Aschkan Abdul-Malek JD/MBA’06 was living in Afghanistan, researching health care constraints in developing countries for the World Bank, when he learned how financially devastating those constraints can be. His Afghan cook, he discovered in a casual conversation, was spending six times his annual income to fly his wife to India for medical care.
The cook’s wife was one of many Afghan “medical tourists” seeking treatment abroad because local health care services were so limited. Despite an average annual income of about $630, Afghans spend nearly $300 million a year traveling abroad for medical care. If local doctors and hospitals had reliable ways to connect with foreign specialists, Abdul-Malek thought, perhaps more patients could be treated at home.
The son of Iraqi and Iranian parents, Abdul-Malek grew up in the U.S. but moved to Asia soon after graduating from Vanderbilt in 2006. After stints as a researcher for an investment banking firm and with a human rights nonprofit in northern Iraq, he joined a Dubai-based consulting firm for which he managed consulting teams in Afghanistan in 2010. The eureka moment sparked by his conversation with his cook came in 2013.
Entrepreneurship was unfamiliar territory for Abdul-Malek, but then again he is not one to shy away from risky situations. He races cars as a hobby and is not fazed by the dangers of working in war-torn Kabul. When his office shakes from nearby bomb blasts, he checks to make sure nothing is damaged and goes back to what he was doing. A typical corporate job was simply not for him.
“At no stage was I ever that guy that would just get lost in a crowd,” he said.
Abdul-Malek hired an office manager, found a partner with telemedicine experience in the United Arab Emirates, brought in a team of Bangladeshi software developers, and opened his telemedicine company, AlemHealth, in 2014. Kabul proved an ideal training ground for launching a high-tech startup capable of succeeding in developing countries; Abdul-Malek learned how to deal with everything from inconsistent electrical service to antiquated imaging equipment to local methods of dispute resolution. “It’s like trying to do things in space,” he said. “It will test your redundancies in ways that you never planned for, and it allows you to build something that’s so robust and flexible that you can take it anywhere.”
To connect with hospitals that lacked computerized imaging equipment, Abdul-Malek initially had messengers hand-deliver X-ray and MRI films from hospitals to his office, where they were digitized and transmitted to specialists in the U.S. and India. As demand increased, his team developed hardware that enables client hospitals to transmit medical images electronically. To address disputes with clients and suppliers, he soon learned that “documentation was key.” When a client accused an AlemHealth worker of breaking a CT scanner, the dispute was settle by a jirga, or traditional council. Abdul-Malek found himself sitting in a community elder’s living room, negotiating a settlement. “You’re trying to explain the nuances of a CT machine to a bunch of old guys with beards,” he said. “It’s kind of hilarious.”
In early 2016, AlemHealth—which also provides pathology services and specialty consultation—expanded to Lagos, Nigeria. Future plans include branches in Kenya, Indonesia, Iraq and Sudan. Like Kabul, these new locations, he expects, will challenge him—and make him better. “You’re constantly reacting and learning very quickly, and these are skills that every startup founder needs,” he said. “If it starts to feel comfortable, you’re probably not pushing the boundaries enough.”
This story is condensed from “This Startup is Fixing Healthcare…in Kabul” by Jessica Holland, published in Entrepreneur, August 2016.