Building Cross-Border Infrastructure
Why My Musawo operates between Aachen and Kampala.
The question arises often, and it is a reasonable one. My Musawo is developing health guidance infrastructure for deployment in Uganda and across Sub-Saharan Africa. Why, then, is the company based in Aachen?
The short answer is that the work requires two things that are difficult to maintain from a single location: a governance-oriented development environment, and deep contextual understanding of the health systems the infrastructure is designed to serve. Germany and Uganda each contribute something operationally necessary. Neither is sufficient on its own.
What a governance-oriented environment contributes
Developing systems that will influence health decisions requires rigorous governance, safety evaluation, and accountability structures throughout the development process.
Aachen offers that environment. The city’s broader research ecosystem, including institutions such as RWTH Aachen, provides proximity to one of Europe’s strongest environments for engineering, applied research, and health technology development. Germany’s evolving regulatory landscape, shaped in part by the EU AI Act and broader clinical AI governance discussions, also creates conditions that encourage rigorous, safety-oriented development. Working within that context is a practical choice. It shapes how the work is approached, evaluated, and developed.
My Musawo operates between Germany and Uganda. The German base contributes governance orientation and research context. It does not confer legitimacy that the work itself cannot earn.
What contextual presence contributes
A platform developed without direct clinical and community engagement in its deployment environment will struggle to function effectively there. This is not a claim about Africa specifically. It is a broader observation about infrastructure design.
The disease patterns relevant to early guidance in Uganda are not the same as those reflected in most European clinical datasets. Care-seeking behaviour, symptom interpretation, economic constraints, community trust structures, and language are not variables that can be approximated from a distance. They require sustained engagement with the clinicians and communities who navigate them daily.
My Musawo’s clinical team is based in Uganda and directly involved in shaping the guidance frameworks the platform is built around. The platform is informed not only by technical development, but by continuous exposure to the healthcare environments it is intended to support.
A platform developed without that grounding may be technically coherent while remaining contextually inadequate.
On the tension
There is a version of this story that frames the German-Ugandan structure as a tension to be managed. Governance-oriented development on one side, contextual grounding on the other. My Musawo does not find that framing useful.
The two are not in competition. A clinical guidance system that combines rigorous governance principles with genuine contextual understanding is more likely to be trusted, more likely to function effectively, and more likely to remain appropriate to its environment over time than one that optimises for either alone.
The tension is by design.
An open invitation
My Musawo is currently in research preparation and infrastructure development phase. The questions we are working through (pre-clinical guidance, contextually calibrated AI, and healthcare navigation in low-resource settings) are not questions any single organisation resolves alone.
We are interested in ongoing engagement with researchers, clinicians, health system practitioners, and institutional partners working in related areas across Germany, Uganda, and the broader field. If the infrastructure questions explored here intersect with your work, we would welcome the conversation.
My Musawo is a clinical AI health infrastructure company operating between Aachen, Germany and Uganda. Field Notes is its publication on health systems, AI governance, and the pre-clinical gap.