Dr Wangari Ng’ang’a was visiting the 719 call centre nestled at the Safaricom offices in Westlands in March when she noticed something.
Dr Ng’ang’a is a technical adviser at the Presidential Policy and Strategy Unit in the Executive Office of the President and her visit, came at a time when Kenya was dealing with the coronavirus pandemic. The phones were buzzing. Kenyans were calling and sending texts.
The call center agents were receiving a stream of queries from the public. Up to two million daily queries on calls, interactive voice recording and text messages.
“However, they were not equipped to handle medical inquiries,” says Dr Ng’ang’a.
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“Some [the inquiries] were not related to COVID-19. There were also questions from medics dialing in to seek guidance on COVID-19 since it was a new disease…but the agents could not answer,” Dr Ng’ang’a recalls.
This set off the process to augment the centre with health workers, and with support from the World Bank, 50 doctors were recruited and trained to consult virtually, keep records and generate reports.
They were then embedded in the call center set up by the Government Spokesman and the Disease Surveillance Response Unit (DSRU) in the Ministry of Health and a system was set up where the agents served as the first filter, channeling any medical issues to the health workers.
The toll-free helpline operated by National Aids and STI Control Programme (NASCOP) was integrated into this service. The experience of running this hotline offered useful lessons to customize it for COVID-19.
Callers who needed psychosocial support were referred to the Red Cross’ toll-free line. These 15 frontline medics at the 719 call centre have been receiving communication support from Safaricom. Each month, since April, they receive a monthly bundle of 12GB of data, 600 minutes for voice calls and 2000 SMS.
Safaricom has also extended this monthly communication bundle to over 5,500 frontline healthcare workers together with Samsung Electronics East Africa who have donated 500 smartphones towards improving communication for the care teams.
“The team of medics is the nerve center. They are real heroes in execution, linking up with other responses to the pandemic. The utility has evolved over time. Initially starting as a decision support center for health workers, it evolved into a system for relaying results when we started mass testing; and then started handling other medical problems and delivering non-medical assistance,” Dr Ng’ang’a says.
The efforts of setting up and coordinating the 719 call centre did not go unnoticed. Dr Ng’ang’a was named among recipients of Uzalendo Award to commemorate the 2020 Madaraka Day on June 1 for her work to set up the call center and for spearheading initiatives to locally manufacture basic medical equipment through jua kali.
“I am extremely humbled. Never would I have expected this since I was just doing my job. It feels good to be recognized, not just by your peers but also the highest office in the land. I could not have done this without the support of the team at NASCOP, DSRU and the Office of the Government Spokesperson in execution and other initiatives that preceded us,” Dr Ng’ang’a added. Over the months, the pandemic has progressed, and the call centre remains busy, and now Dr Ng’ang’a sees an opportunity to deploy it in accelerating universal healthcare coverage beyond the pandemic.
From lessons drawn, she sees its potential to play an even greater role in delivering healthcare to all Kenyans.
“My biggest dream for this is if it can become our ‘911’. I am having strong considerations on how to transition this and house it in an existing institution like the NHIF. Providing telemedicine service on a toll-free line will then become a new benefit. By dialing in, we can have doctor consultation without having to be there physically,” says Dr Ng’ang’a.
The service could have multiple applications. For instance, people with chronic conditions, who need to attend regular clinics would then not need to travel all the way all the time.
“Some only show up for clinics once a year, yet they are scheduled quarterly. By consulting on phone, complications can be caught early even without physical visits. Imagine what this will do in enhancing access to healthcare,” she says.
The helpline, she adds, could also provide first aid advice virtually and even help with hailing an ambulance.
The difficult task is bringing the inspiration to life.
According to Kenneth Okwaroh, the Executive Director of the Africa Center for People, Institutions and Society, an Afro-centric think-tank, effort needs to be invested to avoid the fate of past attempts at setting up a national helpline.
“We have had helplines before but they fell off because they were not well-funded and institutionalized. If the helpline is to function in the way it is intended, it must have funds for running its operations, human resources and technologies. The public also needs to be made aware of its existence and to be re-socialised to consider for other health issues beyond COVID-19, such as asthma attacks and accidents, and so on,” Mr Okwaroh adds.
Before COVID-19 struck, emergency medical services were dependent on the individual’s location and financial situation. The privately insured can seek services at private medical facilities while those who are not have to pay cash to access medical services.
Across the country, there are more than 26 phone numbers one can call in a medical emergency, including the police hotline 999, but there is no public hotline one can depend on in the same way that some countries have 911 or 999.
Nonetheless, Dr Ng’ang’a believes it can be done.
“We need to think about the utility of this platform beyond COVID-19. It may have started because of it, to respond to this particular need but we cannot let it die,” she says.