You have got to take your hat off for this man: He is a doctor, a former missionary, a celebrated entrepreneur, a mentor and a politician. Dr. Ian Clarke is the Founder, CEO and Chairman of the International Medical Group, the leading provider of private medical services in Uganda. Describing his role as the CEO and Chairman of International Medical Group is merely the tip of the iceberg in terms of what he has done for Uganda’s health system in general, writes Taddewo Senyonyi.
Given Ian Clarke’s tight schedule, you would think securing an interview with him would be one of the most difficult things; but as I got to discover, this was not the case. All I had to do was drop him an email and hours later, I had an appointment for the next day. Although he later called to reschedule the meeting to the next day as he had received a last minute call to attend in his capacity as Mayor of Makindye Division, the opening ceremony of a Commonwealth Local Government conference, I still found him quite an easy person to see.
No sooner had I reached his office, than Dr. Clarke came out of his office to personally meet me. Dressed comfortably in black trousers, a checked shirt with folded sleeves, a blue tie, and wearing a watch and spectacles, Dr. Clarke welcomed me with an engaging smile and ushered me into what I perceived to be his board room. I had asked for at least a two hour interview, but before we started off, he requests that I make the interview as short as possible; a request I fulfilled. Straightaway, he impresses me as a man who values every minute. He confesses that given the many things he has to balance in a day, “ being efficient in the way I use my time” is one of his success recipes.
Venturing into un-chartered waters
Born 61 years ago in Northern Ireland, Dr. Clarke holds a degree of Bachelor of Medicine and Bachelor of Surgery (MBChB) and a Masters degree in Public Health for developing countries. He also holds a Diploma in Tropical Medicine and Hygiene (DTM&H). Before coming to Uganda, Dr Clarke practiced medicine in Northern Ireland for nine years. He first came to Uganda in 1987 as a Christian missionary to provide medical support to those who had suffered the effects of the war in the Luwero Triangle.
Clarke and others started a clinic in rural Luwero, which grew into Kiwoko Hospital a Church of Uganda mission hospital. “I was in Luwero for about six years, after which I returned to England, did a masters degree in Public Health for Developing Countries before returning to Uganda with my family,” he narrates. Dr. Clarke has dual citizenship of Ireland and Uganda. On his return to Uganda in 1996, Clarke says he set up a clinic, International Medical Centre in the building that houses what was formerly known as Kampala Pentecostal Church, now known as Watoto church.
“My vision was to bring affordable and quality medical services to Uganda’s middle income group. The medical sector around that time was not catering for the middle class,” he said. However, it was an uncertain market since “people still had problems with paying medical bills.” To develop and sustain his business, Clarke adopted a capitation model, a payment system whereby a client pays a physician, or group of physicians, a set amount for each enrolled person assigned to them, per year, whether or not that person seeks care.
“We entered into a partnership with the Human Resource department of the American embassy to provide them a medical scheme at a fixed price. Money would then come in on a regular basis, and this met our fixed costs,” he explained.
Over time, Clarke’s sweat has paid off. Today International Medical Group, runs 17 clinics under International Medical Centre Clinics, a health centre in South Sudan, one hospital (International Hospital Kampala), a medical insurance scheme (IAA Healthcare), a university (International Health Sciences University), IMG Pharmaceuticals, International Diagnostic Centre (IDC) as well as International Medical Foundation (IMF)- a charity arm that provides healthcare to financially unable communities, with an emphasis on HIV and Aids, Tuberculosis (TB) and STIs.
The foundation runs projects in Lira, Namuwongo and Makindye and other parts of Kampala. IMF also provides treatment of complex conditions such as cancer to the destitute through the Hope Ward Project at International Hospital Kampala (IHK). The university, which occupies the whole top floor of IHK building, was founded by Dr. Clarke in 2008 and currently has 1,050 students. It offers health related courses, providing professionally trained workers for the health sector in various specializations, plus continuing medical education for health professionals already working in the field, with a specific aim of improving the standards of professionalism of healthcare workers in Uganda.
The Power of Partnerships
If you have been wondering how Clarke manages all these businesses, he is quick to say his secret lies in identifying the right partners as well as grooming the right people. “When a company grows, you need more capital. So, in 2012, we took in some equity partners,” he said, adding, “I retained 100% shareholding in the university, while TBL Mirror Fund, a private equity fund from the Netherlands and the The Kibo Fund (TKF) from Mauritius invested in the hospital, and clinics for a 35% shareholding altogether and another individual also acquired 5%.”
He says this has allowed the group to expand. “For example we are currently setting up a Diagnostics Centre on Yusuf Lule Rd, which will be Uganda’s first comprehensive diagnostic centre, making quality diagnostics including a reference laboratory and diagnostic imaging accessible to both doctors and patients,” he says.
To ensure greater service at the Hospital, he entered into a management contract with an Indian group of hospitals called Fortis which has provided IHK with an efficient and very experienced Indian manager. Fortis Hospitals is now the largest high level hospital group in India with 76 hospitals including the renowned Escorts Heart Institute. “With the Diagnostics Centre, we are looking at a management contract with SRL Diagnostics, a Pathology Lab Network from India with another centre in Dubai.
This means that all laboratory tests (up to 4,000 different tests) can be covered, either at our reference laboratory in Uganda or by sending samples to Dubai. We have also linked up with a Kenyan insurance company called Resolution Health to provide medical insurance cover in the region and internationally.”
Dr. Clarke also owns a small construction company and a family hotel in Zanzibar. Although he is not comfortable revealing the turnover of his businesses, given the line of businesses he owns, Dr. Clarke is certainly a billionaire and a successful businessman worth celebrating. “We employ over 800 people in different companies,” is all he can say.
His day, family & leisure
Dr Clarke reaches his office at the Namuwongo based IHK at 8 a.m. “I do a lot of business by phone; write emails and make appointments. I don’t have time to waste,” he says, adding: “I like reading. I read a lot of books to improve my understanding on subjects such as economics or philosophy and I like reading biographies.” He sometimes goes to Zanzibar (where he has a hotel) for relaxation, but also jogs and exercises for the good of his health.
He enjoys writing and writes a regular column in the Sunday Vision. He has also published two books: The Man With the Key has Gone and How Deep is This Pothole? Clarke has three biological children and an extended family of 12. He has four grand daughters. One of his sons is the general manager of IMC Clinics, while the other runs the hotel in Zanzibar. His daughter, who lives in Dublin, is a Clinical Nurse Specialist in the areas of cancer of the blood.
On management
“I have to balance between being mayor and managing my business. In addition to these two jobs, I am also the Chairman of Uganda HealthCare Federation, which is an umbrella organization representing the private health sector, so I am juggling three different jobs.” Dr Clarke says he trusts and relies on his small top team of managers, which includes his general managers and his financial controller, but he is also mentoring and developing his tier two managers which includes positions such as department heads, operation managers and head of nursing, who also have excellent potential.
Regarding staff motivation, he says: “Once one reaches a responsible position where they’re well paid, I have high expectations of performance,” he says, adding, “I am a leader and a good team player, I like people, but I hate bureaucracy.” “Some employees might work for me for some time and then leave to start their own businesses. I don’t mind that , it is progress, development. It makes me happy when someone comes along and says that I helped them a lot. Some say I am a tough boss but I want to see people grow and fulfill their potential.”
Advice to budding entrepreneurs
Dr. Clarke says he has been successful because of setting clear goals, being focused and determined. “Some people have goals but lack focus and the determination to see it through. You must keep focused to attain your goals… you’ve got to work extremely hard to get everything you want out of life.” To start a business, Clarke believes you must be an entrepreneur, but you must be prepared to go through different phases.
“You can start a business as one person with a few staff, then you should expect the business to grow progressively from a small to a medium sized company. Even at that stage you can still control it yourself, but when it goes beyond this stage you need many more systems and managers at the stage of being a large organization,” he says.
“When the business grows to a medium sized company you will need to develop the skill of managing people. You will need good systems and dedicated managers,” he says, adding, “When it grows large, it becomes complex; you will need good governance, good leadership and shareholders will come in and everyone is accountable right up to the CEO who is held to account by the board.” “What’s important about all these levels is maintaining the entrepreneurship flavor along with good systems and management and avoiding becoming bureaucratic.”
On unemployment
He says many students in Uganda are studying the wrong subjects. Germany, he says, for example, a country with the strongest economy in Europe, “trained engineers, scientists, and technicians.” He also says countries like Hong Kong, Japan, Singapore and China also trained their people appropriately the reason why unemployment is low in such countries.
“Ugandans don’t have the necessary vocational training; people should train in vocational schools,” he counsels. Dr Clarke adds that Uganda’s high population growth rate has also escalated unemployment since many of the young people are semi-literate, poorly educated and can hardly boast of any specialized skill. He concludes: “Uganda is still a land of opportunity; there are still many opportunities awaiting exploitation.”