Tebita Ambulance provides a persuasive example of the important role that social enterprise can play in support of the Sustainable Development Goals  

By Adam Pillsbury, Global Stakeholder Manager, Social Enterprise, British Council

Kibret Abebe Tuffa is the founder and owner of Tebita Ambulance Pre-Hospital Emergency Medical Service, a social enterprise that developed the first private ambulance service in Ethiopia.

While working for 17 years as a nurse anesthetist at the largest teaching and referral hospital in Addis Ababa, Kibret handled numerous emergency cases and saw first-hand how many lives were unnecessarily lost due to the lack of ambulance services.

In a country with some of the world’s deadliest roads, the absence of such critical life-saving support was for him a daily tragedy. He asked his colleagues: “How can we wait for a victim to come to us without any life saving measure rather than going out to assist him or her?”

So in 2008, Kibret sold his only house to acquire three old ambulances and the necessary license and launched Tebita Ambulance. He did so against the advice of nearly all of his peers and relatives who questioned the impact he could deliver and argued that ambulance service was the responsibility of government or the Red Cross. His response was, “I prefer to start challenging this problem rather than sit and complain about it.”  

From the outset, Kibret wanted Tebita to generate income so that it would be financially self-sustainable, not aid dependent, but it took time to find the right formula. “When we started, we knew nothing about any practical business model,” says Kibret, who credits a one year training programme on business strategy offered by SIDA, Sweden’s international development agency, with helping him to develop a successful social enterprise.

He has since developed a business model based on cross- subsidization. Tebita offers high quality, ISO-certified ambulance service, remote medical assistance and emergency aid training to multinationals, diplomatic missions, foreign NGOs and expatriates. It uses the surplus income from those activities to subsidize the cost of a local 24/7 ambulance service in Addis Ababa and in surrounding provinces. As a result, Tebita can offer ambulance service to the public for an average of USD $15-20, even though the actual cost is $51.  

Tebita generates a healthy financial surplus, but local banks are hesitant to provide loans citing a lack of collateral.

Kibret began with a team of two employees and for the first five years he continued working as a hospital anesthetist to help pay his staff.  Today, Tebita has 11 ambulances and 63 employees. It has opened Ethiopia’s first emergency and paramedical training centre. It has launched a motorcycle service to send first aid responders quickly through Addis Ababa’s snarled traffic to provide support before its ambulance can arrive. And it has provided ambulance services to more than 40,000 clients and emergency training to more than 25,000 trainees.

In addition, Tebita provides emergency medical services to Ethiopia’s national football team and Kibret himself travels with the squad offering his services pro bono.

In 2014, Tebita received a grant and technical assistance from USAID and DfID through their joint Health Enterprise Fund which, says Kibret, helped Tebita to scale up and enhance its strategic planning and financial forecasting.  In 2015, he also became an Acumen Fellow which offered him the opportunity to participate in a one-year leadership program.

Tebita faces a number of challenges, chief among which is access to finance. Tebita generates a healthy financial surplus, but local banks are hesitant to provide loans citing a lack of collateral. A US impact investor has conducted due diligence and would like to offer financing to Tebita, but current investment regulations in Ethiopia prevent foreign investors from participating directly in the emergency medical services sector.  

Another challenge is Tebita’s fragile supply chain. Their current business license only allows them to import ambulances not the emergency medical supplies they require, and these are not available locally. So Kibret wants to apply for an import license and start manufacturing emergency medical supplies locally. 

Despite these hurdles, Kibret says, “We are very committed individuals who have a very clear vision to change the emergency medical service system of our country and even East Africa.”

Kibret and the tebita Amublance team receive a Ministry of Health Award

Kibret and the tebita Amublance team receive a Ministry of Health Award

For Kibret, launching Tebita Ambulance was about more than saving lives. It was also about changing mindsets. Tebita is an Amharic word meaning ‘”drop” and Kibret chose it to inspire others to consider their own “drop” of contribution to humanity. He believes that by encouraging people, especially the young, to reflect on how they can become active agents of change he can inspire them to develop solutions to the problems they face.

He also affirms that investors and mainstream businesses can play a critical role in addressing deprivation. As he puts it, “without responsible private sector involvement, tackling social problems is like clapping with one hand.”

These messages have been amplified through Tebita Ambulance’s life-saving work and Kibret’s speaking engagements at conferences such as the European Development Days and Good Deals. In 2016, Tebita Ambulance was the only private sector organization to receive an Extraordinary Award for “dedication and exceptional contribution to health and social services in Ethiopia” from the country’s Federal Ministry of Health, while Kibret was named an “ambassador of health and social services in Ethiopia.”

 

The EU and the British Council are partnering in Kenya and Ethiopia to deliver a “Support for Social Enterprises in Eastern Africa” project which supported Kibret Abebe Tuffa’s participation in the EU Development Days and Good Deals conferences.

This article is the copyright of the British Council and was adapted and reprinted for use by ANDE on whysgbs.org. It was initially published on the Guardian Sustainable Business.