The Last Mile: Why Zimbabwe’s AI Future Depends on Places Like Lismore Clinic

By Andrea Nokwanda Bule

CHEGUTU — THE Postal and Telecommunications Regulatory Authority of Zimbabwe (POTRAZ) Q4 2025 Sector Performance Report paints a picture of a
country charging forward. National internet penetration reached 84.55%. Mobile data traffic
surged 11.27% in a single quarter, from 144 Petabytes to 160 Petabytes. Zimbabwe’s total
Starlink subscriber base now exceeds that of all other Southern African countries combined
— over 67,000 subscribers — putting it neck and neck with Nigeria, historically the
continent’s largest Starlink market, according to Space In Africa. Since Starlink’s entry into
Zimbabwe in September 2024, the service has recorded an average quarterly growth rate of
126%.

These are extraordinary numbers. They deserve to be celebrated.

Into this momentum arrives Zimbabwe’s National Artificial Intelligence Strategy (2026–
2030) — an ambitious document that envisions Zimbabwe as a regional hub for AI-driven development, applying artificial intelligence to agriculture, healthcare, education, and governance, grounded in the Ubuntu philosophy of human-centred, inclusive progress. It is not merely a technology roadmap. It is a national development blueprint — a declaration that Zimbabwe intends to shape the AI revolution rather than be shaped by it.

But numbers can also flatter. And blueprints can only deliver on their promise if they reach
the people they are written for.

What the Averages Are Hiding

A national internet penetration rate of 84.55% sounds close to universal. It is not. It is an
average — and averages obscure the communities at the bottom of the distribution, the ones pulling the figure down, the clinic at the end of a road that no navigation app can find.

The TechZim breakdown of POTRAZ data makes the disparity visceral: the average Starlink user in Zimbabwe consumes 836 GB of data per month. The average mobile user consumes 4 GB. That is not a gap. That is a different reality entirely — and it maps almost perfectly onto the divide between connected urban Zimbabwe and the remote communities that exist beyond the last cell tower.

We visited one of those communities recently. Lismore Clinic, in the remote reaches of
Chegutu, is a place where there are no cars. Not really. People travel by donkey cart or oxdrawn cart. The dirt road into the area does not appear on most navigation apps — because most navigation apps assume you have data. Here, there is none.

A Clinic Practicing Medicine in Silence

The World Health Organization defines Universal Health Coverage — SDG Target 3.8 — as ensuring that all people receive the quality health services they need, when and where they need them, without suffering financial hardship. It is one of the most fundamental
commitments of the 2030 Sustainable Development Agenda: access to quality essential health care services for all.

The Declaration of Alma-Ata, which first codified the principles of Primary Health Care in 1978, was equally unambiguous. Health services must be accessible to all people regardless of geographic location. They must utilise appropriate technology — scientifically sound, adaptable to local needs, and sustainable within the resources a community can afford. These are not aspirational principles. They are the baseline.

Lismore Clinic falls short of that baseline — not through any failure of the people who work
there, but through a failure of infrastructure.

When we arrived, we were told the nurse in charge was up on the hill. Not for the view. She
had climbed to the nearest high point, as she regularly did, to find enough signal to send
paperwork to the city and make the phone calls that running a clinic requires. That was the system. That was the workaround that passed for connectivity at Lismore.

When she came back down and the installation was complete, her response was not complicated. She said the work could now be done faster and more easily. Simple words.
But consider what they contain: years of climbing hills, of delayed referrals, of
administrative tasks that consumed hours because a signal had to be hunted before a
document could be sent. What she described as “easier” was, in reality, the restoration of a
basic professional dignity that her urban counterparts have never once had to think about.

The nurses at Lismore are skilled and deeply committed. But they have been practicing
medicine the way it was practiced before the telephone — entirely isolated, dependent on
what they already know, with no ability to reach outward. A nurse who suspects a rare
presentation cannot consult a colleague. A mother in complicated labour cannot access
specialist guidance. A patient requiring urgent referral travels hours before anyone at the
receiving facility knows they are coming.

This is not a story about a failing clinic. It is a story about what accessibility — one of the
foundational principles of Primary Health Care — actually requires in the twenty-first century. Geographical access is no longer only about roads. It is about connectivity. And without it, the principle is hollow.

Government Is Moving — But the Last Mile Needs More

To its credit, the Zimbabwean government has not been standing still. The Presidential
Internet Scheme’s deployment of 8,000 Starlink kits to primary and secondary schools
across remote and underserved districts is a tangible and meaningful commitment. Partners
like the People’s Own Savings Bank (POSB) are supporting solar-powered, high-speed internet access in schools that have never had it. The AI Strategy itself recognises connectivity as foundational infrastructure — you cannot build an AI-powered health system on a network that does not reach the clinic.

These efforts matter. They signal a government that understands digital infrastructure is the backbone of the Fourth Industrial Revolution.

But schools are not clinics. The Presidential Scheme reaches students during the day. The
mother who presents in complicated labour at 2 a.m. needs the clinic to be connected too.
Universal Health Coverage, by its very definition, does not operate on school hours. The broader community — the elderly, the chronically ill, the families separated by migration — needs connectivity that extends beyond the classroom and into the full architecture of community life.

More recognition must also be made of the role being played by the private sector — the
startups, entrepreneurs, and social enterprises covering ground that formal programmes
have not yet reached. The gap between policy ambition and lived reality is being bridged,
right now, by satellite dishes going up on clinic rooftops in places that do not feature in the
quarterly reports.

Appropriate Technology, Applied

The PHC principle of appropriate technology calls for solutions that are scientifically sound,
adapted to local conditions, and maintainable by communities themselves. Satellite internet
connectivity — specifically low-earth orbit technology — meets that definition precisely in
contexts like Lismore. It requires no ground infrastructure, no cable, no fibre backbone that
must first be extended hundreds of kilometres. A dish, a power source, and a clear view of
the sky are sufficient. In communities where ox carts are the primary transport, this is not a luxury solution. It is the appropriate one.

That said, appropriate technology also demands honesty about its constraints. Power
reliability remains a genuine challenge in remote settings — solar backup systems must be planned for, not assumed. Monthly subscription costs, while declining, still represent a significant consideration for facilities operating on tight public health budgets. Hardware maintenance and local technical capacity must be built, not just installed and forgotten. A dish on a rooftop is a beginning, not a conclusion. Sustaining connectivity in underserved communities requires ongoing commitment from government health budgets, development
partners, and the regulatory environment — including clear frameworks for how rural health facilities access and fund digital infrastructure.

These are solvable problems. But they deserve to be named, because the communities that
need connectivity most are also the least positioned to absorb the cost of a solution that is not properly supported after the installation photograph has been taken. When the conditions are right, the results are immediate and measurable. A nurse can conduct a video consultation with a specialist physician in Harare — closing a referral gap that previously required a patient to travel hours on uncertain roads. Patient records can be digitised and transmitted ahead of referrals, so receiving facilities are prepared. Emergency communications no longer depend on someone driving to find a signal. Families separated by migration can communicate without a physical journey. Farmers can access market prices before they travel to sell.

Each of these outcomes contributes directly to what SDG 3.8 envisions: quality health
services, when and where they are needed, without the financial hardship of a long and
costly journey just to access care that should be available closer to home.

The Revolution Must Reach the Road That Has No Name

Zimbabwe’s Starlink story is genuinely remarkable. Fixed internet traffic from Starlink alone grew 42.76% in Q4 2025 — the fastest growth of any provider in the country. The
subscriber base rivals Nigeria’s. The infrastructure exists. The national will, expressed through the AI Strategy and the Presidential Scheme, is real.

What remains is the commitment to follow that ambition all the way to the end — past the
town, past the school, past the last cell tower, and down the road that does not appear on
navigation apps.

The Declaration of Alma-Ata declared that gross inequality in health status between and
within countries is “politically, socially and economically unacceptable.” Nearly five decades later, that declaration still has unfinished business. A nurse climbing a hill to send paperwork is precisely the kind of inequality it was written to address.

So here is the call: to policymakers, include rural health facilities explicitly in national digital connectivity mandates not as an afterthought to school programmes, but as a parallel priority with dedicated funding. To telecoms operators and development finance institutions, the last mile is not a loss-making burden; it is an underserved market with measurable social return. To the private sector and Al developers building Zimbabwe’s digital future, the data you need to train health models, the populations you need to serve, and the credibility you need to claim a human-centred Al strategy all of it lives in communities like Lismore. To health ministries and district authorities, advocate loudly for your facilities. A connected clinic is not a luxury. It is the minimum condition for delivering on Universal Health Coverage.

Zimbabwe’s Al future will be measured not by the sophistication of what is built in Harare, but by whether it reaches Lismore. Not by the national average, but by the people that average has been concealing.

The numbers are impressive. The strategy is bold. No nurse should ever have to climb another hill.

Andrea Nokwanda Bule is a BSc Telecommunications Engineering graduate and Founder of AetherLink Solutions, a startup dedicated to expanding digital connectivity across Zimbabwe. With expertise in satellite deployments and infrastructure logistics, she bridges the digital divide for underserved communities. Andrea is a Cisco Certified Network Associate, Data Analyst and a member of the Young Al Leaders Community, advocating for sovereign digital infrastructure and human-centric Al adoption. Phone: +263771537759