Medwaka, an emergency response platform, has fundamentally restructured its operational strategy to address critical healthcare gaps in Nigeria, following a near-fatal birthing emergency witnessed by its co-founder.
The harrowing incident saw Essence’s friend moved between three hospitals in the early hours of the morning, where she encountered refusal of admission and a facility without electricity before delivering by caesarean section and nearly succumbing to haemorrhage. This personal crisis, which occurred around 1 a.m., provided a stark illustration of Nigeria’s fragmented emergency medical services, prompting Essence to seek a comprehensive solution.
Nigeria’s critical emergency care gaps
Nigeria faces profound challenges in its emergency medical services (EMS), which directly impede timely interventions and contribute to a high rate of preventable deaths. The country records an estimated 2.4 million deaths annually, with the National Bureau of Statistics (NBS) indicating that half of these, or about 1.2 million, could be avoided with an effective EMS system.
Maternal mortality remains a particularly severe issue, with Nigeria accounting for nearly 29% of global maternal deaths. In 2020, the maternal mortality rate stood at 1,047 deaths per 100,000 live births, while the rate was reported at 993 per 100,000 live births in 2023. These figures underscore the urgent need for robust emergency care, especially for pregnant women.
The “Golden Hour,” referring to the critical first 60 minutes after a serious injury, is often compromised by systemic failures. Infrastructure deficiencies are widespread, with only about 500 ambulances nationwide, far short of the estimated 4,000 needed. Lagos, with its population of approximately 20 million, operates fewer than 100 ambulances, with just 35 managed by the government.
Beyond the sheer lack of vehicles, poor road networks, traffic congestion, and inconsistent navigation systems frequently hamper ambulance response times. Many hospitals also contend with persistent power outages and equipment shortages, further compromising emergency care capabilities.
Communication is another significant hurdle. Although 112 was designated Nigeria’s unified emergency number in 2014, its implementation has been inconsistent, and the system often fails to connect callers with dispatch centres capable of responding.
Engineering the initial solution
Essence’s formative experience led him to the Fishbowl Challenge, a programme designed to help young entrepreneurs develop technology-driven social ventures. There, he connected with Dr. Muyiwa Oluwatobi, Dr. Glennise Ayuk, and Abakar Mahamat, who would go on to form the core team behind Medwaka.
Dr. Oluwatobi had already begun piloting an early model in Ondo State, focusing on blood donation and emergency support for pregnant women. This initial concept connected expectant mothers with blood donors during medical emergencies, but the expanded team quickly recognised a larger opportunity.
They aimed to build comprehensive infrastructure that could accelerate emergency response when every second counted. Essence explained to TechCabal that the initial problem the team was solving “wasn’t large-scale enough,” prompting them to re-evaluate their approach. After extensive consultation with healthcare professionals, ambulance providers, and emergency responders, Medwaka transformed into a full-fledged emergency response network.
Through a mobile application, the platform was designed to link patients experiencing medical emergencies with nearby hospitals, ambulances, and trained first responders. Medwaka launched its first prototype in 2024 and began a pilot programme in Ondo State by February of that year. By the close of 2024, the team had trained 10 first responders and successfully integrated 5 hospitals into their system.
Operational realities and the ambulance challenge
Medwaka’s initial pilot in Ondo State, though promising, quickly exposed the stark realities of Nigeria’s emergency medical landscape. The team’s plan to train first responders, partner with hospitals, and establish a clear emergency contact number encountered unexpected obstacles. Low public awareness of emergency services, the complexities of building a reliable first responder network, and a critical lack of ambulance infrastructure proved significant impediments.
To overcome the limitations of ambulance availability, Medwaka innovated by recruiting motorcycle riders as first responders. These responders, who were familiar with their local neighbourhoods, could often reach patients faster than traditional ambulances, providing initial support before hospital transport. However, the vision of a 911-style system, reliant on a dedicated fleet of ambulances, remained Medwaka’s biggest challenge.
Essence noted the difficulty of operating a model in which an early-stage startup lacked the capital to acquire its own ambulances while also contending with the inconsistent availability and delays associated with existing hospital fleets. This fundamental disconnect between ambition and infrastructural control forced a critical reassessment of Medwaka’s strategy.
Strategic pivot to partnerships
Around “Day 1000” of its journey, Medwaka made a pivotal decision: to abandon the pursuit of an independent, asset-heavy 911-style system and instead fully embrace a partnership model. This shift was driven by the recognition that Medwaka could achieve greater impact by strengthening existing emergency response capabilities rather than trying to build parallel infrastructure.
The company began redirecting its partnerships. It moved beyond public health institutions to collaborate with private hospitals, health maintenance organisations (HMOs), various government agencies, .non-governmental organisations (NGOs), government institutions, and community groups, including the University of Medical Sciences in Ondo. This approach allowed Medwaka to concentrate on its core technological and coordination strengths.
Medwaka expanded its offerings significantly, now providing emergency response technology, first responder capacity building, digital emergency coordination tools, and healthcare system integration. Today, Medwaka operates with a team of 20, has trained 11 first responders, and has facilitated more than 550 emergency requests through its platform and partner network.
National efforts bolstering emergency response infrastructure
Medwaka’s journey unfolds against a backdrop of broader national efforts to shore up Nigeria’s beleaguered emergency medical services. The Federal Ministry of Health launched the National Emergency Medical Service and Ambulance System (NEMSAS) in February 2022, a pilot programme designed to help states establish and implement emergency medical services nationwide. NEMSAS has since expanded its reach to 34 states.
In June 2026, the Nigerian government deployed 145 tricycle ambulances and six boat ambulances, along with new communication and dispatch equipment, under the NEMSAS initiative. A digital emergency dispatch platform is also under development, intended to streamline connections between callers, ambulance services, and treatment centres, facilitating real-time response and patient tracking.
A key component of NEMSAS is enhanced maternal transportation in 15 states with high maternal and neonatal mortality rates. Transport to health facilities and treatment for the first 48 hours are provided free of charge.
The National Economic Council (NEC) further solidified these efforts in May 2026 by approving 112 as Nigeria’s unified national emergency number, aligning the country with global standards such as the US 911 system. This move aims to improve coordination and reduce response delays.
Ondo State, where Medwaka began its pilot, has also been active, with Governor Dr. Lucky Aiyedatiwa officially launching the State Emergency Medical Services and Ambulance System (SEMSAS) in November 2025, commissioning 10 new ambulances and reactivating its State Emergency Call Centre with multi-million-naira communication equipments.
Similar to Medwaka, other health tech companies are also working to address these critical gaps.Emergency Response Africa (ERA), founded in 2019, for instance, connects individuals with community first responders and ambulances. The organisation claims to have reduced response times by 80% and managed more than 4,500 emergencies. ERA has also formed partnerships with state governments and received funding from the United Nations Central Emergency Response Fund (CERF).
The digital health market in Africa is estimated at USD 5.6 billion in 2025 and projected to reach USD 7.6 billion by 2029. Health tech was the only African startup sector to record year-on-year funding growth in 2024, posting a 7% increase.
Nigeria, Kenya, South Africa, and Egypt captured roughly 83% of African startup funding in Q1 2025, demonstrating the region’s increasing engagement with AI health platforms.
Engineering integration for complex healthcare systems
The evolution of Medwaka highlights the complex engineering challenges inherent in building and scaling emergency response systems in environments with significant infrastructural limitations. Its pivot from direct service provision to a partnership model underscores the necessity for adaptable, digitally driven solutions that can integrate disparate assets.
Effective emergency response relies on seamless data flow and coordination, requiring robust software architecture capable of handling high-pressure, time-sensitive information. The move towards digital emergency coordination tools and healthcare system integration reflects a broader trend towards leveraging technology to optimise operational efficiency.
These systems must be engineered not just for functionality but also for resilience, accounting for unreliable power grids, varying network connectivity, and diverse user capabilities. The principles of robust software architecture and system resilience, crucial for emergency response, share parallels with challenges faced in developing digital industrial environments.
The successful implementation of platforms like Medwaka will ultimately hinge on their ability to create an interconnected network of emergency services, ensuring that technology serves as a bridge rather than another barrier to critical care.
The ongoing development of Medwaka and parallel government initiatives illustrate a growing recognition of engineering’s role in public health infrastructure. By focusing on smart partnerships and digital coordination, these efforts are laying the groundwork for a more responsive and effective emergency medical landscape across Nigeria.
The goal, as Essence articulated, remains the creation of an integrated emergency response ecosystem, where technology connects patients, providers, and responders to ensure that help arrives when every second matters.
