Tackling corruption and preventing the spread of tuberculosis in Africa are both pretty major challenges. When considering that vast numbers of the African population live without regular access to water, electricity, and health services, and where unemployment is higher than 25% in parts, these tasks are even more daunting.
However, the growth of mobile phone use Africa is leading the world. A recent study commissioned by Vodafone showed that 97% of people surveyed in Tanzania could access a mobile phone, while only 28% could access a land line.
RapidSMS is a SMS-based framework that manages data collection, complex workflows, and group coordination using basic mobile phones, and is able to present information gathered, in real time, on the internet. The Tuberculosis (TB) Initiative of the Millennium Villages Project (MVP) is using RapidSMS in several African sites to develop a robust TB detection, monitoring, and treatment management system.
The primary objective of the TB MVP is to assist local teams of health workers reduce the impact of TB. By improving case detection and increasing treatment success rates the initiative is decreasing TB transmission and fatalities.
Using RapidSMS, community health care workers quickly report patient information via their mobile phones and interact with the TB system using simple SMS messages. The system is then able to monitor and track treatment of patients, sending automated SMS alerts to the patient and their assigned community health care worker. Further, if a patient fails treatment and is suspected of having multidrug-resistant TB (MDR-TB), a specimen is collected for drug susceptibility testing by liquid culture. The specimen is shipped, via regular mail, to the National Reference Laboratory (NRL) for further testing.
Yanis Ben Amor of the Earth Institute, has played an active role in instigating the use of RapidSMS in the TB initiative:
“Traditionally these patients are tested and processed via a paper trail. By replacing some of these steps by SMS, we see no loss of information. Further, when we are dealing with live specimen for liquid culture of TB, time is key. If the shipment doesn’t reach the NRL within a set timeframe, or if the turnaround time for the results is too long, an alert will be sent to health workers to take another specimen. Similarly, other delays will send an alert reporting failures in the work flow, for example if a specimen goes missing.”
The data collected is displayed in a web dashboard, and provides real time monitoring of all specimens collected, their shipment status and their drug susceptibility profile. RapidSMS also generates reports that are fed into the National Healthcare Information Systems to inform local and national policy makers, as well as international groups such as the WHO.
FrontlineSMS is free award-winning, open source program that also turns a laptop and a mobile phone into a communications hub. Through their mobile phones users can send and receive group text messages, with no internet connection required. All information exchanged is stored on the user’s central computer, with developers able to access the source code to add their own tailored features. Also freely available is FrontlineSMS credit, for SMS based microfinance, and FrontlineSMS Medic, which is used to implement healthcare.
Marco Puccia, founder of International Transparency Solutions, has coordinated the use of FrontlineSMS to combat corruption in international micro-financing projects. The battlefield in the fight against corruption looks different in every country, Puccia explains:
“What we consider corruption is considered gift giving in some countries. Corruption is somewhat cultural, and there is some corruption that is driven by need and not greed.”
Puccia was tasked to eradicate corruption in an undisclosed international microfinance group, which we will refer to as MG. MG works with partner organizations in India, Africa and Mexico to distribute small loans to local recipients. Although the financial books were balancing, there had been several media exposes revealing corruption in MG funds distribution system.
To eradicate corrupt communication from partner organizations when relaying the success of fund distribution to recipients, Puccia worked with MG to modify the recipients’ booking keeping process to include FrontlineSMS. All received funds and expenditure is reported by SMS directly to MG, and when numbers don’t balance an SMS alert is sent to a key MG task member. This eradicates the reliance on partner organizations for financial reporting, and gives MG a direct communication channel with the loan recipients.
Technology comes in all shapes and sizes, and sometimes the simplest solutions are the most elegant. By taking advantage of mobile phone use in Africa, the daunting tasks of eradicating corrupt systems and fighting disease can be successfully tackled. By working with a technology that the people already have and have enthusiastically adopted, these solutions are readily engaged with, and become part of the social and political landscape.