Health companies are using Latin America´s largest
last-mile app, Rappi, to book at-home medical services with
certified health workers to conduct them.
By DANIELA DIB and TAMLIN MAGEE
23 MAY 2022 ” MEXICO CITY, MEXICO
Donning a medical robe and a helmet, one nurse working through
last-mile app Rappi’s home-delivery shifts — who spoke to
Rest of World on condition of anonymity to protect his job
— said he was recruited in early 2022 by a private medical
lab partnered with the app. He usually does eight-hour shifts from
7 a.m. to 3 p.m. and moves around by a motorcycle provided by his
lab, which also pays for his fuel. He’s particularly satisfied
with his new job.
“I get around much faster on the motorcycle. … So my
shift usually ends on time,” he told Rest of World.
“Sometimes I go to the park or have lunch between
appointments.”
Rappi, the ubiquitous last-mile delivery platform founded in
2015 in Colombia, allows users in Mexico City and Bogotá to
order and make appointments to get blood drawn for clinical lab
tests — for pregnancy, STIs, and Covid-19 — as well as
to get vaccinations for HPV, herpes, and pneumococcal disease
delivered and applied at their own homes. Starting with Covid-19
testing in 2020, Rappi now acts as an intermediary for half a dozen
health care providers in Mexico City, whose staff apply tests or
vaccines and then process the results.
Rappi executives and one of the company’s partnered health
care providers told Rest of World that the pandemic
offered a mutually beneficial opportunity for partnership. But
health care workers also came out winning, according to the lab
staff that spoke to Rest of World. For the nurse who asked
to remain anonymous, the delivery gig meant an opportunity to
secure a full-time job. For Viviana López, also a trained
nurse who has been fully employed for seven years by Previta, a
Rappi-partnered provider, and supervises its lab department, it was
a chance to do better at her job. “For medical workers like
us, it’s very fulfilling to be closer to the patients in times
like these.”
Rappi came upon the model of health delivery through
partnerships after botching much of its own company’s health
care policy throughout the Covid-19 pandemic. The self-proclaimed
super app stumbled first as it tried to ramp up its delivery services
for millions more people in lockdown and also when it infamously
tried to assign a small number of Covid-19 vaccines to its workers
on the basis of their delivery performance. The company swiftly
backtracked, but it never lost sight of the opportunities offered
by “medical services, for tests and vaccinations at
home,” Gloria Ruiz, new verticals manager at Rappi Mexico,
told Rest of World.
After a user orders a health service on the Rappi app, the lab
takes care of the rest. The health care provider receives a
notification, and one of its employees is sent to the
customer’s home. Unlike the last-mile delivery app’s
rappitenderos, who carry trademark oversized orange
backpacks, health workers are armed with normal packs,
filled with tourniquets, needles, gauze, and other medical
equipment. The worker races back to the lab before their next
appointment with many of the results sent to users within 24 hours
through WhatsApp or email — not via the Rappi app itself.
Because of their employers’ partnership with Rappi, both
López and the anonymous nurse have become delivery workers
and yet are far from being gig workers.
“You become a gig worker,” Miguel Díaz Santana,
coordinator for digital workers at grassroots workers’ rights
and civic advocacy group, Nosotrxs, told Rest of World,
“when you don’t have a secure salary, benefits, or
employment rights.”
But the two nurses interviewed were, at least, fully employed by
the companies providing the health workers for Rappi. Morgan
Guerra, co-founder, CEO, and head of medical affairs at Previta,
the lab that employs López, said that though his company
does not employ all its medical staff full time, all of the workers
who provide at-home services via Rappi are. It’s a stark
contrast to the circumstances of typical last-mile app delivery
workers, who work long hours as third-party contractors and are
paid per job without any type of social benefit.
“In the gig worker–employer relationship, work does
not disappear — what disappears is the employer as the one
who has to guarantee those labor rights,” said Díaz
Santana.
Though last-mile delivery apps, like Rappi, have faced criticism
for the working conditions of mobile couriers over the course of
the pandemic, Ingrid Ortiz,
attorney and digital health specialist at Mexico City–based
law firm Olivares, said legislation in Mexico
relating to labor and health is not as flexible as consumer product
delivery. This has meant that the rights of health workers are
generally assured.
For medical providers, partnering with Rappi was a “natural
fit,” said Guerra. Early during the pandemic, his company was
forced to go from providing health services to people through their
employers to going directly to individual customers via their own
e-commerce platform.
“Everyone became an expert in rapid tests,” Guerra
told Rest of World, referring to the multitude of small
testing companies that sprang up during the pandemic. “We
realized we had to keep up, so we partnered with Rappi to offer
business-to-consumer services,” bolstering their own in-house
platform.
However, Díaz Santana expressed concern about the
on-demand model being adopted by more industries and what it meant
for those making the deliveries. The danger is that the delivery
model spearheaded by Rappi could become the thin end of the wedge
for introducing other practices that casualize labor:
“It’s worrying that other industries adopt the precarious
model of distribution platforms, since they’re occupations that
do not grant social security and encourage informal labor,” he
said.
Even though online health care has not been addressed directly
in any specific legislation, attorney Ortiz said
that “under Mexican labor law, they most likely have a
contract with the partnering lab, meaning established working hours
and the need for the lab to be in compliance with certain specific
regulatory requirements.”
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