor, measuring the “wows” and “boos” generated through follow-up phone calls to a sampling of patients who visit a salauno clinic. Management finds that such direct feedback is an invaluable tool in identifying areas of care that need improvement.
Leger has also reduced wait times in salauno clinics by using Lean and Six Sigma methodologies to change clinic schedules, optimize operational flow, and improve communication. These practices have resulted in a 20 percent drop in the number of patients who wait more than an hour for their medical consult.
“At salauno, anytime I have doubts about the work we are doing, I go downstairs and enter the hospital, where I am immediately reenergized by seeing the impact we have on our patients,” Leger says.
One patient whose story has resonated with her was Soledad, a woman who had arrived for her cataract surgery in a wheelchair, badly bruised from injuries sustained the day before that had been caused by falling in her home as a result of poor eyesight.
“She said she couldn’t take it anymore and felt it just wasn’t worth going on like this,” Leger recalls. Following Soledad’s surgery, a nurse removed the patch from her eye in the recovery room, just for a second. “Soledad turned toward me and said, ‘I can see you! Normally I wouldn’t be able to see you. Now I can, with colors and all!”
Excited about her new lease on life, Soledad began talking about her family and how she was planning to start cooking again and wondering when she could have surgery on her other eye.
“I could tell she had just gotten a part of her life back,” says Leger. “We give eyesight back to patients like Soledad, every single day.”
Leger is excited about the future, as salauno just opened a new, high-volume surgical center for which she led the design to optimize for both patient and staff experiences.
“I will now be leading projects to drive our operational efficiency to the next level and to deliver an even better ‘wow’experience through technology,” she says.
Long-term, Leger is committed to empowering people through innovative social-impact models, in particular by moving toward a coaching and consulting role. She encourages current HBS students interested in social impact to not follow someone else’s idea of a path for success, but rather to look themselves for innovative ways in which to make a real difference and achieve financial success, simultaneously.
“It will be so much more fulfilling personally and it will lead you to the types of endeavors the world needs, to tackle the tough social problems we face,” she says. “Don’t accept traditional tradeoffs; instead, create new win-wins.”
Class of MBA 2012, Section I