Swimming gets you wet

Gaining popularity but despising criticism is like diving into a pool and then being surprised that you're wet… it's inherent to the experience… all part of the package.

Yet, I see "public figures" (I put it in quotes because the internet has given rise to numerous niche influencers) who love the attention that comes with popularity suddenly crave privacy and detest being held accountable when things go south.

It's telling. These people either don't understand the deal or simply use righteous indignation as a tool. Either way, if I see it, I hit unfollow.

I'm a high-caliber young person – What should I do with my life?

(SUCCESSFUL) CAREER = SKILLS + OPPORTUNITIES

Don't have a rigid "career plan" – The world is changing too rapidly and life is too complex for anyone to accurately predict the future. Be flexible.

1. Develop skills that are rare & valuable.

2. Be on the lookout for opportunities with the best risk-reward ratios.

OPPORTUNITIES - THERE ARE TWO KINDS.

• The first will present itself to you (ex: your friends are starting an exciting company and want you to join)

• The latter you may go out and create. (ex: Last year, someone working at McKinsey in the UK reached to me via Linkedin for a Product role at Pathao because they wanted an experience in frontier markets)

• Either way, the ability to properly assess opportunities based on risk-reward is vitally important.

SKILLS - THERE ARE TWO KINDS.

• Be Michael Phelps - Top 1% of their field. Gifted with the right physique and fanatically driven to train and reach the zenith of their field.

• Be Shakib Al Hasan - Top 25% in multiple skills/fields. In 2021, if you're an 80th percentile programmer + communicator + designer, you're extremely well-placed for financial success. This is because this combination is both rare and valuable. This brings us to...

• Capitalism rewards people with skills (or a combination of skills) that are both rare and valuable.

WHAT SKILLS (OR COMBINATION OF SKILLS) ARE RARE & VALUABLE?
In my opinion, these 5 skills (or a mix of them) are quite valuable. In terms of hard skills (or educational ones) – anything technical is a great choice. More on this later.

1. Communication: Communicating skilfully means conveying information so that it changes people’s behavior… or at least probes their thinking. Most technical people quaintly underestimate this skill. They expect good ideas to prevail based on merit. Good ideas are not Immiscible like oil. They don't necessarily surface because of their innate quality. Ideas are like precious metals. They need to be dug out, polished and marketed to have economic value.

2. Leadership: Learn how to lead people. Whether it’s through a university club (ex: NSU YEF / IBA CC) or practical work experience (ex: from a good manager at your job). Even if you choose to be an individual contributor, knowing how to lead/manage a team makes you less reliant on others for organizing things.

3. Sales: Selling doesn’t mean talking someone into buying things they don’t need. It means finding common ground with people and showing them your point of view.

4. Finance: Being financially literate is a huge advantage. The good news is that there are very easy wins. Get better at personal finance. (ex: know how your taxes are calculated). Learn how to read financial statements (ex: Balance sheets, income statements) Finally, learn more about how capital markets work, internationally. That last bit is important (and overlooked), which brings us to…

5. Global: The world is vast. It is teeming with people, capital, and opportunities. But you’ll never come across it if you’re stuck in your 9-5 and Dhaka traffic. The internet is your oyster, explore it. Meet people. Travel. Open your mind.

I will dissect opportunities in a future post.

If you liked this, feel free to subscribe to Build Bangla: https://www.ahmedfahad.com/buildbangla

Telemedicine: A Tipping Point

This was first published on the Financial Express.

In the past decade, Bangladesh has seen salient improvements in health care. We’ve significantly reduced child mortality rate and maternal death, and increased immunization coverage and life expectancy of citizens.

That said, there is a huge disparity in health care distribution between urban and rural areas, a large portion of people living in rural areas are deprived of modern health care facilities. The total population in Bangladesh is over 160 million (World Bank, 2018). Among them, 77% people live in rural areas. Access to medical personnel (general practitioners), medical facilities, and equipment is unevenly distributed throughout the country. 

Two problems stand out:

1. Most doctors in Bangladesh are located in urban areas due to poor infrastructure in rural health care centers and villages. 

2. Rural dwellers are required to travel long distances to access health care services which makes it costly and time-consuming. Cost is two-fold. There is a cost of travel and a cost of treatment. 

Telemedicine in Bangladesh

Telemedicine service takes advantage of the developments in telecommunication and growing internet facilities to provide medical facilities in remote areas where modern health facilities are limited.

The idea isn’t new. In fact, telemedicine in Bangladesh emerged around 1999 when a telemedicine link was established by a charitable trust named Swinfen Charitable. Although it was a short-lived collaboration it planted the seed of an idea for remote treatment quite early. Over the years, many attempts at telemedicine have been taken.

In 2005, Grameen Telecom (GTC) in cooperation with the Diabetic Association of Bangladesh (DAB) launched telemedicine services, giving patients at Faridpur General Hospital access to specialist doctors of their choice in Dhaka. DAB’s BIRDEM Hospital Dhaka, was connected via a video conferencing link to DAB’s Faridpur General Hospital.

What does the post mortem of these initiatives reveal?

The initial results of the DAB Pilot Project were promising. In the first 3 months, there were 52 new patients and 6 returning patients. However, it never took off. The number of patients waned over the months. They had technical problems which made service delivery difficult. Another reason for failure is implementing the project in a city that’s quite near to Dhaka. It takes only 1.5-2 hours to travel between Dhaka and Faridpur by bus. Thus, the problem of access to physicians in the city may not have been as acute for Faridpur residents.

Mostafa et.al in a study stated as ‘Even though enthusiasm has been observed in deploying telemedicine in Bangladesh from different quarters, however, lack of sustainability and long-term deployments are major issues. Many pilot projects are not followed up to turn into stable and fully functional healthcare systems. The primary reason is that the projects started with a narrow scope and did not address a proper framework for telemedicine application in Bangladesh.’

What does success look like for Telemedicine?

The success of Telemedicine largely depends on effective communication during consultation in spite of differences in location, time, equipment, levels of expertise, and health care organizations involved in the exchange.

Challenges

According to Shammi Quddus, previously at health startup Jeeon, “As of today, telemedicine is a product for urban folks. For rural people the user experience is poor so that people don't come back. Also what you can solve is very limited. One can only prescribe OTC drugs, the video actually does not add any additional treatment abilities. In that way Grameen’s 789 is probably the most cost-efficient way to deliver the same outcome.

Where telemedicine adds huge value is for pre-existing doctor-patient relationships. Follow-up reports, regular check-in so that you are saving the time and cost of Dhaka traffic, getting your tests done and results back, and the doctor then actually has something valuable to opine on.”

Ahmed Bakr, from the current Jeeon team mentioned “With enough information, our doctors prescribed more than OTCs where necessary, especially in the dermatology cases. The key piece being: enough information such as pictures of past tests, reports, and prescriptions as well as current weight, BP, temp, etc. Getting all that information is challenging and time consuming”

What has changed in the past 5 years?

1. Mobile Phone Connections: As of March 2020 there are 165 million mobile connections in Bangladesh (BRTC, 2020). Compared to population numbers, that’s nearly 100% penetration. Of course, this is not true since the number doesn’t represent unique mobile connections. It is, however, directionally correct to say that nearly everybody now has access to a mobile phone.

2. Internet Usage: There are 103 million internet subscribers, out of which 95 million are using mobile internet. That means more than 57% of mobile users are using mobile data. This number is likely higher since not all mobile connections are active or unique, thus the denominator is likely smaller. The number of internet users is growing at a healthy rate of 10% yearly.

3. Bangladesh has become mobile-first: More than 62% of web traffic is coming from mobile devices, roughly 32% from desktops, laptops, etc. 

4. Android hails supreme: More than 95% of mobile traffic comes from Android devices. Less than 2% from iOS. 

These trends will likely continue for the next 5 years as local manufacturing of smartphones continues to drive down prices, mobile data gets cheaper and digital literacy continues to grow. 

All of this is to say, internet services delivered via android smartphones are the best way to reach the average Bangladeshi today. This holds true in the context of telemedicine.

Who are players in this space?

Here’s a comparison of startups in the health-tech space, as of May 2020:

View fullsize

Download here (Could also make this the cover image)

These organizations have done well in developing a network of general practitioners and establishing reliable operations. Through increasing awareness about telemedicine and delivering reliable service each startup has received good traction. Although they carved out a niche for their services, their distribution and reach is limited.

There may be an opportunity to increase the awareness and adoption of these telemedicine and related services by featuring them in more widely distributed internet-enabled services. 

Three options come to mind: 

1. Telcos:

   Grameenphone is in a prime position to do this with their MyGP app. With over 40 million downloads, it has extensive reach and is more geographically dispersed than other apps. 

   They have the customer information, the payments system in place and the balance sheet to take on this line of business. 

   Providing these value-added services shouldn't be an antitrust issue either. After all, the MyGP app already houses 3rd party services. 

   Having the vision and driving the execution may be a challenge. The bureaucracy is particularly virulent in large companies such as GP, with employees buried under 8 or more layers of management. 

2. bKash:

   They have the reach. They are already pushing for adoption of the app, which has crossed 10million downloads. They have also been onboarding 3rd party services onto the platform. This could be a good use case for them. 

   Their interface and experience is not optimized for these use cases yet, but it's not a daunting task for the team there.

3. Pathao:

   With over 6 million downloads and a network of users and drivers across the country – the Pathao app could also play this role of the aggregator. 

   In fact, last week Pathao launched Pathao Health, in collaboration with some leading health-tech startups. They aim to serve 1 million users in the next 90 days. 

Telemedicine can level regional differences since the same information can be accessed sitting at home as from a medical facility several thousand kilometers away.

In terms of cost, studies revealed that telemedicine service reduces the health care cost of patients to a great extent. Users had to spend even less than 1/10th the amount to access the same service in a conventional means of the service. This is possible through higher efficiency (doctors being able to serve more patients) and lower infrastructure costs.

It’s unlikely that telemedicine can replace physical clinics. Instead, the aim should be to harness technology and empower doctors to fulfill their calling of helping patients, bringing down the geographic and cost barriers many folds. 

Security considerations are a major obstacle to telemedicine uptake. These include an absence of a legal framework to allow health professionals to deliver services in different parts of a country; a lack of policies that govern patient privacy and confidentiality vis-à-vis data transfer, storage, and sharing between health professionals and corporations; medical liability for the health professionals offering telemedicine services, health professional authentication and so on.

This was first published on the Financial Express.

Full disclosure: I work at Pathao, which gives me a good insight into the race for use cases among aggregators/platforms. I’ve tried my best to be objective throughout this analysis.

––––––––––––––––––––––––––––––––––

Ahmed Fahad is VP & Head of Product at Pathao, and a Global Shaper of the World Economic Forum. He can be reached at fahad@pathao.com 

Building Pathao Tong

This article also appeared on Future Startup.

Lessons on

Moving Fast

–

100X Growth

in 7 days

What principles do you follow for fast growth in startups?

Khobaib bhai, having followed the fast launch and growth of Tong – asked me this question.

As always, bhaia has put forth a well-phrased question.

A couple of thoughts before answering:

1. Growth looks different at each stage.

   0-100 customers are about finding product/market fit and (dis)proving assumptions about your business model.  

2. Context is everything. 

   There is no one-size-fits-all.

   But there are guiding principles that hold true at different stages. 

3. Timing matters. 

   The COVID-19 lockdown has created an acute need for grocery delivery– the demand curve, for sure, would have looked different at any other time.

Here’s what Tong’s growth looked like in the first 8 days:

In terms of principles, I would say 3 things:

1. Zero to one is all about nailing product/market fit... 

2. Then, the goal shifts to scaling your distribution.

3. The endgame isn’t product/market fit — it’s to build a sustainable business.

Let’s dive in.

#1 Zero to one is all about nailing product/market fit. 

On Day 0,

 Your only job as Founder/Launcher is to state your assumptions and run experiments to see whether they hold true in the real world. 

You could do market surveys, desk research, customer interviews, quantitative modeling. Or – you could quickly create an MVP. Release it. Learn from the market. 

By now, you know which one we preferred. 

Here’s the email I sent our team before starting work on Tong.

This initial game plan, executed well by the team, got us the first 100 orders. 

Based on our data from Pathao Food, we know the Banani-Gulshan-Bashundhara area is a hotbed for online orders and compared to other areas in South Dhaka these places had a scarcity of convenience stores around them. 

Thus, this ‘Tristate area’ was perfect to start our first Tong. 

By onboarding a superstore near Banani Bazaar, we could cover Banani and Gulshan-2. That too, without screwing up our targeted delivery time of 30 mins.

That left Bashundhara, which we’d need 1-2 stores to cover.

So 2-3 stores to start. Let’s do this.

Four of us were at Banani Super Market. We convinced the owner of the store to be on Tong – for them, it’s simply more sales. 

Do things that don’t scale. 

For our first 2-3 Mudir Dokans, we went with pen & paper to note their inventory. We had to chase the store clerks for prices and availability.

That said, we were clear on two things:

1. We would start with no more than 30 essential products

2. These products should always be in stock

This would be enough for our MVP. 

You too should narrow your focus and decide what’s the bare minimum needed for your MVP. Guard your team’s precious energy and time. 

Anyway, back to the story. 

And after 2 hours of note taking, speaking to the staff and placing our banners at the store – we left excited...but also wondering if we exposed ourselves to COVID-19 in that crowded store.

That same night, we sat down and transcribed the inventory lists. 

35 items, at each of the 3 locations. 

Another 4 hours. 

In parallel, operations started educating drivers about what they needed to do. Outbound calls and notifications were underway.

In parallel, designers got our design work done. 

In parallel, marketing got user side communications ready. 

Parallel path until it all comes together.

The Founders/launchers are basically jugglers. 

Her job is to keep several things in the air simultaneously

Not holding any item herself but making sure they’re all moving and the act is coming together. 

Generate some buzz. 

Post on social media. Get the word out. Rally your friends up to launch.

Launch at 12pm. Always.

It helps to have a precise launch time. 

Everyone works towards that deadline. 

12pm is nice because it’s before lunchtime.

Troubleshoot in real-time.

It’s out in the wild now. 

At times requests will spike and you won’t be able to keep up, other times it will feel like your mom’s the only person ordering to show support. 

Either way, it’s data. 

Read it, discuss it with your team, collectively (but decisively) take action.

I’ve heard people (and myself) ask before

‘Do we have product/market fit? How do we know?’

1. Monitor traction.

   How’s the traffic on your app/site? How are orders? How are they compared to your expectations? More on this on another post.

2. Talk to your customers.

   In our case – we talked to customers, and even more rigorously to our delivery people. What do you think? What’s easy, what’s hard?If you’ve found a product/market fit, you’ll know it. 

If you have to ask, then you probably don’t, yet.

#2 Next, the goal shifts to scaling your distribution.

100s of requests are cool. But you know what’s cooler? 10x that. 

But, your old model breaks apart at 10x.

The model you start with is not the one you scale.

Let’s try asking our first model a few questions…

Why do we put in the time to go physically ‘onboard’ Mudir Dokans? 

Don’t all of them have (almost) the same products?

Ok, and if all Mudir Dokans are the same, why do drivers need to go to a specific one? Why not go to their nearest one and be done with?

Could we also deliver medicine? Maybe just non-prescriptive ones to start? 

I think you and I arrived at the same answers. 

It was time to virtually onboard dokans all over Dhaka.

–––––––––

But the countrywide lockdown would change everything.

Operationally, 

How would we balance supply (or delivery people) to meet demand? 

How do we raise awareness and market this quickly? 

As a business, 

What’s the revenue model? How will this fit into our business in the medium-long run?

What synergies and comparative advantages are there?

In the final article, I will cover:

1. The challenges we faced in scaling distribution in the midst of a lockdown.

2. Moving towards a longer-term, sustainable business.

Till then, keep growing.

👉 The final article will appear in my newsletter first – Build Bangla. 

Build Bangla is a curated monthly roundup of my writing and stuff I’m following.

Check it out.

Shoutout to Khobaib bhai, Ruhul bhai, Tawsif bhai for reading versions of this.