Nikhil Burman came to be known as a man who parked his car beside the highway, turned on the flashing lights, and answered questions. The surprise was that Nikhil was a driver, and had no medical training at all. His expertise was in helping patients go where they needed to be. Each evening, Nikhil met with dozens of patients to help them understand what to expect from their visit to Silchar’s hospitals and clinics. On any given day, he estimated, there were usually over two hundred calls from patients in Tripura. Nikhil saw himself primarily as a logistics manager; but while he was careful not to give medical advice, he frequently ended up as a de facto triage nurse, directing patients to certain facilities based on his past experience with cases like theirs. He charged a minuscule daily amount for his services, and fully expected to be haggled down. Seen one way, Nikhil was an entrepreneur, ingenious in finding and serving a market. But seen another way, if India’s systems worked the way they were intended, this market would not exist at all.

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