For three years, a group of Polish students and physicians from the Treating with a Mission association has been traveling to Kenya to share their know-how with local professionals. Each time they come back with experience that can teach us a lot about care delivery challenges and the value of innovation. We talked to Jan Niziński, a co-founder and vice-president of Treating with a Mission.
How is Kenya's health care system organized? What kind of problems do the patients face?
A public health care system with a government-owned health insurance company (the National Hospital Insurance Fund – NHIF) is responsible for covering the treatment costs of Kenyan citizens. However, due to the difficult economic situation, only one in five Kenyans has health insurance, which means that 36 million of 45 million people have no access to health services. The consequences are alarming. Insufficient funding of the healthcare system negatively impacts healthcare infrastructure.
“Only one in five Kenyans has health insurance, which means that 36 million of 45 million people have no access to health services.”
There are many other problems specific to the region. One of them is delivering care in rural areas. Public hospitals are mostly located far away from local communities. Due to the lack of proper road connections, visiting a hospital is challenging, especially in an emergency. Another worrying issue is the shortage of medical professionals. According to World Bank data, there are only 2 physicians per 10,000 people in Kenya. As an illustration of just how dramatic the situation is, Poland, with ten times more physicians, is also struggling with a medical workforce shortage. Some healthcare problems can be fixed only by Kenyans themselves, but there are areas in which help from the outside might be beneficial.
Do patients in Kenya have access to care services provided online? What kind of digital health solutions are a good fit for domestic needs?
This is a fascinating topic. Online health care services are generally not widespread. Surprisingly, the cause doesn't lie in limited access to the internet. Internet penetration in Kenya amounts to 90%. We were quite impressed by the fact that mobile internet is usually available even in small villages. But again, funding for medical services is inadequate.
In my opinion, the spread of online health services in Kenya is only a matter of time. During our project in Kenya, we had the opportunity to work with Polish digital health companies, such as Medapp and Infermedica, and to introduce their solutions to Kenyan hospitals. Local professionals welcome new health technologies enthusiastically. They crave innovation! But there are some barriers to overcome, such as the need to adapt new technologies to regional conditions.
It’s not possible to simply copy and paste solutions from the USA and Europe. Kenyan doctors need effective and easy-to-use digital tools to improve workflow. Hospitals will not be able to adopt overly sophisticated technologies that require the latest technical equipment and software and or long training. Simplicity is the key. Technology must also address specific problems, which are obviously different in Africa than in Europe.
“Hospitals will not be able to adopt overly sophisticated technologies that require the latest technical equipment and software and or long training. Simplicity is the key.”
One example is the implementation of telemedicine ECG. Once we had left the hospital, the medical workers didn’t want to perform the ECG examination, although they had been well trained to do it. Why not? It turned out that only a few patients had health insurance or enough money to cover the treatment costs out of pocket. Sometimes it’s necessary to analyze the entire health services circuit and the specifics of the health ecosystem to identify an obstacle.
There are a few inspiring examples of technologies that address specific healthcare problems in Kenya. One of these is Flare, a local startup that has developed a service which provides emergency access to medical assistance within 15 minutes. This solution is an answer to the fundamental problem of the inadequate, state-coordinated medical emergency system.
With these examples in mind, can technology improve health care in Kenya?
I strongly believe that. In fact, it’s the only way to strengthen healthcare. A shortage of medical professionals can’t be fixed in a short time. Even if the Kenyan government increases admissions to medical studies, or manages in some way to import medical workers from other countries, the first positive results of such initiatives will be a long way off. Patients can’t wait so long.
For this reason, I believe that technology that can to some extent replace a doctor has great potential to improve quality of care. This includes solutions that can help with triage and health assessment of patients, or AI-based tools to interpret the results of medical tests. If these and other ideas fit the local ecosystem well, they have a chance to transform Kenyan healthcare.
Could you please tell us how Treating with a Mission helps people in Africa?
We are focusing mainly on development aid, so our goal is to assist local professionals in acquiring know-how and to exchange medical experience. Our work makes real changes only when it is well-planned in consultation with the local community. In our effort to meet the needs and challenges defined by our partners in Kenya and Uganda, we agree on every step.
Members of Treating with a Mission assist in some crucial areas, including mothers and childcare, cardiology, and cancer prevention. Healthcare specialists provide training in local hospitals and deliver the most needed medical equipment. We want to support organizational and technical improvements in hospitals in such a way that doctors and nurses can continue their work independently, without our help. Our local partners work hard to provide the highest quality of medical services to their patients, and we do everything we can to help them, having their goals and principles in mind.
Why did you choose Kenya as the first country for medical aid?
A development project requires good partnerships. We started in Kenya because of the good contacts Polish doctors had previously made with local hospitals while working there. We managed to start the project there and expand it over subsequent years. Another reason is fruitful cooperation on certain projects with the Polish Embassy in Nairobi. Their help is priceless.
Kenya is a fast-developing country, and the local healthcare system is changing dynamically. However, despite considerable progress, many challenges remain. The gap in the quality of healthcare between Nairobi and the rest of the country is enormous. In the capital, a patient can receive world-class healthcare services - provided you have enough money, or are insured. But at the same time, in rural areas, people are struggling to get essential services. Kenya must now work hard to bridge these disparities.
What do you and Treating with a Mission plan for the upcoming years?
First, we plan to develop a project in Uganda and continue our engagement in Kenya. As we think about expansion to other African countries, we are looking for local partners who want and can benefit from our support. To succeed, goodwill on both sides, cooperation and good communication are required. Moreover, at Treating with a Mission, we hope to expand our partnerships with digital health companies like Infermedica. This is always a “win-win”: we can deliver useful solutions to our partners, while cooperating organizations get feedback on how their products can be adapted to the specifics of the African health ecosystem. We are open to new projects that can bring real changes for Kenyan patients.
Jan Niziński, a co-founder and vice-president of the Treating with a Mission association, has been named one of Forbes’ “5 under 25”. Jan is a medical student who is passionate about research and new technologies in healthcare.