Meet Angella and Francis, two of the four Co-Founders of Kaaro Health. With their start-up they provide healthcare solutions for small private owned clinics and healthcare centres in the rural areas of Uganda. They empower small and middle sizes enterprises to upgrade their facilities and acquire more modern medical equipment. With their newest solution, a containerized clinic, they started to provide basic healthcare for people that have not had any attendance until now.
If you had to describe Angella in three words, what would these be?
Francis: Aggressive, passionate and focussed.
Angella, do you agree?
Angella: I am passionate about the things that I do. I agree on that. I also follow through and always make sure to gather my team around me. I am definitely a team player. That is how I would describe myself.
How did you become a founder? What was the beginning of Kaaro Health?
Angella: I would say it was a team effort, but I did have a closer connection to how our company was coming up. It is a very personal story actually. I was initially working in a bank before we started our business. I was working part-time for a bank and at the same time also working for a telecommunication company. At some point I was transferred to a rural area. I knew it was going to be a life without cars, without electricity and other conveniences. A very simple life.
When I got there, I made a few friends since I am a very social person and I love to have people around me. Most of these friends I made were women. Some of them were selling groceries to survive, others were young girls that dropped out of school, again others were going to school but had to drop out at some point because of poverty, and again others were forced to get married at a very young age. There were many stories of women getting married at a very young age, at 16, having children, suffering from violent husbands. It was a cruel environment for women and it was an environment that was very different from where I came from. The girls and women I know from the city get a good education, they go to university, they know what they want. What I encountered in the rural district that I was sent to, was a very different experience. At first, I thought this was just a snapshot in time and it will go away. But eventually I realized – mostly because I was talking to my new friends who had certain pains in life – this situation was not going to change. At the end of my transfer year, I had a very different picture about the situation women in the rural areas of my country.
How did you end up starting in a business in the health care sector?
After my assignment in the rural district I returned to the city. A while later I got to go back to the rural area again. This time, I had a life-changing experience myself. I knew about the situation of the women connected to poverty and to home violence. But when it came to the health situation, I had no idea. Until I had to visit a health centre for personal health reasons. The nurse that attended to me had no idea how to help me. She had no experience and very little knowledge. She prescribed me some medication, but she didn’t know what she was doing. I was lucky because I could ask someone from back home to send me some medicine. But the people living here were depending on these health centres. Women would come to the centre with their pains and were referred to a congested far away hospital, which is the district hospital. Depending on where you live these district hospitals can be around 20 to 30 kilometres away. And going to the district hospital meant even more: The women would have to walk there, at the same time leave their family and children in the care of someone, they would have to leave their business and often walk all day and sometimes return with no medication at all. It was frustrating.
And while I was in the health centre I also had another experience that shocked me even more. There was a pregnant woman who was just about to give birth and the way they helped her give birth to the baby was traumatizing. I knew something had to be done.
These experiences made you realize you wanted to do something to help these women in rural areas. And how did you two come together and start building your company?
Angella: I had some complications during my sickness and had to go back to another health centre and there was a nurse who did have some medical knowledge. She helped not only me but also other women with their pains. When I had fully recovered, I returned to the city and then realized that if we did something about the health centres we could really help women in these rural areas.
Francis and I talked about it and the first time I told him about this idea he laughed because I did economics and finance – what would make me a specialist for healthcare? But we had a first idea: What about creating a streamline to provide these health centres with medicine? We started to brainstorm, together with our other two co-founders, and after a few meetings we came up with a plan to empower health facilities rather than just sending them medication. We wanted to make sure that the nurses were trained properly, and they could call a doctor for help if they knew what they needed help with.
After you had the initial plan, when did you start and what were the first steps to turn your idea into a start-up?
Francis: We started brainstorming in 2014. Initially, we didn’t realize we could turn our ideas into a business. It only started crystallizing after a few brainstorming sessions.Interestingly, I run a small business in the same area that Angella was working and had her bad healthcare experience. At the same time we were brainstorming, some of my employees were missing work because they had fallen ill and couldn’t get proper treatment themselves.
For us the first steps were very clear: we needed to get an overview of the situation and we decided to do a study in that district. We started to visit the health centres and observed what was happening. In the facilities that wanted to cooperate with us, we could even look into their records and see how many women had visited the facility, how many were taken care of or how many had suffered complications and maybe even lost their lives. What type of pain were patients coming in for. We also read publications on the health situation and in the end got a very good picture of the health situation in the area.
The result of our research efforts was very clear: There was a big gap between the service delivery.We realized if we could improve the capacity of the local health centres on village level (not the big district hospitals), we could cut the traffic that went to the hospitals and complications that were involved in-between. We therefore decided to empower the local health centres and small clinics in the villages to be able to provide a little more health care, so patients wouldn’t have to go through the efforts and pain to walk to the next bigger hospital.
What was the first centre you worked with and how could you improve their situation?
Francis:We registered the company with the four co-founders, pulled together our savings and started cooperating with the first health centre. It was the nurse that we had at first started reaching out to as she had some solid knowledge. We assessed her facility – she ran the clinic out of her home – and started considering how many patients would come to her and with what complaints.
In her case, we decided an ultrasound machine would make the most difference. We bought and ultrasound machine and a small solar system to power the machine and provided that to her and her clinic. Just with that system she could attend more patients, make more money and the number of referrals that she was making to the big hospitals were cut by more than half in the first month.
At the same time, we also assessed other clinics and we realized that the area they needed support the most was the maternal health care. This was the moment we chose to focus our efforts on the maternal health and childcare. We mapped all clinics in the area we started our work and began to supply machines within our financial possibilities. Today, we have provided 23 clinics with ultrasound and solar systems.
What was the biggest challenge when you started out?
Angella: Most of the workers at the healthcare facilities thought we wanted to take business away from them. Which wasn’t the case. And secondly, they thought we would do business in their facilities and again take away their profits which wasn’t the case either. It took us a couple of visits to the health centres to convince them that they would actually not only keep their business but also make a lot more money. And at the same time, we would make a change in many people’s lives. Together. It took us a lot of explaining.
Was there a highlight moment that you clearly remember and that will bring a smile to your face for the rest of your life?
Angella: Oh yes. When we delivered an infant warmer to the nurse that we first started to work with she couldn’t believe it. She was so happy to be able to help young mothers with their early born babies. At first, she did not know how to operate it and I was the one showing her how to do it. I remember how she was smiling as she was learning, and that happiness is a memory I will always cherish.
Francis: For me it was a woman who had returned from a big hospital not having received any treatment. The next step would have been to visit a local traditional birth attendant. But a lot happened there – some called it witchcraft – the number of successes was always connected to supernatural abilities. The woman was getting scared and didn’t want to visit that traditional birth attendant. But normally, this would have been her last and only choice.
However, when she learned that she could now receive most of the treatment that she had gone to the district hospital directly in her village at the local clinic she came in with her husband and her children. What I should explain is, when you go to a district hospital, the treatment itself doesn’t cost anything, but the way to the clinic is expensive: Firstly, you need to make sure your family and your business, in case you have one, is taken care of for the day. Secondly, the way itself costs depending how far you must travel and what transportation is involved.
At the local health centre, she had to pay for the treatment, but it was a lot less money and effort for her than going to the hospital. And it was less dangerous.
Her telling me this story is something that shows me, what we do is right. It is what drives us. We make a difference in people’s lives. We not only provide them with local health care, we also save them money that they can use to feed their children or put them into school. This is what makes me happy. And there are many stories like this one.
What’s next?
Angella: We are planning to scale our business. Right now, we have 23 existing clinics that we cooperate with. But during our work with these clinics and through further conversations with others we realized that we need to offer a package to be able to help more villages with their health care. We call our package a Containerized Clinic. We have deployed our first containerized clinic and we plan to deploy more in areas where there really is no health care at all. We want to ensure that nobody is left out – not even in the most remote area of the country.
How does it work: It is a fully equipped facility that is also connected to a doctor service to be able to provide health care to those who currently don’t have any support. We have done a pilot early September and by the end of this year we plan to already have installed five clinics. By 2020 we want to have 150 Containerized Clinics up and running all over the country and with focus on areas that currently have no access to healthcare. It is a modular solution that we can install within a week and make sure everyone in the country has access to health care.
Who inspires you personally?
Angella: The person that really inspires me is one of our Co-Founders. She is a mother of six and she has been in the healthcare sector for over 30 years. I have known her for many years but never really got to sit down with her and listen to her experiences. One day she told me how the health system really works on ground, how much efforts she had put in over the years and how much she had also sacrificed – staying away from her family, sometimes having to sleep over at the clinic just for someone she is not related to – but not expecting anything in return. Sometimes her salary would come in late and it is a very tough and unforgiving job.
Still, she chose to do this work. She chose this path when she was a young woman to give something back. This is what she was going to give back. She has a deep passion for what she does. And this inspires me. She does not only work to earn money, but she wants to give a child and a mother a chance to live healthy lives. She is a hero. If we had more heroes like her it would a beautiful world.
If you could give a tip to aspiring entrepreneurs, what would it be?
Angella: I believe, that we do things out of passion. And through this passion we can actually achieve a lot. Everyone in this world is blessed somewhere. I believe, strategically, there is no wrong placement. Wherever you are, in every circle of influence, you can always look out for that one thing you really care about. Then you will not lose a lot of energy. I worked in the bank and in the telco industry, but I remember my drive to work was: I have to get this done. I must focus and get it done. Today, I am doing something that gives me joy. I am giving life to a child, I am giving a second chance to someone out there.
What I would tell especially young girls out there: Wherever you are, it doesn’t matter what age you are at or what circle of influence you live in, look out for something you really care about. And start to team up with people who believe in what you believe. Because in my opinion, a team drives you farthest. Look out for people who have the same values and together you can achieve a great deal.
The interview was conducted by Christina Richter from FIELFALT, the community and blogazine for female empowerment. FIELFALT wants to encourage women to leave their comfort zones to dare something and to achieve their goals and realize their dreams.