Wireless lifelines

Cell phones, ubiquitous in the developing world, can be used to save countless lives

March 28, 2010|By James BonTempo

In Malawi, community health workers are using mobile phones to coordinate emergency care, track patients, improve the use of medications and connect support groups. It's just one example of the growing potential for mobile technology to change lives and improve the health of the poorest and most under-served people around the world.

There are now more than 4.6 billion mobile phones in the world -- a phone for more than two-thirds of the global population. Surprisingly, most of the growth in the past decade has occurred in the developing world. A number of things have brought this about: technology standards that allow for economies of scale; pre-paid systems that run on cash; competition that has reduced service costs; basic phones that cost less than $20; and macro- and microeconomic benefits that have been realized through phone ownership.

Why not take advantage of the most impressive technology adoption in history and leverage a tool that is in almost everybody's hands? Mobile technology can be repurposed to strengthen health systems and empower people. Here are some examples of how:

• In the Malawi case, a Stanford student and the staff at a rural hospital used 100 recycled phones, a donated computer and free software to develop FrontlineSMS: Medic, a communications system for health workers who often travel up to 50 miles to support thousands of patients in an area the size of Rhode Island.

• When violence erupted in Kenya after the 2007 elections, a group of hackers developed an application called Ushahidi. It mashed up text messaging, e-mail, the Web and mapping and was used to track outbreaks of violence. Today, Ushahidi is powering Stop Stock-Outs, an initiative in sub-Saharan Africa in which text messages alert health officials to dwindling stocks to ensure that lifesaving drugs are directed to where they're needed most.

• In South Africa, mobile operators provide a service called "Please Call Me," or PCM. If you're out of air time, you send someone a free PCM message asking them to call you back. The message includes your number, but there's room for more text. Project Masiluleke incorporates health messages in the remaining space; after the first messages were sent out, calls to their help line tripled.

Mobile technology also can help address a lack of medical diagnostic services in the developing world. Laboratory equipment is expensive, difficult to procure and maintain, and there's a lack of trained technicians. A group at the University of California, Los Angeles came up with a technology called LUCAS that captures images of the shadow of human cells using a mobile phone camera. This information can be used in the detection and treatment of HIV, tuberculosis and malaria. The extra hardware costs less than $10.

Realizing the full potential of mobile technology in places like Malawi and South Africa remains a challenge. Despite reductions brought about by competition, the cost of services in the developing world is still disproportionately high. For example, in Kenya, the bottom three-quarters of earners spend more than 25 percent of their income on mobile services. And $20 phones are very basic, with only voice and text messaging.

Then there's the issue of research. There is anecdotal evidence about the impact of mobile technology on health, but there's not much data. Before donors will support such programs, they want proof of the technology's effectiveness. It's a "Catch 22" -- we need support to generate the evidence, but we need evidence in order to secure the research dollars.

Such challenges are not insurmountable. The cost of services and hardware is falling every day -- a $20 smartphone will revolutionize global health, and the technology's efficacy will be evident.

How can you support this movement? Find your old mobile phones, print out a free shipping label from Hope Phones (hopephones.org), and send them in. They will be recycled, and the proceeds will go to buying new phones for health workers in the developing world.

This may be one of the greatest technological opportunities in our lifetime, and as the challenges are overcome, we can look forward to saving lives, one mobile phone at a time.

James BonTempo, a technology adviser at a Baltimore health nonprofit, blogs at http://linearityofexpectation.blogspot.com/. His e-mail is jamesbontempo@gmail.com. A version of this piece was delivered at Ignite Baltimore #5 and is available on YouTube (www.youtube.com/watch?v=OD5FievbNnw).

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