Affordable Ambulances in Rural Nigeria & Africa

According to WHO, there is 1 ambulance to 289,000 Nigerians. This data does little justice to the people in rural Nigeria where a recent research by the Nigerian Ministry of Health confirmed there is zero availability of ambulances in over 80% of rural Nigeria. Families who live in rural Nigeria and sub-Saharan Africa are some of the most deprived strands in the world when it comes to quality of life, especially in area of EMS: emergency medical service. In rural communities of Northern Nigeria, donkeys are been used for EMS transportation. Southern Nigeria is far worse; the people depend on athletic young men whom they call "carriers" who lift pregnant women, children and the sick on their backs while trekking stretch of miles to a hospital. In a time when Nigerian is has the world highest cases of Antenatal Risk; when the nation is facing its worst security crisis, which is characterized by open internal conflict between government and opposition groups, high crime rates, GBV, increasing food insecurity and high malnutrition rates, plus the ravaging and mutating Covid-19 virus as well as continous clashes between herdsmen and farmers over farmlands, ambulance services are presently in high demand. Having timely access to a well-equipped ambulance or low-end ambulance alternative called ACVs: Ambulance-Converted-Vehicles (that can be effectively, safely and partly used as ambulances during emergencies in rural communities) remain a crucial factor in emergency situations where every second counts. An ambulance service, or ACV and emergency medical supplies delivery is now a necessary asset to every community and RHASE is leveraging this growing demand to ensure our service is available for the poorest, hardest to reach communities and every single Nigerian.

RHASE which stands for Rural Health & Ambulance Service Enterprise is a health-logistic company that uses low technology such as “voice calls, USSD Codes, toll free emergency numbers and text messages” plus hi-tech such as AI, Blockchain and Machine Learning to facilitate low and high-end EMS and ambulance services to rural, peri-urban and hard to reach communities in Nigerians. The RHASE emergency center which functions 24/7 can be reached through over 10 channels (calls, text, USSD codes, instant messaging, Android & IOS app, plus others) to connect customers to aggregated on-demand ambulance, ACV or medical delivery service. During medical emergencies, our Emergency Center will instantly deploy either a reliable, safe and efficient low-end ambulance called “ACV” Ambulance-Converted-Vehicles” or standard ambulance. The RHASE emergency center will guide the ambulance driver using either Google Map, or the “RHASE-GIS AI” for locations that are entirely not on Google map to get the ambulance or medical supplies to the destination safe and fast.

As a former ambulance driver and manager for the public Hospital in Ifo, a community of over 1,000,000 residents in Ogun, Nigeria, daily, my office received 10 to 30 emergency calls but we could only attend to mostly 2 or 3 while neglecting the rest. The entire Ifo has just one functional ambulance shared by 5 clinics. The ambulance broke down at peak of the Covid-19 pandemic due to the community bad roads and hasn't been replaced to date. Ifo typical of any rural Nigerian settlement is highly disorganized and remote, and with road networks that are impossible to use during rainy seasons. Mostly, the people depended SOLELY on lifting pregnant women and the sick on their back and walking long miles before getting them to the hospital. Most of the patients are dead before even arriving in the hospital, and there seems to be no hope in tackling maternal mortality and children's death due to lack of EMS and reliable ambulance systems. RHASE is focusing more on rural communities, rural women and families and with greater attention on pregnant women in our quest to reduce and eliminate needless deaths. Our targets are low-income earners which is why we introduced the ACV: Ambulance-Converted-Vehicles, which are low-end ambulances with semi-paramedic partners.

The co-founders of RHASE are from the paramedic, EMT, EMS, Management and IT background. We have worked for over 5 years in rural communities and understand the great challenges regarding EMT during emergencies within these communities. We have great experience in creating a centralized EMS platform, which brings health-logistic to some of the hardest to reach communities in rural Nigeria and every part of the country. We pioneered the first ever world ACV systems. ACV are clean and reliable vehicles with trained semi-paramedic who provide essential intervention during the peak of Covid-19 by providing crucial health pick-ups and evacuation in rural and hard to reach communities while delivering vaccines, health kits and other materials to the people.

Solve will be a networking opportunity for me to learn from some of the best minds in the world and gain greater knowledge. I intend to develop lasting relationship with the organizers and the participants. It will be bring me close to accomplished mentors, business leaders and aspiring young change makers like myself. It will provide me with immense exposure to my project and give me new data, information and skills which I can use in tackling EMS challenges in my community, Nigeria and sub-Saharan Africa at large. It will definitely help me Clarify my Ambition. I believe by the end of the program, I will have stronger vision of the career and experiences I wanted to have. Solve will provide me with Hands-On Experience since I will be working one-on-one with world-class mentors and it will provide the opportunity to dive deep into the work they are doing. In exchange, I will learn more by teaching and broadening my horizons. Finally, it will also help me Sharpen my Professional Skills and make maximum impact within my field.

RHASE combines several features in its quest to provide EMS and EMT for underserved communities by providing the following solutions which can serve different people anywhere, anytime and anyday:

1. The RHASE Mobile Application: which connects customers to every single ambulances and ACV agents within Nigeria is available for free and requires no fees by users who only pay after using it for a health trip.
2. RHASE USSD Codes: A short code service that allows any type of phone to send us emergency and connect with ambulances. This gives access to millions of Nigerians using non-data enabled phones.
3. RHASE Emergency Numbers: we have over 10 toll-free numbers that can be called, texted, messaged via whatapps, telegram and signal. 
4. RHASE GIS AI: guides rural drivers in locations not covered by Google Map to connect to nearest hospitals (e.g., after heavy rain fall, the app can predict the roads is safe and alternatives)
5. RHASE-Alerts: are reminder service sent to designated customers and their hospitals regarding pick-up schedule.
6. RHASE Ambulances & ACVs Network: Ambulance-Converted-Vehicle Network. RHASE created the 1st ever ACV Network in the world to build a volunteer and flexible ambulance service that uses rural vehicles and trained semi-paramedic drivers. Presently, there are over 5,000 ACV agents using our platform.
RHASE charges service fee of 20% for every health pick-up or health supplies delivery initiated through our platform. Charges are different depending on different factors: time, terrain, and quality of service. For a rural pregnant woman, RHASE is Tech Company that connects her to ambulances or low-standard ambulances called ACVs which are available in rural communities; the benefits of RHASE include risk reduction in maternal mortality, online and offline mobile emergency services for rural communities to tackle any medical emergency, connection to ACVs, ambulances, local dispatcher who delivers her to the closest medical facility, timely intervention and rescue during pregnancy emergencies and scheduling maternity visitation reminder, centralized EMS systems and medical items delivery within rural and urban Nigeria, data acquisition system to help doctors with patients past emergency records and provision of jobs for rural drivers whose vehicles can also serve as ACV: ambulance-converted-vehicles while the service costs for a trip to her healthcare provider within 1 kilometer might cost €5. Presently, our innovation is the first of its type in Nigeria, and offers a centralized platform which makes it easy for us to even work and earn from competitors. 
Therefore, considering the scenario with innovation and another without it—this price is sustainable as long as the organization is capable of sustaining a positive cash flow and the country inflation is manageable. Therefore, there will be no likely sharp change in price in the future. 

Presently, over 15,000 customers use our platforms which include rural, peri-urban, and urban women, families and individuals. We also have hospitals such as New Merit, AfriMed, and 122 hospitals using our app, including or shortcode services. We presently have hundreds of ambulances and ACV partners signed up on our platform using it daily. In the next 5 years, we are positive of surpassing 1,000,000 subscribers, inclusive patients, ambulance drivers and ACV agents as well as hospitals, health insurance companies and other secondary customers by years 2027.

(i) Growing by Data: we will get our customers and project communities, participants and stakeholders feedback to improve our business and create recommended improvements

(ii) Creation of new market segments: we understand the importance of innovation, and are constantly working, improving to enter new market and create more refined and acceptable products (e.g. we are planning of building collaboration with the FAAN: (Federal Airports Authority of Nigeria) to contact aircraft owners so they can join our platform to provide executive and premium airborne medvac to influential customers.

(iii) Create network: we will continue to maintain an active community and customer group network through Whatapps group chat, emails, social media and events to offer updated information about our organization, future projects and products.

(iv) Grow Customer Base through Referrals: and rewarding new customers discounts through free perks

(v) Training our staff and employing more professionals to take the organization to newer customers and increase sales and effectiveness.

(vi) Have more rural, regional and urban presence through networking with rural vendors

(vii) Create a payment plan that will allow more rural women, pregnant women and other customers become fully subscribed customers within 6 months.

(viii) Fire our Sales & Marketing Engine on Multiple Cylinders: through showcasing why our innovation is essential to target communities and customers

Our impact would be measured using health and economic KPI to track the benefits provided by our innovation

(i) Health Care KPI: Online and offline mobile emergency services for rural communities to tackle the pandemic and other health challenges

(ii)Health Care KPI: Connects urban, rural and peri-urban families ambulances, local dispatcher and ACV: Ambulance-Converted-Vehicle drivers who delivers them to the closest medical facility

(iii) Health Care KPI: Timely intervention and rescue during pregnancy emergencies and scheduling maternity visitation reminder for pregnant women and their primary health care provider

(iv) Health Care KPI: provision of health data and information for future uses

(v) Health Care KPI: Data acquisition system to help doctors with patients past emergency records

(vi) Health Care KPI: Centralized EMS systems and medical items delivery within rural and urban Nigeria

(vi) Economic KPI: Creating equality for urban and rural families

(vii) Economic KPI: provision of jobs for rural drivers whose vehicles can also serve as ACV: ambulance-converted-vehicles

While the SDGs we are accomplishing include:

Goal 3: Ensure healthy lives and promote well-being for all at all ages 

Goal 5: Achieve gender equality and empower all women and girls 

Goal 10: Reduce inequality within and among countries 

Goal 12: Ensure sustainable consumption and production patterns 

Goal 13: Take urgent action to combat climate change and its impacts

THEORY OF CHANGE:

Ultimate Outcome: Connect anyone anywhere in Nigeria to Ambulances & ACV also called Rural Health Logistic services using low and hi-tech devices.

Intermediate Outcome: Enhanced collaboration with collaboration between Ambulance Companies, Certified ACV agents, Hospitals, Health Insurances and other secondary customers with primary end users e.g. pregnant women, nursing mothers, families, rural, peri-urban and urban communities through our digital platforms

Short Term Goals: (i) Increase our product & service's market share (ii) Grow and train our team members & retain talents (iii) Create new market segments – penetrate urban communities by creating improved products (iv) Fire our Sales & Marketing Engine on Multiple Cylinders                more rural, regional and urban visibility through 3-tier marketing approach (v) Create a financial system to allow more rural women to own our products

Activities: (i) R&D and Data Collection/Analysis (ii) App & Digital Platform Upgrades (iii) Have over 10,000 subscribers monthly (iii) Space, Equipment & Materials Procurement (iv) Approvals, Legal and other Fees For Patent (v) Marketing, Advertising & Promotions (vi) Staff Training / Hiring & Retention

Output:  (i) Use direct marketing approaches, i.e. banners, flyers, radio, plus social media and digital marketing (ii) Strengthen awareness about the importance of RHASE services, EMS, EMT in rural communities (iii) Build solid relationship with secondary customers (hospitals, Ambulance Companies, ACV drivers, health insurances, etc) & develop capacity for participatory roles for rural women (e.g., rural nurses, midwives, and others) in EMS and prevention of ante-natal risks and unnecessary deaths through our innovation (iv) Create a financial system to allow more rural women to use our services (e.g., pregnant women can save ahead for health-pick-up for ante-natal consultation etc)

Enabling Outcomes: (i) Availability of ambulances or alternatives during emergencies anywhere in Nigeria and sub-Saharan Africa at large (ii) Mitigation against preventable death through provision of EMT (iii) Access to timely and quality health services (iv) Centralization of health care systems (hospitals and health logistics) (v) easier medical deliveries in hardest to reach rural clinics and etc.

RHASE combines several features in its quest to provide EMS and EMT for underserved communities by providing the following solutions which can serve different people anywhere, anytime and any day:

1. The RHASE Mobile Application: which connects customers to every single ambulances and ACV agents within Nigeria is available for free and requires no fees by users who only pay after using it for a health trip.
2. RHASE USSD Codes: A short code service that allows any type of phone to send us emergency and connect with ambulances without using the internet. This gives access to millions of Nigerians using non-data enabled phones or for people living in off-grid communities.
3. RHASE Emergency Numbers: we have over 10 toll-free numbers that can be called, texted, messaged via whatapps, telegram and signal.
4. RHASE GIS AI: guides rural drivers in locations not covered by Google Map to connect to nearest hospitals (e.g., after heavy rain fall, the app can predict which roads is safer and faster)
5. RHASE-Alerts: are reminder service sent to designated customers and their hospitals regarding pick-up schedule.
6. RHASE Ambulances & ACVs Network: Ambulance-Converted-Vehicle Network. RHASE created the 1st ever ACV Network in the world to build a volunteer and flexible ambulance service that uses standard rural vehicles and trained semi-paramedic drivers. Presently, there are over 500 ACV agents using our platform.

Since women and children are the greatest victims of lack of EMS, the founders of RHASE believe girls/women must play key roles in creating more health-conscious communities. Therefore, rural women, families and communities in remote communities remain RHASE's core targets. 

RHASE is a women-centered organization; its activities are centered on providing health-logistics or its alternative to protect rural women who are majorly the victims of zero EMS in rural Nigeria and Africa at large. Also, RHASE annually provide health education by training to 100 rural midwives and ACV partners on how to use our innovations, while working with rural financial institutions to ensure rural women can easily save ahead to pay for health pick-up, or to get medical supplies delivered to them in their community, no matter its extreme location and no matter the emergency. 
In 2022, we signed an agreement with 3 community savers groups to allow women savers group to easily use our services during emergencies. We are focused on underserved communities without any concern about their ideologies, faith, culture or ethnicities.
RHASE is founded by 2 women and two young men who shared similar concerns regarding the growing cases of post-natal deaths and infant mortality in rural Nigeria. According to Remilekun, one of the co-founders: "I had in the past watched dozens of villagers died in my village during emergencies. After going to the city, and witnessing the same scenario, I realized some had to do something, and I was excited when I realized we could actually create a business that could truly save lives."
Since the co-founders had similar childhood background, and had lost siblings, families and loved ones in the past, they are united in their quest to creating an innovation that can create a “Zero-Death” consciousness through provision of EMS and EMT during emergencies.

Business Model: Key Resources: Digital Platforms: Cloud, BlockChain, AI & Others - Trained ACV Agents - Registered Ambulance Drivers - Network of hospitals, and medical workers & facilities - Software and analytics -- Website  - Insurance companies and funding 

Partners and Key Stakeholders: Rural Women Associations -- Medical Workers -- Hospitals -- Telecommunication Companies -- IT Firms -- Ambulance Drivers  -- Medical Association and others.

Key Activities: Centralized System Platform - RHASE App Front-end & Back-End Supports - Software Design & Development - Partners Training  - Marketing
- Operations  - Outreach Programs -Health Awareness Project
Type of Intervention: Rural Health & Ambulance Service Enterprise is a health-logistic company that uses data, low technology such as “short codes, toll free emergency numbers and text messages to facilitate EMS services
Channels: -direct marketing -referrals -community and rural women associations - community speeches, conferences & workshops - Social media - Word of mouth - Website - digital marketing - midwives association - hospitals - health workers, etc
Segments: Primary Target Customers: rural, urban, peri-urban pregnant women, children, families, elderly, and people of every age.
Secondary Target Customers: ambulance drivers, rural vehicle owners (registered ACV Agents), logistic companies, mid-wives, rural health workers, hospitals, insurance companies, diagnostic centers, medical labs, pharmacies, patients and telecommunication companies..
Value Proposition: Online and offline mobile emergency services for rural communities -- Connects urban, rural and peri-urban families ambulances, local dispatcher and ACV: Ambulance-Converted-Vehicle drivers --Timely intervention and rescue during pregnancy emergencies and scheduling maternity visitation -- provision of health data and information for future uses-- Data acquisition system to help patients -- Centralized EMS systems -- Creating equality for urban and rural families--  provision of jobs for rural drivers whose vehicles can also serve as ACV
Impacts: 
Promotion of economic, health and improve life style benefits.
Our service will ensure the protection of lives during emergency and protect those who are direly in need of intervention even if they are in extremely hard reach communities.
KPIs: (i) Health Care KPI: Online and offline mobile emergency services for rural communities to tackle the pandemic and other health challenges(ii)Health Care KPI: Connects urban, rural and peri-urban families ambulances, local dispatcher and ACV: Ambulance-Converted-Vehicle drivers who delivers them to the closest medical facility (vi) Health Care KPI: Centralized EMS systems and medical items delivery within rural and urban Nigeria
(vi) Economic KPI: Creating equality for urban and rural families
Revenue Model/Cost Structure: (i) 20% for every health pick-up or health supplies delivery initiated through our platform.  (ii) We charge separate prices for ACV, Basic and Premium services  (iii) Subscription fees: Hospital, ambulance and health company owners subscribe annually to our platform. (iv) We charge per hour depending on the situation (emergency or non-emergency). (v) There are extra charges for First Aid services, paramedic, mileage, additional care, terrain, night and weekend services and others.

(i) Growing by Data: we will get our customers and project communities, participants and stakeholders feedback to improve our business and create recommended improvements

(ii) Creation of new market segments: we understand the importance of innovation, and are constantly working, improving to enter new market and create more refined and acceptable products (e.g. we are planning of building collaboration with the FAAN: (Federal Airports Authority of Nigeria) to contact aircraft owners so they can join our platform to provide executive and premium airborne medvac to influential customers.

(iii) Create network: we will continue to maintain an active community and customer group network through Whatapps group chat, emails, social media and events to offer updated information about our organization, future projects and products.

(iv) Grow Customer Base through Referrals: and rewarding new customers discounts through free perks

(v) Training our staff and employing more professionals to take the organization to newer customers and increase sales and effectiveness.

(vi) Have more rural, regional and urban presence through networking with rural vendors

(vii) Create a payment plan that will allow more rural women, pregnant women and other customers become fully subscribed customers within 6 months.

(viii) Fire our Sales & Marketing Engine on Multiple Cylinders: through showcasing why our innovation is essential to target communities and customers

(i) We charge service fee of 15% for every health pick-up or health supplies delivery initiated through our platform. 
(ii) We charge separate prices for: 
(a) ACV service 
(b) Basic Ambulances
(c) Standard Ambulance 
(d) and Premium Ambulances services
(iii) Hospital, ambulance and health company owners subscribe annually to our platform. ($19)
(iv) We charge per hour depending on the situation (emergency or non-emergency).
(v) There are extra charges for First Aid services, paramedic, mileage, additional care, terrain, night and weekend services and others. 
(vii) We also charge for premium services that cover Basic Life Support (emergency or nonemergency), Advance Life Support, Advanced Cardiac Life Support (ACLS) and Advanced Trauma Life Support (ATLS) and Specialty Care Transport" 

We have received grants from RUFORUM: Regional Universities Forum, Oracle and technical assistance from Ashoka Change Maker and are presently expecting committed grants from the Queens University, Canada & Jim Leech Foundation plus the MasterCard Foundation.