Josh Nesbit networking community health workers

Author: Ethan Zuckerman
Posted: 10/23/09 18:10 UTC
Info: Bio
Tags: Africa, malawi, sms, Technology, telephony, Health, ict4d, Fellows

Josh Nesbit spent summer of 2007 at a hospital in rural Malawi – St. Gabriel’s hospital.

CC image by Kris Krug.

The hospital serves 250,000 people spread over a radius of 100 miles, and has 2 doctors to privde healthcare. To deal with this incredible disparity, the hospital relies on 500 community health workers. These workers get basic training and a drug kit, and stay in the field – Nesbit tells us that he met only one of these volunteers in his first visit to the hospital.

That volunteer, Dickson, carried a notebook with him at all times, carefully wrapped in newspaper. When he finally got around to asking Dickson what was in the notebook, he learned that Dickson was keeping “beautiful handwritten drug adherence charts for 20 HIV patients,” which he was then delivering to the hospital by walking 30 miles and having nurses sign off on the charts. He realized that these health workers were often doing extraordinary work in the community, but were doing so in almost total isolation.

Josh Nesbit, photo by Kris Krüg

Shortly after, Nesbit met Ken Banks, the founder of Frontline SMS, a powerful platform that allows the sending and receiving of lots of SMS messages on a laptop. Frontline SMS was, Nesbit felt, the perfect platform to empower and network health workers. So he bought 100 phones for $10 each, a laptop, and a plane ticket back to Malawi. He’s been training workers to use the phones and to power them with solar panels, turning remote community health workers into a network.

More than 2000 patient updates have come in through the program. Certain messages merit a response from clinicians – there’s a roaving clinician who’s able to jump on a motorbike and visit patients who are in dire straits. Using the system, 130 visits have been carried out, triggered by urgent SMS messages. And thousands of less necessary visits have been saved by moving follow-up to an SMS-based system brokered by community workers who send in patient updates and adherence reports.

You can help this remarkable new project, Frontline SMS Medic. Their project, Hope Phones, encourages people to donate used phones. They’re sold and used to buy phones appropriate for the developing world which are donated to clincs. Nesbit’s target is to help 50 million people in the next through years by networking clinics and wants your used phone.