In Bushenyi, Uganda, I worked with two ART clinics to set up FrontlineSMS:Medic programs. The SMS programs will focus mainly on supporting ART monitors and RPMs (Resident Parish Mobilizers) working within the communities. The clinics will use the system to enable patient tracking, emergency care services, symptom reporting, and adherence reporting. The following is a video of Dr. Elioda Tumwesigye, introducing the project:
Selected notes from the first two days of my 10-day trip:
2-hour all-encompassing FrontlineSMS training session with ART coordinator, community nurses, and data managers included…
Connecting the GSM modem
Checking for new messages
Sending one-off messages to contacts
Sending group messages
Managing contacts and groups
Enabling emails via auto-forwarding
Auto-replies via keyword (e.g. drug information)
Auto top-up system (“ID#_units”)
Elly, Arthur, and Joham interacting with FrontlineSMS for the first time
An important component of that training session — group worked together as one person used FrontlineSMS to, for example, add a new contact and set that contact up to receive SMS credit upon request.
During a meeting with 30+ clinicians at KCRC, I talked about the St. Gabriel’s pilot, introduced FrontlineSMS + the handsets, and talked through use cases with the staff. One nurse asked if we could recruit participants for clinical trials (and monitor trials) via SMS. That may work well, with CHWs in the field relaying study info, CHWs texting back mobile #s of interested community members, and those contacts being added to an SMS info distribution list. A few sheets of paper were passed around the group during the presentation, for staff to make note of ideas for use within the ART + community-based care programs.
More often than I expected, a very simple question arose, “What should we be talking about?” The easiest response is that it depends – on who “we” are and what we’re doing. I heard three broad options, each of which is tied to different factions I’ve encountered throughout my brief but focused mobile tech sprint, of late:
Talk about what works, right NOW. This is what interests NGOs and clinics working on the ground. They want to know what they can do, today, to impact operations and better serve beneficiaries (e.g. treat patients and support community health workers). For the most part, this group doesn’t know exactly what tech’s available, and they doubt they can afford it. I’ve heard from numerous clinics, “We knew mobile technology initiatives existed, but we never expected them to come – or work – here.”
Talk about where the technology is going, and what it’s going to take to get there. I turn to others for this information. Tech junkies rule this domain, and rightly so. They should be the ones leading the charge to construct and control tech advancements (e.g. WiMAX). This conversation excites and is clearly best suited for techies. End users are less interested.
Talk about theory and long-term convergence of best practices and competing technologies. Tech experts and NGOs with case studies can offer bits and pieces, but this conversation lends itself to policy experts, economists, and fortune tellers. If we can find technology and implementation strategies that scale horizontally, outputs of these conversations may be less prescriptive and more descriptive – with organizations choosing and mixing available technologies at their liking. Erik Hersman of White African and Ushahidi wrote about this idea a little while ago.
Obviously, there’s some crossover. But it may be useful to keep in mind how we fit into these discussions.
Those who know me will understand why I’m most passionate about the first discussion. We don’t have great means by which to connect “on-the-grounders” with tools they can use. The clinics and service providers I talk to certainly feel disconnected from what they perceive to be immense, unattainable opportunity to utilize mobile tools. Their perception of value may be accurate and real, but the barriers to entry need not be.