The SnooCODE RED System & Development Partners Initiative

A system to strengthen the capacity of ambulance services in Africa for rapid and efficient emergency response

Sesinam Dagadu, Founder and CTO, SnooCODE Limited

In most of Ghana and several other developing countries, people spend a considerable amount of time citing landmarks and descriptions like “take the third rough road after the big mango tree” to direct the Ambulance and other services to them. In Nigeria, some emergency services ask patients for their Google location, requiring an Internet connection or otherwise knowledge of their 16-digit longitude and latitude. This is how people in emergencies and epidemics have typically addressed the challenge of no addresses. 

These common approaches mean that offline populations, the illiterate, tourists and others who don’t fluently speak the lingua franca are by default excluded from easily accessing essential services. Even for the knowledgeable or privileged, spending valuable time giving directions is more than just an inconvenience – it could mean the difference between life and death. 

The national emergency response time target for our home country, Ghana, is 8mins. Practical fieldwork however shows the time can be as long as 1 hour, owing partly to the time spent locating cases.  

There is thus the need for a robust solution that empowers people with an offline address that will optimise their emergency services and even power their mobility, logistics and public services.

SnooCODE recently changed her tagline from “an address for every man, woman and child” to “an address for everyone and everything.” Suffice to say, SnooCODE was designed to be usable by everybody, however, our target population is the developing world. Here, many of the people who would most need and use a digital addressing system – drivers, delivery people, community health nurses – are not well educated or cannot afford smartphones. The good thing about SnooCODE’s design is that even people who do not own a smartphone can have a SnooCODE for their home. Our favourite case study is our founder’s grandmother who lives in the village. Her grandson paid a visit, stood in front of her house and used his Android smartphone to generate a SnooCODE. He got it in 3 seconds, wrote it on paper and stuck it to her fridge. If ever she had an emergency, she could call the ambulance and quickly say out the 6-digit code on her fridge, ensuring they could find her in good time and transport her to the nearest, most suitable facility. As reported on bbc.in/39AJOgA, “founder Sesinam Dagadu says the system is so easy his grandmother can use it.”

Our SnooCODE RED Development Partners gain the SnooCODE RED emergency medical services product at-cost and open-source. They are all able to benefit from modifications or updates made to the system by any member. As an example, members in countries from Gambia to South Africa will benefit from the developments we are making to the system with the Embassy of Switzerland in Ghana. The public in all member countries will thus be able to call the Ambulance and be advised for instance that there is an available 1st responder just 3km away – or that the patient will be transported to Hospital 2 instead of Hospital 1 because the echocardiogram machine in Hospital 1 is broken down, one scenario that is unfortunately not uncommon in our part of the world.

Upon completion of our Project HEAL, we plan to publish white papers about topics like the pre-clinical patient journey, some of which will be freely accessible to the public.

In the developing world, even planned communities lack recognised street and home addresses, so it’s unsettling to imagine how an infected slum resident’s contacts can be traced and given medical attention to manage epidemic spread.

SnooCODE is democratising access to emergency and public health services by enabling people of all backgrounds, including women, youth and people living with disabilities, to have a memorable, easy-to-use address. Not only do they get a unique, offline address that powers digital transactions, but they can also enjoy the aspirational element of beautiful address plaques to adorn their shelter, advertise their workplace and confirm their location for the Ambulance.

In 2017, only 44% of the measles campaigns and 31% of mass drug administration for Neglected Tropical Diseases conducted reached intended coverage targets (Bill & Melinda Gates foundation, 2019). The impact of these campaigns is found to be lessened by poor infrastructure, logistics and staff compliance (Ghana Ministry of Health, 2015). With SnooCODE RED allowing health workers to easily locate their cases, optimise their routes to these cases, and verify their service delivery, uptake can be maximised, high-risk populations will be better identified, mapped out and reached, and campaign resources will be efficiently utilised.

We are working with a database of 110 ambulance services across 23 different African countries, to engage and onboard these services into our SnooCODE RED Development Partners community.

The total population of direct beneficiaries in these countries is about 260 million citizens (assuming 30% penetration), while this addressable market is worth about USD320,000. We arrive at these figures from our emergency medical services database, in addition to a sample of top international development organisations on the continent. (The SnooCODE RED suite can include products for disaster response and resilience. We are currently part of a multidisciplinary team of researchers that won seed funding from a Royal Academy of Engineering symposium last year. Our project will establish new technologies (including SnooCODE), and participatory approaches to disaster resilience.)

In terms of Global Health, the COVID-19 pandemic continues to disrupt public health systems around the world. With often over-stretched personnel, the market for our products to improve efficiency develops further. 

In our recent partnership with the Embassy of Switzerland in Ghana, we receive not only funding but also an agreement to promote/distribute the resulting innovation among their embassy network. We look to scale up using this model with our other partners.

To monitor and evaluate impact, we first run simulated trials to measure the difference in response times for conventional ambulances and SnooCODE-enabled ambulances.

In trials with Ghana’s National Ambulance Service, we helped improve response times by up to 56%. This was done by having teams using SnooCODE to describe a location to EMTs versus other people using the traditional directions to a different but equivalent set of EMTs. The experiments were carried out in both Accra and Kumasi, the most populous cities in Ghana.

Moving forward, we will monitor national ambulance records to measure changes in number of emergency calls.

We will continue to track new SnooCODE downloads by the public for visibility on the number and growth in users.

All ambulance data will be monitored and evaluated together with our emergency medical service partners in the different countries of implementation.

These are our success indicators:

- Emergency response times reduced by at least 40%;

- Patronage of ambulance service (as opposed to common practice of using taxis and private cars) increased by at least 15%

- Two or more different emergency services per country using SnooCODE RED in emergency response

- SnooCODE users increased by at least 30%.

From our dialogue with different African emergency medical services, we realise most services struggle to invest in good quality mobile devices. They manage the resources they have with a quiet pride and focus on saving lives amid non-conducive conditions like bad network connectivity. They are eager to improve their operations with our robust technology but are unsure about how to fund effective activations and other public education campaign efforts to onboard the citizens they serve on downloading the free SnooCODE app and generating their home (and workplace) code before there’s ever an emergency.

In terms of our own funding, there is also the challenge of a much smaller pool of VC cash in Africa, and the risk perception is so high that it is almost impossible to raise any capital even at our very conservative valuation of $42.88 million.

We therefore pursue Challenges such as The Trinity Challenge to showcase and convert our class-leading technology into real value for populations all over Africa and other regions.

Royal Academy of Engineering

UNICEF

Agence Française de Développement

Delegation of German Industry & Commerce in Ghana (AHK)

Embassy of Switzerland in Ghana

Emergency Medicine Society of Ghana

Emergency Medicine Kenya Foundation

Namibia Private Ambulance Services

Benka Life Ambulance (Cameroon)

With £2million from The Trinity Challenge, we can overcome the barrier of inadequately resourced emergency medical service (EMS) operations. We would be able to support EMS in 3 African countries with quality mobile devices and a subsidized budget for public education to improve their communication and logistics for better patient outcomes. We would also be able to provide address plaques for their clients, with a focus on underprivileged populations. These plaques, with their RFID integration, would be the bedrock for collecting and analysing data on response times (together with the SnooCODE RED Control Centre), facilitating monitoring and evaluation.