Joaquim Choge is a busy man. He is a man on a mission to see that critical healthcare services such as ultrasound and x-ray are easily accessible and affordable to those in dire need of them.
We meet him as he heads to a local healthcare facility located about 20km from the Nairobi Central Business District. For him every second counts because sometimes that is what determines life and death
In Kenya, healthcare access is still out of reach for many, and if accessible, the cost is often prohibitive due to the fact that majority of the population still do not have health insurance.
Official statistics indicate that only 19% of Kenyans are covered by any form of health insurance. In poor households health insurance coverage is just 3% compared to 38% among the rich.
“When I was working, I realized that the patients were not involved in what was happening. So I thought what if the patient knows what is happening. If we were doing an ultrasound for example we are able to tell the patient this is what we are doing on this and this is what you can see. Even if the patient may really not understand, there is that feeling by the patient that I am included,” says Choge as we navigate the heavy traffic.
Choge is always on the move due to many calls he receives from various small healthcare facilities within Nairobi and its environs.
He says high mobile penetration rates in Kenya has been key in deepening mobile healthcare services such as Jionee Ultrasound Services established he established three years ago.
His services have been on high demand especially during the COVID-19 pandemic as orders surge due to many patients requiring x-ray at home as opposed to hospitals which are often full.
Due to restriction of movements which had been deployed by the government to contain the spread of the deadly respiratory disease, mobile x-ray services have become an alternative to many home-based patients.
“Restriction of movement has meant there are inbound home patients. There are facilities that have come up with Intensive Care Units just to try and solve the issue of COVID-19 and once they have set up their ICUs, they actually do not have x-rays and portable ultrasound equipment. So this has increased our demand and made the facilities that outsource the service from us to know us because with a patient in ICU we can actually deliver an x-ray for them whether the hospital has it or not, we can deliver from their bedside even when the patient is on oxygen,” said Choge.
According to the radiology expert, almost 60% of x-ray orders come from covid patients.
Making healthcare affordable
Currently Kenya has 62 million mobile subscribers representing a penetration rate of 130.3%. This high adoption on mobile technology has been key in making radiology services available even to those living in informal settlements.
“The product designed by Jionee focuses on three pillars of healthcare which is accessibility, affordability and accuracy of diagnosis on time. You realize that there are places which cannot access the service. Nobody is willing to invest in radiology centres in slums and that is what we have seen as a major issue. You go to a place like Kibera there is no radiology centre, all of them are in Upperhill or in town. Now there is this patent who seems to have been forgotten in the slum, so we go for them and try to solve the problem,” says Choge.
Currently an x-ray cost an average of Kshs. 2500, in the informal settlements that is at least 10 days of meals.
“Kshs. 2500 for someone in a slum is a piped dream. We try to make our prices affordable by charging at least Kshs. 1800 and we deliver at home. So the affordability is answered in a way that the patient will not have to spend on fare and among other expenses.”
Thirty minutes later, we arrive at the health clinic which ordered an x-ray service for a patient. Choge and his assistant are quickly ushered into the room.
The clinic ordered for a Magnetic Resonance Imaging (MRI) for a man who had been involved in an accident. Within three minutes, he completes the set up with this portable radiology equipment producing instant results for a local clinician to give further diagnosis.
“For a good treatment we always need to understand the cause. It is part of an investigation. So the service has been impactful because we need to understand the damages and everything about the patient,” says Esther, a clinician at the healthcare facility.
Cost and space are two major reason x-ray and ultrasound equipment are not available for such small health facilities. Esther, the clinician tells me how the mobile medicare solution has been key in patient diagnosis.
“It is really helpful and we really appreciate their services considering that we have not yet expanded to having such instruments in our facility. It is really helpful because it is fast and affordable to the clients. We have big hospitals around but considering the amount of time patients need to go and make queues, it makes it much faster for us to order for them to just bring the equipment here and do the tests.”
Choge hope such services will be critical in improving access in the country and reduce deaths related to accidents and child birth complications.