Treating every emergency with urgency - Emergency Response Africa

Emergency Response Africa is changing the way medical emergencies are managed across Africa, beginning in Nigeria. By connecting emergency victims to our network of First Responders, emergency vehicles, and hospitals using technology, we guarantee fast, reliable response at the scene and transportation to the most appropriate hospital for end-to-end care.

Folake Owodunni, CEO

Every year, more than 200,000 people in Nigeria die from road accidents, birth complications and cardiovascular diseases - just 3 of the top causes of emergencies. Across Africa, this number is in millions. Many of these deaths can be prevented with access to an effective emergency system. Unfortunately, just 9% of Africans are covered by any formal EMS system. Governments struggle to acquire, staff, and maintain ambulances at scale and lack the communications infrastructure to coordinate an effective system. In Nigeria, 1 ambulance serves nearly 191,000 people (compared to 1:11,000 in developed countries). Ambulances take 1 hour+ to arrive and a single ride costs 1.5x an average wage earner's monthly salary. Emergency victims are often left to get themselves to a hospital, yet have no guarantee of treatment because the hospital may not be suited to their emergency. These severe delays lead to unnecessary death and disability. The COVID-19 pandemic has further worsened the situation as people are less likely to seek proper attention due to fear of COVID, even in an emergency. We saw an opportunity to use technology to effectively coordinate a community-based emergency response and leverage data to predict and prevent future emergencies.

Although medical emergencies can affect anyone, we have identified the following as key audiences to serve:

• Middle-aged and older adults managing chronic conditions (high blood pressure, diabetes, respiratory illnesses, heart disease) totaling about 48 million people
• Pregnant and nursing mothers, families with young children, propelled by one of the highest fertility rates in the world at 5.4 children per woman
• Corporate organizations or associations engaged in high-risk industries e.g. logistics, construction, manufacturing. With its poor occupational health and safety record, Nigeria has very high rates of workplace accidents yet few companies can afford an onsite clinic, making fast, reliable emergency services a needed solution.

We have partnerships with healthcare organizations supporting individuals living with chronic conditions, enabling us to better understand their needs and risks of emergency incidents. We recently launched our new mom community with a group of pregnant mothers across Nigeria, supporting them and their babies by answering pertinent health questions. By providing our services as a subscription, we can build a customer database that not only help to save lives when an emergency occurs, but helps prevent  emergencies using data. By providing care at the emergency scene, we also reduce emergency room visits and ultimately healthcare costs.

Our solution increases public health knowledge on the prevention and management of medical emergencies through the content we create and disseminate on various channels. We have already hosted several free webinars, radio programs, and a WhatsApp-based community to educate and inform the public about health topics that increase their risk of having a medical emergency. To better reach lower-income populations often at higher risk of the medical, financial and social impacts of poorly managed emergencies, we established a content partnership with KaiOS Technologies - a mobile operating system developer and one of the fastest-growing distributors of low-cost smart feature phones. This partnership allows us to distribute free healthcare content through their Life App, targeted at first-time internet users.

We have also hosted medical education webinars for healthcare professionals in partnership with other healthcare organizations, contributing to their knowledge and quality care delivery.

The data generated by our services will also be leveraged to improve emergency response at national levels and therefore health outcomes. We are actively engaged with the Nigerian government to contribute data in support of emergency preparedness and response and support the development of relevant policies on emergency medical services.

Our solution has potential to contribute significantly to Africa achieving SDG 3 - Good health and wellbeing. Specifically:

Target 3.1, 3.2 - Reduce maternal and child mortality. Pregnant mothers and families with young children more frequently require emergency care. In fact, ERA was founded because of our founder's experience needing emergency care for her child. Research shows that 1 in 3 emergency room visits can be addressed by prehospital care, so we will impact this population by saving lives and reducing healthcare costs - a benefit also to healthcare payers like government and insurance.  Our new mom community is already providing a platform for that impact.

Target 3.4 - The growing prevalence of non-communicable diseases are translating to higher rates of emergencies. Our current pilot has already saved the life of a diabetic/hypertensive patient through fast treatment on scene and transport to hospital. Through data analytics of pre existing conditions and behaviours monitored through regular health checks, we can also help patients predict and prevent emergencies.

Finally, our solution also impacts the healthcare system by providing access to training  and career opportunities for healthcare workers that would ordinarily leave Africa to practice elsewhere creating a virtuous cycle (https://www.ncbi.nlm.nih.gov/p...).

We are already changing the way medical emergencies are managed within our pilot area by replacing the guesswork of what to do in an emergency with a fast, reliable service.

Over the next 1 year, our goal is to have a network of at least 200 active First Responders and 50 emergency-ready hospitals in Lagos, enabling us to consistently achieve an under 10-minute response time. With a population of about 24 million people, Lagos experiences an estimated 100,000 medical emergency cases each year. Our network will be able to respond and save thousands of lives.

We are also already working to expand our First Responder and hospital footprint in at least 1 state in each of Nigeria's 6 geopolitical zones across Nigeria within the next 1 year. By having a command centre (hub) in each zone, we can expand our network of responders, vehicles and hospitals (spokes) to reach both urban and rural patients.

In three years, we expect to be entering two new African markets, starting with Ghana. Anecdotes suggest that Africa has about 100million emergencies per year. Our impact will be measured in millions of lives saved as we expand our reach.

We have identified the following as our some of our most important KPIs:

• Lives saved
• Response times
• Active First Responders in network
• Emergency-ready hospitals/Vehicles in network

Because we exist to save lives, lives saved will always be our core
measure of success and impact. We are glad to already be receiving testimonials from patients' families of the impact of our service on their love one's life. One estimate by a Minister of Health in Nigeria states that at scale, an emergency medical services solution like ours can save at least 100,000 lives per year, impacting millions more indirectly.

In addition to this, we measure several metrics that enable the lifesaving work - response times and growth of our network. During our pilot, our team has consistently reached incident scenes in an average of 20 minutes, 66% faster than average response times, and we know that this response time will continue to improve to reach our target of 10 minutes as we grow our first responder and hospital network. Investing in growing our network will be a key focus for us to ensure that we have the best resources available to our beneficiaries with a single request.

One of the key barriers for the success of our solution is the technical ability to automatically transmit location data to ERA's technology platform from an emergency patient or caller's device.

In the short term, we have found creative ways to enable emergency requests such as by setting up a toll-free line for calls and an emergency request mobile application that transmits location data when used (ideal for avid app users).

However, valuable seconds are wasted when the dispatcher is working to determine the location of an incident during a call and several circumstances can make it difficult for the patient to communicate. We believe several of the Trinity Challenge founding members and Solve's amazing community of partners are exactly the leverage we need to find a lasting technology-based solution to this problem for an emerging market like Nigeria.

The second key barrier is the operational cost associated with building the largest network of First Responders, emergency vehicles and hospitals. To ensure we attract the right partners, we will need to invest in the right growth and technical team. The funding from The Trinity Challenge will leapfrog our solution from a single pilot location to multiple markets in three years.

Japan International Cooperation Agency (JICA)

Accelerator Centre

United Hatzalah

University of Waterloo, Ontario (Conrad School of Entrepreneurship and Business)

KaiOS

Several private hospitals including: St. Mary’s Specialist Hospital, Idowu Specialist Hospital, Shoreman Medical Centre, Soteria Maternity Hospital, The Shepherd Medical Centre, County Hospital, Olan Comprehensive Healthcare Centre, Blue Cross Hospital

We are applying to The Trinity Challenge's because the focus on better preparing the world against health emergencies aligns closely with our solution's vision - an Africa where anyone can receive emergency medical care in 10 minutes or less. A funding and support relationship between The Trinity Challenge coalition and ERA can accelerate the achievement of both the coalition and ERA's visions. Specifically:

1. Access to funding will accelerate our timeline towards building Africa's largest network of emergency care. With this in place, coordinating a response to future public health emergencies is as simple as activating the network.
2. Access to the technical expertise of the coalition members will greatly enhance the capacity of our technology team, enabling us to solve problems quicker, better collect and analyze data, and create a suite of technology products that enable more effective response.
3. Access to the centuries of operational excellence demonstrated by the coalition members across many emerging markets will enable our operations and growth team take a huge vision and distill it into actionable, achievable milestones.

Few competitions and funding/acceleration opportunities align as closely with ERA as the Trinity Challenge and we would be honored to be selected as a finalist.

We are very interested in building relationships with technology, data analytics, insurance, and healthcare organizations, as well as government. Specifically:

• Organizations like Google, in collaboration with government, will be critical for helping us solve the issue of automatically transmitting location data from callers' devices to our technology platform. This will significantly reduce our response times by at least 2 minutes.
• Insurance and financial services organizations like Discovery and AXA will be valuable in expanding our network's reach to covered patients in new markets as the network grows. We will also contribute to their customer value proposition as a responsive provider.
• The data analytics capacity and health industry expertise in organizations like Institute for Health Metrics and Evaluation, McKinsey & Company, and University of Cambridge will enable ERA's solution to not only respond effectively to emergencies but leverage our growing dataset to better predict and prevent them.
• The Bill and Melinda Gates' Foundation's has years of experience working on various health issues across Africa, reaching the furthest parts of the continent with care. Their expertise in delivering high-impact well structured programs will be invaluable as we build our network of care.