How Kenya’s “Uber for Ambulances” is Taking a Stance Against Covid-19
As the Coronavirus continues to take its toll on the US and other countries around the world, one aspect remains apparent—the unpreparedness of our civilization to deal with the unexpected virus which has now infected over 7 million people and killed over 400,000. In addition to significant global impacts, ranging from economic to social, the pandemic has unraveled a multitude of gaps that need to be addressed in healthcare systems worldwide. While the need for change and innovation within the healthcare space was always important, Covid-19 has pushed it to the top of a priority list for many in the entrepreneurship and innovation space.
Caitlin Dolkart, a 2015-16 Legatum Fellow, is one example of an entrepreneur dedicated to transforming the healthcare space—by building a functioning 9-1-1 system in Kenya. Upon first living and working in Nairobi, Kenya, making use of a seed grant post-graduation, Dolkart recalls she was struck by the lack of a 9-1-1 system that worked for the people of Kenya. “I think most people don’t actually realize that 9-1-1 doesn’t exist in the majority of the world,” Dolkart says. In Kenya, the wait time for emergency response can extend for hours—if someone picks up at all—and you most likely have to dial multiple numbers until you’re finally able reach someone. In Nairobi alone, there are literally thousands of different numbers just for emergency services. When faced with a medical emergency such as a stroke or a car accident, this waiting time can be fatal.
Realizing this immense market gap and area of potential, together with business partner Maria Rabinovich, Dolkart sought out to build a new 9-1-1 system in Kenya that can be scaled to the majority of the world currently lacking such a system—an idea which, she laughs, is “as simple and as complex as you could ever imagine.”
The simple explanation—Rescue.co is an emergency response platform based in Nairobi that aims to cut the waiting time for emergency services in Kenya to just a few minutes, rather than hours. In order to achieve this, Dolkart and her team bring together ambulances and first responders throughout Kenya into one centralized system, who are all reachable by one phone number. Through a single number (rather than thousands) patients reach the dispatch center where care is provided over the phone, and the nearest ambulance is dispatched using their technology, called Flare. Because of this, Rescue.co is often known as “Flare” by ambulance companies, and frequently dubbed “The Uber for Ambulances” by patients—an association which Dolkart doesn’t fully disagree with: “In some parts that’s true. We don’t own the ambulances; we just bring all ambulances that do exist onto one central system.”
Rescue.co now operates the largest network of ambulances across the country. Dolkart recognizes that this is no small feat—and as with any startup, the road to success is never a smooth one. Especially in the company’s early stages, one issue she had to grapple with was convincing investors that her company was worth investing in. This is where Rescue.co differs from Uber: “I’d oftentimes argue with investors—we’re building a 9-1-1 system, so we need just as much money, if not more than, say, Uber. You want the system to never fail. You know, it’s okay if Uber’s app goes down for 30 minutes, it’s not okay if we go down.” As Dolkart explains, most investors couldn’t understand that they weren’t just trying to improve an existing 9-1-1 system—they were trying to build a new one: “They had no idea that the US and Europe are the exceptions, and that most of the world does not have a 9-1-1 system in place that works”
Another hurdle was convincing people in Nairobi, where streets are filled with traffic nearly 24/7, that faster, functioning ambulance service was even a possibility. As Dolkart says: “Because I’ve seen 9-1-1 work [in the US], I’ve never questioned the purpose of it.” For her, it became a matter of changing people’s perception of what an emergency response should look like in Kenya, and proving that faster, more reliable response was, in fact, possible.
The arrival of Covid-19 brought on a new wave of challenges—and opportunities—for Dolkart and her team. Although Kenya seemingly has only a small number of cases compared with other countries around the world (3,215 confirmed cases as of this writing), Dolkart says the healthcare system in Kenya, as with many other markets around the world, is “not capable of responding to a spread of similar scale to what has happened in the US, Italy and other parts of the world.” In addition, the number of actual Covid-19 cases is likely much higher than the number of confirmed cases. This is due to the low per-capita testing rate in many African countries; the approximate testing rate in Kenya is 387 tests per one million people, and only 24 tests per one million people in Nigeria (according to a blog post published on their site).
As emergency services are central to the Covid-19 response—transporting infected patients to the hospital and ensuring that no one gets infected along the way—Dolkart knew the first step she had to take was ensuring that all paramedics within the Rescue.co network were equipped with PPEs and properly trained on how to deal with Covid-19 patients. “It’s actually better not to respond if you don’t have any [equipment] or you’re not trained,” Dolkart explains. As in many other countries around the world, access to protective equipment and training in Kenya remains a major issue, and has resulted in a number of healthcare workers turning down COVID-19 patients due to lack of resources. To help them supply enough PPEs for all 600 nurses and paramedics within their network, Rescue.co recently launched a fundraising campaign with the option to donate towards PPE, training, or a life-saving rescue for someone who ordinarily would not be able to afford an ambulance.
In addition, Rescue.co has partnered with a number of other organizations to launch a “Wheels for Life” initiative, offering free ambulance and taxi services for pregnant women to get to the hospital during Kenya’s curfew, which limits movement in the evening hours. Although this 45-day curfew (which will now be extended an additional 30 days) has been effective in reducing the spread of Covid-19, it has resulted in an increase in maternal mortality rates. So far, they have been able to achieve a 100% survival rate among mothers.
Dolkart’s example is one of many Legatum Fellows and entrepreneurs worldwide who are pivoting their ventures to join the fight against Covid-19 (you can find a growing list of them here)—and, for companies like Rescue.co, the pandemic has become an opportunity for action and innovation. As Dolkart says, “I think it’s this very odd time where there are certain businesses that can kind of taper back. We have to actually ramp up.” Dolkart explains that an additional opportunity has been launching her business in an emerging market, where she has found more room to innovate and achieve lasting systems change than in the US—especially in the healthcare space. “What drew me to this part of the world was the impact you can make on a systems level. There’s more opportunity and more blank space to actually innovate.”
Written by: Rafaela Marinello, Communications Coordinator, MIT Legatum Center