Olorunyomi Fola-Oyetayo
300-level Medicine & Surgery
University of Ibadan
Good afternoon, Dr Neto. Thank you once again for granting us this interview. I would like to formally introduce myself. I am Olorunyomi Fola- Oyetayo, a 300-level medical student of the University of Ibadan and a member of PENDICAL, a platform that chronicles the lives of the African medical student and professional.
I would like you to tell me a little bit about yourself.
I am a physician, trained in internal medicine in Europe. I also went to medical school in Europe, travelled a little bit and worked in different places so yeah, done all that. Although I enjoy medicine, I realized that what I wanted, more than just seeing and talking to patients on a day to day basis, was solving the underlying systemic problems that faced them and so, a few years ago, I made the switch from just practising. I hung up my stethoscope to become a health technology entrepreneur; I build technology and business processes that help to improve the adoption of health care and the proliferation of access. That is a little bit about me at the moment.
Okay, this begs the question, why come back to Nigeria?
Abi o, it’s the same question I ask myself, “Why have I entered this sufferhead instead of chilling and chopping dollars and Euros?” *laughs* I’m being fictitious, but ultimately, Nigeria is my heritage, and I always just felt that pull to return home; plus, everywhere I worked in the higher-income countries, there wasn’t really a lack. You didn’t feel like you were, you know, making the biggest impact that you could. Sure, I was making their diabetes stable for a little bit longer and improving their life expectancy by a couple of years perhaps; but I didn’t really feel like it was something transformational and of course, I wasn’t doing it for people who looked or felt like me. Whereas, if you look at Nigeria, a lot of people that suffer tremendously because they do not have access to healthcare. I knew that coming back to Nigeria and with a little bit of effort, I could make a difference in a way that I couldn’t in all these other countries. I could build things that would actually add 10, 20, 30 years to life expectancy here. In all these other high-income countries, what you do on a day-to-day basis maybe adds a couple of years to people’s lifetimes. So I think that is really where the draw was: Nigeria is my heritage, where I’m from, and I always wanted to have the greatest impact on the people that I most relate to.
Hmmm, you make me sound unpatriotic.
I think patriotism for many Nigerians is a luxury, right? I mean, I am a Christian, and I very much subscribe to the idea that to whom much is given much is required. A good number of Nigerians cannot afford to be really patriotic because they have to look after themselves so that’s totally understandable. But there is certainly a section of Nigerians that can afford to be patriotic and do a lot more. Unfortunately, it is this section that actually does more damage to the country. These people who are a little bit more comfortable and benefit from the country should make themselves a bit more uncomfortable for the country’s progress. Those are the people that need to be more patriotic and show the rest of the country the way, to give other people something to believe in, and I think when that happens, you will see that it is easier for everybody to be patriotic.
Nigeria is our country and we don’t really have any other country to go to; it is the heritage we have, it is where we’re at, and it is always going to be. Unfortunately, it’s also a stain that because you cannot individually outperform the impression your country creates. You will come to a point where that will be a barrier of some shape, manner or form, but if you can improve the country, you improve the lot of everyone immensely across the world. Imagine going somewhere and saying that you are an American, there is a certain respect you get, and that is the kind of thing we can do for Nigeria if we are a little bit more patriotic.
So was going into the tech industry a nose dive, or were there certain skills you acquired during your practice as a doctor?
Regarding tech, I was totally brand new to the space; I didn’t really have any other tech knowledge beyond the everyday tinkering. I was always interested in technology, of course. I had a computer growing up—I was one of the few people in my generation that had internet at home in Nigeria, so I was privileged in that way. I think a lot of my journey around technology and healthcare was my experience working in different systems that integrated technology into their care. The last one I worked in before I moved back to Nigeria was in New Zealand; and the systems were so good that I could almost work from home unless I was, say, doing ward rounds or on call, seeing patients. Outside of that, everything was on a system that I could access online, and I could even do e-prescriptions, phone in my orders to nurses, or ask my house officer to do an exam. I’d go home for lunch and wouldn’t go back to work because I could just do everything from the computer at home. So it really opened my eyes to the possibilities that technology—a doctor could really sit anywhere and do something for a person in Nigeria, even in the rural area, once the infrastructure was there and the software was set up.
Regarding skills, I had to learn a lot of things. I had to learn to code, so I know a little bit of some front end language, as they call it; but I very quickly realized that it would take so much more effort to truly learn to code. I was better off partnering with someone that could, and then focusing on the other side of things, which included the medicine, product development, understanding business—all the other things that are just as important in a technology business beyond actual tech skills.
Oh, the comfort! You mentioned hanging up the stethoscope to become a tech entrepreneur. Could you tell us about your company/companies?
Erm…so over the years, I’ve built many products under different companies. I’ll talk more about the products than the companies because that is really more relevant. The first product I built was a directory for health providers—mostly doctors—so you could search for a doctor in your town, find out who and where they are, and you could go there. We tried to layer some appointment booking system onto that but very quickly realized that appointment booking wasn’t really a thing in Nigeria. So, we abandoned that and then went into trying to build a chronic disease care management platform. A lot of my experience was in managing chronic diseases and with the talk of the double burden in Africa, where a lot of chronic diseases come alongside infectious diseases, we tried to build a platform to coordinate the care around that. But we couldn’t do that because we needed data to be electronic and very few providers, in fact, no provider actually had their patients’ data stored electronically. So we decided to pivot that into a personal healthcare record for patients and then try to go in and digitize the individual health care providers.
We built, or tried to sell, a lab management system that made lab resources digital but that didn’t go very well. We went back to the drawing board and realized that the pharmacy was where a lot of health care was going on in Africa, so we built software to help pharmacies manage their patient communication and patient relationships better. We worked with a few hundred pharmacies and was able to look at the data of tens of thousands of patients. On top of that, we built a malaria service where people could obtain care in their local neighbourhood and then we realized that to make it more affordable, we could then pivot it into providing micro-insurance products for people. Currently, we have a micro-insurance plan for malaria with other things—telemedicine, cashback for hospitalization, some preventive services—layered on top of that, and these only cost N450 a month. Alongside that, we’re building other businesses, doing e-prescriptions and drug fulfilment for several health insurers, so quite a number of things are going on.
What are some of your biggest challenges that you’ve experienced as a startup? Especially those that you think are peculiar to Nigeria.
Biggest challenges. Ahhh, if I start that one, we won’t ever finish this *chuckles*. I could go on for days because they’re just too many. I think that number one is probably talent and expertise. I find that it is really challenging to get the right people in the right frame of mind to actually pursue the available opportunities. Related to that, is capital; there isn’t a lot of capital around, and you really have to get creative with funding what you need to fund. So yes, talent and capital. Beyond that, there’s a box standard, inefficiencies of ease of doing business, government regulations, electricity, all those sorts of things. But I think at the heart of it is getting the talent and the capital to be able to persist and persevere. Nigeria is what it is, right? So I don’t think that an entrepreneur can really change much but, if they had the right capital and the right talent, they could potentially surmount that. There are a lot of opportunities and I think once you hit that escape velocity, the market just kind of gets you to the end. The traditional example of success in Nigeria in recent times has been the GSM companies, but, early on, nobody thought they would be successful—it was expensive and difficult. Look at MTN now and how much money they make. So there is a model there that things can work if we can get the capital and the expertise to make it happen.
I would have expected data collection to be at the top of your list, with how much trouble you had to go through concerning that.
Yeah. I mean, data collection is a problem, but that’s a secondary problem. If I have enough money and the right people, then I can collect any data I want, right? So a lot of the problems are really secondary to those two.
You mentioned a health insurance scheme earlier, is it different from the NHIS? What would make people patronize you rather than the widely-popular government scheme?
Well, first of all, the NHIS is not widely popular; it only serves a small percentage of the population—in the formal market. There is a huge number of uninsured people, like 70-80%, so the NHIS isn’t even on their radar. But there are a lot of government schemes coming up across states, and it would be interesting to see what the uptake is like for those. For us, we just wanna focus on the market; we are a private company, and our value is in the value we give to customers, so the interest for us is to continue to serve customers in a valuable way. I think that government schemes are important, but until we solve the underlying problem of accountability and effectiveness of our government, you will find that the insurance schemes they promote will always be a challenge. So while they are laudable, I think you would find that a lot of them end up doing quite badly, because there is no real accountability in governance yet. In Africa, I think the easiest way to do a lot of these schemes is in the private sector where it is actually easy to be accountable. It’s either I make money or I don’t, and I just optimize myself for making money, you know. It isn’t that easy or straightforward for the government to do.
I didn’t know that, so thank you. Maybe you should run for president, what do you think?
Erm… good suggestion. About seeking political office, I think that’s important, and I think more people should do it, rather than just criticize. We need more progressive people in the political space running for office, but that office does not need to be president. I think even within our flawed system, there’s a lot of good that the right person can do in, say, local or state government. I think the president gets far more flak than he deserves. State governors and local government chairmen should have a lot of power, especially concerning healthcare, and make a lot of improvement. So, you might see me at some point running for maybe local government chairman or even state governor, but don’t hold me to that—it’s a difficult thing to do and I don’t know if I have the temperament for it. Some of us cannot stand nonsense, and I think that as a politician you need to be able to stand nonsense. *laughs*
In that case, are there policies that, beyond being passed into law, you would like to see implemented? Or policies that are not even in place yet?
Regarding specific policies, there are certainly a lot but I tend to shy away from recommending more policies because we already have a good bit of laws, policies and resolutions that haven’t even been implemented. So, saying ‘Oh, we need a new law, a new policy’ is too easy and abrogates the responsibility that we have, to implement what is existing. If you get a new policy in, no matter how perfect it is, and you’re not going to implement it, then it’s just a waste. So can we just focus on the existing policies, flawed as they might be? Let us have that muscle—an understanding of how to implement policies—and then when we have done that, we can go back and say, ‘Okay, now that we’re implementing these policies, here are the drawbacks, here are the challenges; let’s make the policy better’. So I don’t think new policies are the solution—it is in implementing existing policies that we really struggle.
*laughs* I’ll be on the lookout for the campaign banners. I remember talking to someone who, alongside his team, was at the forefront of tackling the Ebola outbreak in Nigeria and one thing he said to me was that the lack of implementation of laws gave him some slack and allowed him to set up things faster. Wouldn’t you consider this an advantage of sorts?
I agree that the lackadaisical attitude to a lot of laws and enforcement actually gives you a lot of room and opportunity to innovate and we’ve certainly taken advantage of that but it only works up to a certain point. After that, you need a lot of structure and laws in place so that you can grow and actually scale those things well. So yes, there are advantages, but to me, I think that the disadvantages outweigh them. You can move fast but not far; so one has to be careful not to think that just because you can move fast, that that is the way to go. I think you also want to be able to move far.
I think it should be said that he was a foreigner, so he was probably enjoying the freedom of sorts.
Well, there you go.
And in line with outbreaks and pandemics, Nigeria is facing her fair share of the coronavirus. How has it affected your company as regards your consumers and the associated financial difficulty that they may be facing?
Regarding the coronavirus, for us, it has been good because people are far more interested in healthcare. Our product is always cheap anyway so I don’t that think it would actually affect the demand for it. If anything, there is more awareness now, and people are actually asking us to try and provide more affordable healthcare for them. Altogether, it’s actually been a very good opportunity to sell more, with more people interested in accessing really affordable healthcare.
So how have you been dealing with the pandemic hands-on?
My company and I have been involved at several levels, trying to help with a response to the pandemic, especially on the tech side. I mean, you can see clearly that, abroad, technology has played a HUGE role in their response. And so, generally and broadly speaking, in places where there’s a lot of technology, you are in a much better position to deal with pandemics. So locally, we worked with a couple of state governments on some strategies involving technological solutions. In the case of Abuja, for example, I was in a committee and was able to write up recommendations around technology tools. Also, we built some software to look at resource utilization and availability—you could match a patient to the right resources, where you have beds; you could see what’s available, what isn’t, where the beds are and so on. We also have a USSD code with which people can take a risk assessment, and that comes into a dashboard where the authorities can look at that and funnel the high-risk ones into testing. The pandemic is going to be here a while so we’re working on a lot of tech solutions that will allow the authorities to respond to a lot of people at once, in a way that isn’t so challenging. So yeah, that’s what we’ve been doing.
Well, on behalf of Nigerians, I’d like to say thank you very much. I think we have 2 or 3 more questions on something more relaxing before we round up. When I’m stressed out, or just want to get away from worldly pressure, I like to read a good book. What do you do to relax?
My favourite past time is Latin dancing. I’ve been dancing for almost 10 years now, and I love it a lot. At one point, I used to dance every night. Anywhere in the world I go to, the first thing I do is dance. So, it’s a lovely community, and it is really good exercise and really enjoyable; I highly recommend it. When I retire, I might go on to actually open up a dance studio, become a dance teacher and a Latin DJ. and promote events all across the world. So that is what I’m planning to do when I retire, and I hope that is not too far away because all this stress is too much; I need to retire soon.
*laughs* I think you forgot to add that you would recommend it only for people who can actually dance. I personally have given up on that.
If you can walk, you can dance. No excuses.
So, is it safe to say that you might have had a career in performing arts had you not ventured into sciences?
Ehn career-wise, I would probably have become a teacher because I love teaching. What I have done recently is create a course to help young doctors, in particular, to be able to navigate what I call the future of medicine. I think doctors in the future would not just need to have medical skills—those are important—but also other skills regarding business, understanding digital and social media, being able to communicate, being able to lead and manage people. I have a course to that effect—it’s quite affordable, and I use it to teach young doctors. You will get a lot of benefits from it, including mentorship from me via a WhatsApp group and also the opportunity to network with other like-minded, progressive young doctors. So, I would have taught, and I’m still getting a chance to fulfil that goal of teaching now. I taught as well while I was still practising.
Hmm. Are we going to get any links to register for the course?
https://paystack.com/buy/future-proof-doctor-course-fhnxnd
Finally, the ultimate, most important question: jollof rice or fried rice?
I’m trying to be erm..healthier and cure my rice addiction, so my answer is no rice. Avoid rice. Bad.
*laughs* I’m afraid I won’t be able to take your advice on this matter. Thank you very much, sir, for your time. I immensely enjoyed the interview.
You’re welcome.
P. S.
Click here to watch our YouTube video on why you shouldn’t study Medicine at the University.
