Liza Kimbo is Director of the South Lake Medical Centre in Kenya, having had a decades-long career as a healthcare services leader and entrepreneur with an interest in improving access to quality healthcare for low-income groups. Liza has started three social healthcare enterprises in Kenya using both for-profit and non-profit models; one of these is CFWshops, a network of medical clinics and micro-pharmacies providing access to essential healthcare across Kenya. Now, South Lake Medical Centre is seeking to provide increased access to medical expertise by using Proximie.
I’ve been working in public health for about 25 years now, looking to improve primary healthcare access for underserved populations in both rural and urban areas of Kenya.
My career started in banking, but I moved into healthcare when I collaborated with a philanthropist to set up CFWshops — a network of medical clinics that we designed to tackle the geographical difficulties around accessing medication.
Distance from healthcare can be a major problem for rural communities; not only do they have to pay more for healthcare in terms of travel costs, but the time spent travelling is also an issue. Then there are the search costs — when you finally find a facility, will it be the right sort of facility for the care that you need, or will you need to spend more time and money looking for another facility with the necessary means and healthcare professionals to treat you?
Four years ago, I started running the South Lake Medical Centre (SLMC). It’s a small rural hospital, approximately 15km from the large public health facilities that tend to be in urban centres. Our 50,0000-strong community is primarily made up of minimum wage workers employed at the flower farms, many of whom move here looking for jobs on either a full-time or seasonal basis.
Along with distance and cost, one of the main obstacles to accessing healthcare in Kenya is that there are too few doctors and even fewer specialists. If, for example, a woman is diagnosed as having a high-risk pregnancy, she is likely to have great difficulty not only in finding a facility that is equipped to provide her with the kind of care she needs, but also in accessing a specialist who has the expertise required to provide optimal care.
“At SLMC, we have been exploring technology and its capacity to bring healthcare professionals closer to patients, and — better yet — to access specialist expertise which would have previously been out of reach.”
We had to find a solution because we were referring an average of three women with high-risk pregnancies per week, and we knew we needed to address this through providing surgical services. We sought and obtained funding for a new surgical unit which we began work on, but still the challenge remained of how we were going to obtain specialists to provide this type of care. We had a medical officer who could perform C-sections, but we knew that once we had a surgical unit, other emergency cases would be brought to us as well. In the entire Naivasha area where we’re located, there are just two OB-GYN specialists for a population of 150,000, and they’re at a public facility where understandably they’re extremely busy. How would we be able to gain access to such expertise?
We were discussing this challenge at an SLMC board meeting when one of our board members mentioned Proximie and put us in contact with them. We began our conversations with Proximie just as the COVID pandemic was taking hold and lockdowns started occurring across the globe; all of a sudden even the few specialists we thought we had access to were having difficulty travelling, so we had discovered this technology at a very opportune, emergent moment. We hadn’t realised that we were looking for a technological tool, but it turned out Proximie was exactly what we needed: a solution to the problem of specialists not being able to travel physically, that instead provides us with access to a number of specialists who are able to remotely support the SLMC medical officer. It seemed like the perfect solution: having a system in place that enables us to quickly find out who is available — wherever they might be — and then immediately benefit from their guidance whenever we need it.
Now that we are testing and rolling out Proximie, the feedback we are getting shows there is a lot of excitement about the possibilities it opens up — while also being realistic about the infrastructure challenges we face in Kenya, such as lack of internet coverage in rural areas and the frequency of power outages. Regardless, the medical officers that have used the Proximie platform have said it has the potential to be a game-changer.
For my part, I’m especially excited about the opportunity to use Proximie for training and simulations. In even more remote areas, telemedicine raises the possibility of our medical officer, for example, being able to support a nurse at a smaller clinic such as those we established with CFWshops. Then there’s the potential of using the technology for consultations and diagnostics — so if a woman may be having a risky pregnancy, the consultations could be carried out without her having to travel, and she can be much better prepared for delivery without having to go back and forth between various facilities beforehand. Finally, there is the possibility of broadening our application of Proximie to help carry out other kinds of surgeries, and to access a wide variety of expertise much more quickly; we often find that people in remote communities tend to postpone seeking medical help, and once they finally do time can be of the essence.
“Telemedicine could be transformational for Africa, because technologies like Proximie enable us to leapfrog a number of challenges in our healthcare systems.”
If we don’t have access to a certain type of healthcare professional, we don’t necessarily need to continue trying to obtain them because we are gaining access to a global pool of expertise. When I first learned about Proximie, my mind immediately leapt to the idea of a doctor in New York providing medical support to a nurse in rural Africa. It’s a transformative technology, and my hope is that when it comes to health insurance and health financing programmes, solutions like Proximie will be able to transcend borders; maybe if you can access your clientele from anywhere in the world, there will be better insurance packages and health financing for patients. I believe there are going to be huge global opportunities.
