How mobiles save lives

A mobile phone might not seem like the most obvious tool with which to cure cleft palate. But in 2007 mobiles helped more than 40 South African children get operations to reverse the disfiguring condition as a result of a campaign that perfectly exemplifies the value of an emerging field called mobile health, or mHealth, where mobility tools are applied to healthcare delivery.

In the Smile for You campaign, private hospital group Netcare teamed up with service provider Vodacom and the Praekelt Foundation, a mobile technology incubator, to boost response rates for an appeal for free cleft palate operations.

A previous campaign had relied on print and radio ads to spread the word about the availability of 50 free surgeries, but had only yielded 12 candidates over six weeks.

Corporate social responsibility

In contrast, the October 2007 push, promoted via widely used Please Call Me text messages, drew 355 responses and helped 42 children get treatment...in three days. The initiative not only helped launch an ongoing corporate social responsibility program which has now been responsible for more than 320 palate deformity operations, but also added to the growing trend of using of mHealth in developing countries. The big opportunity that clinicians and healthcare policy makers see in m-health is that while few people yet have access to computers in the developing world, mobile phones are increasingly ubiquitous.
"The health sector is saying 'there are all these mobile phones out there - close to five billion - so how can we capitalise on this technology?'," says Dr Patricia Mechael, director, Strategic Application of Mobile Technology for Public Health and Development, at Columbia University's Earth Institute. "Many governments, particularly in Africa, are developing mHealth strategies and public-private partnerships to see how they can leverage the pioneering work non-government organisations have been doing for almost 10 years."

Basic healthcare

This work, she says, started out with fairly basic applications, such as healthcare workers communicating with each other by mobile to get advice or a second opinion. But in recent years the use of mobile technology has become more complex, and now encompasses a wide range of health-related applications, including remote patient monitoring, data collection, mobile telemedicine, awareness campaigns, and more. Furthermore, it is an area in which developing nations are very much taking the lead.
In a survey of 51 schemes in a 2009 mHealth for Development study by the United Nations Foundation and Vodafone Foundation, South Africa and Uganda boasted six each, with a further nine in the rest of the continent. This has since increased dramatically.

Rural populations

Asia meanwhile had 18 (including 11 in India) and Latin America, 10. "In a lot of developing countries, reaching remote populations with health information and services can be very challenging," Mechael notes. "People are not living close together, there are large rural populations, and health services may not be accessible. In trying to bridge the gap of access to health, mobile technology is the first entry point."

Notable mHealth initiatives include Project Masiluleke in South Africa, where text messaging helped increase HIV/AIDS helpline calls almost threefold, and Text to Change in Uganda, another HIV/AIDS campaign which boosted the number of people getting counseled and tested by 40 percent. Because most of the development activity around mHealth is taking place in developing nations, many of the applications emerging are ones that might not even occur to Silicon Valley entrepreneurs.

mHealth applications

Ghana-based non-profit organisation MPedigree, for example, has developed an mHealth app to fight the drug counterfeiting which is rampant in many parts of Africa.
"Our service allows consumers to send a free text message to a universal number and get a response back telling them that the medicine they are about to take, right at the point of purchase, is safe for them," says MPedigree President Bright Simons. And it is not just the general public that benefits from mHealth in Africa.
"At the next level, you have the quality of care," says Patricia Mechael. "Many healthcare workers work under isolated and stressful conditions."
Mobiles help them connect with colleagues and improve their access to advice and training, she says.
"The mobile phone has made them feel less lonely, and that is a huge benefit."

Improving interoperability

There is still a way to go before mHealth reaches its full potential, however.
"Programs are being implemented independently of each other in different countries, so there will be a big push to standardise and improve interoperability," Mechael points out. "Otherwise there is no additive impact to the work we are doing.
"You might have two NGOs doing similar projects next to each other but it is no good to the community they are focusing on if the two systems they are implementing do not work together."
Luckily with mHealth, the answer, in theory at least, is easy: get on the mobile to each other.
 
Jason Deign