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Interview with Dr Jabilo, family physician in Nairobi

Jabilo works in a Community Wellness private clinic that he owns for 3 years. He has been a doctor for 26 years and worked in a different state before. Coming from a farming family, he still has a plot of land to farm as a hobby and only had 3 options in terms of what profession to choose: farmer, teacher or doctor. He uses his smartphone to look up medical information sometimes, often provided by MayoClinic.

His clinic is pretty quiet with about 5-6 patients a day. They are mostly middle-income (and their staff) and he charges them 1000 KES per consultation. He is also selling medicine and is able to do different kinds of tests in the clinic. There are only about 4 other clinics like his in a 5km area, so people go often to him instead of the hospital.

Jabilo with some of his patient records

Patient Education
“Understanding helps people avoid the doctor, they won’t return if they know whats wrong with them - so they withhold."
“People are becoming more enlightened, they want to know exactly what they have and what caused it in this urban area."
"I am not writing in a way for patients to read, it’s for other medical professionals to read”

He doesn't want to educate his patients and keep the power with him, so that patients won't go to the pharmacy the next time directly to buy the drugs they need.

Impression, not diagnosis
“In the case of my patient Joyce, I gave both, anti allergens and antibiotics, because it could be both. I wanted to make sure she would be okay. Sometimes people only have 500 shillings, I have to assist the client - sometimes you’re pressed into the wall."

He want to help his clients with what they got, so when they can't afford a test he just gives them every kind of drugs, just in case. He calls it an impression, not a proper diagnosis.

Showing SmartPrescription

Prototype Feedback

Smart Prescription
“If I use this service, patients would prefer it, they would think I am with them all the time and that I am taking care of them even when they’re sleeping”
“Out of this tool, it will bring me more clients, because they would think I would care more”
"When a patient can check if it’s a valid prescription, will improve the overall standard of health"

Doc in Chat
"I think would be better for people who are less educated - the nurses, or paramedics of the community health workers."
"Every region does things in different ways, I would want to see how you are treating people with pneumonia in London."

Visual Aids

On the chainsaw-on-flow metaphor

"This is like saying to someone you don’t go to Kenyatta Hospital to treat them with a cold. The chain saw is too big for the small flower."

He found the other ones hard to understand and misleading. He wants to show that antibiotics are effective, not just powerful.

He imagines a visual aids card on the wall of his clinic