Why you should care
London’s ambulances struggled to find victims of the city’s 2017 terror attack. Had it been Ghana, emergency services might have had it easier.
London’s ambulances, sirens screeching, searched for civilians wounded in the 2017 London Bridge terror attack. But many of the injured hid away from the streets and were hard to find. Had it been Accra, Ghana’s capital, instead of the English capital, the ambulances likely would have had a much easier time. That’s because, while Ghana has a notoriously inexact postal address system, it also has a new fix for ensuring that emergency services get precision guidance during moments of crisis.
SnooCODE Red, a service developed by 32-year-old former Ghanaian banker Sesinam Dagadu, provides location codes on request, with a degree of accuracy within 25 cm (around 10 inches), allowing emergency services to reach a person without worrying about inaccurate or incomplete street signs or addresses. Users download the SnooCODE app and generate a six-digit code that identifies their current location exactly. In London, this could have helped medical professionals reach patients with the app wherever they were hiding. It’s only one of a growing number of out-of-the-box fixes turning West Africa — one of the world’s poorest regions — into an unlikely hotbed of innovation that’s transforming emergency medical care in the region and, slowly, beyond.
Cardio Pad, an electrocardiogram kit that launched commercially in Cameroon in 2016, lets local medical practitioners carry out heart tests and send them electronically to distant specialists who can promptly interpret results and respond with diagnoses. It has already spread to Gabon and Kenya, and to Nepal, 5,000 miles away. Dagadu’s patented SnooCODE, deployed by the Ghana National Ambulance Service since 2013, has seen a nearly 60 percent improvement in service time, from 28 minutes to 12 minutes.
Helium Health, launched in Nigeria in 2015, and KEA Medicals, launched in Benin in 2017, are both building electronic health records platforms that help hospitals and patients access medical records instantly in societies where piles of handwritten doctors’ notes are still common in clinics. Helium Health has received $170,000 in funding so far, and its service is used by more than 20 hospitals and 500 doctors.
All my stress and worries went away — I can get blood when I need.
Dr. Patrick Olori, Nigerian physician
In Cameroon, 22-year-old Melissa Bime started an online blood bank called Infiuss in December 2017. Infiuss has since delivered more than 2,300 bags of blood to 23 hospitals, relying on motorcycle riders. Meanwhile, LifeBank in Nigeria, founded two years earlier in 2015, has developed a logistics team of motorcycle riders and a 24/7 support center that helps it deliver blood and oxygen to needy hospitals quicker than ever before in the country. Just over three years after it started, LifeBank now delivers to 107 hospitals — always within 55 minutes.
“All my stress and worries went away — I can get blood when I need,” says Dr. Patrick Olori, head physician at Patol Medical Centre in Lagos, who has been using LifeBank for two years now.
(A drone SnooCODE is developing to deliver emergency care even more efficiently.)
What’s driving West Africa’s emergence as a laboratory for innovation in emergency medical care is the alignment of multiple factors, experts say, starting with the explosion in software-led technology businesses across the region and, indeed, the entire continent. Last year, investments in Africa’s startups grew by more than 300 percent. That’s allowing the emergence of better technologies. Globally, startups focus on sectors most in need of disruption. In Africa — and in particular, West Africa — emergency health care fits the bill perfectly. A 2018 study by the Kenya Medical Research Institute found that only 16 countries out of 48 in sub-Saharan Africa had more than 80 percent of their population within two hours’ travel time of the nearest hospital. Sub-Saharan Africa also suffers from low penetration of public health insurance — 60 to 70 percent of health expenditures are paid out of pocket compared to 46 percent worldwide — making even basic tests at hospitals an expensive proposition for many. Dr. Stevan Bruijns, the editor of the African Journal of Emergency Medicine, says some countries like Nigeria don’t even train medical specialists in emergency care. Others, like Ghana, have started to do so only recently.
These startups are targeting different pain points within West Africa’s emergency medical system. As an intern at the Department of Cardiology in Yaoundé General Hospital in 2009, Arthur Zang realized that Cameroon had only 40 specialist cardiologists for a population of 19 million people at the time — which forced citizens, many of them poor, to travel hundreds of miles for consultations. That led him to invent the Cardio Pad. “It is very difficult to find a very good device for ECG or blood pressure [measurement] in rural hospitals,” says Zang.
Temie Giwa-Tubosun, founder and CEO of LifeBank, started the firm with the aim of informing “hospitals where blood was available.” Soon, though, the company realized that hospitals wanted more. “They asked us to deliver it too,” recalls Giwa-Tubosun. “So we said, you know, we have to do this right.” When a call comes in from a hospital, LifeBank determines the closest center that has blood or oxygen available; then its riders collect and deliver it to the hospital.
For Dagadu, the founder of tinyDavid, the company that’s developed SnooCODE, the need for accurate geolocators for emergency services came out of frustrations in a completely different sector: banking. As an intern at a bank in Ghana, he says, he would struggle to track customers he had previously met, down to an address, because postal codes are rarely used in the country.
Helium Health is tackling an even more basic need in emergency situations: legible, reliable medical records. Nigeria’s National Academy of Medicine estimates that misread physician handwriting on records is responsible for 7,000 deaths every year in the country. And that’s if the hospital finds the correct record in time in the first place.
But the solutions these startups are offering hold the potential to transform emergency care far beyond West Africa. Cardio Pad is already being used in Nepal, and the challenge of poor road signs and imprecise addresses that SnooCODE tackles is common to most developing nations, including rural parts of India and China. The aftermath of the London bombings of 2005 that left communication systems overloaded and delayed emergency services also influenced Dagadu, as did the Haiti earthquake that brought down the internet there. That’s why he designed SnooCODE so that once the app is downloaded, it works offline. “It was clear we needed an emergency system that doesn’t rely on the internet,” he says.
(The Cardio Pad)
For sure, these startups face multiple challenges. One of them is the need for patient investors as they deploy their solutions in new cities and grow to other countries. Another is adapting their solutions to different types of hospital clients: government hospitals, which typically have more patients and specialists but little bandwidth for new solutions, and private hospitals, which may have more income but far fewer patients. The ultimate advertisement for these innovations will come if West Africa significantly eliminates its own emergency medical care shortcomings — a scenario that still looks distant.
But the region’s innovators aren’t sitting on their laurels. They’re looking ahead. SnooCODE, for instance, has plans to power new technologies, like drones, to deliver packages or medical relief accurately. The rest of the world? It can play catch-up with West Africa for once.