How ambulance shortage deepens inequality in care in slums

Poor response to emergencies has caused many Kenyans to miss out on vital lifesaving services.

In the country, the services are largely fragmented, underfunded, and inefficient, with medical ambulance response times, for instance, often ranging from 20 to 60 minutes, far exceeding the 15 to 20 minute national policy standard.

On average, one ambulance serves 100,000 people. In some underserved areas like Nairobi’s slums, one unit serves 250,000. The World Health Organisation(WHO) recommends one ambulance for every 50,000 people.

The medical emergency response sector is also battling other challenges, including lack of a unified, toll-free national dispatch system, a majority of ambulances are non-functional and there are severe shortages of trained personnel.

The cost of hiring an ambulance is also a challenge to many, especially those who may not be able to afford medical insurance coverage that comes with evacuation and ambulance services.

So bad is the situation that, recently, the national government signed an Emergency Medical Care (EMC) agreement with the counties to decentralise and strengthen emergency response services across the country, aligned with the Kenya Emergency Medical Care Policy 2020–2030. 

It is for such reasons and others that AURA was co-founded in South Africa in 2017 by Warren Myers, Ryan Green and Adam Pantanowitz.

Despite being founded in South Africa out of necessity due to high insecurity and crime levels in its major cities, the platform has found its usage in Kenya.

As per the name, officials say the service will be bringing out that aura or flair when it comes to providing technological solutions to address emergency responses.

The AURA app, which is a smart, on-demand emergency response marketplace and available on Appstore and Playstore, connects responders to real-time alerts, accurate GPS locations and clear workflows to support faster, safer emergency response across the country.

“AURA is a business to business to customer (B2B2C) platform that allows users to get connected to a network of responders, emergency service providers in case of an emergency,” said Victor Odera, the head of operations at AURA in Kenya.

“In our network, we have aggregated service providers across three different emergency sectors, including security, medical and roadside for Kenyans to access to emergency services,” Odera added.

The company, he said, sits in the middle of this three-legged kind of ecosystem, whereby, on one side, they have demand through the business-to-business (B2B) partners who then give their services to their users, who can be employees or clients and then, on the other side, they have a response network.

The response network includes emergency response companies such as St John's Ambulance,  AAR and security companies like KK Security (now Garda World), BM Security, Radar, Riley Falcon 911, among others.

“What makes us unique is not only the technology, but also aggregating the service providers. We work with all these different service providers in our network. That way, we can reduce response times,” Odera explained.

“For medical cases in Nairobi, we are looking at some 10 to 15 minutes response times on ambulances, and 10 minutes for security response as opposed to the one to two hours on the conventional ambulances,” he added.

On security, the App team respond to any situation that exposes a client’s life to danger.

“It could be a situation where you are seeing goons coming and that your life is in danger basically. That is what we categorise as a security case,” he said.

On the medical side, the App is vital in cases where one needs urgent medical intervention at home or at work due to sickness, an accident, a fall or a sprain.

Odera said the company would be able to send well-equipped ambulances to a client’s location.

“On the roadside, we are able to tow your truck and help you jumpstart your car. We are able to help you change your tire if you’re a lady and you don’t know what to do. We respond not only to accidents but also to mechanical issues,” he said.

The official, however, clarified that being a B2B business model, an individual cannot use the service unless they are onboarded through a company, which can an employer or a frequent service provider like a bank or insurer, through white labelling as they sit at the back and power the operations.

In mobile apps, white labelling is the practice of purchasing a pre-built, third-party app framework and rebranding it with your own logos, colours and, in some cases, features.

Odera says AURA leverages on businesses because they give them networks to be able to make the net cost per user to as little as possible while looking at distribution in scale or volumes of the businesses.

Some of the businesses that AURA currently works with include Uber, ICEA Lion Group, Sanlam Allianz, Old Mutual and Greenwheels, such that if their client interacts with the product, they will do so as ICEA Lion Group and not as AURA.

The above companies can decide to give their customer a value-added service (VAS), which is a charged or free non-core, supplementary features that enhance a primary product or service to increase customer value, satisfaction and loyalty.

“Essentially, what these businesses will do for Uber for instance, is give you access to these emergency services should you be in and within their ecosystem,” he said.

A company management could give employees access to any of the three-emergency response services as an employee benefit.

Currently, Odera said, the company covers about 70 per cent of the major urban areas in Kenya on full technology, meaning they have equipped devices on the response vehicles.