The NKF: Controversially ahead of its time?
by Susan Long
A RETIRED contractor who wants to be known only as Mr Tan used to be a National
Kidney Foundation (NKF) donor until he was hired to install some bathroom
fittings for its new headquarters at Kim Keat Road in 1995.
Inside chief executive T.T. Durai's office suite on the 12th floor of the $21
million building, he says he 'lost it' when he had to install, among other
things, a glass-panelled shower, a pricey German toilet bowl and a gold-plated
tap.
'I started screaming my head off. The gold-plated tap alone cost at least
$1,000. It was crazy. If you're Bill Gates and own your own multinational,
whatever you want, fine. But you're a charity, using donors' money,' he huffs.
After his outburst, he was told to 'just do' his job. The shower stall remained,
but the taps he eventually installed were 'scaled down' to an upmarket
chrome-plated model.
To this day, the 54-year-old belongs to NKF's die-hard detractor camp, unmoved
by its shining success in social entrepreneurship and its track record in saving
lives. As he puts it: 'After that day, not a cent from me. I'm not going to pay
for gold-plated taps.'
Asked for its response to the contractor's story, the NKF's public relations arm
sidestepped the details and said yesterday: 'Since you can't give us details of
the contractor... it is difficult for us to give an answer to enlighten your
readers.'
In the past fortnight, the NKF has hogged the headlines. Propitiously, the news
of its amazing $189 million in reserves broke the very day it celebrated its
35th anniversary on April 7. Since then, a stream of more than 130 people -
former employees, former donors and disgruntled members of the public - have
e-mailed or called this newspaper to let off steam about its hard-sell tactics,
thick carpets and controversial chieftain.
At the same time, about 30 others, individuals and organisations, have sent in
letters of support for the organisation, praising its dialysis programmes and
pledging continued donations.
So far, the NKF kitty appears none the worse for wear despite all the
caterwauling. On April 11, its 11th NKF Charity show raised $6.7 million, just a
fraction short of last year's $6.8 million. Last night, it netted another $6.4
million.
These serious sums of money - how the NKF gets it, spends it and accounts for it
- have been a well-gnawed bone of contention among its naysayers. Way before
details of its $5 million tie-up with insurance giant Aviva unleashed a
ferocious debate on donor privacy issues, charges of 'invasive' fund-raising
have dogged the outfit.
But the NKF has made no bones about gunning for the charity dollar - the more
the merrier, just like any other profit-and-loss business. Relentless innovation
over the years has brought new ways of fund-raising: greeting cards, live
charity shows, donations via SMS, consultancy services, even selling its spare
telemarketing capacity to private companies. In the social service sector, the
NKF is the unparalleled paragon of the art of 'heartsell'.
Most impressive of all, notes Mrs Tan Chee Koon, executive director of the
National Volunteer and Philanthropy Centre, is its ability to tap on the health
screening it conducts for heartlanders to ensure a 'sustained pool of regular
givers'.
Unlike many charities which rely on large, one-off infusions from wealthy
foundations, NKF's bread and butter is the $3 to $5 monthly Giro donations from
about one million ordinary Singaporeans. With such a big base of small heartland
givers - its website says nearly two out of every three Singaporeans are donors
- the pennies add up.
Every day, seven days a week, some 100 'prevention evangelists' and nurses fan
out to companies, army camps, condominiums and churches islandwide to test the
blood, body fat and urine of at least 1,600 people daily.
Since 1997, more than one million Singaporeans have undergone these free health
screenings, which are followed typically by an impassioned pitch: 'This is
something we're doing for you; is there something you'd like to do for us?'
A voluntary sector consultant notes: 'Even old grannies are not spared the
spiel. Most are pressured to do a Giro contribution for a minimum of six months.
Nothing they do is illegal, but it's all very aggressive. Nothing wrong with
that, but when they push the fund-raising envelope, they tend to be insensitive
to the larger consequences for the charity sector.'
But the NKF's head of what it calls 'prevention marketing', Ms Shirley Tan,
makes no apologies for the 'heartfelt pleas' it delivers along with its basic
health checks, which she notes would cost at least $60 in private clinics. She
says these are 'free-will offerings' and the 'evangelists' have no financial
targets to meet at each venue.
PAINFUL LESSONS
NKF chairman Richard Yong, 63, a former private banker who has been on the NKF
board for 18 years, makes clear that lucre is the necessary lifeblood of the
organisation.
Every cent literally buys time for each patient. And the NKF's mission to save
the lives of those with kidney failure is undeniably daunting, which explains
why there are no other self-funded, non-profit dialysis providers in the world.
Each patient is admitted for life - or until they are lucky enough to get a
kidney transplant. The average life expectancy of those on dialysis is 10 to 15
years, at a cost of $150,000 upwards a head to the foundation.
Mr Yong says patients themselves pay from nothing to $800 each month for
three-times-a-week dialysis which would cost at least $3,000 each month outside.
The incidence of kidney failure here - increasingly a lifestyle disease closely
associated with diabetes and hypertension - is now the third highest in the
world, trailing only affluent countries like the United States and Japan. This,
coupled with a fast growing grey-haired population, means that the NKF has
plenty of costly work cut out for it.
Its money-minting machinery, however, was not always so hard-nosed or
well-oiled. Starting out in an unprepossessing Singapore General Hospital attic
with just two beds and one metal tray in 1969, Mr Yong says, it battled the same
growing pains that less publicised, cash-strapped charities face today.
When it set up its first dialysis programme in 1982 in Kwong Wai Shiu Hospital,
it dispensed free treatment with little regard for outcomes and costs.
In 1986, it ran out of money, so he and other board members had to make the
heart-wrenching decision of who among their 32 patients should continue with
dialysis, and who would have to be sent home with morphine to die.
'I couldn't sleep; I couldn't eat. Who were we to play God?' he recalls. It hit
home then: It was important to have 'healthy reserves that can withstand even
the most dire economic times', and self-generated income 'so that we can be
independent, instead of on our knees, poor and begging for life'.
So the irony is that, despite being one of the oldest, the NKF is yet one of the
most progressive charities here. As a mature 35-year-old, it is looking at
sustainability and continuity issues for the next 100 years, even as most other
voluntary welfare organisations (VWOs) grapple with day-to-day survival issues.
In the international arena, it is such a trail-blazing model of social
entrepreneurship that American universities like Harvard, Johns Hopkins and the
Massachusetts Institute of Technology have done case studies on it.
Locally, however, it is so far ahead of its time that society has yet to keep
pace. Unlike in the West - where charities aggressively campaign for the charity
dollar, professional fund-raising is a bona fide industry and tie-ups with
commercial entities are old news - the social sector here unfortunately is still
in its infancy.
According to Mr Terry Farris, head of charity management for Asia at European
private bank MeesPierson, the fact that it costs money to raise money - the
accepted norm, he says, is now 15 to 20 cents out of every dollar - may not have
sunk in here yet.
Many VWO chiefs note there still exists an arcane expectation that non-profits
should survive on the 'goodwill and sacrifice' of volunteers, even though it is
recognised worldwide that the public good is much better served by hiring
professional managers at market rates.
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