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Recently the Ministry of Health gave an Exceptional Contribution on Health and Social Service recognition award to over 10 private clinics and Tebeta Ambulance Pre-hospital Emergency Service was one of them. Tebeta which began its service with three vehicles eight years ago now has 13 ambulances and 63 workers providing first aid and emergency care service seven days a week 24 hours a day. Kibret Abebe, founder of Tebeta and one Capital’s top ten entrepreneurs last year, was attending the 2016 European Development Days. Capitals’ Tesfaye Getnet sat down with Kibret to learn more about his experience. Excerpts
Capital: We heard that you established Tebeta Ambulance Pre-hospital Emergency Service by selling your house. What motivated you to provide first aid service in Addis Ababa?
Kibret Abebe: Before I established Tebeta I had been working in Tikur Anbessa Hospital as an anesthetist. While I was on duty I observed many people who were involved in car accidents, sick or physically injured, arriving at the hospital without an ambulance. Some of them came via taxi and others were carried in by other people. I also observed that most ambulances were not fully equipped and often did not have emergency care equipment. This includes things like: heart defibrillators, intravenous drips, splints, oxygen and drugs. Most ambulances and paramedics were not trained in first aid skills and were not able to deal with profuse bleeding, crash injuries or cardiac arrests. So this inspired me to start a private professional ambulance service and I began to talk with people who are near to me but most of them saw my idea as an impossibility. They told me that helping one or two people would not make a dent in a country that has lost many people through car accidents. Then something happened which caused me to take action. I was part of a team assisting a person from the UK who was traveling from Addis Ababa to London. I gave him pre-hospital emergency service and he reached there safely. What struck me after that was if I can assist one man traveling from Addis to London why can I not assist someone in Addis trying to get to a hospital. After that I resigned from Tikur Anbessa and started working to see my dream become reality. Finance was a big challenge. I applied for a loan at three banks but they were not convinced by my proposal. I went to my wife and asked her to sell our house but she thought I was crazy. She summoned elders to try and convince me to change my mind. She looked at it like I was selling our home to assist a few people. Eventually, however my wife allowed me to sell the house and then I went to Dubai and bought three vans and established Tebeta ambulance.
Capital: What was it like when you first started?
Kibret: I used my wife and my personal mobile numbers to return emergency calls. I worked as the paramedic, driver, and ambulance technician for four years which was very challenging. Getting the license took six months because private pre-hospital emergency service is a new idea in Ethiopia.
Capital: Can you explain what it is exactly that you do?
Kibret: If a person calls our number (8035) we rush to the place where the person needs help and provide emergency service. We also offer remote medical service where we park our ambulances and medical team at construction and mining sites in case there is an accident. We also work with companies who contract our services. We receive a premium in exchange for being on call for them in case they have an emergency. We also offer first aid training for non health professionals and emergency care training for health professionals. We also work with the Ethiopian Football Federation by having ambulances ready at Addis Ababa Stadium for Ethiopian Premier League and international games.
Capital: Tebeta recently started a motor cycle ambulance, how do they differ from the fleet ambulance?
Kibret: Motorcycle ambulances were started in Israel to pass through traffic jams easily. A lot of people don’t really know how to safely handle a patient when an accident occurs, but motorcycle emergency medical technicians are able to give oxygen, and provide emergency medical service until the ambulance arrives.
Capital: You are the only private Pre-hospital Emergency Service in the country, what has prevented other’s from getting involved?
Kibret: It is not a lucrative business, rather it is one you do with your heart. You are working with bloody and injured people and there is not much profit, especially when you consider that we pay over 100,000 birr every month for house rent and the government is not offering land for an ambulance service building. There is not really any special incentive to start this business.
Capital: Many people in Ethiopia don’t have first aid knowledge and due to this many people die when they are involved in auto or other types of accidents. What should be done to change this?
Kibret: Knowing just a few first aid skills can save lives and empower people when an emergency occurs. You don’t need to be a doctor to know how to help someone. First aid needs to be taught to everyone and those who do know some should extend their knowledge and practice the skills regularly. It should be taught at school, work and the community.
Hospitals need to have ambulances to transport unconscious patients to the hospital. With the increasing number of car accidents this is even more needed now. While several nations of the world are seeking to develop the health and safety of all citizens by addressing First Aid as part of their overall disaster preparedness and emergency response responsibilities, this is largely not the case in Ethiopia.
Statistics have revealed a sharp rise in the number of accident victims who die annually due to poor emergency management. Ethiopia has lost uncountable lives, including some of its best brains to avoidable emergencies. In developed countries first aid is elementary school knowledge. We need to figure out how to reach more people.
We also need to train more skilled paramedics, I have seen that many hospital and health stations have ambulances but ambulance is nothing if you don’t have the necessary equipment and trained emergency medical staff.
Capital: What has been difficult for you to experience while providing ambulance service?
Kibret: The heart of emergency medical service system is the call center. We need to have a synchronized emergency number that is being known by every fellow citizen. Unless and otherwise every stakeholders including the government work on this, the difficulty will continue.
Capital: You attended the European Development Days in Brussels where you presented a speech on social enterprise, what was that about?
Kibret: The reason why I was invited to Brussels was to share my experience on the sustainability of social enterprises by a cross subsidization business model. Many social enterprises in the world failed to sustain themselves due to the financial constraints in their work and one study indicated that due to poor business models social enterprises are mostly wiped out after four years. As Tebeta Ambulance our pre medical and ambulance service is not earning much money, we get less than 15 USD per kilometer but the average cost of one ambulance service is around USD 51 and in every service we subsidized costs us USD 30. However, our remote medical assistance offers peace of mind. So I argued that in places where no support is available cross subsidization is the preferred model.
Capital: We heard you had a chance to speak with Prime Minister Hailemariam Desalegn at the Ethiopian Embassy in Brussels.
Kibret: After the European Development Days were completed the PM was invited to the Ethiopian embassy in Brussels for a dinner and I also attended there. He said to me: “I heard that you are the only invited social enterprise from Africa and I am proud of you.’’ I told the PM we are surrounded by many problems like land and other additional support and he promised to talk to me again and I am waiting.