On March 20, 2017, Clement Okoh walked into a Lagos hospital with what previous doctors he consulted believed was a muscle strain and routine pain. Hours later, he said he could no longer walk. 

He later learnt the muscle strain diagnosis was incorrect. What had been dismissed as routine pain was later diagnosed as aggressive multiple myeloma—blood cancer that develops in plasma cells—eating away at his spine. By the time the error became clear, the damage was severe. The tumour had weakened his vertebrae —the bones that form the human spinal column—so much that a minor fall was enough to fracture his spine and leave him paralysed.

Within hours, Okoh said he was flown to the United States. The doctors at John Hopkins Hospital, in Baltimore, Maryland, USA, he said, gave him four to five years to live, with a range of immediate risks: stroke, pulmonary embolism, deep vein thrombosis, blood poisoning, and internal bleeding. Surgeons removed the tumour and fused his spine. Okoh recalled his neurosurgeon once telling him that he would never walk again. But he did.

That recovery did more than save his life; it shaped his direction afterwards. During his time in intensive care and rehabilitation, he resolved that if he survived, he would return to Nigeria and work on building systems that could reduce the chances of similar outcomes in the future.

That promise became Monte Sereno Health, an artificial intelligence-powered platform designed to deliver proactive primary care and continuous health management, founded in 2021.

The company is attempting to address a deeper structural problem in Africa’s healthcare systems: fragmentation. Patients often move between informal providers, under-resourced clinics, pharmacies, and labs that rarely share data, while overstretched doctors make decisions with limited information. 

A 2021 World Health Organisation (WHO) report on health information systems found that 30 of 47 African countries lacked the capacity to accurately register births and deaths, with cause-of-death data largely unavailable. The absence of common data standards further limits the ability to integrate and compare health information across systems.

Okoh’s misdiagnosis, he said, was not simply incompetence. It was the predictable outcome of a fragmented system,  where doctors operate with limited data, patients carry paper records, and there is little real-time verification or support during clinical decisions.

In many cases, diagnosis depends on a single doctor’s judgment, often without access to full patient history or decision support tools. A study by Mayo Clinic, a non-profit academic medical centre, shows that up to 20% of serious conditions are misdiagnosed during initial visits globally. Telehealth, which has expanded access in recent years, does not fully solve the problem. It connects patients to doctors, but offers little oversight or quality control during consultations.