Quality healthcare may be a basic human need, but it’s beyond the reach of millions of Kenyans.
In 1987, when gynaecologist and obstetrician John Mutua Chamia was posted to Nyali to work in a Government hospital, he was inspired to help bridge this gap and improve healthcare.
Today, Dr Mutua owns Jocham Hospital in Mombasa, a fully-fledged facility with 85 beds, outpatient and inpatient services, including an emergency room, HIV care clinic, professional labs, dental clinic, maternity and paediatric wards and operating theatres.
Since its formation in 1999, he has successfully built his hospital one brick at a time. In 10 points, the 60-year-old shares his wisdom with Hustle on how to craft a dream, actualise it and sustain it.
1. Know your calling
I studied at the University of Nairobi to become a gynaecologist and obstetrician. It was clear to me what my career path would be, but I still needed to discover my calling.
It was to start an affordable, professional hospital that would predominantly serve the middle-income patients who didn’t want to take out loans or hold harambees to meet healthcare costs. I first saw a need and then asked myself how to plug it.
2. Build on the dream
Starting a hospital is no easy task and can look impossible to many. The idea was, of course, daunting, but I knew all I needed was to start somewhere. I was working full-time at a hospital and running a private clinic. I saved as much money as I could from these two jobs.
The first thing I did once I could afford it was buy land, which cost me Sh500,000 for an acre and a half. I didn’t have any more money to build, so I paused on the hospital project and kept working my two jobs.
Sometimes people take loans to get their projects off the ground, and while this is perfectly acceptable, you need to be realistic about how viable it would be to repay that loan. Does taking the loan advance your dream or simply cause it fail later on?
I chose to build slowly over time, eventually spending Sh2 million on the first phase, which consisted of male, female and maternity wards as well as an outpatient section. All this was done debt free.
Less pressure when you start often means you can focus more on growth and not on catching up with yourself.
3. Don’t compete with the big boys
When I got to Mombasa, there were three renowned hospitals. I knew I was the underdog and I placed myself in the correct lane. When I was building, I didn’t try to do anything fancy; my structures were sound but basic, my finishing neat but simple.
Years later, I refurbished my hospital, but I never would have got here if I’d started out trying to mimic the more established hospitals.
Stretch what you have as far as you can, and then come back later to perfect it.
I live by the Kaizen development method, which states that change for the better comes from slow, continuous improvement.
For instance, if you want to walk from Mombasa to Nairobi, you can either see 500 kilometres as an impossible distance, or you can break it down. If I walk 5 kilometres every day, in 100 days I’ll have accomplished what seemed impossible when I started.
The big boys weren’t born where they are; they got there in similar fashion, one stride at a time.
4. Grow your reputation
My biggest challenge when we started was getting patients and good doctors. We were new; we didn’t have a track record or a history. But we used the satisfaction of one patient to get us 10 more, the satisfaction of one doctor to bring in five more.
When we started, we would see maybe 20 patients a day, totalling about 600 a month. Currently, we turn over approximately 5,000 patients a month.
That number grew because people spread the word about our services; good patient care, good follow up, constantly improving facilities and affordable costs.
We realised we couldn’t be a in a hurry to get it right, we had to get it right continuously and consistently.
5. Weather the storm
The first three years are always the hardest; you’re basically learning the ropes.
My challenge, for instance, was accounts, but I had to learn. If I was going to buy new equipment, how long would it take to recoup my investment? If I was going to hire new qualified staff, how many more patients did I need for the books to balance? This is knowledge I never would have grasped from a textbook. To learn, I had to make mistakes, go through tough times.
I’ll give you an example. In the beginning, we had an amazingly high turnover of nurses. Why? Because nurses would come to us without much experience since none of the other hospitals would hire them.
We would train them and make them extremely marketable, then they’d get better offers from the top hospitals. Since we couldn’t match those offers, we lost our nurses.
This happened until we learned how to motivate them – even with less pay – and paint the picture of the vision we had for our establishment and give them assurance of growth. Now, we retain most of our nurses.
We had a staff base of just over 20 when we started. I’m extremely proud to say we’re at over 200 strong today.
6. Never stop expanding
Any company that has refused to transform or advance with the times has inevitably been left behind. You must change.
One of the best ways of doing this is to listen to your customers and your staff. What happens if you don’t listen? For one, you lose the trust and commitment of your employees, and secondly, you lose your customers to better services.
At Jocham, we’re always renovating and recreating ourselves. Our latest project is an Intensive Care Unit of six beds. When we started, nobody knew us; today, we’re among the top three hospitals in Mombasa.
7. Never stop learning
You have to keep improving your knowledge base to stay competitive. Three years ago, I took an executive leadership course at Strathmore University. I have taken many courses over the years and I will continue to take them, despite being 60. To say you don’t have time or energy is all in your attitude.
If you want something badly enough and you need an hour to do it, instead of working for eight hours, work for nine. It’s a temporary adjustment that could give you unlimited results.
8. Accept the nature of your trade
Some things are innate to one’s career. As a doctor, I have to accept that sometimes we lose patients. Now the question is, when this happens, can we look the family in the eye and truthfully say we did everything we could?
And if we can’t on any one occasion, we stop and re-evaluate and see what we could have done differently. Perceived failure is a tough thing to look at, but unless I’m strong enough to face it, I can never improve myself.
I’m a strong believer in multiple streams of income. Why? Because there will always be something to keep you afloat during the tough seasons.
I started my hospital using the funds from my clinic and salary as a full-time doctor. Today, my family and I also run a hotel and a group of schools.
The schools, Jocham Group of Schools, are predominantly run by my wife, and go from nursery to primary.
The hotel, Chamiachi Hotels and Apartments in Nyali, consists of eight apartments, 35 studios, a swimming pool and conferencing facilities.
We would be stretched if we were doing everything ourselves, but I’ve learned the power of training, inspiring and delegating to employees. That way, they can do what you don’t have time to do, and sometimes do it better than you would. Master diversity and delegation.
10. Live with humility
I’ve been blessed with success, but it would be foolish for me to think I walked the journey alone.
I am also blessed to have a family that wants to continue my legacy. Three of my children are studying to be doctors and one of them is a lawyer who’ll soon be returning to Kenya from Australia to join the family business.
When I ponder this, I’m satisfied that I’ve built my life and my career in an honourable way. I’m leaving behind a legacy so that even after I’m gone, my philosophies and methods will live on.
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