Affordable healthcare for the masses: Ilara Health’s sustainable business model saves lives


This week we’re featuring what has to be one of my favourite business models to date.

One of the dominant themes in East Africa is that individuals and businesses don’t have the cash to afford products and services that would earn them more money, and make their lives better.

To open up access to electricity, off-grid solar power systems are now commonplace, provided on a Pay As You Go basis.

This model is being adopted in other markets too, such as cooking fuel, irrigation pumps and TVs.

Where it becomes especially powerful is, in my opinion, if the financing can be for a revenue-generating asset.

The new owner gets a top of the range piece of kit and is able to pay for it through the additional income they earn from it.

This is what Ilara Health has done for medical diagnostics.

Ilara Health takes the most advanced, modern equipment (often smartphone-based) that offer the same results and cost only a few thousand dollars, and then provide them to peri-urban medical clinics in Kenya who then pay back in installments.

The result – routine ultrasound tests become available to a local population at an affordable rate, (rather than spending hours to travel to have one), medical clinics can grow their business, and Ilara Health has a sustainable business model.

Emilian also has a number of top tips on starting any business in Africa which come from over 20 years of him running and investing in companies on the continent.

I’d strongly recommend following him if you’re interested in building ventures in the region.


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Social Media Links



Twitter: @HealthIlara



Sam:                                      00:07                     Cool. So we’re here today with Emilian from Ilara health, Emilian welcome to the show.

Emilian:                                03:44                     Thank you.

Sam:                                      03:45                     So to get started, can you tell us a bit about you and a bit about Ilara health?

Emilian:                                03:48                     Sure. So I’m Emilian, I’m the CEO and co founder of Ilara health. And we make diagnostics more affordable, accessible and accurate in Africa. I’m an entrepreneur, but also an investor. I spent the past four years building and, and growing growth stage technology enabled venture capital firm focused on Africa, mainly in between South Africa, Kenya, Nigeria and Egypt. Prior to that I used to run rocket internet, the parent company with Jumia in a couple of markets, between China Russia, India, South Africa, and later in Nigeria built one venture with not for us funding in South Africa and run Groupon, South Africa for a year.

Sam:                                      04:46                     Got it. Cool. And when did you start Ilara health?

Emilian:                                04:50                     So we started, Ilara health is a result of over a year, actually year and a half of market research around how to build a sustainable healthcare venture in Africa and emerging markets. We’ve launched commercially in March this year. Well, I spent half of my time last year researching the primary healthcare sector in multiple markets in Africa as well as India and Latin America to find the right business model to build here.

Sam:                                      05:28                     Got it. And if I’m right, you’ve settled on lease financing for a diagnostic test, is that…

Emilian:                                05:37                     Yeah, so, I mean, starting with a problem so 70% of of medical decisions require diagnostics such as blood tests and, but there are half a billion you know, 500 million people in Africa, who struggled to access or afford a simple blood test. So I’ve, you know, as I mentioned to you over over a year, I visited hundreds and hundreds of health clinics across the continent and it’s shockingly poor. So I remember even meeting this lady in one of the clinics, and she actually lost her child from pregnancy complications because she just couldn’t afford an ultrasound before birth. But, but thanks to advances in artificial intelligence, robotics, technology there are companies around the world which create new diagnostic devices, which are much smaller, lower cost and can work directly at the point of care in the doctor’s office providing results in minutes. So at Ilara health we do four things, to get back to your question, so we partnered with those companies and we integrate their devices into our technology platform. Number two, we distribute this bundle of devices into the petty urban and rural clinics where 70% of the patients live. So we’re not in Nairobi itself, but we’re outside the main city in the suburbs. We also offer financing, which is very important because those doctors cannot afford to buy even a much cheaper and smaller diagnostic device upfront. Number three, we charge the doctors an affordable subscription or, or paper test as they use the equipment and we continue helping those doctors growing their revenue by providing new diagnostics devices and new services.

Sam:                                      07:35                     Got it. Okay so you sort of said you were always interested in health care is that it seems like if you went and did it, spent a year going through lots of clinics. That was your kind of…

Emilian:                                07:45                     Exactly. So I’m, I’m super proud, actually, I’m very passionate about health care for myself and it’s been a while. I’m very into prevention and early detection of diseases. I go every six months to see a doctor in Cape town and I do 20, 30 blood tests, you know, to just to…

Sam:                                      08:06                     What’s a 20, 30 blood tests.

Emilian:                                08:08                     So anywhere between the, you know, starting with the basic ones, between all the biochemistry the lipid function, no cholesterol up to more complex tests tumor markers hormones, just to make sure that, you know, if anything goes wrong, I can detect it and I can do something about it. And these communities with you know, with a reasonably healthy lifestyle, you know, doing lots of sports, eating very healthy, sleeping, you know seven, eight hours a night. So that’s my goal. My goal is to make sure that I can, you know, I can live healthy and you know, hopefully longer. So longevity is one of the things I’m looking into. However, in Africa we’re actually not talking about longevity, we’re talking about survival in those regions. So I’ve been looking for a while how to apply my interest in healthcare into a business, a sustainable business model, tackling the basic needs that a patient, you know, sub in, you know, in suburban area in around the main cities in Africa would need and people, you know, during those hundreds clinics, we, you know, one of the first questions that we ask doctors is why, what are the main reasons someone comes to see you? And there are four, five reasons people come with upper or lower respiratory infections and ideally they would need a full hemogram to make sure to, to identify if those infections are viral or bacterial. So to see if they they take antibiotics or not then there are just the infections they will need a stool test. Then urinary tract infections they need a urine test. Then a high percentage of people here are pre-diabetes, pre-diabetes or diabetes. Some are, two thirds don’t even know same for cardiac diseases. And they would need, for diabetes, they will need, not the glucose because glucose, a basic glucose test can not identify, but rather, you know, the spikes can, can obviously influence the test. But you need an HBA one C test, which is a bit more complex, which is on average over three months of your blood sugar same for cardiac diseases, You need the cholesterol, you need the lipid function test and the other reason is pregnancy. We may need one to two, well it’s recommended that they get one to two ultrasounds before pregnancy, and the problem again those tests are normally done in a lab, which labs are far away, too expensive and people would incur costs and time to go. And that’s where the care breaks down.

Sam:                                      11:04                     Right.

Emilian:                                11:04                     And, you know, if someone sees a doctor and the doctor refers the person to a lab, you know, half of the people won’t go.

Sam:                                      11:11                     And so the, well, one of the innovative things that you’ve spotted is, OK part of the reasons that these clinics don’t have, don’t currently have the ability to do these tests, the tests that machines are too big of an expense…

Emilian:                                11:26                     The machines are expensive. So those clinics don’t you know, they don’t make some revenue. And the problem is that the consultations are usually the consultation fees will be too small to make the doctor survive. So it’s 100 to 200 shillings, so $1 to $2 the, every single small clinic will have a pharmacy or dispensary where they sell medication to the, to their patients and they make you know, significant revenue out of it and they would love to provide diagnostics but they can’t buy the machines because they don’t have enough steady revenue to buy the machines.

Sam:                                      12:02                     Am I right, the part of what you’re doing is you actually identified innovations with these machines and then brought them here.

Emilian:                                12:11                     Exactly. So typically, I’ll give you an example so exactly what we, what we’re doing. We identify the latest technology developments in those three, four, five areas which equate into much smaller and much cheaper but high tech devices which can be run remotely through a cloud and which can sit at a point of care so keep typically an ultrasound, right? A full size ultrasound made by one of the big brands will cost between $25,000 and $35,000. Miniature portable ultrasound made also by some of those super innovative high tech companies would cost a fraction of this maybe four times cheaper, five times cheaper. But those manufacturers are actually startups sitting somewhere in the US, in China, in India or somewhere else in Asia far from Africa with no or little plans to come to Africa today because they’ve just launched, they’ve just raised money. They’ve gone through an FDA or C approval and they have enough market where they are. So what we do, we go and then approach those companies at a founder’s level and to try to convince them to let us bring their products into Africa.

Sam:                                      13:28                     Are they, do they have any resistance to that? I mean from branding perspective or from a…

Emilian:                                13:33                     So obviously it’s, it’s easier to it’s easier to talk to companies which are startups because they’re used to you know, they’re much more flexible compared to a big corporate, which may not have a direct interest to come immediately here or which will be, you know, more difficult to work with.

Sam:                                      13:53                     Got it. Okay. So you’ve kind of got this quite good this quite good dynamic by the fact that you’ve kind of, did you say found the founder of these startups they obviously they’re not able to do a little, a little bit cheaper, but I mean is let’s say it now costs $5,000. You’re saying that the clinic is not still not able to pay?

Emilian:                                14:15                     Exactly. The clinics, even a device which is four to five times cheaper than the full size one, a doctor cannot buy it. One of the main reasons is when you look into the revenues of those clinics, no one third of them have are approved or accredited by the national health insurance and they get a certain computation, money on a monthly basis, based on a number of patients they record the day they choose to go to the clinic. This capitation money comes in batches and comes late so the biggest issue of those clinics is actually cashflow management. It’s less as a, you know, at the end of the year they would make money but they will not have money today. They also usually don’t qualify for land for credits because either they don’t have their balance sheet is very thin banks would ask them for a collateral, which is usually two X or even more as the value of the loan. And there are some digital lenderswhich may be able to lend, but digital lenders, would ask the clinic a certain size of the daily or monthly revenue coming through their digital channels, M-Pesa. And if the clinic does not have, either or, assets or significant digital revenue, they will not qualify for credit. So what we try to do is to first of all match them with a lender. If we, if we can, based again on their revenue or on their total revenue. And if we cannot, then we look into potentially lending to them ourselves on balance.

Sam:                                      15:55                     So it’s not, the default is not for you to do that.

Emilian:                                15:59                     The default. We’re not a lender actually, we’re an, we’re a technology company. So our business model is again, identifying those you know, high tech diagnostic devices somewhere else in the world, bringing them here, placing them. So distributing or placing them in clinics, linking them into a tech platform that we’re building connecting them, being able to turn them on and off collecting data.

Sam:                                      16:28                     When you say being able to turn them on and off, does that mean being able to turn off the ultrasound?

Emilian:                                16:33                     So typically if the, the device becomes a collateral for a loan. So, if the clinic in this case stops paying for any reason, we could potentially turn off the device. Obviously now it’s not our goal. Our goal is to make sure that we have that. But our goal is to make sure that we can, our goal is to make those clinics make more revenue and we work with them, we’re flexible and we try to understand how can we help the clinics make more money because we believe that if the doctors make, if those clinics make more revenue, they can deliver better health eventually. We may not be able to completely control the prices today to make the ultrasound cheaper or the blood test cheaper. We hope that we will about in the future, but at least we can bring accessibility and the rapidity of those tests and more revenue for the clinic. And by doing this, we’re also looking to into how to streamline the processes with the clinic. Once we’re in the clinic, we have a foot in the door, we see their financials, we see the processes, we understand how do they order medication we, both myself and my co-founders come from a consulting background. So we also sometimes put our consulting hats and think how can we improve the processes of our clinics?

Sam:                                      17:58                     Yeah. Okay, cause one of the things, the thing just to touch on is this idea of, you’re giving people a revenue generating assets.

Emilian:                                18:08                     Exactly.

Sam:                                      18:08                     So it’s not like somebody’s getting financing and it’s, they’re getting often consumer or is it, one of the things I always find with with financing is yes, it’s all well and good to, you know, be given some money and then being told you need to pay back 10% in 30 days or whatever. But is there a path towards peak people legitimately increasing their revenue? So…

Emilian:                                18:30                     A massive path, it’s massive but let’s take the ultrasound the modern ultrasound, if a clinic receives a pregnant woman and the clinic does not have an ultrasound machine in most of the cases, the doctor will reffer that pregnant women to a third party ultrasound clinic the lady would pay 1500 shillings for a pregnancy ultrasound, the referral clinic would receive anywhere between 200 and 500 shillings as a referral fee. In our model, if we place an ultrasound machine on the clinic desk, another doctor can perform an ultrasound, can receive that full price, which is 1500, even more if the clinic is accredited by NHIF. So up to 3000 shillings, full revenue and they will be able to pay us back a certain amount a month, which will be somehow equivalent of a two year loan at a reasonable interest rate, so this interest rate actually includes a market interest rate plus a surrogacy as if it we’re to be able to count the number of tests, we just were approximate it for now but we always look to make it affordable for the clinic, we would not place an ultrasound in a clinic where we know personally that they would not be able to get enough patients therefore per day or per month for ultrasound or for other blood tests therefore they would not be able to pay back the loan.

Sam:                                      20:14                     As I said, is there, there is pent up demand this, isn’t it? It’s not like you’re suddenly going to put these ultrasounds machines in and the local population are going to be like, well, I can’t afford this or I’m not going to…

Emilian:                                20:25                     There is a demand. There is a, the demand is there. It’s just concentrated and takes time and the logistics to go and then, you know, do those tests.

Sam:                                      20:35                     So this setup is basically opening up the market in terms of making it easier to access thesethese sites. And as such that is going to grow the market.

Emilian:                                20:47                     And eventually hopefully more affordable.

Sam:                                      20:49                     Yes, got it. Okay. You’ve had a lot of experience running companies in across East Africa and Africa. What are some of the lessons that you’re taking from your past that you’re applying to, to running Ilara?

Emilian:                                21:05                     Actually a couple of lessons one is every successful business I’ve seen in Africa has a financing component. And you know, there are businesses distributing fruits and veggies in the market. They lend eventually to those merchants they lend cash or they lend products, their business is distributing FMCG products. They also end up lending they are you know, there are a number of asswr leasing businesses, you know, lending for people to buy or to lease a motorbike, a pro a commercial asset. What am I feeling is that the successful business, the businesses amongst the six or 700 companies, I’ve seen my, in my venture capital career across, you know, around four years, across a continent, most of the successful ones have a FinTech component, even if they are health tech or education or distribution or logistic or something else, it’s always a FinTech or a financial component. So what we do here, we, yes, we we build a health technology business but with a strong FinTech component through the lending and through the cash collection from the clinics, which we try to automate. The second the second learning from us at leasing is if we can avoid to have those assets on our balance sheet. So match the existing clinics with the lenders it’s better. I know that we won’t be able to do in every single case but our first approach is enabling the clinics to access lending and only if we believe that the clinic can not access lending for a specific reason, but if they still, if we still assess them from a credit perspective as a good payer, then we lend the assets to them. Another learning is, and if I put my investor hat, you know, the market is massive. We can always think there are five, six markets around or the needs are the same. However, what we build here is a strong operational business. So some of the, some of the things we build need time. We need time to learn how to scale this business in an effective manner, in a profitable manner before we go to another market, even in another city. So we have enough clinics around Nairobi where we need to focus. So focus is super important cash management for ourselves, right? I mean, one of the main reason of startups failing is they don’t have money because they spend too fast too soon.

Sam:                                      23:51                     Okay. So then they said, forget it. And I sort of get that from a investor top down. What’s, you know how to do it, but I think what’s also interesting about you Emilian is that you’ve always had experience being the operator. So I’m interested in, I mean, can you perhaps give us an idea of how many people are currently working at Ilara? What are some principles of the way in which you’ve decided to run the day to day operations of it?

Emilian:                                24:15                     Sure. So we’re a small and nimble team for now, we’re three confounders we have two salespeople we have a couple of advisors whom we may onboard on a full time position soon. We have a medical advisor slash chief medical officer. We brought 2 other people now one on operational finance and another one on corporate development on a specific new project that we look into those clinics. So we try to keep the team small for now and indeed, each of us does a number of things there is no you know, I do the CFO, the credit manager, the HR, the legal while my cofounder Aman focuses on product and my cofounder Hannah focuses on sales and operations. Very important is the, the dynamics and the team. I’ve seen so many startups failing because founders misalignment.

Sam:                                      25:17                     What does that mean?

Emilian:                                25:18                     Founders may be misaligned in terms of goals for the company and then…

Sam:                                      25:23                     So one wants this to happen and the other…

Emilian:                                25:23                     Yeah, so, you know, luckily we’re aligned and we will continuously work on, on communication, spending time together, making sure that we, we focus on the same goals and going very fast. Speed is super important because what we miss is actually time and that’s our our most I would say scarce resource before we need to raise the next round. So we try to achieve, we have very specific goals. We’re even implementing OKRs now in the company…

Sam:                                      25:56                     And OKRs are?

Emilian:                                25:58                     So goals basically similar to KPIs, but…

Sam:                                      26:02                     What’s the difference between?

Emilian:                                26:04                     The KPI is a very specific it’s a very specific goal.

Sam:                                      26:15                     Key perfomance…

Emilian:                                26:15                     Exactly. OKR is more on a longer term.

Sam:                                      26:21                     Alright. OKRs are the thing to be doing these days?

Emilian:                                26:24                     So you know, big, successful companies always look at you know, accountability and longer goals with also with specific numbered goals for, each of the team members. So we’re implementing we have very clear objectives and we try to align on a weekly basis to make sure that we steer the company into the right direction. Yeah.

Sam:                                      26:51                     And are you doing this in an office?

Emilian:                                26:53                     So we are, we spend most of the time in the field I’m actually, we share, we have a shared office space we spend time in Nairobi garage or in key guy. But I try to spend most of my time and my team’s time in the field because I strongly believe that this is a field business. If we are not in the field, then we become too comfortable and then we stop understanding the needs of the market. One of our advisors was telling us a few a few months ago saying, you know, you can always, you know, fail to achieve a certain revenue goal, but what you can’t fail to achieve is understanding the needs of those doctors better, even than the doctor themselves. So we spent time with the doctors understanding what they need, understanding how can we help understand their behavior to be able to bring the products, the technology and the solutions that would make them make more revenue and thrive and serve better eventually their patients.

Sam:                                      27:58                     Yeah. Okay why is it called Ilara health?

Emilian:                                28:03                     It’s a good, a good question actually. The idea is that we started we wanted initially to launch this business in Nigeria and we called the company Ilera with an E instead of an A, Ilera in Yoruba means health. And then we changed from Nigeria to Kenya for a number of reasons that, you know, we understand better. Kenya, we felt, I’ve been in and out Nairobi for the past four years. Aman, my cofounder, his family comes from East Africa easier to do business that we decided to start in Kenya. And we changed the name from Ilera to Ilara.

Sam:                                      28:45                     Does Ilars mean something in Kenya.

Emilian:                                28:48                     Not really, I mean there’s a, I know that there is a milk brand, there’s a dairy brand here, but nothing, nothing else.

Sam:                                      28:58                     And will, will I certainly think so that the patient, the lady who’s coming in for the ultrasound what’s her experience? What’s her relationship with the ultrasound? Should we say? So is it that she’s feeling this is a white label product which my clinic is offering? Is it that, Oh, this is actually an Ilara health ultrasound. Is it that this is the actual manufacturer’s thing, where does the name Ilara health? Who does that?

Emilian:                                29:27                     That’s a really good question. So specifically for ultrasound, women know that they need an ultrasound the question is do they afford or not? Can they get an ultrasound? Some are close to there, to the place where they livbe. And that’s where the smaller clinics are. And they’re plenty they may not afford to come to Nairobi, take a matatu, spend, you know, 150 shillings back and forth when they’re pregnant and take time off work. Are they, I mean, those, those ultrasound machines, they’re not an Ilara brand but they come from reputable companies around the world, which have been already have gone through the approval process. They’re in the US or Europe and in Kenya so the quality of the, of the brand and actually the quality of the result, which is a color image, which is very clear for a sonographer finally is less of the patient. But is the sonographer, the person who performed the ultrasound, who needs to vouch for the device and before choosing the rights the brand that we have today, we’ve been testing a number of brands. 3 of them actually which sonographers in their offices and in the field and we’ve done the same thing for the, the blood test machines that we have currently in the market to make sure that the one that we placed in the clinics is a right one, which answers to the needs of the market. Typically, you know, a color ultrasound is, is needed versus a black and white, a certain mode is needed to identify certain conditions of the baby. The fuetus, and that’s how we, we’ve got to the products that we distribute today. Now Ilara brands so we believe that what we can build here is really bringing those clinics to a certain level. They’re very different. They’re small, they miss, they don’t have a name, they don’t have color on the wall. They don’t have assets, they don’t have processes, they don’t have IT, they may not have even beds. So there’s a lot of stuff to do within, inside those clinics, so diagnostic devices is just the first step to put a foot in the door of the clinic. But as we are in, we can help with other things with, as I said, with platform, with processes and eventually bring all those clinics, or some of them at least to a certain level which where they could become a clinic X by Ilara health where Ilara health can become a brand, which would equate with the quality service of devices, of doctors, of processes and finally, quality of care. That’s what the patient needs, in sickness needs, needs care.

Sam:                                      32:21                     At the moment, your ultrasound devices or whatever, you know, they’re in a clinic, a patient could come in, have an ultrasound, get their receipt from the, get the receipt from the clinic, walk out and have no idea that Ilara health has had any involvement with that?

Emilian:                                32:38                     Today. No. They don’t know.

Sam:                                      32:40                     But the idea is in the future it’s almost like this, you’re a franchise model.

Emilian:                                32:45                     It’s a, yeah, it’s a franchise or reverse franchise model, indeed.

Sam:                                      32:48                     Reverse franchise?

Emilian:                                32:50                     Somehow the models where you basically don’t go and your brand don’t go and then find someone to open a store, but going to an existing…

Sam:                                      32:59                     Okay…

Emilian:                                32:59                     Establishment, call it franchise.

Sam:                                      33:02                     You go and you sort of say, right, you’re a business, you’re an independent business. You’re already here. If you play by these rules, then you can call yourself Ilara.

Emilian:                                33:09                     You become part of the network.

Sam:                                      33:11                     And not only that, I imagine the sell is, you know, we’re also going to make you better?

Emilian:                                33:15                     Exactly, that’s the end goal.

Sam:                                      33:16                     Yeah. Got it is there something which is like quite a few years down the line or is it something where it’s like might be a bit sooner?

Emilian:                                33:25                     It’s going to take time, I mean, there are a couple of examples here there’s, you know, tunza brand which is a tunza NGO, which you know, gives training and I think some financing to some clinics and it has become a brand Tunza clinic is recognized as a good clinic. This model exist in education in India, exists in hotels in India, China, US, Europe. So the model were, you know, one comes the brand or a brand comes and, and brings a number of individual businesses to a certain level exists. It’s gonna take time, we’ll take time and diagnostics is a first step, probably pharmacy. The second step. Education training of those doctors is another step and eventually bringing other assets, other devices, you know, so a lot of clinics tell us, we, if, you know, if we had you know, $10,000, we would love to buy a small operating theater for C-sections cause they, they could make revenue, they could provide this you know, small surgeries to patients and they can’t. As we go, we’ll discover more opportunities.

Sam:                                      34:40                     Okay, cool. And what have been some of the surprises that’ve sort of come in the months you’ve been here?

Emilian:                                34:48                     So one interesting thing is before we started this business, I thought that there is a high demand for financing but those clinics, which are businesses finally can just not access financing. What we find now, we found also a number of cases where the owners of those clinics run away from, from financing they have that perception that banks would never give them loans, and the banks ask them for collaterals, which are impossible to provide. And they have this image of these how do you call them, shark loans. Some of them actually take loans at 30% interest rate per month to be able to pay salaries knowing that they will get revenue in the future. So some of them are actually concerned when we talk loans. So we actually have changed significantly the way we present these. It’s not alone, it’s an asset that we place and they pay back for a service so there’s no interest rate as such, it’s a bundle payment.

Sam:                                      35:57                     This is, I think one of the nuance, one of the, one of the features of the solar industry here in the solar panels is that, you know, effectively people, you know, someone comes along and puts a solar panel on the house and they pay $5 a month to keep the electricity on behind the scenes. Actually, that’s quite a sophisticated asset, it’s quite simple as a financing, but it doesn’t feel to the end customer like, Oh, this is my exact thing that I’m paying. So you’re basically taking it off…

Emilian:                                36:30                     I’m taking this experience from several companies, which I’ve looked at or invested in the past and being close to. So we apply a lot of, we try to take from solar what, what has worked and avoid what hasn’t worked. I think another thing which changed my perception. I was under an impression that they’re not enough medical establishments. I actually started, I’ve started to change my perception. There are so many we see every day. So we have a database of 10,000 clinics across Kenya, which is the government database. I found already about 50% of the clinics that we see. They’re not in the database. So I think there are more than that are they 13,000, 15,000. I don’t know yet so I don’t think there is a lack of establishments, but there’s a clear lack of training and skills amongst the 200 killings that we’ve stepped into. To date. I may have seen five doctors, like doctors, all the students have nurses or clinical officers which can perform, you know, can perform computer, can, can do consultations. They can even perform basic surgeries but they’re not doctors, so they need, they badly need training. So that’s where we come now. And typically with the ultrasound device, we provide training. We teach them how to perform a pregnancy ultrasound. We cannot teach a clinical officer to become a sonographer. Absolutely not. That’s a one that’s a one to two years you know, medical or pre-medical school. But we can teach someone to provide basic pregnancy ultrasound potentially with a real sonographer on the other side of the line. So the device that we’re bringing now has an embeded telemedicine, tele-sonography functionality.

Sam:                                      38:30                     You’re almost like you’re on Skype.

Emilian:                                38:32                     Exactly. So because the device is to a camera and then the doctor or the sonographer on the other side has access to the image and can actually freeze the image, can do whatever. A sonographer in front of a big ultrasound with buttons can do, freeze the image, increase the image stop the image, print image measure and as same for the, for the blood. So we have a device now which does a lipid profile and HBA one C. So the diabetes markers we’ve seen actually in the beginning that was for one of the tests. The results were actually fluctuating a lot and we tried to understand why, the device come from Taiwan has been CA approved, has been tested in Europe, even in India. And they haven’t had these problems before. And we realize that the problem comes from the manual part of the process, which actually equates to training, training how to drop that blood drop exactly in the place for the blood, where the drop needs to go for the device to function properly. So training plus automation or just automation. So this is the other thing that we discovered. We thought that just automation can actually replace a skill natural. And finally, finally it’s just about people. People perform, people give care that a machine cannot deliver the feeling of care, can deliver results but you know, they were feeling you still need people, doctors or clinical officer or nurses. It’s very difficult to replace them and I don’t think that the pure machine or tele-medicine will work anytime soon here. So we are in a people business but we train, we want to train an upscale those medical officers or clinical officers to get to the level of skills to operate our devices while performing or giving care.

Sam:                                      40:28                     Got it. Yup. I see that.

Emilian:                                40:31                     So we also have an education part of that.

Sam:                                      40:36                     As you, I mean, when it comes to learning how to use this company’s blood test machine, I mean, is that cost that you incur, that Ilara incurs.

Emilian:                                40:47                     So we blend this in our service fees. Obviously we perform a training initially, which is part of the sales process and we even this morning I had a meeting with a potential partner on tele training for the clinics. Face to face is very important. Face to face in the clinic is super important, but we need continuous training so we haven’t yet figured out how will we do that at scale. We do it now for the ultrasounds. We do it for the blood, for every, every device we, we deliver, we place, we train but we need to find a sustainable solution to perform continuous training.

Sam:                                      41:30                     And if we just sort of go back a few steps, I’m interested in exploring this, this crinkle you mentioned about the financing and how you’ve got these third party financing organizations, which are the ones actually putting up the money. I sort of can get how from the perspective, not having those assets on your balance sheet is useful. Is a, is a good characteristic to have? How does that complicate the operation you’ve got when you’ve then got this extra party who’s needing to

Emilian:                                42:00                     Actually, it simplifies, simplifies because the reality in this case would broker a relationship between a clinic and a lender. And we’re in a business of enabling.

Sam:                                      42:14                     So is the clinic, are they paying one payment to you and one payment to that…

Emilian:                                42:18                     They would, the clinic would pay actually a down payment to us and they will pay a principal part plus interest to the leaser, to the loan provider. So in this case, there won’t be a usage fee. There will be a one off fee that, so of clinic pays us a certain amount. In the beginning.

Sam:                                      42:41                     Say if they pay like 10% down?

Emilian:                                42:42                     10% down and they will enter in the lease agreement with a provider. So in this case, for those those clinics, we would be just an asswt provider and a trainer while the credit risk and the lending relationship will be, is between the lender and the clinic. In the clinics, which cannot, well we believe that they can not they cannot get a loan for a number of reasons and we pre-assess them, then we lend or then replace the device.

Sam:                                      43:16                     With the case where yoiu’ve got this external lender, so the clinic is paying a monthly fee?

Emilian:                                43:21                     They’ll pay a monthly fee or a daily fee actually.

Sam:                                      43:23                     A daily fee. Okay.

Emilian:                                43:25                     Which is equivalent to an interest rate, a market based interest rate.

Sam:                                      43:30                     I’m more interested in dynamics of like you, being that you have this relationship with the clinic and saying like, we’re the ones who are finding this ultrasound machine and then the payment actually going somewhere else. And like if, if you understand some of these breaks like who…

Emilian:                                43:44                     So those machines are actually, they have a manufacturer warranty for the first year. We priced in the price of the asset. We priced another year, it’s an additional year of local all risk warranty or all risk insurance actually, which covers everything from breakage to tests to malfunction.

Sam:                                      44:09                     Okay. So if the two years…

Emilian:                                44:11                     For two years the clinic, basically for the length of the loan. The clinic is, is covered. Post this, obviously we are still finally like any distributor of medical devices. We are we present, we ended up representing the brand so we’ll provide a service obviously at a cost if needed.

Sam:                                      44:38                     And that that will be basically from the finances perspective by saying, right, we’re going to put down this money every day, we’re going to get paid and the duration, two years at the end of it. Thanks very much.

Emilian:                                44:49                     Yeah.

Sam:                                      44:50                     Got it.

Emilian:                                44:51                     Because you tell lease to own, finally the goal is us to become the owners, the full ownership of the clinic. So the clinic can capture the full revenue instead of paying the interest and the principal back.

Sam:                                      45:04                     And who are these financers?

Emilian:                                45:07                     So we’ve been we have a couple. We started to work with the medical credit fund which is part of farm access here. The medical credit fund offers a digital loan as well as an asset loan, both of them based on the digital revenue potential of the clinic and they collect payments on a daily basis actually on the person’s action basis from those clinics. The medical credit fund currently focuses on bigger establishments so we were trying to you know, bring them into those small, medium to small size, and then low income clinics. We are working with a bank here CDN bank to enable the same type of lending but on a pure bank type loan and we look at other debt providers. We’re in touch with two others. So we’ll see how these relationships will evolve. We actually have the first five clinics with ultrasounds. We already have four clinics in the market part of a plan of that we started in March with smaller devices which we did on balance sheet. We just bought them and placed them just to understand the clinic processes and how we can perform to do the collection. The real business starts now with the first five clinics, which we train this week, this coming weekendwith ultrasound devices and to, you know, a couple of them will be financed through the medical credit fund and the rest will be having the other half will be on balance sheet, so that’s the first trial to see which, you know, how this is going to evolve. And as I said, we’ve been stepping into about 200 clinics and some of them are in various stages of discussions in the sales or placement process. And as soon as we’re done with those five, we’ll move into selected clinics from the pipeline. The goal is to get to you know, 60 to 100 clinics 60 things by the end of the year. And probably another hundred in the next six months, for six months.

Sam:                                      47:23                     Fantastic, we’ll just do a few more questions.

Emilian:                                47:26                     Sure.

Sam:                                      47:27                     Alright. So we’ve spoken sort of a bit about the supply side, but on the demand side, I mean from your perspective in working in this health or you’re working in the health markets, should we say I think what’s quite interesting is you’re saying you’re viewing medical devices as the first step into opening up this potentially much bigger market around improving clinics and potentially one day doing a reverse franchise or franchise with it. What are some other interesting opportunities that you’re seeing within that medical area, which you’re like, that’s really great. It’s not for us right now, but someone else should do that.

Emilian:                                48:05                     Sure so a clinic, if you look at what’s, you know, what are the needs of one of those small clinics, so they need diagnostic devices, they sell medication, so pharma products, and that’s a massive market. We’re not yet there other people do it now, we may be there one day, so we’re looking into it. They need education training face to face or distant they may need remote tele-medicine solutions and they need other assets apart from the diagnostic devices. I think I mentioned earlier, some of them need beds, others need operating theaters. So I believe that there is a huge opportunity into enabling those clinics to perform whatever they need to and where they have patients for and you know, provide better care, through training devices, inpatient surgeries and education.

Sam :                                     49:11                     And you may not have that much exposure to it, but I’m interested, outside of clinics, are there any other areas where you think other entrepreneurs should come in and do particular…

Emilian:                                49:20                     Specifically in healthcare?

Sam:                                      49:24                     Sure, I mean actually you’ve looked at lots of businesses.

Emilian:                                49:28                     Oh, in general?

Sam:                                      49:29                     Yeah, let’s go in general. Yeah.

Emilian:                                49:30                     Sure. So one thing, I think it comes from seeing a lot of businesses in Africa, is, and I have this, I always compare Africa to China, to the US and you know, in the US, you can build a pure tech platform because you have the infrastructure, you have the infrastructure there. In China, most of the, you know, technology businesses today have built infrastructure over time. And you look at Alibaba. Alibaba even has clinics by the way, or Tencent actually has clinics. So they build technology alongside infrastructure, right. In Africa, the problem with infrastructure is in existence. So Africa is in my opinion, very much about distributed things, distributed solar, distributed diagnostics. That’s what we do, right? We bring pieces of a lab into a clinic distributed everything, distributes logistics. So there’s a massive opportunity, a number of sectors and we’ve seen very successful companies here tackling the biggest needs of the consumers, which are actually still fairly basics. People need to eat. So they need to get fruits and veggies. They need to get FMCG products, there are companies tackling this with distribution and financing. Businesses selling various products, you know, there are companies doing lending market, B2B lending, which is massive. And there’s still a lot of place here. Education with a fund, I was involved for four years. We invested into one of the most successful or the most successful education technology company in Africa, based in South Africa, which sold to a US listed education online company. So education is massive. I haven’t seen too many education companies across the continent unfortunately, but I think there’s a still a huge needs, someone will need to come and find the right model, the right profitable model, how to deliver online education or on mobile education. Within financial technology there’s so much need Kenya is somehow lucky with mobile money. But there’s so many other countries in the continent where it’s very difficult to pay, very difficult to send money somewhere, very difficult to capture money as a merchant very difficult to get money as a merchant on a product loan. So bottom line, the kind of the biggest sectors that I think are the most interesting are FinTech. Obviously, you know, within the, within the $1 billion venture capital money invested in Africa last year about 35% I think was FinTech, I don’t remember exact, the number from disrupt Africa or from Partec, so FinTech is a massive sector. Within FinTech, there are a lot of sub-sectors, some of them more profitable or more interesting than others, more impactful than others. But financial inclusion is super, super you know, super needed, education mobility, massive. People need people move, right? Those cities you know, Kenya is still a, you know, massively rural or actually moving from rural to very urban but those cities in this African cities will actually double in size in the next 10, 15, 20 years and people need to move from one place to the other. Finding using technology to help those people moving is super important. Yeah. So healthcare, education electricity, so distributed electricity, solar renewables moving, moving people from A to B, moving freight from A to B, moving, you know, food or other things inside of cities.

Sam :                                     53:06                     And any words of warning or words of caution for people who are thinking of coming into this business in this part of the world?

Emilian:                                53:13                     So this is not a, this is not Silicon Valley, this is Africa. Those are emerging markets where I think the point of caution is you know, what other people think that they can, you know, build top line revenue with no or no profitability or vision for profitability and they can raise another round and another round and another round, that’s less possible in Africa because you know, from an investment perspective, if we look at macroeconomics in Africa, it’s still far in terms of returns compared to Europe or US or Asia, right? So a P firm would say, why should I invest in Africa when I can, you know, make a great return in the US, Europe or China or Southeast Asia but Africa is the future. I think Africa is the only place in the world which still has this massive potential of huge population growth, huge mobile penetration, huge, very, very young people and it’s funny, a very good friend of mine Ron, is one of the, you know, successful technology companies based in Barcelona. And I was having a call with him a few weeks ago and he was sending me why are you spending your prime, even if I’m not yet prime, but what prime years in Africa? And I was laughing. I said, well, let’s talk five years from now. So I have a massive belief in this continent. I’ve been in Africa, even if I’m not born in Africa, but I’ve been in Africa for the past 12 years plus, in and out and mostly leaving actually out of those 12 years around, so I see the massive opportunity and I still think it’s going to take time because it’s not just about technology, it’s about increasing the, growing the, the spending power of people to be able to buy those products and services. But again, I would be very careful and that’s what we try in a Ilara health as well. Very careful on how to go towards profitability, towards building a profitable high margin business, but which can be impactful at the same time and bring value to everyone, bring value to our clients, our customers, bring value to oyr investors, bring value to us.

Sam:                                      55:36                     And people listening home. How can they learn more about Ilara health, more about you? What are the best ways to learn more?

Emilian:                                55:42                     Sure. We are online. We have a website there are a couple of articles which got published last week as we closed our first seed round. So we’ve been in the media lately. People can find me on LinkedIn.

Sam:                                      55:59                     Very good. Cool. Well it looks like it’s about to start raining, so we should probably call it.

Emilian:                                56:04                     Excellent.

Sam:                                      56:05                     But yeah. Thanks so much Emilian.

Emilian:                                56:07                     Thanks a lot. And then yeah, thanks for the time.


From Uber to call centre: why Flare decided on the human touch for emergency dispatch in Kenya


In this catch-up episode, I chat with Caitlin who runs Flare.

Caitlin and I first spoke in late 2016, and you can listen to the original interview by scrolling down to the episode named Ambulances.

The premise then was that Flare would become a technology platform to connect people with ambulances much in the way that Uber has developed the model of hailing a driver through their app.

Whilst the vision of providing world-class emergency dispatch services remains unchanged, the company has developed more of a human touch.

As Caitlin and I discuss, a core offering they now have is a 24/7 dispatch hotline where trained medical professionals consult with callers before dispatching them to the appropriate provider.

We also talk about other things that have come from running the business over the past three years.

How they’ve been cautious to not scale too quickly, how large corporates are signing up to the service, and their considerations for international expansion.

The interview takes place in the garden of the Flare house (you may notice a number of companies such as Lynk and SunCulture operate from residential homes) and so there may be some background noise, not least from Koko – the office dog who comes over halfway through.


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Social Media Links



Twitter: @RescueByFlare



Sam:                                      00:07                     Intro.

Sam:                                      02:37                     Cool. So we’re here today with Caitlin from Flare again. Caitlin, welcome to the show.

Caitlin:                                  02:42                     Thank you so much.

Sam:                                      02:43                     So we first chatted nearly three years ago, would you believe it, and we went through bit of an overview of what Flare was doing, what you were sort of getting set up to do. But yeah, just for people who perhaps haven’t listened, could you just give us a bit of an overview as to what Flare is and what your doing at the moment?

Caitlin:                                  02:59                     Absolutely. So at Flare we are building next generation emergency response systems. So what that actually means is that we’re building 911 for the 60% of the world that currently does not have an existing system.

Sam:                                      03:13                     Very succinct. And that was pretty much, that vision has not changed?

Caitlin:                                  03:17                     That vision has not changed. Definitely, the way that we’ve gone about it has changed. And how, you know, we operate. But as it relates to what we focus on, the vision has been the same since beginning.

Sam:                                      03:30                     Fantastic. And it started off sort of version one, I seem to remember was talking about was there’s a real problem with ambulances, like calling an ambulance in Nairobi in particular and that you’ve got I think it was 43 private ambulance companies. And then if you need to call an ambulance you’d need to go through in theory all 43, and it could be that there’s one around the corner but you don’t give them a call and you are basically looking to aggregate them all together, so that you can call, I think the dream was that you could call one number and then the one that was closest would be dispatched to you. How did that go in building that out, is that basically been built out?

Caitlin:                                  04:09                     Yeah. So from three years ago to today, we’ve actually made that a reality and have today responded to thousands of calls and dispatched thousands of ambulances to patients in Nairobi and also across Kenya. Our fastest response time is four minutes, which was amazing. And it was the exact same scenario that I described where someone calls us distressed and we knew that there was an ambulance around the corner, based on our technology and were able to dispatch. The part that’s changed is that we actually today operate the 24 seven dispatch center. So when someone has an emergency, they do call one single number, that single number routes to our dispatch center. It’s picked up by a paramedic or nurse who triages the call, provides care over the phone and uses our technology to dispatch. So I think the change is that we realized the value of a human in emergency response and that there is absolutely and was opportunity to digitize a lot of it, but there’s still is that value of having a voice at the other end of the call to calm you in some of the worst moments of your life.

Sam:                                      05:14                     Got it. Because the initial awareness was that it was, you know, Uber for ambulances and you’d kind of press a button and, you know, so and so is on his way. So you’ve sort of tweaked the products in such a way that there’s now, when, when you say they call a number, do they call Flare?

Caitlin:                                  05:33                     Yeah, so they call us, our consumer product is called rescue and so they call rescue. So we have a number that is…

Sam:                                      05:41                     Is it like a 07…

Caitlin:                                  05:43                     Yeah, incredibly easy to remember.

Sam:                                      05:45                     What is it?

Caitlin:                                  05:45                     So you are provided it once you sign up as a member.

Sam:                                      05:47                     Okay, very good, so I’ll sign up first.

Caitlin:                                  05:49                     So you should sign up at and then you’ll be given the number, but you make that single call. And what we realized again, in the moment of emergency, you don’t necessarily need to download an app or press a button is you just want to call instantly that one number and hear someone at the other end of the line reassure you that you’re going to be okay. That other individual at the other end of the line needs to be enabled by technology such that they can quickly make the right choice. And that’s where our technology is built in, is that it’s on the back end. And it allows our dispatchers to, you know, quickly find the right resource and get that ambulance moving towards you.

Sam:                                      06:26                     Got it. Okay. So when somebody signs up to rescue, they save the number in their phone?

Caitlin:                                  06:33                     Yep. It’s as simple as that.

Sam:                                      06:35                     Alright, very good. And then the dispatch team, so these are employed by Flare or employed by rescue. So you’ve got like a team and it’s 24/7?

Caitlin:                                  06:44                     Absolutely. So we have a team that works 24/7, 365 and is there to pick up your phone and phone call in seconds. And they’re all medically trained and so that they can provide directions over the phone. So if you’re having a heart attack, they can give the caller the step-by-step directions in layman terms such that you can actually provide that care over the phone while they’re also dispatching the ambulance.

Sam:                                      07:07                     Really? So 4 a.m. On a Wednesday morning, you’ve got a trained paramedic on an end of the phone?

Caitlin:                                  07:12                     Absolutely.

Sam:                                      07:13                     Is that quite expensive? To like, I’m thinking, if I’m a trained paramedic, would I want to be at work at 4:00 AM on Wednesdays? Do you have to pay them quite a lot?

Caitlin:                                  07:21                     I mean, we make sure they’re taken care of, but I don’t, I think one of the things is medical professionals here are a little bit more affordable, but at the same time, like we saw the actual value of having someone trained at the other end of the call. Also, because the system here is so fragmented and chaotic, there are more medical decisions to make. In the US or the UK, it’s pretty straight forward. You call 911, they dispatch an ambulance and they know exactly what hospital you’re going to because it’s based on your location. Here, there’s a lot more that needs to be decided, so they need to decide at 4:00 AM on that Wednesday, if you have a heart attack, where do you go? And you don’t know that there’s only one 24/7 facility that has a cardiologist, our dispatchers do. And they can make those decisions using our technology, which helps guide them, you know, to make the best decision. But otherwise, you know, if you just have a nonclinical person, we believe that you wouldn’t have as meaningful of a service.

Sam:                                      08:18                     Makes sense. So is there like a big sort of database of hospitals? If I click this button, click, click, click, click, click, cool, here’s your list of three.

Caitlin:                                  08:26                     Exactly. So it’s based on proximity and then what we say appropriate. So appropriate means does the hospital actually have the service that you need or we suspect you need to provide you that care. So some of it is pretty straight forward. Like if you think about it’s a woman who goes into emergency labor or has obstructed birth, does that facility have the ability to do emergency C section or you’ve broken your ankle, does that facility have an x ray machine so they can actually see whether or not you know, you have a fracture. So it’s some really basic stuff, but all of that is in our system such that our dispatchers are enabled by that technology.

Sam:                                      09:04                     Yeah. I can’t remember if we spoke about this on the podcast or at another time, but you basically had to go out and build that database of categorizations of everything. That doesn’t exist.

Caitlin:                                  09:14                     Exactly.

Sam:                                      09:14                     That sounds like a massive headache if you’re, not headache, but that’s quite job to get around to.

Caitlin:                                  09:22                     It was quite a job, but I would say now because we have a lot of throughput, meaning we have a lot of calls, we’re validating that information every single call, in the sense that if today Nairobi hospital has a functioning CT scan, but tomorrow when we call them for a dispatch, they don’t have a CT scan that will be turned off in our system. So we’re constantly revalidating that information. So once you’ve built out the system, we were able to kind of quickly adapt and kind of adjust. But it is an unbelievably like powerful set of data that no average individual will ever know or understand.

Sam:                                      09:53                     Are you utilizing it just for Flare? Or could you, I don’t know, sell access to that database to another organization?

Caitlin:                                  10:01                     Maybe if the price tags is big enough.

Sam:                                      10:03                     Yeah. Alright. I was thinking like it’s quite a lot of work that you’ve done. And I’m just wondering if there are other ways, if you’re sitting on it, like are there other companies like, I’d really like to be able to tap into this and yeah, maybe you could start like medical equipment leasing or something where you could, if you notice that these particular, sorry, I’m getting off topic.

Caitlin:                                  10:20                     I think for right now, our focus is on just making sure that we provide an unbelievably lifesaving service and that we do that in seconds and we make sure that not only do we save your life by getting you an ambulance, but that we also make sure that you get to the right hospital. That hospital is ready to actually provide you that care.

Sam:                                      10:36                     And you’re also doing fire engines?

Caitlin:                                  10:39                     So we are, so the kind of longer term vision meaning longterm in startup land is like six months, is that we build out our service capabilities such that we can provide, you know, not only medical emergency support but fire as well as security, police so that you can call, just like in the UK where you call 999, they then, you know, triage the call, is this, you know, police matter is this medical. Sometimes it’s both, you know, and so you need both resources. And so that’s the kind of future that we’re working towards is bringing all of those services together.

Sam:                                      11:13                     Yeah. How have the government been, I tend to say, are they sort of aware of what you’re doing? Have you had to like go through some regulations and things if you’re doing this or is it as a private company, are you perfectly legit? Is it perfectly legitimate for you to offer these services which could in other places be done by the States?

Caitlin:                                  11:31                     Yeah, I mean I think that’s an interesting question. I think a lot of countries, actually you think of it as a public service, but it’s actually offered by a private provider. So I’ll give you one European country, Denmark. And it’s, actually the largest providers called Falck and they’re a private provider. So I think there is actually a lot of historical precedents across the globe…

Sam:                                      11:50                     That’s a medical or fire?

Caitlin:                                  11:51                     Ambulance.

Sam:                                      11:53                     Ambulance, ok.

Caitlin:                                  11:53                     And so they do that. I think here we have engaged the government at a national level. So as probably most are aware in January there was the terrorist attack. And so I think another big use of our system is that during a mass casualty or a natural disaster, this was not obviously a natural disaster, but if there were to be a landslide or something like that, the need for emergency services is heightened. Like, you know what only need one ambulance, you might need dozens. And so from that level we’re starting to work with them to figure out how do we plug into that system because we are the largest provider and network of ambulances. And so we’re actually best able to provide that support. So at a national level, we’re working on that. And then Kenya is divided into 47 counties. And every single County manages their own emergency response. We’re starting to work on a pilot basis with some governments to understand how we could best work with them.

Sam:                                      12:51                     They’re basically saying, we’re currently trying to do this on our own, but we could just use Flare, and that basically take that problem away from us.

Caitlin:                                  12:58                     And it would, yeah, help optimize their services, make them more accountable, give them the data that they need and be able to provide a service back to their constituency.

Sam:                                      13:06                     Okay. So who are the main customers of Flare at the moment? So is it mainly just consumers, you know, individuals that are paying for flare?

Caitlin:                                  13:20                     Yeah. So the individuals pay for it through the membership. So you can sign up at

Sam:                                      13:25                     Yeah.

Caitlin:                                  13:25                     And it’s 2,400 shillings per year per person. It gets cheaper as you add on additional family members, but that includes everything. If you ever have an emergency, you never pay for the ambulance. And so the brilliant part about that is…

Sam:                                      13:37                     We never pay for that? Cause you were saying before, it’s like anywhere up to a hundred dollars.

Caitlin:                                  13:41                     Exactly. So we lowered the price so that a membership, because we know that every year you’re not going to experience an emergency and you should never think twice about having our product, you should always have it.

Sam:                                      13:52                     Yeah.

Caitlin:                                  13:53                     And so when you have an emergency, we don’t want to ever have to collect or ask you for money. Cause if you can imagine that you’re like choking and we’re like, “and our paybill number is 500134, put your account name as your name,” you know, or whatever. Like we don’t have the time to deal with that. And so it’s just a super simple product, highly affordable, meaning that you know, most can actually afford it. Today we sell to big corporates or small corporates. A lot of our clients are schools, factories, taxi companies, anyone who has the likelihood of experiencing an emergency tends to be a good client of ours. But we also sell direct to consumer online so you can buy it as a family or as an individual to make sure that you’re covered.

Sam:                                      14:33                     Okay. So, how did you land on 24, to 2,400? How did you, did you, is there a spreadsheet somewhere of like, Yeah.

Caitlin: 14:45                     There is a spreadsheet. So it’s basically a calculation of risk. Meaning how often will you actually need an ambulance?

Sam:                                      14:51                     How’d you get that? How’d you get a gauge for that?

Caitlin:                                  14:53                     Well, so every country is different. And the amazing thing is, is no one has that data in emerging markets or places we’ve never had 911 system. So we’re starting to build that up. So there so our membership prices, you know, may become cheaper or may become more expensive as we get smarter about the actual data. But generally you need an ambulance more likely in the first five years of your life and then in the last 10 years of your life. So there’s a big spread of like little babies and kids and then once you’re, you know, in the last 10 years of your life.

Sam:                                      15:23                     Yeah. Okay. And how many people have signed up?

Caitlin:                                  15:29                     So in total we have over 30,000 members.

Sam:                                      15:31                     Really? 30,000 members.

Caitlin:                                  15:33                     Yeah.

Sam:                                      15:33                     That’s incredible.

Caitlin:                                  15:34                     Yeah.

Sam:                                      15:34                     How have you done that? What have been some of the successes? Have there been any, I’ll rephrase. Have there been any things which like worked surprisingly well or things which worked surprisingly unwell or didn’t work surprisingly well or anything that you were like, this is going to be dead set and it didn’t work. And other things where you’re like, Oh, we’ll give it a go. And it ended up being really good.

Caitlin:                                  15:54                     I think the one strategy that we had is just said, who are the corporates that potentially have the greatest risk? And actually focused on that, which is opposite of what you think of insurance or insurance-like products, it’s usually they want the lowest risk people. But what we realized is that that was a captive market. These are, you know, companies that have experienced an emergency before and maybe it has, likely has not gone well.

Sam:                                      16:20                     Yeah.

Caitlin:                                  16:20                     And so if you look at what are the greatest reasons why you would need an ambulance you would realize that a majority of it is because you’re on the road. So car accidents and so focusing on taxis or mobility companies are a huge, you know, opportunity or factories or schools cause kids are more prone to injury and accidents and things like that.

Sam:                                      16:42                     And does your coverage apply only when they’re during work hours? Was it also when they’re back home?

Caitlin:                                  16:47                     It depends. Depends on like how the corporate would like to structure it. We’re pretty open to like structuring it in whatever way they like. Ideally we would like it to be again, simple such that no matter where you are, whatever time it is, you’re covered. So the ideal is that it covers you 24/7.

Sam:                                      17:03                     Yeah. I imagine also from your perspective you’ve got to factor in, you know, if you’re kind of looking at it from a factory perspective and then someone goes home and like falls over. Exactly.

Caitlin:                                  17:15                     Yeah. So some of it, and it depends on are they casuals, are they full time employees, all that kind of stuff. So we’re, I mean we’re very open to customizing and kind of working with the corporate to find what the best plan is for them.

Sam:                                      17:26                     Yeah. Sounds great. Now, note that we’re currently in the rescue garden and your dog has come over. So if there was any sort of panting or anything in the background, it’s not me, it’s just the dog.

Caitlin:                                  17:36                     It’s the Coco. She’s doing an internship.

Sam:                                      17:38                     Is she? Yeah. Is she gonna get the job. Do you think, what’s your sense?

Caitlin:                                  17:41                     You know, she’s got a couple more months left, but we’ll see.

Sam:                                      17:43                     I’m positive on it, I think. Okay, cool. So you’ve got rescue. Got the fires. Okay. what have been some of the things where you’ve been surprised that the company’s taken this direction? Why, actually I’ll rephrase, what have been some things where you’re like, I really would’ve thought we would’ve been doing this, but actually we ended up not doing it?

Caitlin:                                  18:06                     Yeah. I think one of the things was that, when we talked three years ago, we thought very much we were going to be a SAS product in the sense that we were going to offer this technology and charge our ambulance companies and that was going to be kind of our strategy or that we were going to use kind of like an Uber like model where we take a commission and things like that. And I think that was a big shift for us, just realizing that in emergency the last thing that we need to deal with is money, is that that actually creates an ethical quandary in the sense of do I help or do I not? And just how important that was for us to make sure that no matter what, we always help. So I think that was a big shift and kind of reason that we went to that process.

Sam:                                      18:48                     How did you land on that conclusion? Like was there like a series of team meetings? Was it like you were doing a company away day and you were like Oh my God, this is what it needs to be, how did that sort of…

Caitlin:                                  18:58                     Yeah, one of our, so we’d been stewing over it for a while and one of our ambulance partners was just like, you need to launch this, like it’s time. We actually launched officially during the Kenyan elections in 2017 so the first elections during August. And then between then and the second election, then we had launched the membership product. So we just realized that there was a huge need for it. And that, you know, we had built this amazing network of ambulances and it was time that we finally launched

Sam:                                      19:25                     Get into the world. Okay. How do people react to it? Was there, do people get it or they, did it take a bit of time for people to warm up to what’s going on? Like I’m paying this money but I might actually use it. Was there any sort of behavior changes or things we can say?

Caitlin:                                  19:43                     I think less so. I think that it’s hard to sometimes understand, especially even for myself growing up in a country that has 911 and you never even think twice. But I think that every time we go into a sales meeting or we have a conversation, if you ask anyone, have you ever had an emergency personally or a friend or relative, where you need to get an ambulance? And the question, the answer is always yes because it might feel very rare at an individual level. But at a population level, it’s not rare at all that someone needs an ambulance. And so I think that just the power of like having that experience and knowing what it feels like to not actually be able to get an ambulance really sits with people. And so it’s not a hard product. Most people are like, why didn’t I think of that? It’s, you know, it’s not a thing that you have to really, you know, sell. It does not take a lot to sell, to be honest.

Sam:                                      20:35                     OK.

Caitlin:                                  20:36                     I think that interestingly though, a lot of people have a lot of questions about it cause you know, now that they’ve started to think about it and they have a lot of experience of what didn’t go well when they tried to get an ambulance. So there is some kind of cynicism of like, Oh my God, is it going to really work? But I think the incredible thing is, is like we’ve gotten past that we’ve done thousands of calls and dispatches and there’s tons of proof points and testimonials and stories. And so if you didn’t believe it before, you do now.

Sam:                                      21:04                     Yeah. I was once with my so my friend works for a company that did online surveys and part of their sales pitch was cool, I’ll just right now go on a platform and ask the question and then suddenly be like demo like there and then. I guess you can’t really demo your products in a Live way. You can’t really say…

Caitlin:                                  21:25                     We can do it. But we do a lot of drills. So a lot of times like for some of the corporates they want to do a drill because I mean like a fire drill, you know, it’s always best to plan or like we work you know, with the US embassy to do drills as well. So drills are a good way, but yeah, you can’t really test in the same sense. But I think a lot of it just comes through having the testimonials and having a number of big corporates that have signed up. And so therefore the kind of confidence that if someone else bought it, then, you know, we must be okay.

Sam:                                      21:57                     What would you say is your like sales cycle, the typical sales cycle for let’s say, let’s say you’ve got a pretty big customer. How long would you expect it would take?

Caitlin:                                  22:05                     You know it’s so different. Our biggest thing right now is that we focus just on like really big corporates that we know will be kind of game changers and so.

Sam:                                      22:12                     Yeah.

Caitlin:                                  22:12                     It’s hard to say. It’s not.

Sam:                                      22:15                     I suppose each one’s different.

Caitlin:                                  22:16                     Yeah,

Sam:                                      22:17                     Isn’t it? Okay. And does it basically involve, you going on for meeting, you have a series of meetings. Figuring out the decision makers.

Caitlin:                                  22:24                     Yup.

Sam:                                      22:25                     Yeah.

Caitlin:                                  22:25                     Exactly. It’s pretty straight forward as it relates to that.

Sam:                                      22:28                     What are some of the objections that people have or think maybe not, you sort of mentioned a bit of cynicism around whether it works. Are there any of the parts which people find they need clarification or they’re not clear about?

Caitlin:                                  22:41                     Less than that. I think that sometimes people get confused about us and insurance and so they may say like as a company we have taken out a health insurance policy with Jubilee resolution or whomever and don’t they cover ambulances and that’s the only thing that people sometimes scratch their head on. The incredible thing is, is like sure they do technically, but they have no connection to those ambulances. So there are no more able to get an ambulance than you are yourself.

Sam:                                      23:08                     Yeah.

Caitlin:                                  23:08                     Which is kind of frightening. So a lot of times what we do is we double insure someone in the sense that we’re giving you access to our services that maybe you technically have access to anyway. But the insurance is never gonna help you.

Sam:                                      23:21                     Could you partner with insurance companies?

Caitlin:                                  23:23                     Absolutely. That’s part of the plan.

Sam:                                      23:25                     Very good. Have you had any of those conversations yet?

Caitlin:                                  23:29                     Of course. Yeah.

Sam:                                      23:30                     Are they, are they open to it or do they see it as, why would they, why would they not be open to it?

Caitlin:                                  23:37                     I don’t know why they would not be open to it. I think the only thing is then insurance generally don’t have such a strong touch on the actual service provision. They’re more a financial instrument. And so I think that getting closer to the actual services maybe is just something they’re not used to.

Sam:                                      23:54                     And if, would they, would the dream be take out Jubilee insurance, comes with Flare.

Caitlin:                                     24:01                     Exactly. Yeah. The dream is is that like everyone literally has access to our service that it becomes a national number. It’s recognized by all and whether it’s embedded into, you know, a product, you know, sold by this company or your car insurance, it doesn’t matter. Is that you have access to our system.

Sam:                                      24:19                     Yeah. So last time I was here, I think I mentioned Flare house everyone was around one table and now you sort of spread out a bit. So how many people have you got now?

Caitlin:                                  24:28                     We have a total of 23.

Sam:                                      24:30                     Okay.

Caitlin:                                  24:31                     About a third dispatchers, third kind of general ops strategy and then a third that are software developers.

Sam:                                      24:38                     Got it. Okay. Which is the most difficult section, which is the most difficult thing in terms of like this is the bit which is causing me headaches. Not in terms of the actual employees, but in terms of like the way the workers are?

Caitlin:                                  24:51                     I think the hardest part about the team is just that constant evolutions that we make and is how do you hire the right people that can grow with the company and at the pace of the company? Cause you can’t always foresee all of the needs that you need. So all of the needs that you will have. And so just having that foresight of someone’s like potential and allowing that individual to continue to morph into new roles and positions. And I think that’s a big piece of it because it’s not, every company does it differently. Some people like automatically hire a CFO and COO and all these kind of things. For us it’s very much about emergence of those leaders and that talent. And so how do you hire people with that potential and that are open to also constantly changing their responsibilities and roles.

Sam:                                      25:40                     Have you defined the rescue culture. Have you defined the company culture?

Caitlin:                                  25:46                     It’s a work in process. You know, it’s a lot of, I think, you know, initially, where you could choose, you know, several adjectives or tenants, but ultimately it’s something that evolves over time and it’s more that, you know, what you don’t want to be. And.

Sam:                                      26:02                     So what do you not want to be?

Caitli:                                     26:05                     What we don’t want to be is we don’t, we want, well, we want to remain human is that at the end of the day we’re doing incredibly lifesaving work and to always kind of remember that. So yeah, to keep that kind of passion in us incredibly collaborative is that, you know, that we realize that what we’re doing requires multiple, you know, partners and stakeholders and companies and everything that we do so that we’re never trying to just section ourselves off, is like, it’s always about kind of the power of many.

Sam:                                      26:40                     Okay. And that’s been quite easy to do. Or like how do you kind of test for some of those qualities in people, when you interview them?

Caitlin:                                  26:48                     I don’t know. So that’s what I’m saying. Cause I don’t know, I think that’s the hardest thing is like sometimes I think the easier thing to do is to hire, well, to make sure that you check off the boxes of like, it’s easier to check off technical skills like Kevin A, are they analytical or can they compose, you know, nice emails and texts and stuff like that. Some of those, those skills, it’s easier to test for, but I think the culture is like, you gotta almost have a trial and see, and…

Sam:                                      27:18                     So did you do that? Did people come in for like a week?

Caitlin:                                  27:22                     Yeah. And I think that that’s how you actually see, do they fit and jell. Cause I think what I’m saying is there’s not like a check box of like, do they have this, do they have that, and it’s also like, we’re so complex as individuals. Like it’s really hard to understand all of those things and the dynamics and a lot of it’s also the other people on the team and how do they fit in, and I don’t think we’ve totally figured that out, except that you got to try.

Sam:                                      27:47                     You got to try and just, if there’s a fit.

Caitlin:                                  27:48                     Yeah, yeah.

Sam:                                      27:50                     What are the next employees that you’re going to be, or the next positions you’re going to be hiring for?

Caitlin:                                  27:56                     So I’ve kind of, across the board, we need to increase on all fronts from dispatchers to developers to more people on kind of our ops side to scale. So we definitely believe the lean kind of team. But yeah, we need to kind of add in all of those three spaces.

Sam:                                      28:14                     Get a little bit more fat.

Caitlin:                                  28:15                     A little bit more skim, skim milk,

Sam:                                      28:19                     And the company, funding wise, you’ve obviously stayed afloat and things. Have you, and it sounds like you’re making some good revenues if you’ve got 30,000 paying customers. How’s the company sort of looked from the sort of fundraising perspective?

Caitlin:                                  28:39                     Yeah, so we still, I mean, we’re still growing much faster than you know, our revenue, but at the same time, but our revenue is growing really quickly as well. But we continue to raise from private investors VC funds, have gotten some grants and awards along the way. So externally funded to be able to support the kind of rapid growth that we’re seeing.

Sam:                                      29:01                     Yeah. What were the grants for? Was it just like, here’s some money to keep going? Or was it like, oh, we’d like to do these specific projects, we would like you to do so…

Caitlin:                                  29:10                     Like general funding, not specific.

Sam:                                      29:12                     That’s quite handy, yeah. And then I remember you mentioning that there is a company in India or a couple of companies in India that have been doing something similar and so they’ve been quite useful. It’s been quite useful. Like barometer, barometer is the wrong word, just like idea of what could be going down the line. How have those Indian companies been doing?

Caitlin:                                  29:34                     I have no idea.

Sam:                                      29:35                     Yeah.

Caitlin:                                  29:35                     I’ve totally lost track to be honest. I think one of the things that we’ve just done is like focus on what we’re doing and yeah. Who knows? Yeah.

Sam:                                      29:43                     Nice. I just felt like that kind of makes some sense isn’t it? Like you focused on your own.

Caitlin:                                  29:50                     I think it was like I was curious in the beginning to understand because we were all sorting out some of the same decisions, but I have no idea if like we reconnected and if they’re one, still operating or two, what their business looks like. I’m sure that we’ll cross paths at some point, but I really have no idea.

Sam:                                      30:08                     So I’m just wondering, I can imagine that might be something that an investor asks is you’re doing this quite innovative business model, like has it worked elsewhere? Or are they not really that concerned?

Caitlin:                                  30:19                     No, because I think what we’re doing is we’re building a basic infrastructure that everyone understands is required for growing cities, countries. And that’s not innovative in the sense that 911 and 119 and 999 exists in parts of the world that had the resources and could put that system up. So I think that that’s never a question. That’s the cool thing is we’ve gotten past that stage is everyone recognizes the invaluable resource of having that three digit number to call upon. And regardless of how, what we’re doing of how we did it is we’re using, you know, cloud based technology and we don’t need landline phones to build 911 any longer. And so that’s what we’re doing is innovative as on the tech side. But the actual businesses itself is not the innovative part.

Sam:                                      31:05                     Got it. You say at the moment, currently Kenya or all across Kenya. Views to go elsewhere?

Caitlin:                                  31:12                     Yeah, we’re trying to identify where that elsewhere is. There’s tons of opportunity. I mean 95% of the continent is without 911. So there’s no lack.

Sam:                                      31:23                     Where’s the 5%?

Caitlin:                                  31:23                     The 5% is Egypt, and then Botswana and then parts of South Africa.

Sam:                                      31:28                     Only parts?

Caitlin:                                  31:28                     Only parts.

Sam:                                      31:29                     Why is that? Like local government?

Caitlin:                                  31:32                     Some of the local government outside of the cities, it’s pretty hard to get access to the provincial ambulances. And there’s not like a strong central system, and the cities, it tends to be privately run.

Sam:                                      31:44                     So it will be Africa, it won’t be anywhere else in the world?

Caitlin:                                  31:49                     I think that makes, proximity-wise, the most sense.

Sam:                                      31:52                     Yeah.

Caitlin:                                  31:52                     But there is definitely opportunity elsewhere. But I think for right now we’ll stay closer to home.

Sam:                                      31:57                     One of the things that kind of shocked me, on our last interview, was you saying how like the system you’re building is much better than, or has the potential to be much better than elsewhere in the world, where it’s built on a landline system. I was wondering if there’s going to become a point where countries like Denmark or the UK or Germany are going to pick up the phone and say, can we just use your system even though they already have it, that 911provision.

Caitlin:                                  32:26                     Yeah. I mean that would be incredible. But yeah, I don’t think we’re that far off from being at a place as it relates to our technology that that would be a conversation that we could start.

Sam:                                      32:35                     Yeah. Because is the premise that everyone has a smart phone when they make the call. Is that what is necessary to get the location or kind of, can you get a lot of the benefits from Flare on a smart, on a feature phone?

Caitlin:                                  32:50                     You could, I mean there’s some creative ways to get location information. It depends on how precise you want that location information to be. If you have a smart phone, it’s obviously much better. But even for places like Denmark or the UK that have landline based technology, it’s very difficult for them to get any type of geolocation information from your smart phone. So we’re already kind of lept over that.

Sam:                                      33:13                     Yeah.

Caitlin:                                  33:13                     Because we’re able to pull your geolocation.

Sam:                                      33:16                     And so people, the 30,000 users in Kenya, they are all using it on a smartphone?

Caitlin:                                  33:22                     No, no. So we have a hotline, they just call a number. If they don’t know where they are, we can then ask for their location.

Sam:                                      33:28                     Yeah. And you can identify them.

Caitlin:                                  33:30                     Yeah.

Sam:                                      33:31                     Very cool. Okay. What have been some of like the big lessons you’ve learned, you think over the last few years? Like in terms of either things, which on reflection you’re like, Oh, we should’ve figured that out more. Or just, yeah, just generally things that you’re like glad that you know now, from the last few years.

Caitlin:                                  33:54                     I think one of them is to stay lean and that, as a founder, is to try to do everything in a little way in the sense of really understand the business from start to finish because you can quickly, in the beginning you’re always in the weeds and then you need to quickly get out of the weeds to be able to pitch to investors. But to always have your hand deep in the business as well because I think you could easily lose touch with what’s actually happening because you’re just changing so quickly. And so I think being lean has helped us do that, such that we don’t have a ton of layers, we don’t have a massive team, is that we hire highly skilled, experienced individuals and we try to always kind of stay at the high level but also stay in the detail. I think the second lesson is just that everyone scales in different ways. And I think sometimes the focus is always on one metric and realizing that a business is so multidimensional and just making sure that you confidently, or we confidently kind of tell the story that we want to tell because we ultimately know our business kind of better than anyone. And so making sure that yeah, that you understand how your business is going to scale, but that it doesn’t need to follow the same path as say for example, Uber and that it can follow a very different pathway. And I think for us being in healthcare or preventing an emergency service quality is everything. And so just making sure that you scale at the right pace to show your potential but also don’t ever compromise the actual service that you’re providing.

Sam:                                      35:27                     Yeah. Do you have like some high level metrics that you keep an eye on each month or each week?

Caitlin:                                  35:33                     Yeah, we look at a lot of different things from, you know, number of ambulances on the system to number of memberships to number of dispatches to response time. So it’s quite a complicated number of different metrics to really understand like how are we performing, but definitely something that, you know, we look at regularly to kind of understand are we scaling too quickly, are we not to be able to kind of readjust.

Sam:                                      35:58                     Yeah. Okay. And so just a few more questions, if that’s all right. You said that a long term, for startups along the longterm view is six months. If you were to extend it a little bit further, 12 months, what do you think Flare could be doing?

Caitlin:                                  36:15                     Ideally we’re operating in multiple countries. We’re offering a more holistic emergency response. So beyond medical and yeah, I sleep a little bit more. Yeah.

Sam:                                      36:34                     Okay. All good goals, And at the moment we’re, we’re here in the Flare house. Would you need, are you kind of at capacity here or would you need to, would you need to move to a new location?

Caitlin:                                  36:46                     I think we’ll be good for the next like 12 months. I think if we operate in another country, we will open, you know, an office there. But for right now, I think we’re good.

Sam:                                      36:55                     Yeah.

Caitlin:                                  36:55                     We’re going to try to stay lean as long as we can.

Sam:                                      36:58                     Yeah. Okay. I’m sure your investors love to hear that.

Caitlin:                                  37:00                     Yeah.

Sam:                                      37:00                     Yeah. What would be like a dream customer for you to get at the moment if you were to sort of just like think about it, what would be like, what would the characteristics be to get a dream customer? Like what does the dream customer have to have?

Caitlin:                                  37:20                     I think it always helps to have a customer that has, you know, high visibility or credibility in the market and whether they’re kind of a leader in whatever field, whether it’s a premier school or premiere factory or also any international company tends to be high profile. So I think,

Sam:                                      37:37                     Yeah,

Caitlin:                                  37:38                     Some of those.

Sam:                                      37:38                     Okay. I imagine it’s, yeah. What is your, cause is this, from their perspective? Is this just a cost which they didn’t have previously or an internal account whose budget this comes from?

Caitlin:                                  37:53                     Yeah, that’s not really the question. I mean like people, it is a cost, but it’s also on the other end, there was another cost if you lost an employee’s life on the job, someone was paying for that.

Sam:                                      38:05                     Yeah.

Caitlin:                                  38:06                     Whether it was PR and your image, your reputation that you were actually paying out an insurance claim for death and disability. So it’s not such that we’re just adding an additional cost. Oftentimes it’s offsetting a huge risk that you actually had.

Sam:                                      38:21                     I say that like I’ve sort of had, sometimes I’ve experienced yes. Sounds good. Sounds good. Sounds good. But, you know, budgets, are fixed and yeah, I’ve, like, this department, yeah, it can’t come from this department. And so I’m just wondering, is there, like, do you need to speak, do you need to be speaking to, yeah, who do you speak to when you go to a corporate? Who’s the, who’s the agent? Who’s the sort of decision-maker that you talking to?

Caitlin:                                  38:45                     You know, it highly varies whether or not it’s like the CEO or the HR person or a managing director or there isn’t, I wouldn’t say there’s a rubric.

Sam:                                      38:56                     Okay.

Caitlin:                                  38:57                     It’s really understanding that company understanding why they would want the product and also making sure that we’re quite strategic about how and who we sell to.

Sam:                                      39:04                     Okay. And after that they’ll just make it happen.

Caitlin:                                  39:07                     Yeah. Or if they don’t, we try to get them to push to a yes or no quickly.

Sam:                                      39:10                     Okay. That makes it sound like you’ve had a few experiences where a no has been dragged out.

Caitlin:                                  39:18                     Yeah. But that’s what, I mean, I guess that’s okay. It’s like you kind of learn. I don’t think that, to be honest, that’s not, our issue is not about selling. That’s which most people don’t, I guess have that luxury. Our issue is how do we maintain quality and how do we scale in the right way such that we don’t overextend ourselves and we provide that service. The same service that we provide to the first a hundred customers that we provide to our current customer base that we can provide to the next hundred thousand, to the next million.

Sam:                                      39:44                     Yeah. Fantastic. And people who are listening, they can sign up and that’ll just take them through the whole process.

Caitlin:                                  39:53                     Yeah. It will take no more than five minutes, hopefully even less to sign up here. It’s integrated directly with M-Pesa or credit card. Yeah. And you can sign up. It’s 2,400 shillings per annum and it covers everything. Once you start adding households and family members, it becomes even cheaper

Sam:                                      40:09                     When you say everything like any ambulance?

Caitlin:                                  40:13                     Any of those.

Sam:                                      40:13                     Yeah. Very good. And in theory, not you would want to, you can take six ambulances a year and it was still getting covered.

Caitlin:                                  40:21                     So technically it covers you up to two ambulances, but the chance that you need two ambulances in a year is pretty rare. Yeah.

Sam:                                      40:27                     In the spreadsheet, it’s like not point, not.

Caitlin:                                  40:29                     Yeah.

Sam:                                      40:29                     Very good. And so And if they want to learn more about the company, perhaps sort of understanding, see if they’re a fit with the culture, et cetera. What’s the best way to learn more about you?

Caitlin:                                  40:40                     You can go to also or you can visit us on Facebook or Twitter or any of our other kind of communication channels.

Sam:                                      40:49                     Fantastic. Cool. Well Caitlin, thanks so much.

Caitlin:                                  40:51                     Yeah, thank you.


The need to digitalise the pharmacy business in East Africa, and the benefits that come when you do


Pharmacies are found in almost every community in East Africa, however the way in which they are currently operating leaves a lot of room for improvement

The business is largely run from pen, paper and phone meaning shop owners don’t have the visibility on how everything is run.

Beyond this though, there is a huge potential to drive change in the medical space through formalising the way in which medicine is delivered across the region.

In this episode Jess Vernon, CEO of Maisha Meds and I discuss how her technology company is using data to improve how local pharmacies are run and their ambitions to transform the broader industry.


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Moved to Kenya 8 years ago

This has been my goal for nearly a decade. I went back to the US for medical school before returning to work on improving private sector health

It’s a Point of Sale system for pharmacies

We collect data on everything there is to do pharmacies. This helps them with their supply chain operations.

There are 6,000 licensed pharmacies

MM operates in Western Kenya where half the population lives. Currently there are 100 pharmacies signed up by our operational team.

Credit is biggest feature

that pharmacies request. Almost all of them do it, but MM now has this as part of the software. Pharmacies are now able to track the credit they give.

We take $100 downpayment

Most people pay between $100-200 to set up.

The owner is away

And so the main use case is being able to see, at a glance, what is happening with their pharmacy. Visibility is key.

Medication packages

This is our main focus for 2018 – helping them grow their business through the insights we collect.

Most medicine is made in India and China

MM is plugging into existing supply chains. There are usually 3/4 touch points to get to the pharmacy and so we’re looking to move up the chain.

“Maisha means life in Swahili”

It used to be a name about trees, but that had connotations with witch craft/ herbal medicine.

“We leverage the data across the supply chain”

As opposed to other POS systems that just track the movement of stock etc. This is the part which makes us relevant in the health sector.

Strategy is to get usage

And so we focus on getting in pharmacies around the region. For this, we partner with the Gates Foundation, GIZ and other grant funders.

A great product is driving growth

As a result of having a stellar software developer who can run the process.

There’s seasonality

It depends on when people receive throughout the year, as well as at the beginning/ end of the month

“During harvest time, our sales go up”

People have more money around this time which trickles through society, including a spike at Christmas once city family go home.

“We compete with a Whatsapp group of pharmacy suppliers”

Currently pharmacies make orders are made over the phone, with prices being quoted on a case by case basis.

MM can drive what pharmacies sell

We can shift towards having evidence based medicine in pharmacies as well as diagnostic tests.

Social Media



TechCrunch article on market networks (which are like Maisha Meds)

Training rats to save lives (no joke) in Tanzania, with Georgies Mgode from Apopo


Humans are good at a lot of business functions, but one where animals have got us beaten is at sniffing things out.

Rats have the best sense of smell of all mammals and can detect landmines and turburculosis to a much higher accuracy and in a fraction of the time of the best detection technology that humans can manage.

Apopo trains rats from birth and then sets them out to do the job of detecting things which humans struggle at.

Georgies and I discuss the applications of Apopo rats, the school program that they go through and how it’s easier to train the Giant African Rat rather than a dog.

This one is a lot of fun and so I hope you enjoy.


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Here are some of the key quotes:

“Apopo is part of a university department”

I’m a professor at the university, and the department I am in is all about training the Giant African Rat for useful purposes.

“Rats detect land mines and turburculosis (TB)”

We train the rats to find solutions for problems that are difficult for humans to solve.

“The rats go to school”

Some are at kindergarten. Others have graduated. They progress through different classes learning along the way until they can off into employment.

“We use the Pavlovian method”

From when the rats are born they are trained in the laboratory to get them used to humans, then obeying command, then identifying a target. Typically it takes 6 months to do the program.

“Rats have a super developed sense of smell”

They have the most olfactory receptors of any mammal which means they can discriminate whether a sample has TB microbacteria or not incredibly quickly. 120 in 20 minutes vs 20 in a day for laboratory technicians

“TB is detected by a spit sample”

These are collected anyway when a patient goes into hospital and once there is enough, the rats sniff them out. 40% of the time rats identify samples which humans missed. This is because rats can smell the microbacteria of TB, rather than the actual TB present in spit sample which can sometimes not be present.

“It takes 200 miliseconds to detect”

The rat spends 3 seconds scratching at the spit sample to indicate when it finds a positive sample.

“Rats scratch at the landmines”

It sniffs out for TNT in a field and when it finds a place, it stops. Because it is very light, it does not set off the landmine.

“They live to about 8 years old”

In the wild things are more competitive, though after eight years they start to wind down the amount of work that they do.

“Apopo customers are anyone interested in saving human lives”

We are a humanitarian organisation whereby we are hired by organisations such as the World Health Organisation. The major beneficiaries are people in areas of high levels of landmines or TB.

“Individual donations are accepted!”

There are many ways for people to support what Apopo is doing, such as adopting a rat. More details at the bottom.

“You could also train wasps and worms”

These are other animals with a good sense of smell. It’s possible to train dogs to sniff out cancer, however it takes a long time to train a dog which somewhat makes things more difficult.

“Taking our rats elsewhere”

The next few years will be spent training rats and applying them in areas of Tanzania where there is a high probability of TB, such as prisons and refugee camps.

Social Media Follows etc.

Pavlovian conditioning

BBC article on Apopo

Adopt a rat:



Uber for ambulances. Why most Africans can’t call 911 and how Flare solves this, with Caitlin Dolkart


There are some ideas that, when someone tells you about it, your first reaction is surprise that there even needs to be a business

I had this reaction about Flare, which is improving how people get access to emergency care in Kenya.

Described as “an Uber for ambulances” it is consolidating the 50 companies that exist in the country so that there is one place for patients to call to get fast emergency care.

Essentially making a something akin to 999 (or 911 in the US).

We discuss the current state of the emergency healthcare market across Africa, the stepped process in which they are deploying the app and educating the population that this is a service that can actually exist.

It’s one of the most interesting conversations I’ve had and so I hope you enjoy


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Here are some of the key quotes:

“We saw a supply and demand imbalance”

Working in healthcare across Africa for several years, my co-founder and I saw a need to bring people closer to the sparkling new hospitals that are being built in the region.

“Our first focus is emergency response”

In Kenya, and indeed across the region, there is an abundance of ambulances

“There is no equivalent of 911”

Each of these private healthcare companies exists independently and has its own unique phone number. There is no centralised number to call.

“It takes 2 hours to get an ambulance”

Whereas in New York its 7 minutes. Flare is here to really improve upon this latent inefficiency.

“Most people don’t even consider calling an ambulance”

The process is so painful (identifying location, negotiating price…) that people will typically call their friends, a taxi, or other means with which to get them to a hospital.

“The ambulances look similar”

They have sirens and can overtake traffic and contain all of the supplies that are typical in an ambulance in the UK or the US.

“Ambulance companies are for profit”

They look to generate revenue from the call outs they make to cover their costs. Though in 20% of the time they will take someone in, say, a roadside emergency and not charge.

“$55 per trip”

The cost of a trip in an ambulance is between $30-$100. The spread is owing to time to get there, but also the sophistication of the equipment in the vehicle.

“Flare with stitch together all of the companies”

Right now there are 50 different phone lines. As a customer I would contact the nearest ambulance to me.

“Customers will download the app”

The main benefit for this is the geolocation of patient. It makes things easier in terms of matching with the closest ambulance.

“Flare is for profit”

We will take a percentage of each trip. Right now demand is really suppressed and so we think that by creating a better user experience, we can really grow out the market for emergency care.

“We see a public-private partnership”

At the moment, the state doesn’t have the resource to offer this service. Flare are carving out the portion of society who can pay for the service with a view of extending it later, probably with the help of the government.

“To start, it will be like Uber on the back end”

Our first phase in rolling out Flare is to manage the behind the scenes logistics of deploying the correct ambulance. Patients will still have the same experience, but things will be more organised.

“India does something similar”

The benefits of launching in a developing market is that there are no existing systems to compete with. You not need to unwind current behaviours, you can jump straight to the solution.

“It’s not just Kenya”

The market structure of many small ambulance companies (where Flare gives most value) is present across other sub-Saharan countries, meaning there is a room to expand.

“You need a neutral stitcher”

Having no affiliation to a particular ambulance company means that Flare are in a good position to be organisation to consolidate the players in the industry.

“No one realises there could be a better way”

From customer interviews I’ve been surprised to see people think through how they would be get to a hospital in an emergency. People don’t think it’s possible to call an ambulance.

“There are ways to shortcut people using the app”

It could be in terms of educating people, or having the app pre-downloaded, or linked to the “Emergency” features that many smartphones have in-built.

Social Media Follows etc.


John Oliver on 911:

Digital transformation in Tanzania hospitals – how Geek Technologies make local businesses paperless


As more of East Africa goes online, they need web services.

The trend is towards broader access to the internet and with that
a demand towards bringing more and more offline interactions into the digital world.

In Tanzania, this is exactly what Geek Technologies are doing

Mbelwa and I discuss the trend towards making services digital, how they win customers and why they decided to name their business Geek Technologies

It’s an insightful interview about technology in the country, and so I hope you enjoy


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Here are some of the key quotes:

“After graduating I started Geek Technologies with my friends”

The core services we provide are graphic design, website design and software development. We also do PC Maintainence etc.

“Our team is nine”

The three founders and then six part time workers who undertake specific functions such as marketing.

“We do not market ourselves Face-to-Face”

Instead we focus on getting customers through social media platforms and advertising agencies. We have about 50 customers.

“Paperless Hospital System is my favourite project”

It’s all about making things more efficient in hospitals by using digital processes, helping save lives, and increasing incomes.

“We just said ‘Paperless’”

When it came to winning this big contract, we convinced the person at the hospital that this was the best way forward. As it was our first customer, we went to them.

“Trusting start ups is the biggest lesson”

Customers really want to learn that you are doing all of the professional things and that they can entrust you. This helps by being as open as possible. Never lie.

“University and the internet”

This is how we learnt how to do the skills that we now provide for customers.

“To redesign a website it’ll roughly cost $200”

Most companies can afford this, however for private clients that’s probably quite restrictive.

“Personal communications are now online”

Very few companies using social media for business purposes, and so we are finding good results when people see our adverts.

“Digital data is a big prize”

The country is instilling a movement where more and more services are going to move online. The Tanzania Backbone is the nation’s fibre optic internet connection that is being installed.

“‘Geek Technologies’ needs to stand out”

The word is still thought of as “a bit weird”, but we’re happy with that. Not everyone knows what it means, but we tell people that it’s about the person who uses computers to maximum. That’s us.

Social Media Follows etc.

Paperless Hospital System: case study

Website: Geek Technologies

Facebook: Geek Technologies