jopsa.org

The Hope Phones campaign launched last Monday – 8 days ago. Thanks to you (colleagues, friends, family, acquaintances, bloggers, Facebookers, and tweeps) we’ve collected over 700 phones. What impact will this make?

In short, we’ll be able to provide up to 1,400 cell phones for healthcare workers in Malawi, Burundi, Uganda, Honduras, Bangladesh, and Lesotho. Once all 700 phones are processed by our recycling partner, I’ll give you a full breakdown of the phones’ values and which clinics will benefit.

Every phone matters. Each one will give another ~50 families a connection to clinicians and clinic resources. Malawi’s average family size was 5.5 in 2006 — in a little over 1 week, what would have been trash could pull another 385,000 people into FrontlineSMS:Medic programs. Phone donors are doing more good than they know – check out a recent post on TrackerNews: “Phone Riff: Hope Phones, Healthy Texting, Conflict Minerals, Ecological Intelligence, Blue Sweaters and Doing the Right Thing.”

Clinics benefiting thanks to Hope Phones donors

There’s still a lot of work to do, and the Hope Phones campaign isn’t going anywhere. In the 8 days since Hope Phones launched, Americans have discarded more than 3.5 million phones. If we recycle just 0.5% of next week’s phones through Hope Phones, we could provide tools enabling better healthcare for 9.9 million people.

You can help. Just spread the word, and toss your old phones in the mail — one email to friends and family, one tweet, one conversation with a coworker on a lunch break. Check out the map below to track Hope Phones collection sites and partners. Email info@hopephones.org to get involved. If you’d like to start up a program at your school or workplace, we’d love to hear form you.

Thank you to everyone who helped launch this campaign.

FrontlineSMS:Medic today launched www.HopePhones.org and Hope Phones, a nationwide mobile phone collection campaign supporting mHealth programs at medical clinics in over 30 countries. The campaign will make use of old cell phones in the US to provide phones for clinics and healthcare workers in the developing world.

Cell phones are valuable tools in the battle to reduce disease and illness. The field of mHealth – the provision and coordination of health-related services via mobile communications – is blossoming in response to a global shortage of healthcare workers and the demonstrated impact made by simple, mobile tools.

Hope Phones will make use of the nearly 450,000 cell phones discarded every day in the US. HopePhones.org allows donors to print a free shipping label and send their old phone in to The Wireless Source, a global leader in wireless device recycling. The phone’s value allows FrontlineSMS:Medic to purchase usable, recycled cell phones for healthcare workers.

Hope Phones lets you give your old cell phone new life on the frontline of global health. Just one, old blackberry will allow FrontlineSMS:Medic to purchase 3-5 cell phones for healthcare workers, bringing another 250 families onto the health grid via SMS.

FrontlineSMS:Medic is an nonprofit organization advancing rural healthcare networks in the developing world through the implementation of sustainable, appropriate technologies delivered through mobile phones. Its first pilot project distributed cell phones to community health workers in 100 rural villages in Malawi, saving thousands of dollars in travel and hospital costs and doubling the number of patients treated for tuberculosis in the catchment area. Stories about FrontlineSMS: Medic projects have been featured in CNN, Discovery Channel news, the BBC, The Guardian, PC World and Reuters.

The organization uses FrontlineSMS, a free, open-source software program that enables large-scale, two-way text messaging using only a laptop, a GSM modem, and cell phones. Their pilot implementation model places a laptop running FrontlineSMS in a central clinic and distributes cell phones to healthcare workers to coordinate care with patients in peripheral villages. Their programs currently serve 1.2 million patients in Malawi and Uganda. Future development of the FrontlineSMS:Medic platform will encompass electronic medical records and diagnostics at the point of care.

Coupled with free, open-source software, the hardware provided through Hope Phones will scale mHealth initiatives, connecting thousands of clinics worldwide to remote healthcare workers and patients. The campaign was designed in partnership with Wieden+Kennedy – the global advertising agency of the year in 2007 and the creator of Nike’s “Just Do It” campaign – with support from kiwanja.net and The William and Flora Hewlett Foundation.

Simple ways to help:

1. Visit www.HopePhones.org and donate your old phones.
2. Spread the word!

• Email your friends, family, classmates and coworkers.
• Post on Facebook and become a fan of the Hope Phones page.
• Tell the world on Twitter – use #HopePhones as a tag so we can thank you.
• Let us know if you want the Hope Phones widget for your website or blog.

3. Contact us at info@hopephones.org if you’d like to help set up a Hope Phones collection center.

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:

Day 1:

2-hour all-encompassing FrontlineSMS training session with ART coordinator, community nurses, and data managers included…

1. Connecting the GSM modem
2. Checking for new messages
3. Sending one-off messages to contacts
4. Sending group messages
5. Managing contacts and groups
6. Enabling emails via auto-forwarding
7. Auto-replies via keyword (e.g. drug information)
8. Auto top-up system (”ID#_units”)

Elly, Arthur, and Joham interacting with FrontlineSMS for the first time

See more photos from Uganda here.

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.

Day 2:

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.

Me + Henry of Ushahidi

So much has happened in the last few weeks, I’ll have to retro-blog a bit. I’ll be sharing stories from my time at clinics in Bushenyi, Uganda, soon – but I wanted to post quick thoughts on a particular discussion thread at the recent W3C workshop, “Africa Perspective on the Role of Mobile Technologies in Fostering Social and Economic Development.”

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:

1. 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.”
2. 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.
3. 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.

With support from The Children’s AIDS Fund, I will be working with Dr. Elioda Tumweisgwe to set up FrontlineSMS:Medic programs at Bushenyi Medican Center and Kabwohe Clinical Research Center in the western rural district of Bushenyi. Dr. Tumweisgwe is the Chairman of the Uganda Parliament’s HIV Committee.

Over 200 CHWs will be involved in the two programs for the clinics, which collectively serve 800,000 people in 29 subcounties and 2,304 villages.

Here’s my schedule from the night of March 18th:

• Land in Washington, D.C.
• Join Ken Banks and Alex Ngalande for a talk at IREX at Noon on the 19th, then catch a flight to Uganda
• Spend 10 days on the ground in Bushenyi at the clinics, working with local staff and CHWs
• Fly to Maputo, Mozambique to present at a World Wide Web Consortium workshop on “Africa Perspective on the Role of Mobile Technologies in Fostering Social Development” April 1-3

I’ll be documenting those two weeks with a Flip video camcorder, courtesy of the Clinton Global Initiative. Somewhere in there, my last quarter at Stanford begins. \+/

Over the past few weeks, a team has formed around FrontlineSMS in healthcare – FrontlineSMS:Medic. From our website:

FrontlineSMS:Medic is a team committed to supporting community health workers (CHWs) in the developing world using appropriate mobile technology. After almost a year of working with FrontlineSMS in Malawi, we are launching FrontlineSMS:Medic to extend the capabilities of this software and bring it to health centers across several continents.

The group will have a multi-pronged focus: (1) Rolling out the current FrontlineSMS build and supporting global partners as they implement SMS programs, and (2) Taking a modular approach to the creation of innovative mobile technologies, furthering the impact of FrontlineSMS in rural healthcare settings, and (3) using prospective studies and RCTs to assess the impact of FrontlineSMS:Medic.

Planned additions to FrontlineSMS’s functionality include (a) best practices for using the upcoming forms client within FrontlineSMS, (b) a patch with OpenMRS, allowing CHWs in the field to remotely update and retrieve electronic patient data via SMS, and (c) interfacing FrontlineMMS with SMS/MMS mediated medical diagnostic currently being developed at UCLA.

Please point your browser to medic.frontlinesms.com, read through our extended mission statement, shoot us an email, and get involved.

On March 19th, 2009, Alex Ngalande will be speaking at IREX, the International Research and Exchanges Board, in Washington, D.C., alongside Ken Banks – founder of kiwanja.net. Alex is the home-based care nurse at St. Gabriel’s Hospital, and runs Mobiles in Malawi. It will be his first time in the US.

Before the SMS program, Alex had never used a computer. After a few hours playing with FrontlineSMS and the donated laptop, the entire program was handed over to him. A large reason – if not the reason – the project has been successful is Alex’s ownership. I missed his presentation at MobileActive08, but I hope to be by his side, this time.

Alex is kind, committed, and professional – I couldn’t be happier he’s been given this opportunity. My family is equally happy, as we’ll be hosting Alex for a portion of his stay.

With this post, I am responding to kiwanja’s tag, and following in the footsteps of very impressive voices. Here are my $.02.

If someone asked me why I blog about Africa, I would give a straight response, “Because I work there.” A question might follow – “Well, why do you work there?” I think I can tackle that query with a quick story.

I was at St. Gabriel’s Hospital in the summer of 2007, volunteering with the mobile HIV testing unit, helping with immunizations, and counting pills in the pharmacy. When I wasn’t occupied, I spent time in the wards with my Mother, a physical therapist. It was my first time on the continent.

I was told that the hospital serves over 1/4 million people, spread 100 miles in every direction. There were two doctors on staff, assisted by a small group of clinical officers. The staff told  me they had recruited over 400 volunteers to act as community health workers (CHWs).

In four weeks at the hospital, I met only one CHW, who came in every week or so. I’d learn his name was Dickson Mtanga.

One day, Dickson was watching my Mother as she worked with a stroke patient, keeping track of the different exercises. As always, he carried a small notebook, wrapped in newspaper. I had seen him with the notebook, before. This time, curiosity got the best of me, and I asked him what was inside. He turned to me with a smile, scooted my way, and proudly opened the journal – revealing impeccable drug adherence charts for over 20 HIV-positive patients he was tracking. He’d walk 15 miles to check in with the patients, then another 25 miles to the hospital – just to have the ART clinician sign off on his volunteer work, and look over the statuses of his patients.

The thought that there were, potentially, 400+ ‘Dicksons’ within the hospital’s catchment area stunned me. The staff admitted that these CHWs were as disconnected from the hospital as the patients, and Mobiles in Malawi was born. I write about Africa and Malawi because I work there, and the people I work for are there.

Jopsa is excited to announce a partnership with VillageReach, a US-based nonprofit, to support their community health initiative in Balaka district, Malawi. Since 2000, VillageReach has been developing innovative solutions to issues of “last mile” healthcare logistics and infrastructure, collaborating with governments and local partners to bring healthcare and other essential services to those most in need.

In Mozambique, VillageReach and its local partners are working with 251 health centers, covering a population of over 5.2 million people. They recently released an evaluation of their projects there, cataloging some stunning results – e.g. 26.5% increase in immunization coverage and reduced vaccine stockouts from 80% to 1%.

In 2007, VillageReach began exploring opportunities for a community health project in Balaka district. Based on intensive needs assessments, their community-driven, cost-effective interventions will focus on Kwitanda health center and its catchment area. Jopsa’s goal is to complement VillageReach’s efforts to improve disease prevention and increase access to health care. The implementation of an SMS network in June 2009 will link remote communities and Health Surveillance Assistants (HSAs) to Kwitanda health center and Balaka district hospital.

The SMS program will expand the Mobiles in Malawi model, using FrontlineSMS, low-cost cell phones, solar panels, and text-messaging to support rural healthcare delivery. Jopsa.org will provide updates from the project manager, on the ground.