In Yoruba culture, the name Yetunde is given to the first girl born after her grandmother died. Months before I was born, my grandmother got ill and my dad went to her remote village to assist her. She lived about an hour's drive to the nearest hospital and she died within a few hours of reaching that hospital. She was diagnosed with simple diarrhoea which is something that simple salt and water solution would have solved, had she lived close enough to care. This tragedy shaped my life in many ways. My father encouraged me to go to medical school, in part to make sure that nothing like that ever happened to our family again. So, I carried not just my grandmother’s name but a story and that of millions of Nigerians like her who died because they could not get a doctor in time.
What were you doing before you started Market Doctors?
When I graduated as a doctor, I really knew that I did not want to do something conventional. Even though I had earned my degree as a doctor, I knew I did not want to work in the hospital. I knew I did not want to specialize in clinical work, so instead I ventured into the health insurance world. I worked for different departments and my work ranged from working with customers, hospitals, andin marketing. I also started another company called Preventive Health Managers- a company that did a combination of consulting and training.
What made you start Market Doctors?
When I was working in the health insurance industry, I noticed that a lot of people did not have access to health insurance. I started asking myself how I can create access to healthcare for the common Nigerian. I knew if I wanted to prevent deaths like my grandmother’s and to do that successfully, I needed to meet people where they were. So, I focused on a place that many people, especially women visit daily- the market.
For context, Nigerians get everything at the market- food, clothing, furniture, etc… We also find connections and friends there. So, I had the idea of having people add preventive healthcare to their shopping bags. I knew from my training that preventive care like blood pressure readings and diabetes screenings would make a huge difference for people. It could even save lives. So, one day underneath a canopy, sitting on a folded chair, my team and I welcomed our first patient and we called ourselves Market Doctors.
I remember on that first day, shoppers walking by with trays full of fresh tomatoes, and grains on their hips were curious to see us in our white coats holding simple medical devices like stethoscopes, and blood pressure readers which they had never seen. The first questions to us were the expected ones. Are you a doctor or a nurse? How much will this cost? I would tell them that I was a doctor, and I was proud to say that healthcare was accessible and affordable right in the market.
Dr. Ayo-Oyalowo speaking to patients during an outreach program
Could you paint for us what the state of access to healthcare is in Nigeria?
Many Nigerians live so far away from health centers that they would have to forgo days of wages just to afford transportation costs alone. When I became a doctor, fewer than 5% of Nigerians had health insurance,and today, more than 70% of the population works in the informal sector where health insurance is even more out of reach. Often people are turned away at hospital doors or leave the hospital before they recover because they cannot pay.
In your speech at the Gates Foundation, you said that ‘Money, unfortunately, keeps people alive’. Could you expand on that?
My work with Market Doctors for the past 7 years has been an eye-opener for me and made me realize the sad truth that money really keeps people alive. I will give examples to clarify what I mean. In Nigeria, and I believe this is the case in many other African countries, you get to the hospital, and if you do not have money to pay, you cannot be treated. Sometimes you are not even touched despite how dire your situation is. In another case, you are in the hospital and you have been spending money, but if you need more treatment that is above your means, then the treatment stops. Sometimes this goes so deep that people do not even attempt to seek care because they already know they cannot afford it. With recent crises such as COVID-19, the hike in fuel prices, and costs of living, several people who were already poor became poorer, exacerbating the disparities we were already seeing in accessing care.
Can you share with us in detail how your business works?
We bring healthcare to a location many Nigerians visit almost daily—the market—as well as to people’s homes. A team of health workers goes from stall to stall in the market or house to house in the community. The team carries medical devices to measure blood pressure, blood sugar, and cholesterol levels, as well as perform other tests depending on the patient’s needs. Health workers use mobile devices to connect by voice or video with medical doctors to confirm diagnoses and prescriptions and they can dispense drugs on the spot. Our doctors travel in a school bus that has been converted into a mobile clinic. We serve consumers who do not have access to primary healthcare. We also work with non-profit organizations that want to support medical services driven by non-governmental organizations.
A doctor from Market Doctors takes a patient’s vital signs in a local market
How many people have you been able to impact so far?
From that first stall in the first market, we have exceeded our dreams for the program. We have served more than 500,000 people in 2000 communities across 18 states in Nigeria. We have worked with 7 mobile clinics to reach people in more places delivering health care on a little fitted school bus. We also provided hundreds of antenatal care kits to help women and babies stay healthy after birth.
Reaching the underserved sometimes means targeting people with limited purchasing power. How do you balance providing care and running a financially sustainable organization?
We realize that some patients are unable to pay and supporting them to access care is a big part of how we measure our access. This support costs time and money and below are some things we practiceto keep the organization sustainable:
We follow our mantra that no one will come to us and leave without obtaining care and therefore our growth might be very slow but we believe our impact is significant.
How do you see the ABH community as a resource for you as you continue to pursue such an important mission?
Applying to ABH really gave me the clarity that I needed on what the organization was about and what we wanted to achieve. Beyond the application process, the ABH community is a strong community of entrepreneurs who are always ready to share knowledge, resources, joy, and support and I feel privileged to belong to such a community. The recent trip we had to China really gave me a lot of exposure and connected me to an amazing group of people.
