Safewheel

Anas Hossain Makki, Chief Operating Officer of Safewheel. He earned BSc from the country's top engineering school, Bangladesh University of Engineering and Technology and developed architectural blueprints in tech innovation and platforms for NGOs, academic institutions, and private projects. His thesis paper has been presented in International Conferences and been recognized by industry expert academicians. He has a close connection with the engineering community of the country. He brings a combination of technical and operational value to the team. Being a student, he has led multiple student-run clubs and organizations and has in-field experience of operational execution. Anas also gained vast experience of management by working with several social organizations and NGOs.

105 million people in 68,000 rural villages of Bangladesh are suffering and at times dying because of ambulance unavailability. Currently, there are only 1200 ambulances in the entire rural areas – that's 1 for 88,000 people. The recent COVID-19 pandemic is doubling the problem resulting in more people needing emergency medical service.

Safewheel designed a low-cost three-wheeler ambulance and provides an affordable solution to the rural villagers. Before Safewheel, rural people were deprived of their basic access to healthcare rights. Safewheel intends to keep a significant impact on SDG 3: Good health and well-being. We envision to reach every rural doorstep with affordable healthcare, not only in Bangladesh but beyond.

105 million people in 68,000 rural villages of Bangladesh are suffering and at times dying because of ambulance unavailability. There are only 1200 ambulances serving this entire rural population, that's 1 for 88,000! Many of these are not even working properly, and below 7% have paramedic onboard. Patients with emergencies are taken to the hospital with risky local vehicles that are life-threatening for them.

As there are fewer ambulances operational, they take hours to reach a patient due to large geographical coverage per ambulance, charging beyond villagers’ affordability. These conventional ambulances are costly to manufacture, and can't reach the narrow village roads due to the big size. Current ambulances do not have proper medical equipment, neither have any paramedic on board. There is no patient location tracking system for the drivers. In times of an emergency, they face trouble finding out the patient's location – which is another reason for reaching late. We have observed a similar problem in most of the developing nations which include India, Philippines, Indonesia, Nigeria, Mexico, and many more.

Rare availability, expensive service charge, absence of paramedic and location tracking system, late response, inaccessible to village roads – this summarizes the scenario in rural Bangladesh!

Safewheel provides affordable emergency medical services for the rural people of Bangladesh. We designed a low-cost three-wheeler ambulance by modifying locally available vehicles that cost 1/10th of the conventional ambulance and can reach everywhere in the village. Every Safewheel ambulance has the necessary basic medical equipment to save lives. Our real-time vehicle tracking system allows us to monitor the effectiveness and efficiency of the system.

We provide two emergency medical solutions – firstly, the regular ambulance transportation for emergency patients. Our second service is doorstep medical service where we provide in-home treatment to people with minor injuries who do not require visiting hospitals. In both cases, we charge half of the available ambulances in the market.

Our response time is already the shortest in rural Bangladesh. We believe 20 minutes response time is not enough when it comes to saving lives. We want to be even faster. We are developing a smartphone app that would allow a patient to find the nearest Safewheel ambulance. Our tech-enabled ambulances send live updates to the hospital about the condition of the patients. This system would reduce the waiting time in emergency treatment for millions and save the lives of critical patients.

Safewheel provides services to the rural people of Bangladesh. They are mostly deprived of healthcare access due to not having any ambulance service in the locality. There is also a huge knowledge gap in basic hygiene and primary healthcare in the market we are operating in.

“Moving Wheels, Saving Lives” this motto of ours narrates the way of impacting the lives of rural people. As we give our patients the highest priority, we have observed a direct improvement in health statistics in our operational area which includes reduction of maternal and infant death, increasing the availability of health services. 

We also teach people about the necessity of hygiene and how to react during an emergency as part of our marketing. We are observing consistent health-seeking behavior among people which was missing before our entrance in the area. 

1. Elevating opportunities for all: In Bangladesh, around 60% of total ambulances operate in Dhaka. Rural people are deprived of their basic health rights. Safewheel solves this crucial healthcare problem by making ambulance services affordable, accessible, and available for all.

2. Elevating issues and solutions: Bangladesh has poor emergency medical transportation infrastructure as every day thousands die for emergency cases. COVID-19 has weakened the healthcare system as well. At Safewheel, we bring affordable healthcare with our unique solution. Within the next 5 years, we want to create impacts in million lives by building affordable healthcare infrastructure for the rural people. 

The idea of Safewheel came through bitter personal experience. All 3 of the co-founders of Safewheel have been friends for more than a decade. In 2015, Rafiq’s (Co-founder and CEO of Safewheel) uncle had a road accident. He was bleeding severely and Rafiq’s father was taking him to the hospital with a local unsafe vehicle. He couldn’t find an ambulance at that time. On the way, Rafiq’s father had to witness the death of his own brother in his lap.

After this incident, we wanted to find a solution that would end this problem once and for all. We experimented with different ideas to solve it. Meanwhile, we also prepared ourselves to learn about the global emergency medical system of both developed and developing nations. In November 2018, we took the first official step towards the journey of Safewheel through partnering with the local government division of Bangladesh.

I had a wonderful childhood. When I was 8 years old, I was introduced to a nearby library. Most of the time of the day was spent at the library. I read whatever I came across. The more I read, the more I started observing problems that still exist in the world. Ever since I have made a mindset to be a change-maker.

The incident mentioned in the previous answer moved me a lot. Prior to our operation, I saw pregnant women dying on the edge of the delivery to give birth. I saw villagers holding their loved ones dying, waiting for hours on the street for an ambulance to come but it never showed up. When I put together all of these sufferings and experiences, I was convinced that this system needs to be changed and I must be the change-maker who brings peace and happiness to rural areas so that no one like women in rural villages has to end her life while bringing a new life to the world.

I have graduated from the top engineering institution in Bangladesh. In my undergraduate life, I led numerous national and international competitions as I was vice president of the Entrepreneurship Development Club. My co-founders and I led different projects where I had to manage the operations.  

In 2016, I won the Leadership Prize of BYLC worth $10,000 for a project called "Waste-free Bangladesh". In this project, I tried to make people understand the values of waste segregation on the basis of their recycling and reuse process. I also am a graduate of  10-week-long leadership training of the country’s largest leadership institute Bangladesh Youth Leadership Center (BYLC). 

I know my co-founders for more than a decade. Followed by our previous social projects, we decided to start something on our own. Later on, they joined the business school to learn more about business, whereas I joined engineer school to learn technical aspects. Currently, my co-founders are looking after business growth, financial, and strategic parts. I am leading the technical and operational sides. I have a vast network of the country's top engineering community, from where I get any technical and architectural support. Along with the experiences in management and leadership, I  have the hunger to learn and evolve myself. 

It was 03:30 in the morning. Raining outside. The pregnancy cramp of Nasima had started unexpectedly. Her husband called and begged a hospital to provide an ambulance as the cramp was severe. Hospital couldn’t help as they don't own any transport. She was on the edge of the delivery as her water broke hours ago. Finally, her husband managed to find Safewheel's number and contacted us. Within 10 minutes, Safewheel ambulance arrived at the patient's home. As her condition got worse, from our database, we onboarded the nearest midwife. On the way she delivered a baby girl with the help of the midwife.

As I was in charge of that territory, I sat with my co-founders after this critical event and came up with the idea of an Ambulance Subscription Package for hospitals. We registered 4 subscriptions after this incident. We also started collecting data of pregnant women. We communicate with them beforehand, track their condition to provide safe transportation to the hospital. Ever Since then, it has been a key part of Safewheel’s marketing.

In my early high school days, along with my friends (My current co-founders), I participated in a competition called PDF Summer challenge 2012. We launched a project named “Making Smile”. It was almost a 3-month-long project. We were asked to find a solution for physically/mentally challenged students. 

We started the project by finding physically/mentally challenged students. We found six families with financial problems. They were unable to continue the educational expenses of their children. Instead of donating money, we wanted to find a sustainable financial solution for the family. We looked for the reason behind their financial challenge. We observed a common pattern among them. The sole earner of them was the male figure. So, I led a group of volunteers in different fundraising events. With the funds, we bought sewing machines for mothers so that they could earn money and bear the educational expenses. I’m still in touch with those families as that experience helps me stay focused on my life.

The key innovation of Safewheel lies in finding an affordable solution to reduce the scarcity of ambulances in rural areas. We have observed that the main reason behind the unwillingness of traditional ambulance service providers is a high fixed cost. Also, big ambulances cannot reach the narrow village road. Rural people don't earn much compared to urban ones to make a living. They avoid expenses for something which is very uncertain. It is difficult for a traditional ambulance owner to reach the break-even of an ambulance in the rural area.

We understood this problem and found the solution in our three-wheeler mini ambulance. Our ambulance costs only 3500 USD and can easily move through the narrow village road to help the patient. This reduction of fixed cost helps us minimize the charge as well.

The attached photo is the illustration of our Theory of change. The ultimate impact of Safewheel is “Affordable EMS and Developed Healthcare System”. We divided our inputs/activities leading towards outputs as our service. These outputs eventually direct us to have impactful outcomes such as reducing death due to lack of EMS, the development of affordable and efficient healthcare systems, and building a conscious tech-enabled community. 

We have seen a glimpse of the outcome in our pilot where we served over a thousand patients within only 4 months. We have experienced numerous horrifying examples where patients like pregnant women, infants, or elderly people would suffer for not having proper access to an ambulance. Within a short time, we proved our impact in the area. We strongly believe that the impact slope will remain high and Safewheel will have more impact on the post-COVID-19 Bangladesh.

Within 4 months of operation in 150 villages, Safewheel validated its idea by serving over a thousand patients, impacting the lives of more than 3500 people. We want to launch 25 ambulances this year. At the end of 2024, we want to onboard 525 ambulances under the umbrella of Safewheel, impacting millions along the way. The following is the brief of our future projection:

Safewheel envisions reaching every rural doorstep with affordable healthcare, not only in Bangladesh but beyond. We have designed our goals aligned with the vision of Safewheel. Let’s look at our goals in different aspects of the company:

1. Scaling in Bangladesh: Safewheel grows every quarter as we launch new ambulances expanding to the next region. We want to reach 40% of Bangladesh’s rural area with our services in the next five years.

   

2. International expansion: We have seen similar market opportunities in other developing nations. We want to expand Safewheel’s operation to the international market within 2023.

3. Partnership: Safewheel believes that collaboration among different national and international entities can ease the pathway of access to healthcare to everyone. We want to achieve important partnerships along the way to strengthen our journey.

4. Business model: The recent COVID-19 has opened the door for telemedicine globally. We have seen a rise of telemedicine in Dhaka as well. On the other hand, as Bangladesh develops, the usage of smartphones has increased significantly. We believe, there is a huge opportunity of telemedicine in the rural part of Bangladesh which we want to tap within next year.

5. Insurance: Bangladesh is one of the few developing nations without health insurance. We have already started an “ambulance subscription package” for the hospital as part of our revenue model. We want to start a subscription model for the villagers next year. A successful pilot can be a lead towards bringing the health insurance system in Bangladesh.

Within next year, we are planning to launch 75 ambulances in 25 new regions. We are estimating upcoming barriers to achieve that goal. The following is a brief about our potential barriers.

• COVID-19 pandemic: Due to the lockdown in this pandemic, our progress has been slowed down by a big margin. We import vehicles from abroad and modify them into ambulances. Currently, we are facing trouble bringing vehicles due to the regulations of the customs. We are also experiencing fear among the mass population about potential Coronavirus transmission. Bangladesh is the worst hit of COVID- 19. 

• Financial: We will survive until the end of November with our current financing. We have already narrowed down our expenses by a large margin to stretch the runway. We are facing trouble raising investment in this pandemic. 

• Vehicle procurement: We are currently bringing vehicles from abroad. The entire process takes time. As the company grows, the shipment costs might become a burden for us.

• Lack of health awareness: There is a huge gap in the mindset of rural population in Bangladesh. This has been a challenge for us in the operation. We will constantly face this challenge as long as we scale to the next region, serving new people.

In the previous answer, I acknowledged our potential barriers to achieving next year’s goal. Our plan to overcome these barriers are given below:

• COVID-19 pandemic: We are planning to be partnered with the Health Ministry of Bangladesh to get support on easing down the process of customs. The government of Bangladesh has already doubled the investment in healthcare in this new fiscal year. We see COVID-19 as an opportunity to create more impact.

• Financial: Our required investment (180,000 USD) would give us a runway for 24 months. We have secured a quarter portion of the investment. Currently, we are looking into our global partners like Hult Prize, EarthTech, and Youth Co:Lab communities for potential impact investors. We have also got selected for The Rockefeller Foundation-Acumen Student Social Enterprise Accelerator and Singapore International Foundation’s Young Social Entrepreneurs (YSE) challenge. We are hopeful to secure 40,000 USD grants from them.

• Vehicle procurement: Number of new companies in Bangladesh have recently started producing tricycle vehicle to meet the country’s demand. We are in talks with them in order to find if they can meet our specifications. It will reduce our expenses by a significant margin and also will ease the way to the operation.

  

• Lack of health awareness: We have tackled this challenge through small local health workshops in different operational areas. It has been very effective so far as villagers are willingly learning about basic hygiene and necessity of an ambulance during an emergency.

Currently, we have partnered with 4 national and international enterprises. We are getting different types of support from all of them.

• EarthTech: Our Business Development partner. We became the champion of the EarthTech Challenge 2020 in Australia. EarthTech has been supporting us with funding, mentorship, and Go to Market Strategy. 

• UNDP Youth Co:Lab: We are the winner of Youth:CoLab Bangladesh 2019. Since then, they are supporting us through SDG based opportunities and grants. On the other hand, UNDP Bangladesh provides support in last-mile operations. 

• Hult Prize: Safewheel is the birthchild of Hult Prize incubation. We are the winner of Hult Prize accelerator 2019 and one of the global top 6 finalists of this prestigious competition. Hult prize is supporting us in international reach and collaboration. 

• Lightcastle Partners: Country’s largest data-driven consultancy firm. They are helping us with geographic data and analytics which is very essential in our operations. 

We have three sources of revenue. Two from patients and another one from the hospitals. In all cases, our end users are village patients who need emergency medical attention. Following is the detail,

1. Regular ambulance service: Our average charge for an ambulance ride to the hospital is 5 USD, where existing ambulances charge more than 20 USD per ride on average which is beyond the affordability of villagers.

2. Doorstep medical service: Our trained paramedics are able to provide in-home treatment to patients with minor injuries who do not require visiting the hospital. On average we charge only 3 USD, where even the unauthorized village doctors (Small medicine shop owners) change more than that.

3. Ambulance subscription package for hospitals: Rural hospitals that do not have any ambulance can use ours with a monthly subscription fee of 100 USD.

If we look at our Unit Economy, one Safewheel ambulance can generate monthly revenue of 810 USD against the cost of 475. This gives us break-even for an ambulance within 11 months only!

Our financial sustainability comes from the generated profit margin of an ambulance. As we mentioned in the previous question, one Safewheel ambulance generates enough profit to reach the break-even within 11 months only. Safewheel ambulance has a lifetime of 6 years. In its own lifetime, it can generate profit to buy 5 more Safewheel ambulances! In this way, we don’t depend on spending our investor’s money all the way on our assets, rather we produce them quarterly through the profit made by the initial ones.

We have raised 50,000 USD in SAFE Notes from Edward Ring, an impact investor brought by our Business Development partner EarthTech, an Australia based impact entrepreneurship firm. (https://earthtech.io/)

We have also become shortlisted and at the final stage of securing a Switzerland based matching fund facilitated by Biniyog Briddhi, an impact enterprise scaling initiative in Bangladesh. They will give us 100,000 USD non-repayable grant funds matching our seed round of investment. (https://www.sie-b.org/impact-ready-matching-fund/)

Safewheel is currently raising $180,000 as part of its SEED Round. As we have raised 1/4th of the target already and now open for investment to raise the rest of it. The initial investment is offered to us in SAFE Notes. So, we are yet to have our lead investor for this round. 

We are also looking for impact based grand funds. In partnership with DLA Piper, we are currently incorporating the parent company of Safewheel in Singapore. Any person or organization who supports the cause and believes in what we have been doing to ensure basic human healthcare rights are welcome to fund us.

Just like the rest of the world, Safewheel has been hit hard by the current global crisis “COVID-19”. To tackle the situation, we have reduced our expenses by a large margin to increase our runway. Our estimated expense for 2020 would be 65,000 USD. With the current investment, we have a runway to survive until November of this year.

• Funding: As mentioned before, we are seeking funding opportunities to grow and scale our operations. COVID-19 has taken a toll globally as well as Bangladesh. The demand for Safewheel is now more than ever. We aspire to serve more areas to reduce unnecessary life risks. We believe the Elevate Prize can help us find opportunities for investment and grants from the other part of the world. Also, the given 300,000 USD prize money of the Elevate Prize would help Safewheel as well as the communities we are serving.  

• Training and Mentorship: We are at the early stage of our social enterprise. The next few years will be crucial for us to grow and make more impacts. We know that the journey of Safewheel is not going to be easy. We will eventually face unpredictable barriers to the growth of the company. The two years of learning, mentorship, and connections from the huge pool of industry leaders and experts will enable us to tackle those challenges efficiently.

• Media and Marketing: We don’t want to be stuck in Bangladesh only, rather we want to expand globally to help millions on the way. In this regard, we need global partnerships, collaborations, and recognition. Elevate prize can be helping hand for us with their tailored media and global reach throughout the world.

• Healthcare training: We are looking for a healthcare partner who can help us with paramedic training. This partnership will help us to prepare the training modules for our paramedics and ensure their standard. 

• Vehicle procurement: Safewheel is currently looking for partners in Bangladesh to procure the vehicle locally. Local vehicle procurement will reduce our operational expenses by a large margin.

• Insurance: Currently there is no health insurance system in Bangladesh and nearby neighbor countries. We have a goal to establish a sustainable and efficient health insurance system in the future which will ensure affordable healthcare for people. We will look for partners in the coming years.

• WHO: We are in talks with the former head of the Emergency Medical Team (EMT) of WHO. We are trying to onboard him as an advisor and make a partnership with WHO as we believe WHO can help us meet the global EMS standard.

• Health Ministry of Bangladesh: Partnership with the Health Ministry of Bangladesh will enable different opportunities in the operation as well as it will help us ease down the process in customs.

• BKash: We are in need of a smooth and efficient Fintech for payment system. By far Bkash is the best one in our country. We are trying to be partnered with them to make the payment system secure and easy.