EOTV: Doing Mobile Health Right

Published February 24, 2009 @ 10:49AM PT

It's July 8th, 2008, in Namitete, Malawi. St. Gabriel's Hospital receives a text message from a community health worker (CHW), 40 miles away. A man, suffering from epilepsy, fell into a fire and developed a massive ulcer on his left heel.

I hop on the back of a motorbike with a nurse and a bag of drugs, and jet through villages to get to the patient's home. His heel is a mess - there is no way he could have traveled to the hospital. As Alex bandages the patient's foot and explains proper administration of pain medication to the CHW, community members gather in the background, eager to witness an unprecedented medical response.

Earlier in the summer, I lugged 100 recycled cell phones, a donated laptop and a copy of FrontlineSMS through customs. In eight weeks, the hospital staff and I trained 75 CHWs to text-message. Alex Ngalande, the Home-Based Care nurse, had never used a computer in his life. After a few hours playing with FrontlineSMS, he was coordinating a community health network from a laptop. The network allows the hospital to track patients, record HIV and TB drug adherence, stay updated on patient status, mobilize remote communities for outreach testing, and provide instant drug dosage/usage information. Every piece of functionality developed from what the hospital and communities needed.

I spent my summer and Winter break in Malawi - which included Christmas, New Years, and my birthday. I left a family in the US to reconnect with family in Namitete, spending the holidays with groups of friends in the surrounding villages. When I wasn't working on the SMS program, I was proving my worth - consuming plenty of nsima, continuing an unbeaten streak as the local football team's goalkeeper, and broadcasting over-rehearsed Chichewa greetings.

I'm now back at Stanford, finishing up my Senior year. Since leaving Malawi last summer, I've jumped headfirst into expanding and replicating the Mobiles in Malawi pilot. I spend more than six hours a day talking with heads of NGOs, CEOs of corporations, government officials, in-country project managers, university faculty, and - basically - anyone interested in the project.

I do what I can to stay connected to the hospital and the patients it serves. When the internet is working, incoming texts are forwarded from the hospital to an email account. I wake up every morning to messages from the communities surrounding St. Gabriel's. It's a powerful way to start the day.

Over the next few months, I'll be sharing stories as we launch FrontlineSMS:Medic, to extend the capabilities of the FrontlineSMS software and bring SMS programs to health centers across several continents.

Josh Nesbit is the co-founder of FrontlineSMS:Medic and has spent much of the last year in Malawi helping community health workers to improve the reach and quality of the care they provide by harnessing mobile technology.

This is the first column of the Entrepreneurs on the Verge series, which will spend the next six months following the stories of four social innovators working around the world.

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Comments (6)

WOW this is a great project. I have a bag full of cell phones I'd love to donate. Can you use them?

Posted by leatrice brantley on 02/24/2009 @ 11:48AM PT
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I never tire of this story, Josh. What you're doing brings mobile health to life, something so many projects struggle to do.

Keep up the great work, but don't forget the studies!

Ken

Posted by Ken Banks on 02/24/2009 @ 12:19PM PT
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Great to have you blogging Josh.

@leatrice Josh can probably tell you more about that!

Posted by Nathaniel Whittemore on 02/24/2009 @ 01:13PM PT
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@leatrice We can definitely use them! Shoot me an email at josh@medic.frontlinesms.com and I'll explain how. Many thanks for reading.

@Ken 'The studies' will always be there. ;)

@Nathaniel I'm really excited to be on here, and can't wait to read the other EOTV posts.

Josh

Posted by Josh Nesbit on 02/24/2009 @ 03:17PM PT
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Wow what an amazing project!

Posted by Lucy Henderson on 02/24/2009 @ 06:38PM PT
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I had the humbling and inspiring opportunity to meet Josh this past weekend and let me tell you, this guy is the real deal. So wonderful to be able to read this post and envision what you have done/will be doing. My interest in using mobile tech for public health has probably increased 100 fold since learning about this project. Can't wait to learn more from you Josh and the others!

Posted by Andre Blackman on 02/24/2009 @ 07:01PM PT
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Josh is about to graduate from Stanford, after years studying international health and bioethics. He's committed to a global community and its health.