What is NMS's history in Kurdistan?
My Swedish partner and I came here in February 2005, and we began working with DNO. We started working on their logistics and security, supporting their first well in Tawke, construction of their production facilities in Fishkabur, and the pipeline for production. We then realized that we needed to branch out onto our own, and saw the opportunity in medical services. We found that there was a gap in the Region's ambulance system, and we decided to replicate the ambulance system in Sweden. We started very small—we went to a Swedish bank and told them that we wanted to drive an ambulance to Iraqi Kurdistan, without a contract or insurance. The banks were initially very, perhaps reasonably, hesitant to lend to us. Eventually we found a bank that was willing to extend a small amount of financing to us, and we bought an ambulance and drove from Sweden to Kurdistan. We managed to get our first contract in the first week that we were here, working at an oil rig. Today we have 25 ambulances, air ambulances, more than 300 Swedish doctors and nurses, as well as roughly 45 local staff working on oil rigs and in Erbil.
Do you have any non-oil and gas clients?
Yes, we have a few non-oil and gas clients. Nokia and Siemens, for example, have partnered with us. However, oil and gas have been our most natural clients, because they have a large number of employees that work in isolated and sometimes dangerous situations. We have also developed a very good relationship with the Ministry of Health. Through this partnership, we have been training local nurses. We bring in instructors from Sweden and provide training so that we can leave patients with our locally trained nurses and know that they are in good hands.
How has NMS's acquisition by RMSI affected your operations in Kurdistan?
Our merger with RMSI has provided us six air ambulances based in Dubai, which allow us to easily fly patients out if needed. Also, because RMSI International SOS has 12,000 employees, we have a significantly expanded number of doctors and nurses to work with—a lot of new knowledge and systems that we didn't have access to as a small independent company. It has largely allowed us to increase the quality and breadth of our services.
What training services do you offer in Kurdistan?
What we identified was that most of the doctors here work at a very high level, but that nursing is lacking is some respects, especially on the emergency side. So, we started our training programs with nursing. We have started our Pre-Hospital Trauma Life Support (PHTLS) courses, which were developed by the American College of Surgeons, who approved for the course to be conducted in Kurdistan for the first time. We conducted the program initially with a crew from the West Erbil Emergency Center, Rizgari Hospital, and the EMC Cardiac Hospital. So, for a week, we brought in certified instructors and conducted pre-hospital training. For example if there is a car accident, we taught things such as how to immobilize a victim and take care of the spine. We are have become very good at the medical services that happen outside the hospital, and much can be achieved if patients are treated in the proper way directly after a car accident rather than waiting to get the patient to the hospital.
I strongly encourage more healthcare companies to come and invest here. As oil production and monetization takes off here, the standards will grow higher and higher, and there will be increased demand for medical services.
How would you assess the development of the healthcare system in Kurdistan?
Since 2005, development has been very quick—just like hotels, infrastructure, and other sectors. The difference between Kurdistan now versus 10 years ago is striking. While things are still not perfect, the speed in which progress has been made is very impressive. In healthcare, however, development can be more challenging than in other sectors. It is easy to build a nice hospital and buy the right equipment, but it takes a long time to get well-trained staff that can work together according to the proper protocols. Education is something that cannot just be bought—it will take more time and effort to develop properly educated staff for the healthcare system here. It is happening, but it is necessarily a much slower process than making buildings and equipment. International companies are coming here and prioritizing capacity building and development of knowledge. The MNR is doing an excellent job in this regard, by making capacity building part of the production sharing contracts (PSCs) with oil companies that come here. All said, however, staffing is still our biggest challenge, as medical competence takes a long time to develop.
Do you believe that there is still room for foreigners to come and invest here?
Yes, there is a lot of room for investment. It is a shame that still, many big companies are afraid of investing in Iraq. Companies sometimes do not see the difference between Kurdistan and the rest of the country. Kurdish people recognize that they need expertise from all around the world, so there is significant room for foreign companies to come here. I think that opportunities will continue to grow as the Region continues to develop. The market is continuing to increase, and as in all business, we need competition. I strongly encourage more healthcare companies to come and invest here. As oil production and monetization takes off here, the standards will grow higher and higher, and there will be increased demand for medical services. More companies are beginning to provide competition for us, including a local company. Of course, we maintain a good relationship with them—there are clients for all of us in this huge and fast growing market. However, companies cannot just come here and sell goods or equipment, for example. Companies that want to thrive here must stay, train locals, and provide services for whatever equipment they bring in. If you want to be successful here, you must have a long-term presence.