Dominic Otieno, three months old, fell sick on a Wednesday morning and was taken to a clinic in Komarock, Kenya. Three hours later, the clinic referred Otieno’s family to Mama Lucy Hospital. There, the doctors put the child on a life-support system and told the father that his son was in a critical condition and should be transferred to Kenyatta National Hospital. It took the ambulance five hours to arrive; in the meantime, Otieno died.
With a population of almost 50 million, three million of which live in the capital Nairobi, emergency services are not only late in Kenya – many Kenyans don’t actually know who to call in an emergency. “With so many dispersed providers and with hundreds of phone numbers to call, it is impossible to know who can get to you the fastest,” observes Maria Rabinovich, the co-founder of Flare, a mobile app that works like Uber, but instead of hailing cabs, it hails ambulances and firefighters. “Getting everybody onto the same system is critical to making sure there can be coordinated and effective response for patients anywhere in the country.” According to Rabinovich, 15 percent of Kenya’s documented emergency situations end up in death compared to one percent in U.S. cities.
Before Rabinovich and Caitlin Dolkart established Flare, they had already worked in Kenya for a number of years on health and health-tech projects. During that time, the young ladies, originally from Moscow and Chicago respectively, repeatedly heard stories of Nairobi residents trying and failing to find an ambulance, often with tragic consequences. They observed that the lack of a 911-like system meant that there were hundreds of numbers to call in an emergency, yet these numbers aren’t very helpful.
While plenty of medical professionals, first responders and healthcare facilities exist in the Kenyan capital, the systems and infrastructure aren’t sufficient to allow these different components to operate optimally, Rabinovich tells progrss. “One patient, during the course of a single emergency, may require trained first responders, medical transport, a medical facility with medical personnel, and access to specific medical equipment, and it is important for these different components to work in lockstep,” she adds. “Poor coordination can cause massive delays that lead to bad outcomes and, often, unnecessary deaths.”
During their initial research, they worked with first responders to better understand their needs. This became the inspiration for their startup, Flare Emergency Response Systems, established in May 2016 and launched in March of this year.
Rabinovich and Dolkart designed and developed Flare around the needs and with the help of their ambulance and firefighter partners. Flare speaks to different hospitals, clinics, ambulance companies, firefighters, police and security, and insurance companies, among others, to connect emergency workers with patients. They also communicate with government officials, key players in the private sector, and anybody else who may be interested or who operates in emergency response in their efforts to make the system more effective.
“We have a team member responsible for finding and speaking with new partners, and so far, it hasn’t taken a lot of convincing,” Rabinovich says. According to her, almost everyone that the team has spoken to so far seems to be eager to improve, and Flare gives them the opportunity to do so. “Everybody seems to be on the same page about collaborating to improve response times and save lives in emergencies.”
“We have been working with our ambulance partners who save lives every day, but at the moment it is difficult to say how many lives we have saved together. A lot of these unnecessary deaths can be attributed to slow response times. While the optimal response time (especially for cardiac patients) is eight minutes or less, the average response time in Nairobi is 162 minutes,” she says, adding that in New York City, a city that both ladies have lived in previously and that has double the population of Nairobi, it takes just six minutes to get an ambulance, firefighters or police. For them, New York’s emergency service response system is evidence that optimal response times are achievable, even in large, busy cities – it’s just about getting there.
“By reducing response times, we can significantly reduce the number of unnecessary deaths.”
Flare’s ultimate goal is to make emergency care accessible to all. As a private business that aims to balance financial sustainability with a social mission, the company is funded primarily by private investment. It has also received grant money, raising $100,000 from two U.S. angel investors in September 2016.
Although it kickstarted in Nairobi – the city with the highest density of people and providers – Flare is available across Kenya. Flare’s ambulance partners are even making multi-hour and multi-day trips to transport patients into Nairobi from cities like Mombasa, Garissa, Isiolo, and Wote. However, while Flare is capturing these trips, it has not officially promoted the service outside of Nairobi.
“We are currently building up a larger network of first responders in other areas of Kenya so we can guarantee quality and fast service,” says Rabinovich. “The responders are there; we just need to get them on our system to help patients reach help quickly.”
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