Two-year-old Joy was born with a hole in his heart. His mother, Aarti, and father, Vishal, had already depleted most of their savings during the COVID-19 pandemic, as both had lost work.

Aarti gave birth in a public hospital, and Joy weighed 3kg at birth, but his weight quickly dropped to just 1kg. A two-month stay in the Neonatal Intensive Care Unit (NICU), along with the right support, helped Joy gain weight and return home to live with his family, but the medical bills wiped out their remaining savings.

Vishal works in housekeeping and Aarti works part-time cooking for four families, while also caring for Joy, newborn daughter, Raha, and their older son Manthan.

The family lives in an urban slum on the outskirts of Mumbai, a city marked by stark wealth inequality. Their small one-room home has no bathroom or toilet, and they rely on communal facilities shared with the entire slum community.

They earn enough to get by, but their ability to save is limited, and they do not have insurance to cover health emergencies. Like most low-income urban families, 100 per cent of their health costs are out of pocket.

_{Aarti and Vishal with their children Joy, Raha and Manthan}

Joy needs an open-heart operation to repair the hole in his heart — this will require two procedures, which the family had just begun saving for. However, last year, Joy contracted pneumonia, a serious infection for any child, but especially dangerous for one with complex health needs. Doctors told his parents he needed to be hospitalised immediately, or they would lose him within days. But there were no public hospital ICU beds available.

With guidance from Opportunity’s local partner, Uplift, they placed him in a nearby private hospital to keep him alive. Uplift provided an Emergency Medical Loan of Rs.35,0000 (around A$640), processing the loan within a day to cover Joy’s medical expenses.

However, Vishal needed to borrow from multiple sources to meet the total hospitalisation costs, which came to around A$4,500 for a 24-day stay.

Although the health loan from Opportunity’s local partner in India has a low interest rate and is designed to be affordable for low-income families, other lenders charge exorbitant rates, trapping families in cycles of debt. Health expenses push 1.3 billion people like Vishal and Aarti into poverty globally each year.

The predatory informal lenders that Vishal and Aarti borrowed the rest of the money from charged exploitative interest rates (up to 200 per cent) to people they know have no other option. The family are currently only able to make interest payments on these loans.

 _{A patient consults a doctor at a pop-up clinic facilitated by our local partner, Uplift}

Opportunity’s local partner, Uplift, offers affordable health loans, maternity savings accounts, and health mutual insurance to low-income families living in informal urban settlements across India. The helpline run by Uplift continues to support Joy’s family as they navigate his medical challenges.

Joy is home again, being doted on by his parents and older brother, Manthan. Vishal and Aarti are doing everything they can to stay afloat financially while ensuring Joy receives the care he needs. Manthan’s school has agreed to defer fees for now, recognising the family’s financial hardship.

At times, Aarti feels overwhelmed. She often cries, worried about how she could support her child.

Vishal told her, “He is a gift from God. If God has given, he will do everything.” He encourages Aarti not to cry, saying that Joy will not have hope if they do not have hope.