The Cure: Revolutionizing the Business of Healthcare in Africa
The Cure is a deep-dive podcast exploring what it takes to revolutionize the business of healthcare in Africa. Hosted by Temitope Coker, each episode features candid conversations with the people shaping the continent’s health systems, including visionary founders, investors, researchers, policymakers, and reformers.
We go beyond surface-level insights to unpack the real-world challenges, innovations, and investment strategies transforming care delivery across Africa. At the same time, we aim to infuse hope into the narrative by spotlighting the momentum and progress already unfolding across the continent.
From financing and infrastructure to research, technology, and policy, The Cure is the place for serious thinkers and doers who care about the future of African health.
The show is powered by TC Health, a platform providing healthcare and pharmaceutical insights in Sub-Saharan Africa.
The Cure: Revolutionizing the Business of Healthcare in Africa
Who Shows Up When It All Goes Wrong, The Tech-Enabled System Behind Emergency Response in Africa- Part 2 | A Conversation With Folake Owodunni
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When emergencies happen, who actually shows up?
In this episode, Folake Owodunni (Emergency Response Africa) breaks down why emergency response is one of the biggest gaps in African healthcare and what it takes to fix it.
Because in those critical minutes, systems either work… or they don’t.
Season 2 is about Building the Rails and this is one of the most urgent.
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#TheCurePodcast #EmergencyResponse #AfricanHealthcare #TCHealth
Hello, healthcare enthusiasts, and welcome back to The Cure. This is the podcast where we're revolutionizing the business of healthcare in Africa one conversation at a time. I'm your host, Tim Topekoka. In each episode, I sit down with the people shaping the future of healthcare in Africa, from founders to investors to policymakers and beyond. Our goal is to infuse hope into the narrative by spotlighting the momentum and the progress already unfolding across the continent. At the heart of every episode is one key question: What does it take to revolutionize the African healthcare business model? All our insights are powered by TC Health, your trusted source for healthcare and pharmaceutical insights in sub-Saharan Africa. This is part two of our conversation with Follake Owoduni, the CEO and co-founder of Emergency Response Africa. We're discussing everything emergency medical services and response on the continent. So let's just dive right back into the conversation. I have two follow-up questions. One is around the emergency ready hospital network. The other is around the idea of this USSD SMS layer. Which one do you want me to ask first? You pick. Okay. I'll go in order. The emergency ready hospital network, I think, is doing something a lot of ambulance services have never had to do or have never done, which is verifying that a receiving hospital is actually ready to receive. You talked about it's a it's quite a manual process of calling the hospital and letting them know, hey, there's a case coming in. Before that even happens, what does that verification process look like in practice? So before a hospital is tagged as emergency ready to even receive patients, what has it revealed about, you know, the state of emergency departments in Nigeria? Because they have a really bad rep. I think up until recent policies that made it illegal to turn patients away, a lot of people And it still happens, and it's beyond a lot of people are fearful that they show up to an emergency department in a hospital and they're they're turned away. So why bother going in the first place?
SPEAKER_00So I think there's there's two sides to every story, right? Um, what we've also seen is the hospital side of it. Not in any way saying that it is okay or justified, you know, but we've also come to learn some of the challenges that hospitals face. We will treat out of the duty that we set out, you know, when when we entered into this profession and then encounter multiple challenges, right? It goes back to trust. Let's be honest. Like it still goes back to trust. If you tell me go ahead and treat, I'll pay you. But then you don't, or it takes a really, really, really long time, you know, then my incentive is lower the next time a per a patient comes. And unless it is truly out of the goodness of my heart, you know, there's that reluctance. Um, the other thing is if you have a struggling economy, if you have a world where a lot of your patients are having to pay out of pocket and healthcare facilities cannot um be assured of you know certain revenue levels and all that, it is easier for them to cut corners. Again, not in any way justifying, but just recognizing that the realities of our environment and our economy make for certain things, you know, to happen.
SPEAKER_02Yeah.
SPEAKER_00Um and so what that translates to is not everywhere that is called a hospital or you know, an emergency room is is is gonna be able to serve you.
SPEAKER_02Yeah.
SPEAKER_00Um and we see that with ambulances. You know, we we we're always trying to add more to our network, yeah. Um, and we'll go and we'll inspect and we'll be like, yeah, this is like a bus with a bed. And that's kind of it. Like there's nothing else.
SPEAKER_02Yeah.
SPEAKER_00Um, and then, you know, but but again, I think we've also developed empathy for you know the supplier side because we know what we're up, we know what we are up against and you know how difficult it is. Um and so just fundamentally, like our approach really is to when we identify to actually inspect. And an inspection is not like we're we're not gonna be able to see every nook and cranny, but we want to know certain core things. Do they have the equipment? How do they staff themselves? Um, who do we call? What's the protocol for bringing a patient to you? Yeah. Um, do you use technology in any form? Do you you have internet or are you strictly paper-based? Like all of those things speak to how the the ER is managed and what kind of experience any patient we take can expect.
SPEAKER_02Yeah.
SPEAKER_00Um, and so we have the hospitals that we, you know, kind of say, like, okay, you know, in this area, we have this hospital that that we've partnered with. Um, and what that partnership simply does is it gives the patient a reasonable level of confidence that you go and you get decent care, but also that the handover process is relatively simple. Yeah. In other words, we're not going to take you there and then you'll be sitting in the hallway forever, right? Like that's a thing that also happens. But like I said, in Nigeria, we often will have our own, because again, a lot of it's private sector, right? People will have their preferences, people have the places that they already have a relationship with.
SPEAKER_02Yeah.
SPEAKER_00Um, and so people will often say, like, yeah, no, no, take me to XYZ hospital.
SPEAKER_02Yeah.
SPEAKER_00Now, what we've learned to do is to be like, okay, so who do you have in XYZ hospital? Ah, my uncle is the doctor there, some. Okay. Can we let up so while we're attending to you and while we're en route, can can can we call them? Can we connect with them in advance, right? To make sure that when we get there, yeah, you can actually be attended to. Because I can tell you, till today, we still have patients who will insist on going to one place. We get there, there's no bed space. Whoever was, you know, I guess the person supposed to be advocating for them, I guess can't deliver. And so, okay, now, you know, you wait a couple of hours, now you end up going to another place, then you end up going to another place. And patients deteriorate in that process, right? So it's a persistent issue. Like, yes, we tried to solve it by having this network of hospitals, but the reality is because so many people have their own, you know, places and preferences. And if you're not actively like, if we don't take you here now, you're gonna die, you know. I mean, we we honor those preferences, but it it introduces other challenges.
SPEAKER_01Yes, yeah, interesting. Yeah, yeah. So the trust isn't just if I call, will the ambulance show up? The trust is where are you going to drop me? Oh, absolutely. Like where are you taking? Oh, 100%.
SPEAKER_00Oh, 100%, 100%. If by the time they call, right, there are only two things. One, maybe they genuinely believe that you will show up either because they're maybe they're referred or is their healthcare practitioner calling or they've heard about it, whatever. Or they are that desperate that they know that if I put this person in my car, they will die. So let me call these guys. Sadly, those are really the drivers of why people call as of today. I think we'll get to a point where it's not, you know, you're quartered to death, that's the only time you call. Yeah. But for now, yeah.
SPEAKER_01Yeah. Interesting.
SPEAKER_00Yeah.
SPEAKER_01My second question was going to be about that USSD and SMS layer. I think because we we don't want a solution that's heavily reliant on internet connectivity. Because I mean, if it's an emergency, sometimes internet connectivity is disrupted. Or, you know, the landscape is that not everybody has access to the internet. But since we wrote that piece four years ago, the operating context of technology in Nigeria has shifted quite a bit. You know, mobile money platforms like OPE and Palm Pay mean that people have moved millions onto digital rails, like penetrating even sectors that felt impenetrable into coming onto a smartphone. We've seen ride hailing apps, dispatcher apps. People are used to, they're trained to know I expect a vehicle to arrive once I put something in this app. So, how has that kind of broader shift made your tech-enabled emergency response a more viable business model or product than maybe it was four years ago?
SPEAKER_00Yeah, I mean, I think you're absolutely right, right? Like people are much more aware of the fact that you know this type of system exists and we apply it in other areas of our lives. So it's not so far-fetched to apply it in you know, uh, emergency response. And I think that's why, at least I've observed even in the last like two years, you know, pop-ups of different emergency apps, you know, like, oh, you know, call. And I think that's great. It's a good thing. You know, fundamentally, if it increases access, yeah, win. But what I see is is is is the constraint, and I don't know that enough of us are paying attention to that. Um, you can't continue to layer an app off of infrastructure that doesn't exist or is declining. Yeah. And the the way that I look at it is, you know, and I think of like Uber or you know, any of these guys, um why did it work? Number one, when they started, they seeded their network, right? So they had, I think they bought some cars and they put some drivers, you know, like they had a way that they were like, okay, we need to get this going somehow. Right. Yeah, like we need to start. Yeah. And then, you know, network effects will eventually take over.
SPEAKER_02Yeah.
SPEAKER_00Um, at no point has that seed happened in this space. What we have are many sort of layers and layers and layers, and everybody wants the layer, and new apps come and they reach out to us and say, ah, we see people have a network. Come, let's, you know. And I'm like, well, we can try, but we know, we know the sweat and blood, sweat, and tears that we've put in to even try to get the network to where it is, and we're not satisfied with where it is, right? So anyway, I'm just saying, like, it's one of those things where, yes, we are in a place where it it's more plausible, like people understand that better.
SPEAKER_02Yeah.
SPEAKER_00But because of the fundamental lack of infrastructure, yeah. Um, I don't know that we are at the place where it's as simple as calling a bolt or calling an Uber. It's it's we're not quite there yet. There's still a lot. The rails together need to be built. Yeah, absolutely.
SPEAKER_01Um, so now I want us, and this is the the section I'm actually most excited about. ERA has partnered with a lot of state governments to date with River State, Equity State, Ogum State, Edo State. Each one of these looks different. Each one of these has varying levels of success. And I would love to just walk through them one at a time, just maybe quickly touching on points from each of the four. Um, the first one is with River State, um, RESAS. This was a more design and blueprint engagement, which I found very interesting because the River State Ministry of Health basically asked you to build a framework, to do some research and build a framework before the states procured a bunch of ambulances. And I think it's the inverse of what you typically see in terms of political instinct to just let's just buy more ambulances, like just flood the market with ambulances. So, my question for that one is more you had to do that assessment. What did that assessment surface that the state had not identified or what was surprising, what wasn't surprising? And and yeah, I would just love you to talk through what you found in that assessment.
SPEAKER_02Yeah.
SPEAKER_00Um, so I mean, first of all, let me say that everywhere we've worked, I have an immense amount of respect for um the stakeholders that are leading their, you know, ministries of health, the commissioners for health, um, you know, the um civil servants as well. Uh, I do genuinely believe that we have a lot of awesome people in healthcare.
SPEAKER_02Yeah.
SPEAKER_00Um and that are really trying to actually like do things differently. Um, you know, so using Rivers as an example with the former commissioner for health, um, Dr. Adeze Ore, um, you know, she was very keen on actually reviving what was a legacy for Rivers State. Um, so Rivers was one of the states that actually did have a functioning emergency medical services system in the past. Um, and unfortunately, just because, you know, politics has a way of getting in the way of things, um, you know, it got in the way of that. Yeah. Um and so she knew that it wasn't that there was nothing, right? It was, they weren't really starting from scratch. Um, but rather than trying to replicate what had been done in the past or, you know, just kind of build from the future, what what would be the almost like theoretical basis for charting the way forward?
SPEAKER_02Yeah.
SPEAKER_00Um, and so that exercise for us was really a chance to look back and say historically, what worked? Um, what did what did the state learn? You know, where did things start to go wrong? How did they end up where they are? And can we, as we design the way forward, um, try to, you know, put protective structures in place.
SPEAKER_02Yeah.
SPEAKER_00Um, but also what, you know, what maybe needs to change or what is is different about the times that we're in now, right? Technology being a key piece. Um and so that you know, project over a few months was really very insightful. I think that you know, it told us very clearly that um when there is commitment, when there is political will, anything can happen.
SPEAKER_02Yeah.
SPEAKER_00Um, and it doesn't have to take a long time. But when it is not there, or when it is distracted or diffused by whatever, yeah, um, everything kind of goes wrong.
SPEAKER_02Yeah.
SPEAKER_00Um, I think for me, the most surprising thing in that whole exercise was realizing that there were about I can't remember the number now, it was either 12 or 21. I suspect it was 21, but don't quote me. Um, but there was at least over a decade of data that just disappeared. I don't know where it is. It was let's just say it was not available. Yeah. And that was really painful because what it meant was yeah, we want to build a framework, but we're now having to go off of whatever generic Nigeria level, you know, broad healthcare sector level data is available. Whereas you have a system that actually did work and actually did intervene and save lives, but that data was missing. So that one of the like most fundamental, you know, sort of pieces to the framework that we designed was the importance of data collection at every stage, right? So if we're doing a baseline, quantitative data, qualitative data, what are people saying? And we actually ended up publishing a piece out of that. So we did we did some of the qualitative research, we decided to um pull it together and publish. And and it didn't tell us what, you know, to an extent we don't already know. What it did was really articulate it in the context of River State.
SPEAKER_02Yeah.
SPEAKER_00Um, and you know, by the time that engagement ended, and of course, you know, politics and things happened, yeah, um, but by the time that engagement ended, what the state was left with was a document that they could look at and say, if we want to set up a system, what are the things that we need to do? And, you know, let's not go and lift what is happening in America and come and put it here, what's happening in the UK and come and put it here. This document helps us to see what the role of community first responders are. And this is something that we are just very, very passionate about everywhere we go. We're happy on about community-based first responders. Why? Because at the end of the day, as a country, we have many, many, many needs. Our money is limited and maybe not always distributed the way it ought to be distributed, which means that within the healthcare sector and specifically within emergency response, we're never going to have all the resources that we need. So, how can we better use what is already available within the communities? And that for us is a key part of creating an effective system. And so, what we basically proposed was look, there are models already, you know, Franco-German, like there are other, there are models of EMS already. What you need to think about is how do we layer on the local context and integrate those things so that you have a system that works and meets the needs of the people, understands the local context, but is also cheaper to implement. Because whether we like it or not, resources are always going to be limited and the chances of sustainability go down when the system is very expensive. So that's kind of an overview of River State.
SPEAKER_01Um I would then love to talk about the equity state or Exams. I think it's called Exams. Um that was your first partnership um launched back in 2022. Um, it didn't go so well. And I'm curious what happened? What lessons did you what lessons did you learn from that experience?
SPEAKER_00Yeah, good question. So, I mean, again, a huge amount of respect for the honorable commissioner, Dr. Banjikulani. Um, I mean, truly like what he's done within the healthcare sector there is incredible. Um, and I think that in some ways we were early, right? I think that when we got there, the appetite was there. Um, but there was there was so much else going on that I don't think that it got the you know, sort of full attention that it could have gotten, right? Um, but I think what are the lessons that we learned from it? I think the first one for us was for us as an operator.
SPEAKER_02Yeah.
SPEAKER_00Um we went in believing that we could provide some technology, um, some capacity building um and you know, maybe some support here and there, and basically create a system. What we realized was that, and we've seen this now play out across multiple states that we've engaged with, more than 10 different states. Um, every state is at a different place in the spectrum of you know functional EMS systems. Yeah. So you have the states that have nothing. They never had anything, there's nothing, like nothing. Not even the ambulances are procured. And you have the states that have the ambulances procured, but that's kind of it, right? So maybe it was a purchase and you know, there was a you know a press release and you know, kind of that that kind of thing. And then you have the states that like Lagos that have actually a really, really functional system, but capacity is incredibly limited relative to the population and the needs and the available resources. So there's a whole spectrum. Yeah. And at the time, I don't think we were conscious enough of what that spectrum actually looked like. And what that spectrum means is that the level of support that you bring, the resources that you're bringing to that partnership will change depending on where they are on that spectrum.
SPEAKER_02Yeah.
SPEAKER_00And so IKT was really quite early in that spectrum at the time, right? Like I said, we I feel like in, you know, in hindsight, I think we were earlier than perhaps you know it would have been ideal. Um, and we didn't recognize that we couldn't just go in with, oh, we we have this technology. You know, by the time we started, um, there had to be a recruiting exercise for the medical dispatchers.
SPEAKER_01Yeah.
SPEAKER_00Now, I think anybody will tell you that typically, whenever there's recruitment that's happening with government, um, one of the things that you have to kind of be conscious of or protect against is, you know, people will always want their people to have the opportunity. Um, it's not a bad thing necessarily, right? Again, let's let's call it spade a space. It's not necessarily a bad thing if the competencies required can be achieved.
SPEAKER_05Yeah.
SPEAKER_00But that was not there, right? So that it automatically created a gap. So it's like trying to train somebody to be an emergency medical dispatcher that is not literate. Yeah. Where do you begin? How? Yeah. How? You know that how? There's no magic. You know, so I think that things like that really taught us that if we're approaching government, and and that was always going to be part of our strategy because one of our values, I think by now I've mentioned three out of four of our values. Um, but one of our values is for everyone.
SPEAKER_02Yeah.
SPEAKER_00And it's the value that I always get pushed back on because nothing is for everyone. It's your private business, you cannot be for everyone, and rightly so. But I think the way that we've approached it has said, look, we will serve the customers that can pay us. And for the ones that cannot pay, we will find the partnerships that make it possible for us to serve them.
SPEAKER_02Yeah. Yeah.
SPEAKER_00Right. And so that's where you know connecting with government and partnering government comes comes into play. But anyway, just to say that in order to achieve that, um, we have to be able to adapt to where that particular government or state is at and provide the right level of hands on support or resources, whatever that looks like, that aligns with the stage they're at, which is why when we then went into Edo State. It was a very different transaction. Very, very different. We were so much more hands-on. We came in essentially ready to handhold and do the work alongside the government and all parts of the work, from recruiting to managing the team to fueling the ambulances, to, you know, coordinating, to staffing the uh command center with the dispatchers, training the dislike every aspect of it, we were involved. Why? Because we recognized that in this state we were also at the early stage, starting effectively starting from sorry, they had some ambulances, but that was it. You know, and then going into Ogun State, we realized actually Ogun State is one of the states that has a pretty long history of delivering emergency services. And they try again, simple lack of resources and all of that, right? But they do try. Yeah. So the need there was a bit different. You know, what they needed was look, in these particular areas, we're actually okay.
SPEAKER_01Yeah.
SPEAKER_00But our pregnant women are dying. And this, you know, this is this was a particular area of interest for the uh honorable commissioner for health, Dr. Tomikoka, who is herself, you know, an OB. And so for her, you know, it was like, okay, this is something that I really want to see. I want Ogun State to be a model for supporting pregnant women. And because of that, we were able to again, it's the same core principles, yeah, but tailor that to support and create a rural emergency transport system that now leverages what I talked about before, the community-based first responders, and now connects them into the state ambulance service. So now you have a system that if a woman is in a far, far, far flung part of her village, but she's having an obstetric emergency, her community-based first responder can get her to, you know, maybe the primary healthcare center. But maybe what she actually needs is, you know, a CS, a cesarean section. And so they can get her, you know, from that point there. Or if she needs to go to a hospital further away, the ambulance, you know, can intersect. So it's a system that now works together, right? But it doesn't require every ambulance to be inside the village, but it really, you know, sort of builds on everything. So I think we've learned a lot um working across that spectrum of different needs. And I'm quite hopeful that we will do more with different states. We we have a few in the pipeline.
SPEAKER_01Yeah. Yeah. So you basically touched on the other two I was going to touch on. So Edo State and Ogun State. I want us to maybe we stay with Ogun State. Okay. Um, because this is kind of like that state level maternity and maternal mortality kind of addressing that that challenge. I believe the the number that's quite heavily quoted for Ogun State is 179 deaths per 100,000 live births. Um and one of the things I'm very curious about with this specific partnership was the voucher system that was tied to the Ogden State's health insurance agency. I'm I'm very curious why vouchers specifically. And you know, you could have built this as a maybe direct insurance reimbursement or similar to the Edo State model where that was tied very closely to the health insurance scheme. What made vouchers the right design choice? What was it about the women? And I think you started in the Odeda LGA. What made it the right choice for that specific program?
SPEAKER_00That's such a great question. Um I think vouchers served multiple purposes. Um, one is just bringing tangibility to something that, again, we're trying to change behavior. If you think about what we're trying to achieve, we're saying that, hey, pregnant woman who's gonna have a baby at some point, when you recognize XYZ signs or symptoms, um, we want you to take the following actions. And, you know, how often do we interface with each and every pregnant woman? Maybe at most, if she's regular to her antenatal care appointments, yeah, you know, between four and eight times, I mean, eight is like, whoa.
SPEAKER_02Yeah.
SPEAKER_00But like, let's say like four times at least in the course of her, you know, pregnancy. That's not a lot.
SPEAKER_02Yeah.
SPEAKER_00And when you're talking about changing ingrained behavior, again, don't forget, people are giving birth, you know, with traditional birth attendance. People are giving birth in mission homes, you know, these places like run by like religious institutions. People are giving birth all sorts of places, not necessarily always where where is like you know, the best for their particular situation. And so I think the first thing that the vouchers did was it brought some tangibility. It said, hey, this is a service that is now available to you. Um, it is free to you for this voucher. Yeah. So it kind of made it seem like you know, you are paying for it, but you are not paying with your money. That voucher is given access. Oh, yes, yes, yes. It was. Now keep in mind again, right? We're talking about a rural emergency transport system. So we tried to design with simplicity in mind.
SPEAKER_02Yeah, yeah.
SPEAKER_00The second thing that that voucher did was it became an educational tool. Um, again, we so data, the value of data, and we partnered with a wonderful um communications consultant for this. She does like community engagement, um, Dr. Noemot Balugun, somebody else you should have on this podcast. Strongly recommend. Um, you know, but we we collected data when we started the project, and one of the questions that we asked was around, or you know, some of the questions we asked were around like recognition of danger signs when a woman is pregnant. And I think we had, and I don't know why my my mind is not remembering the exact numbers, but I think we had about nine danger signs. Um, and the only one that women consistently recognize, women, their caregivers, all of that, was bleeding. Fever was not considered like, you know, I mean, thank you. This is normal, you know. There was there were multiple other ones that you would think, yeah, but they were not recognized as danger signs. And so it became very obvious that again, if we're trying to reduce maternal and newborn deaths from obstetric emergencies, if people don't know what constitutes an obstetric emergency, yeah, your ambulances will be sitting there waiting, right? So that voucher then became, again, in design, a tool for education. And so on the one hand, and I wish I thought I'd have brought like the voucher. Maybe we can send you what the design was. Yeah, we'll stick it on the absolute, yeah. You know, but like on the one hand, it was the okay, this is what the voucher is, this is the number to call, on the other side, it was if you see, and again, right, with thinking design, who are these people, what what will help them? Images, pure images, not too much grammar. Yeah, yeah, yeah. So blood, you know, you draw the drop of blood, um, you know, pain, fatigue, like yeah, you you visualize it for them. Yeah. And what that did was it allowed women and their caregivers to recognize, you know, what they would otherwise have missed. And by the time we did our inline surveys, you know, we we we collected data at the end of our pilot, because it was a very short pilot. It was about four or five months. Um, by the time we collected data, there was a significant improvement across multiple measures. But also utilization of the system to get to care had gone way up. And, you know, because the because of the commissioner's foresight, for her, it was, I don't want you to just transport obstetric emergencies. Also transport them to antenatal care. So now you have a system that is effectively a maternal health transport system.
SPEAKER_02Yeah.
SPEAKER_00Yes, emergency, but also just the antenatal care. And what that actually did, and I I think it's a brilliant thing to just do, especially at the rural level, is that it made it easy for them to get to antenatal care, which is where a lot of potential emergencies will be identified and caught and can be prevented. Yeah. But even in the events that they still have an emergency, because they have been in the habit of calling for that transportation, it is now part of their pregnancy journey. When the emergency happens, that's where they go. You're not trying to change behavior at the point of emergency, right? So, again, right, just thinking about you asked about the voucher, but I think design broadly and how we design our programs and projects, it really has to make sense and meet the need of the moment. And again, I will forever give kudos to the leaders that are leading these ministries because Dr. Koka honestly really like I would say led the charge.
SPEAKER_01Yeah, yeah. And that's what happens when your um commissioner for health is an OB and is thinking about these things. Absolutely. So kudos to Dr. Tomy Koka. I don't know if we're related, we have the same last name, and I'm also from Ogun State. You probably are to investigate and maybe have her on. Um, but yeah, that that's amazing. And I I think I I want to then go to the Edo State um program. It's the one I I want to kind of really dive into because, well, I'm from Edo State on my mom's side, so I'm I'm part Bini. Um but in in 2024, March 2024, that was when it was launched, but it it has the um connection to the state insurance scheme, so the Edo HIS directly into the emergency response system as well. So that one I'm curious to understand how were you able to stitch those things together and how did that kind of play out? Yeah.
SPEAKER_00Um, so I I think the first thing was kind of recognizing that um we don't like to do projects that start and stop. In other words, we start, I mean, the nature of your project is that it starts and stops, right? But um ideally, we want to create, we want to be the catalyst for a system existing. That's the goal. And so what that means practically is we come in um with our input, our expertise. In some cases, maybe we have a development partner that is bringing some funding and the government is putting in some funding as well, and we help to that. Yeah. And then ideally, it gets carried out.
SPEAKER_02Yeah.
SPEAKER_00Um and so we recognize that for that to happen, the the sustainability part, it was important that the system was tied into an existing payment mechanism within the state. State insurance schemes and insurance schemes generally, you know, I guess by policy or by law, they're they're supposed to have like, you know, almost like an emergency fund, like a thing that, you know, covers for the unexpected, right? Which is inevitable in healthcare. And so, you know, with all of those things in mind, it was really important that we designed from the beginning. And so we had the privilege of having um some of the key leaders in charge of the primary healthcare development agency at the time, in charge of the health insurance agency at the time, um, really work with us to put that design together. And, you know, there were just some really great key people that were, you know, facilitated that conversation and that design process. But what it basically uh meant was even within our technology, because our technology then went from being a solution that only we use to almost being like an enterprise-level software that we can provision for a state.
SPEAKER_02Yeah.
SPEAKER_00And so Edo had their own version of our dispatch application, all of that. Yes. Um, and what we could do was we actually integrated that into the health insurance scheme. And so it meant that when somebody calls, we can check that phone number against the database of enrollees and know immediately whether the caller is enrolled. Now, it you know, a lot of times, right, people are calling for other people. Yeah. So the fact that they are not enrolled may or may not mean much. Yeah. You know, but at least it's a first check. Yeah. And then by the time we recognize, okay, if maybe you're calling for somebody else, there might be other parameters that we can check against. But what it meant was we could identify who we could transport to, you know, certain types of hospitals and how it would be paid for. Yeah. Keep in mind that I said at the beginning that one of the biggest problems is the issue of paid demand, right? Like whether we like it or not, healthcare must be paid for somehow. Whether you're even going to a public hospital or you're going to a private hospital, doesn't matter, it must get paid for. And so having that system that integrated with the health insurance scheme meant that it was easier to identify how patients would be paid for.
SPEAKER_01Yeah.
SPEAKER_00And that was helpful from the hospital's perspective, the receiving hospitals, um, because it meant that, you know, you're not going to bring me a patient that, again, out of the goodness of my heart, I will treat, but then, you know, I'm going to be stuck with the bill and I have no way of recovering. Um, long term, the objective was that as the insurance scheme collects premiums, a portion of that premium is set aside to support the sustainability of the EMS system.
SPEAKER_02Yeah.
SPEAKER_00And when I think about what does it take, and I know you mentioned like scale, right? Like, what does it take to scale emergency services and to fund them in a way that is actually meaningful? Yeah. It's not going to come from somebody waking up someday, maybe Bill Gates, I don't know, and giving us a giant pot of money. You can remove that pot if you want. I don't know. Um, you know, it's not gonna come from that. Like that's that's great. But those funds, again, are meant to catalyze.
SPEAKER_01Yeah.
SPEAKER_00So what is the sustainable path?
SPEAKER_02Yeah.
SPEAKER_00Whatever it is that we are already collecting money for, whether it be insurance, whether it be taxes, the whatever, we should, if we have the mindset, we should be thinking about how does a portion of this fund the continuation of this EMS system. Yeah. So that whether the service is being provided by government or by the private sector, by the hospital, doesn't matter. It is taken care of. Yeah. And the incentive is there for those services to be continue to be provided. The trust is there for the public to continue to call, and the benefits to the healthcare system broadly and the economy broadly are huge. I was gonna say when you talked about Anthony Joshua, um, I think sometimes we forget that if, and God forbid, I mean, truly like rest in peace to his friends that did pass, if he had passed, think about not just like the social horror of it, yeah, but the economic impact, how many livelihoods were tied to the work that he did. Yeah. And again, we can only process that because he's such a global star. Yeah. But every person that dies in an emergency is in themselves an institution of whose other people's economic livelihoods are tied to. Right. So again, yes, we need the sustainability of the system, but I think we also forget that if you sustain that system, it will also put back more into the economy than what we're actually spending on it if we design it right.
SPEAKER_01Yeah, yeah. And that beautifully leads to our question that we ask everyone.
SPEAKER_00Okay.
SPEAKER_01The cure question. What does it take to revolutionize the African healthcare business model, specifically in your world of EMS? You've you've touched on it just now with that response. Yeah. But, you know, as we said, EMS in Nigeria has existed for decades. It's been fragmented, it's concentrated in big cities, operating without the necessary financing, and you know, maybe the regulation is there or still needs to evolve. But what does it actually take to move emergency response from a service that 3% or 1.8% of Nigerians use into that layer that sits underneath all kind of health reform and and we move, we we we almost how do we flip the script from 3% using and 95% not using to 95% using and maybe 3% not using?
SPEAKER_00Um I don't I don't know if my answer is going to be like very likable. And when I what I mean by that is um I've been told that you know you are too, you see this thing too emotionally, you know, you're too like passionate about it. And and rightly so, it's cool. I am okay with that. Um, but I think it it boils down to ownership and responsibility, right? That that sense of if we like, we don't have to do it. All of us are affected in one form or another.
SPEAKER_01Yeah.
SPEAKER_00Um, eventually everybody gets touched in some way, even if all you do is observe a situation that you are helpless in. Um I think that ownership looks different for different people, right? So let's say, I don't know, maybe you're a bank. Um there are ways in which you can think about how do I offer this to my stakeholders, my staff, my account holders, whatever. Um, but maybe um, you know, maybe I have CSR funding and I say, you know what, actually it's true. Let's, you know, contribute, maybe have a add to the pool of ambulances or add to the trained pool of, you know, whatever. You're a bank. Nobody's gonna ask you to leave banking and come and do EMS work. I can tell you it's not as lucrative. Please stay in the bank, you know. But there's something you can do, right? As individuals, the same is true. As government, the same is true. And I think that to the extent that we are ready to truly take ownership at scale, then we can start to see things change at scale, right? So I talked about um the insurance scheme and you know, trying to, you know, ensure that a portion of those premiums are being set aside. Um, we have a few of those types of models, some of which we've already implemented with some partners, some of which we're exploring with new partners in new industries. Um, I'm a big believer that the funding for this system isn't gonna come from the sources that we expect.
SPEAKER_01Yeah.
SPEAKER_00It's not gonna be from, you know, the standard, you know, hospitals or HMOs. Like they're already, they're trying, they're doing what they're supposed to be doing. You know, they're they're they're there. But what about everybody else? Everybody else who benefits when the system works. Yeah. Everybody else who loses when the system doesn't work. What role can each of them play? So I have my thoughts and opinions, but I think like fundamentally it boils down to a determination that while I may not be in this industry, yeah, it is not somebody else's responsibility to fix it. Yeah. Because it affects me. Think about why do people buy fire truck these days? Estate will buy fire truck, uh, you know, bank will buy fire truck. Why? Because they know if there's a fire, you are on your own. Yeah. Now, don't get me wrong. Again, Lagos State really does try. You know, there are places that we have some, yeah, but it's nowhere near enough to meet the need. Yeah. And so we've learned as a people to be self-organizing. One of one of our advisors at ARA wrote a book about self-organizing Nigeria. Um, and we've learned as a people to do that. But I think self-organizing needs to move from I'm just gonna handle my own little piece of the pie to how do I contribute to a bigger, broader reality that actually leads to systemic change? That part we haven't quite figured out. I think we want to be part of catalyzing that change. Um, but it's a lot of work. Yeah, it is.
SPEAKER_01Um and I guess a a question I have to wrap up our cure question section. What does an African-led, African financed, an African-operated version of this revolution look like to revolutionize this business model in the way you've just described? And what would need to be true for it to happen in your lifetime as an operator?
SPEAKER_00Africa-led, African financed, African operated, African operated. Um, the led and operated, I think, is straightforward, right? Me, I'm African. The co-founder is African, she's from Ghana. Um, pretty much our entire team is African.
SPEAKER_02Yeah.
SPEAKER_00Um, so that piece is straightforward, and I think it's true of many organizations. Um, I do think that what happens as we grow and mature and scale is that we start to recognize that there is also a local talent gap in terms of higher levels of management, higher executive levels, right? And I think there's been some recent controversy, which I'm not, I'm not, I'm not gonna point to that.
SPEAKER_01You can find it if you want. Yeah, exactly.
SPEAKER_00Um, so so I think that that becomes more of an issue as you start to sort of get to certain levels and places, right? Um, Africa finance, that's that's the kicker, right? Like that's the hard, the hard one. Because I think that any company that has raised, and and I want to be clear because I recognize that there's a bit of Difference between in quotes this our modern startup versus like more traditional businesses that have existed for decades. But I would say, like, you know, specifically referring to this more recent startup phenomenon, a lot of the funding is foreign. It is. And it's foreign for different reasons. One is, you know, there are people that are very optimistic about Africa and they see the opportunity to make good money and they think that there's a lot of raw material here. And if they invest invest early, they can, you know, and and there's good truth and true. Makes sense. Yeah. There are a lot of people who have, you know, more philanthropic capital that see a huge opportunity for impact and want to be able to, you know, sort of be part of that impact story and will fund because of that. And all important, all useful. We have certainly needed and benefited from both types of capital. Local capital is harder to come by. Um, like debt capital, for example, um, unless you have your Banana Island property or similar to offer up as collateral. They don't take children, apparently. I'm kidding, I did not offer my child. Um, but you get what I mean, right? Like, unless you have that, it isn't easy to get debt capital. And I again, right, I understand some systems were not really designed to, you know, sort of take the level of risk that is that is there. Um, there is there has been a lot more in terms of like angel investing. Um, you know, people are putting their money out there more. But again, when you have an economic challenge, um, it means that people will hold on more tightly. What they expect or what they demand is also um maybe not unreasonable, but is also just you know higher and makes it more difficult. And so when you think about, you know, African companies that are innovating, um, they are in quote competing with the companies in environments where um the capital available is very much risk capital.
SPEAKER_02Yeah.
SPEAKER_00It's very much, hey, I like what you're doing, I'm gonna make a bet.
SPEAKER_01Yeah.
SPEAKER_00And I am fully aware that this bet may not work.
SPEAKER_01Yeah.
SPEAKER_00Which is why I'm making many bets, but I'm gonna give you enough to truly make a go of it.
SPEAKER_01Yeah.
SPEAKER_00And I think I know it's certainly been our experience where you have what feels or seems to be a lot, but when it comes down to you, you realize that you have enough to survive and enough to kind of keep going and experiment here and there, but never enough to take the big bets to really sort of go all out. And, you know, if it works, it's if it doesn't work, well, you know, you failed, right? No, you experiment small, small, and you say it must work. You know, so it's it's a very different environment. Do I have a solution? I don't have a solution. We need more capital, sure. Um, we need more local capital, sure. What is going to be the trigger that gets that to happen? I'm not sure. Um, maybe maybe it's about thinking about the pools of funds that we have sitting that we don't necessarily want to like throw away and kind of risk anyhow.
SPEAKER_02Yeah.
SPEAKER_00But maybe there's a way to leverage some of that philanthropic capital to de-risk some of, you know, like there's I think there's things that are happening.
SPEAKER_02Yeah.
SPEAKER_00Um, but honestly, I don't have an answer. I just know that there is a challenge when it comes to local, like African-led financing.
SPEAKER_01And it's interesting, someone shared, I think it was um Sugar yesterday or two days ago, an article, a Substack article about the middle. Um and basically, and I'm going to terribly summarize, but the thesis of the Substack article was there's the startups in the very beginning that people are taking these bets on. Like you have this vision, and it's like, whoa. So your series A, your pre-series, all of that, you get a bunch of investments. And then you have your more mature companies that have shown look, track record track record. We have a track record, we have scaled, we are doing, we're doing the thing, and people are investing in that because it's it's it's a sure almost like a sure thing. Yeah, yeah, yeah. And then you have the middle where it's like we we have enough to to get by. We've shown our track record is there, it's not at scale yet. We need that money to scale, but that money is either going to people who are 10 years behind us or 10 years ahead of us, and we're in this middle where it's like, and to me, I'm like when I was hearing you talk, it that Substack article kind of came to mind. I have to remember who the author was. But that's kind of where the capital, whether it comes from VC, whether it comes from you know debt capital or private equity, whether it comes from government pools, that middle. That's where it's needed. That's where it's needed. Absolutely. Yeah.
SPEAKER_00Because there's only so much um impact, a small, you know, what pre-seed, I don't know. There are people that raise like 20 million pre-seed these days. So I don't even know if those stages mean anything. But you know, when you're small, your results usually are small. Yeah. Right. And your impact usually is it it matches the scale of where you're at. When you are huge, again, right? Your impact and results usually match that scale. So it is in our best interest to have at least a decent number of companies make that transition.
SPEAKER_01Yeah.
SPEAKER_00Rather than continually be top heavy and then only a couple, you know, sort of manage through. Um, I mean, I would definitely say we're in that middle right now, right? Enough to show that, look, we know what we're doing.
SPEAKER_02Yeah.
SPEAKER_00Um, we don't have it all together because who does? Yeah. But we've done enough to warrant, you know, a measure of confidence.
SPEAKER_02Yeah.
SPEAKER_00But we're not at scale. There are multiple sort of hurdles that we still need to jump to get to scale. Yeah. Who funds that? Right. And I think so. This is now maybe some of how my thinking has evolved over the last few years. Um, there's, you know, there was kind of the growth at all costs mindset, right? All you're thinking is top line. Um, all you're thinking is getting funding to grow that top line. Yeah. Very little attention to the bottom line, right? And I think many of us in this space have been like, uh, yeah, that works if like Silicon Valley is throwing money your way. Yeah. Uh if it's if not, you know your own sooner rather than later. Um, and so definitely like my thinking has evolved to be like, mm-mm, where's the bottom line? How do we show that we're profitable? So that, right? If I get external funding, I know that I'm using it to scale what works or you know, create new opportunities or invest in new assets, whatever that looks like for us. But if I don't, I am still here.
SPEAKER_02Yeah.
SPEAKER_00Right. My staff are still working, they're still getting paid, people's lives are still being saved. Yeah. We're still, it may it may not be the impact we want at scale, but we're still here and we can we can last.
SPEAKER_01Yeah.
SPEAKER_00Right. And I think that is the shift that I've definitely made. And and you know, that's that's top priority for us is just look, let's be sustainable as an entity. When we are sustainable as an entity, then you have a really strong foundation to start saying, okay, let's scale this, let's scale that. I talked about the vision, you know, training, academy, and all that. Great. Yeah, it will come.
SPEAKER_02Yeah.
SPEAKER_00But I want to build it on a solid foundation, right? And I think I think that's where many of us have to get to and are already thinking in that direction for sure.
SPEAKER_01Yeah. So we want to conclude our discussion today looking ahead to the future. I want to spend, you know, this final stretch specifically on your long-term vision for ERA and where you see the company going. Um, the name of the company is Emergency Response Africa, not Emergency Response Nigeria. So from the beginning, that vision has been Pan-African, Continental. You mentioned your co-founder is Ghanaian. Um, the two of you have spoken about the problem being pan-African from day one. What does that, where does that vision stand today? Like what does the expansion plan beyond Nigeria or even to multiple states within Nigeria? Because there's still expansion needed within the country. What does that look like?
SPEAKER_00I mean, I feel like you've already, you've already said it or you've already touched on it. Yeah. Um absolutely. The vision was always Africa. Um, I have some really good friends in, you know, Uganda, you know, just like other parts of the continent. And I'm not sure there's any African that I've spoken to in any depth about what we do that's like, oh my gosh, you have to come to my country. Yeah. Because we have the same problem. Right. And if you go and dig deeper, similar to Nigeria, it's not that these countries have nothing. Of course, you have the ones that really do have quite robust systems. South Africa, Kenya, um, Egypt. Like they're, you know, they're kind of the usual suspects. But most countries are similar to Nigeria. You have pockets of hope, yeah, and then you know, areas of darkness, and you know, just it's it's it's different.
SPEAKER_02Yeah.
SPEAKER_00Um, and so I think for us, you know, we see ourselves as still in that phase of defining what becomes the model that makes it possible to be emergency response Africa.
SPEAKER_01Yeah.
SPEAKER_00Um, you know, if I go tomorrow, let's say Uganda is like, hey, we love what you guys are doing, come.
SPEAKER_01Yeah.
SPEAKER_00I have a sense of what we would do, right? I have a sense of what the partnerships are that we would need and you know, all of those details. Um, but we didn't know that until we started in Nigeria, until we've, you know, had different engagements with different governments, until we've, you know, we haven't really talked a lot about the private sector in this conversation, but you know, until we've we've learned who our customers are within the private sector, who are the folks that prioritize health and safety and pay for it. Yeah. And those that are like, eh, well, you know, Jesus is my is my is my protection. Um and and it's true. Those are the realities. Yeah, yeah. Um, and so yes, I I think the the long-term vision is to establish an organization that works in all the countries across Africa. Um, I think we're clear that um we want to be able to work with local leadership. Um now, whether that means that you know everything is sort of centralized and you're pushing out, or whether that means, you know, kind of those are details kind of to be figured out. But I think Ghana is like a very next obvious market. We have a couple of team members based in Ghana, in addition to mommy being from Ghana. Yeah, yeah. Um so that's you know, that's the big picture. But the truth is Nigeria is huge. We haven't even begun to scratch the surface. Yeah so there's still a lot of work to do here, but I'm hopeful that um within a few years we should be in a position to actively be expanding into other African markets.
SPEAKER_01Yeah, yeah. And I remember explicitly looking at the NHIS from Ghana, and they explicitly mentioned that all emergency services are covered. So Ghana has that policy framework in place that could be leveraged for a potential expansion. Um I'm I'm very curious, you know, which across the continent, you know, you've mentioned a few a few countries, which markets do you think are the most ready for ERA has built? And which would you rule out for now? Or maybe let's focus on the ones you you you see are most ready specifically for for what your company is building?
SPEAKER_00So I think um because our approach has always been and I think will continue to be um a hybrid of both private and public sector driven in terms of where our revenue comes from, um the markets have to be able to support first and foremost the private sector business.
SPEAKER_01Yeah.
SPEAKER_00Um, and then have a um a pathway into public sector partnership or public public-private partnership.
SPEAKER_01Yeah.
SPEAKER_00Um, I can't like I I don't have set countries, yeah, a list of countries as of right now. Um, but I think what's very obvious to me is that, you know, the countries where um, you know, the health and safety needs are clear and evident based off of the industries that are like dominating their economy, um, make for an obvious, you know, sort of direction to go. Um, but again, just because of the nature of the business, I would always pair that with do we have an active relationship that can get us into a partnership with government so that we're coming in and we're able to serve both those who need it and can afford to pay for it, yeah, um, and those who um can't. Yeah. Um and you know, and we can still sort of fulfill our vision and our mission.
SPEAKER_01Yeah, yeah. And and then my last question if a functioning EMS system actually existed across Nigeria and the rest of the continent, what does it unlock in the wider health system? Like what opportunities does it open, what bottlenecks does it, you know, suddenly start to solve? I'm very curious.
SPEAKER_00So many, so many, so many things. And I think we've touched on them in the course of the conversation. Um I think first and foremost, you mentioned that, you know, it's very much an equalizer, right? Like we we joked that if you're holding 10 million naira in your hand and you get into an accident, like that's not necessarily going to mean that you survive. Yeah, yeah. Um, the system that affects, you know, the really poor person also affects the really rich person. Um and so I think like what would what would life look like? Um, first of all, you know, just people would access the healthcare system better.
SPEAKER_01Yeah.
SPEAKER_00Um, what it means is that when they show up at the hospital, they're not showing up so late that 75% of them are either dead on arrival or dead within six hours. That's a crazy number. Yeah. It tells you that it's not that, you know, the hospital was not ready to work. It's that they arrived so late that intervention really could not be meaningful.
SPEAKER_02Yeah.
SPEAKER_00Um, so I think that's one. But what it also means is that for the healthcare workers, they will see the fruits of their labor more. It's like you're intervening and every patient is dying, or almost three out of four patients are dying. Not because you don't know what you're doing, not because you're not capable, but because again, the system has failed them. So you can imagine the knock-on effect for a healthcare worker who is seeing the value in what they're doing and actually making a difference, right? Um, we're not even talking about funding and all that, which are big, big issues as well. I think what it also means is economically, right? We talked about how each person is a unit, an economic unit who's, you know, who have other people and their economic livelihoods tied to them. Imagine saving the life of you know a father who's a breadwinner of their family in the village, right? So you've literally gone from one situation or one possible outcome where the person actually died and the family was thrown into generational poverty to one where actually he's able to be alive and continue to work and all of that. Or maybe it's the mom, then she's the breadwinner, you know, whatever.
SPEAKER_02Yeah.
SPEAKER_00Um, in other cases, and there's you know research that shows that when the a mom dies in in childbirth or you know during pregnancy, um, the child's educational attainment plummet. And we know that educational attainment is also tied to poverty and generational poverty. Yeah, yeah. Right. So every again, these are sort of the long tail effects that are really quite hard to trace, you know. Um, but again, if you have the system functioning, not only does it help the healthcare system itself, it helps the economy as a whole. And if you think about what do developing countries want more than anything, they want foreign investment, right? They want people to come and do business in their country. They want people to come and boost the economy, pay taxes, all of that. What makes it possible for those companies to come? They need to know that not only can they do their business and get the value that they intend to get, but that they can do it safely.
SPEAKER_02Yeah.
SPEAKER_00Why do countries in conflict suffer so much? It's not just because they don't have the resources or whatever, it's because the safety aspect is missing. And once it's missing, the economic inflows that would have come disappear. And whether we like it or not, as Nigerians, we also have to acknowledge that that has played a role in the decisions that a lot of companies have made. Why will I bring somebody from where they're chilling in, you know, wherever, access to 911, great, you know, hospitals, or we have great hospitals, we have those things. But when again the system, the bridge is broken, it means that all it takes is one incident and everything scatters, right? So I think for me, I think of it from the lens of not just what it does for the healthcare system, you know, reducing the cost of care and it, you know, increasing the satisfaction of the people that are working, but also economically, right? Like if we get it right, it will it will have it will have a huge effect, but then we'll eventually forget about it. Why? Because we become part of you know a functioning society, yeah. And it will be one of those things that we will eventually take for granted the way an American typically would take 911 for granted, right?
SPEAKER_01So yeah. All right. So we've covered a lot today, but I think it's been a fantastic conversation. We want to conclude with our rapid fire.
SPEAKER_02Okay.
SPEAKER_01So, like I said, rapid fire, we ask quick questions, quick responses. We'll go through a couple. Um where do I start? One global EMS model, more African systems should study.
SPEAKER_00That is such a good question. Um, can I reference an Israeli organization that we actually studied?
SPEAKER_01Yeah.
SPEAKER_00Um, I know there's a lot going on, you know, in that part of the world.
SPEAKER_01Yeah.
SPEAKER_00But United Hatzala or United Rescue, um, as it's called in English, they have created a phenomenal system that I think speaks to what a community-based emergency medical services should be. It is volunteer driven, volunteer run. Um, these are literally people that live and work in other professions. They go through about six months of training to become basically EMTs. Um, they get equipped with these motorcycles, they have like their jump bags and everything, and they have 90 second response times. What? Let that sink in for a moment. And my co-founder and I, we had the privilege of actually going to um Jerusalem, their headquarters. This was back in 2019, I think. Um, and actually just like observing. Man, my mind was blown. Wow. Um, they weren't, they're not doing it. Listen, it's not complicated. Yeah, we're not talking like deep tech.
SPEAKER_01Yeah.
SPEAKER_00We're talking simple, efficient coordination, heart-driven work. So these are people who literally lay their lives online. Keep in mind there's a lot of conflict in these areas too, right? But they go in and they intervene, whether they're Christian or Muslim or Jewish, that they all go in and they intervene for their fellow man. Like that's that's how they operate. Um, and I think you know, it was, it gave us a lot of inspiration as to what an effective system could look like. In fact, they were so effective that by the time the government said, okay, we have our own ambulance system, they had to work with them. Yeah, they had to, because that's where trust was. That's what people wanted. That's where that's who they called. Why? They actually played a live call for us 90 seconds.
SPEAKER_01Wow.
SPEAKER_00Somebody was at the scene of a gentleman, it was like a choking child. You know, like imagine that.
SPEAKER_01Yeah.
SPEAKER_00And we're talking about 25. We see 25, 35 minutes too. Why? Because things are hard. There's a lot of things to coordinate.
SPEAKER_01Yeah.
SPEAKER_00So, best case, yeah. Maybe we'll get like 10 minutes. But like sometimes it's 20, it's 30, 50, depending on you know, a lot of factors. But these 90 seconds, come on, come on. So crazy. That would be my pick.
SPEAKER_01Yeah, yeah. Fantastic pick. Um The most surprising thing you've learned from inside the command center.
SPEAKER_00People want hope when they call yes, they want help.
SPEAKER_03Yeah.
SPEAKER_00Right. Um, but what uh upsets them the most is if they feel like they called for help and they're not going to get it. Not because it's taking you too long to come. I mean, that could be part of it, um, but because of the communication. And so, like I said, about you know, our values and empathy being one of our values, we talk about how even the way you speak, um, you know, one of the behaviors under that value is our very presence should bring hope.
SPEAKER_04Yeah.
SPEAKER_00So that means that once you pick up the phone and you call, in talking to a dispatcher, you feel like, okay, I'm talking to somebody who can actually help me.
SPEAKER_01Yeah.
SPEAKER_00And as the conversation progresses, you your your confidence in that should grow.
SPEAKER_01Yeah.
SPEAKER_00Um, I think for me, it's been really interesting to see that. Yeah, the the they want the physical help. Sometimes it's just that reassurance, that sense of you're not alone in this. We will figure it out together. Yeah.
SPEAKER_01Um one piece of advice for a young founder building, well, it doesn't have to be a young founder, an early stage founder, building in a category that is barely on the map. I love that.
SPEAKER_00Barely on the map is such a good way to describe it. Um I think prepare for the long haul. Um, so if someone had told me that seven years later, I want I want to uh quickly say that my daughter is seven years old.
SPEAKER_01Oh wow, okay.
SPEAKER_00When the the Jerusalem trip that I mentioned, she was literally on I was carrying her the whole trip. Oh wow. She went with me everywhere. Um, and so literally been building this, like I say, this is her big, I don't know whether it's a boy or a girl, whatever, right? This is her sibling. Yeah. Um just prepare for the long haul, right? I I think, and this I'll I'll share this. Um, there's a guy that I love very much. That this sounds so awkward. He's an author that I love. I'm a husband. Um and he wrote uh, you know, a couple of of great books, but he he referred to one book that I guess he read. I think it's called Something Systems, can't remember the name now. Beautiful. And he quoted this in a talk that he gave here in Lagos at one point. And the quote basically says something along the lines of um, if you if you understand the rate of change of systems, you wouldn't give up too quickly. Something along those lines.
SPEAKER_02Yeah, yeah.
SPEAKER_00Um, and that came at a time where honestly I was ready to give up. I was tired.
SPEAKER_02Yeah.
SPEAKER_00Um and it's because I at the time didn't realize that I was doing systems building work. Yeah. I was just trying to run a business, I was trying to deploy technology. And realize you were building the rails. And so anyone who's coming into something where you are building a system, yeah, there are things that can move quickly.
SPEAKER_02Yeah.
SPEAKER_00But things never move quickly until certain foundational things have been laid.
SPEAKER_02Yeah.
SPEAKER_00Um, and so prepare for the long haul. Recognize that there is a certain rate at which systems change.
SPEAKER_01Yeah.
SPEAKER_00And no matter how magical you are, yeah, that rate will be maintained. And so your only job is to keep doing what you need to be doing and basically survive long enough for that system to change. Yeah.
SPEAKER_01Yeah. And my last rapid fire question that we ask all of our guests, what gives you the most hope today?
SPEAKER_00Um I think one is that we're still here. Um we could have died a few times. I can tell you with confidence. Um, and maybe this is part of being a faith-driven entrepreneur, knowing that at just the right time, you know, help comes. Yeah. Um, that's one. I think the other one is I'm seeing conversation happening today that was not even like a thought, you know, four years ago, five years ago. Um yeah, some of it we, you know, might still feel like, is it really what it's supposed to be? But the things that people are even using to in quote flex politically now are different, right? They are positive for the emergency services space. Yeah, yeah, yeah. So I think that change is happening, right? Again, it's a system. So change is happening very, very slowly.
SPEAKER_02Yeah.
SPEAKER_00Um, but it gives me hope that at some point um we will have in you know the right position of power a person for whom this is a priority.
SPEAKER_02Yeah.
SPEAKER_00And that if hopefully they are an effective thinker and systems, you know, systems thinker and designer, um, they will put in place the things that will open the doors and create a functional but also sustainable system. So, like I say, I'm an optimist. Yeah. I remain hopeful. Love it.
SPEAKER_01And yeah, let's see, let's see what the next few years holds. Yeah, we love having optimists on our show. For like a thank you for sharing your work, your conviction, and for showing us, you know, what it takes to build in a service category that's in a country that has needed it for a very long time. Um, I think for me, the takeaway is trust needs to be built. And the building of that trust looks different from what I came into this conversation thinking. Um and yeah, the the question now is whether the rest of the system, you know, public, private, federal, state, can build that same standard and speed of service and reliable, trustworthy service that the Nigerians actually need. Yeah. So for our listeners, you can follow Emergency Response Africa to see the work that they are doing. They have a lot of case studies on their website, which formed a big chunk of the conversation today. And if you remember nothing else from this episode, remember the numbers. 112 is Nigeria's national emergency line. You said there's a Lagos line, 777. 767. 767.
SPEAKER_00So different states have different numbers.
SPEAKER_01Different states have different numbers, but this is being recorded in Lagos. So 767, if you are a Lagoshian. And 08000 22 55 372 is ERA's 247 toll free line. Doesn't roll off the tongue as much, but it's there. You know, it's 247 and it's toll-free. Save them both. Save actually save all three of them. 112-767 and ERA's number. If you can just rewind a few seconds back and tell someone about them. And don't forget to subscribe to The Cure and TC Health wherever you get your podcast, wherever you get your insights, we're on Substack at TCHealth.substack.com. And share this episode with anyone who cares about building the rails that make healthcare innovation possible in Africa. See you in our next episode. Bye. Do you want to say bye? Bye.
SPEAKER_00Thank you.
SPEAKER_01Thank you.
