By James Fraser
President & CEO, Madiro
August 19, 2025
This summer’s update brings you stories of transformation across Africa and beyond — from frontline care to digital innovation, new investments in maternal health and emergency response, and the generosity of donors driving change. We also welcome two new board members, Monica Kahindo and Efosa Ojomo, and thank Jesse Moore for his continued leadership as he transitions from the board to our Investment Committee.
In this update:
How a rural hospital in Burundi is becoming a national health leader
When we first met Dr. Alexis Nizigiyimana, he was running Ubuntu Village of Life (UVL) from a rented bar in Mugamba, Burundi. Across the road, a small house served as a makeshift maternity ward. It was the height of the COVID-19 pandemic. The spaces were overcrowded, services were constrained, and risks to provider and patient were high.
But the vision was there.
Driven by personal tragedy and a deep sense of responsibility, Dr. Alexis dreamed of a place where families — especially women and children — could access dignified, comprehensive care close to home. Even in a remote, mountainous region with scarce resources, UVL was delivering outpatient consultations, maternal health services, lab tests, pharmacy access, and care for chronic conditions.
Madiro saw the urgency and potential and stepped in.
In 2022, we helped UVL repurpose a vacant hotel into a district hospital with inpatient care, emergency services, radiography, and a growing maternity ward. In 2023, Dr. Alexis joined a Madiro-supported exchange to Kenya, inspiring a hub-and-spoke model. By 2024, UVL opened its first satellite clinic 50 km away.
Additional support followed:
In 2024, UVL provided 8,895 consultations (781 at the satellite), treated nearly 1,000 malaria cases, and hundreds of pneumonia and diarrheal infections.
At its core, UVL is a social enterprise, blending grants, government reimbursement, and earned income to create a sustainable rural hospital. Inclusion in Burundi’s national maternal and Under-5 subsidy program would be transformational, but required expanded wards and full digitalization. The Rousseau family funded both ward expansion and digital transformation, while Madiro implemented an interoperable hospital system in under six months — leveraging our humanitarian health experience with MSF, ICRC, and the OpenMRS community.
In July 2025, UVL’s government contract was signed. Care previously subsidized by Madiro will now be reimbursed by the state, improving long-term sustainability.
First half of 2025:
Backing solutions with the power to reach millions
Madiro’s philanthropic impact investment fund backs seed-stage social enterprises solving previously intractable health challenges through innovation. We invest in models that scale, improve health outcomes, create jobs (many for women), and strengthen health systems.
On average, every $300,000 raised allows us to find, invest in, and support one new health enterprise — from pipeline development through due diligence to governance and value creation.
Since 2022, we’ve built a portfolio of nine companies in over 15 African countries, alongside targeted grants and program-related investments. At the end of 2024, our portfolio had:
Why it matters: 350+ maternal deaths per 100,000 births in rural Kenya; many pregnancies without professional guidance.
What they do: Digital platform linking pregnant women to trained midwives via app/SMS, plus resources, check-ins, and emergency escalation. (Website)
Why we invested: Rapidly scalable, integrated with national programs, aiming to halve preventable complications.
Why it matters: Only 10% of Nigerians can reach a hospital in an hour; delays cost thousands of lives annually.
What they do: “Uber for emergencies” — dispatch app, 24/7 hotline, trained responders, hospital triage. (Website)
Why we invested: Tech-driven model cuts response times and expands coverage; now scaling fleet, training, and facility integration to halve response times.
From digital innovation to life-saving response on the front lines
Madiro’s programs exist to save lives and reduce suffering by improving access to quality healthcare — especially where health systems are weakest. We partner with humanitarian organizations, ministries of health, and local leaders to strengthen operations, improve clinical care, and extend the reach of essential services. By combining digital innovation, technical expertise, and operational research, we help health systems respond faster, connect better, and deliver care where it’s needed most.
When health systems can’t share information, people pay the price. A woman arrives at a referral hospital without her medical history. A lab test result never reaches the clinician who ordered it. A patient’s prescription is lost between clinic and pharmacy. These delays waste precious time — and in urgent cases, can cost lives.
Across multiple hospitals and health centres, we’ve connected clinical, financial, and public health systems using open-source platforms like OpenMRS (patient records), Odoo (finance and supply chain), and DHIS2 (public health reporting). At UVL in Burundi, this meant going fully digital in under six months, unlocking government funding for maternal and child health services months ahead of schedule.
We also leverage AI to speed up implementation. The AI Mapper Tool — developed with OpenConceptLab and the Columbia International eHealth Laboratory — standardizes medical vocabularies so systems can work together seamlessly. Work that once took 4–6 weeks can now be done in days, reducing both complexity and cost.
In humanitarian settings, time is measured in lives. In Iraq, we’re partnering with Doctors Without Borders (MSF) to digitize and connect 10 different hospital programs — from maternity and neonatal stabilization to surgery, mental health, and emergency care. Initial modules are already in use, linking patient histories, labs, prescriptions, and treatment notes so care teams have the full picture at the bedside. Once fully operational, the system will support care for over 30,000 patients annually, with the goal of adapting it to other MSF projects.
With the International Committee of the Red Cross (ICRC), we’re developing and piloting an offline-capable EMR system for conflict-affected environments in September, with interest emerging from other humanitarian actors.
We’re co-leading a multi-country research initiative on how entrepreneurship can strengthen community health. One result is a geospatial tool that maps where health services are — and where they aren’t — helping programs expand coverage and target resources more effectively.
We’re also creating a lightweight impact measurement framework to help funders and implementers understand what success looks like when adopting Digital Public Goods.
We continue to support a Ugandan PhD candidate and host graduate interns from Kenya, Uganda, and Sudan, giving them hands-on experience in real-world digital health projects. We’ve also published three peer-reviewed papers in 2024, with another under review in 2025 — sharing what we’ve learned so it strengthens health systems far beyond our own network.
Transforming health and prosperity across Africa
Two years ago, Grace Powell and Helmut Schauer shifted from growing their business to growing their impact. They brought the same strategic thinking to philanthropy that had defined their entrepreneurial success.
In that short time, they have committed $1 million to Madiro — a transformational show of confidence in the organization’s mission, model, and team. While they first encountered Madiro through their son, Adrian Schauer, and their daughter-in-law, Gillian Morantz, the co-founders, their decision to give has always gone far beyond family ties. It stems from a deep belief in blending health and social entrepreneurship to drive lasting change.
Grace emigrated from South Africa. Helmut is originally from Austria. Both eventually made Canada their home, and they know firsthand what it means to live in places with vastly different levels of opportunity and stability.
“Giving back for us means starting with health, because health is the foundation that allows people to do everything,” Grace says. “But it’s also about entrepreneurship. Without it, the youth in many African countries simply won’t find jobs; they’ll have to create them. We’ve worked hard for our success, but we recognize that in many places where Madiro works, the basics we take for granted — healthcare, safety, opportunity — are not available.”
As someone who built and ran a company for 50 years, Helmut understands how entrepreneurship can transform lives, not only for the entrepreneur but for entire communities through job creation and local economic growth. “As an entrepreneurial family, we’ve seen firsthand how building a business can ripple outward,” he adds. “We recognize that same potential in Madiro’s investees.”
They also point out that this ripple effect often benefits women most directly. Half of Madiro’s portfolio companies are led by female founders, and in investees such as Healthy Entrepreneurs, Benecare, and Malaica, the overwhelming majority of jobs created are for women. These opportunities provide income, stability, and a better future for their families and communities.
They also value the governance strength that underpins Madiro’s investment model. “The fact that Madiro appoints a director or a board observer on every investee company means you can help those businesses stay mission-focused, drive measurable impact, and avoid pitfalls. For us, that’s a critical safeguard and a sign of real partnership.”
Their first gift of $500,000 in 2024 was followed by another $500,000 in 2025 after they saw the results. “We could see the portfolio growth and impact,” Grace recalls. “The social enterprises Madiro supports make a real difference, whether it’s bringing care into the home, making vision care affordable and accessible, or connecting rural health facilities so they can treat patients more effectively. We know our contributions are going exactly where they’re needed most.”
Helmut adds: “We get direct feedback, whether it’s an impact report that lays out results, an email update on a project milestone, or a conversation with the team that gives us a behind-the-scenes view. It’s not like putting money into a big pot and never hearing back. We can draw a clear line between what we give and the results on the ground.”
For Grace and Helmut, philanthropy is also about global foresight. “Africa’s population is growing fast,” Helmut says. “Its well-being will shape the future for all of us. The only real way forward is to help countries develop so people can build their own futures where they are.”
Their ongoing commitment is both practical and deeply human: a recognition that smart, entrepreneurial health solutions don’t just improve lives. They create the conditions for entire communities to thrive.
This is what it looks like to build health systems that work:
Real tools. Real evidence. Real people — solving real problems.
Help unlock health and prosperity for millions
Madiro exists to save lives, reduce suffering, and invest in solutions and startups that improve health and create lasting prosperity. The most important growth in our work happens when visionary partners lean in. Together, we can extend life-saving care and entrepreneurial health solutions to millions more people across Africa.
Join us in three ways:
• Make a gift that accelerates what works — whether it’s $200, $20,000, or $2M, your contribution will have tangible, measurable impact.
• Introduce us to a like-minded friend, family office, or foundation.
• Explore a co-investment or strategic partnership that aligns with your vision for change.
Let’s shape the future of health and prosperity together — reach us at impact@madiro.org.
About the author
James Fraser is the President & CEO of Madiro, where he leads efforts that combine philanthropy, investment, and innovation to advance health globally, with much of the organization’s focus centered in Africa. He has worked at the intersection of entrepreneurship and global health for much of his career, and believes in building organizations that uphold the dignity of every individual while delivering social impact at scale.
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January 2024 travel log
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From reports to reality: our team members visit Madiro's initiatives in East Africa in May 2024
SIXKNM outreach program in Kenya transforms lives of mental health patients and involves the community to fight against stigma.
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Transformative potential lies in strategic partnerships to drive tailored solutions for community needs.
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