Computing Views of Kenya’s IT Culture Students, startups, and corporations pioneer mobile health applications in a mobile-saturated nation. by David Talbot February 21, 2012 Sponsored by Students fill the computer lab at Nairobi’s Strathmore University. Young Kenyans with code-writing and engineering chops are playing growing roles in providing IT infrastructure for health and other applications. Riyaz Bachani, CTO of the fast-growing Kenyan ISP Wananchi, told me: “Having grown through the system here and been exposed to the developing world, we actually see no reason why these things can’t be built—even at a better level, and a better scale—locally.” At the entrance of Nairobi’s Kibera slum, home to at least 170,000, Kenyans add money to their mobile phone accounts using M-Pesa, a service run by Safaricom. In a population of 41 million, 18 million people use phones for everyday financial transactions. Phones could easily be adapted for health-care payments and delivery of health information. In a Kibera shopping bazaar, a woman carries a baby past a vegetable stand. Even small vendors accept M-Pesa. For 70 Kenyan shillings—a little less than one U.S. dollar—this man in Kibera will sell you a new SIM card, the element within a mobile phone that contains information including the phone number and passwords. The first stop for anyone doing work or business in Nairobi’s Kibera slum is the office of the “chief” who will review your city permit. Kenya is a paperwork-loving civic and governmental culture, a vestige of its days as a British colony. Jackie Cheruiyot, program officer of Shimba Technologies, shows the Kibera chief her permit and gets the all-clear to set up a stand where she can show residents her app. Called MedAfrica, it offers contact lists of doctors and provides health information. At the Narok District Hospital, a government-run facility west of Nairobi, Steve Mutinda Kyalo, CEO of Shimba Technologies, stands near cold-storage boxes of vaccines. Shortages of crucial drugs are a fact of life in many parts of the poor world. Mobile phones can help manage inventories and prevent supply gaps. At Narobi’s Strathmore University, assistant IT lecturer Nicodemus Maingi (right) talks with a student, Winfred Adundo, who is working on an SMS-based way for hospital patients to order their meals from their beds, avoiding paper forms and saving time. Juliana Rotich, executive director of Ushahidi, enjoys a view of Nairobi from her perch on the top-floor balcony of iHub, the Nairobi tech incubator space cofounded by her colleague Erik Hersman. Ushahidi, the best-known Kenyan software innovation, allows people to send text-message reports on anything from rioting to flooding damage; the reports then appear on a Web-based map. Bernard Owuor (left) of the Kenyan mobile startup NikoHapa, a mobile phone loyalty card service and Victor Makenzi, a freelance web designer, share a light moment inside iHub. One evening in January, Robert Collymore, CEO of Safaricom, ventured out to iHub to describe corporate ventures and said he was considering hiring a director of innovation. Safaricom is branching out into health care with a variety of initiatives. iHub cofounder Erik Hersman is at left. Paul Mugambi, senior manager for digital inclusion at Safaricom, discusses phone-based health-care offerings, which include an existing doctor-calling service and an SMS-based way of verifying the validity of serial numbers on pills. Plans for the future include systems to help frontline clinical workers enroll new patients and maintain their medical records. Such efforts, along with payment systems for health care and insurance, could put business models behind some promising pilot projects. One of the largest hospitals in sub-Saharan Africa is Nairobi’s Kenyatta National Hospital, with 1,800 beds. Kenya has only one doctor per 6,000 residents. This hospital’s IT efforts include plans for installing a telemedicine facility so that patients at regional hospitals can gain access to scarce specialists. In a Maasai tribal village in the Narok district of Kenya, 175 residents herd cattle and live in huts made from sticks and dried dung. They rely largely on herbal medicine to treat everything from flesh wounds to tuberculosis. But there is promise for mobile-delivered health information here, as everywhere. Tom Nkuito clutches a walking stick and his trusty Nokia 2311, which as yet has no medical apps on it.