Mobilising around FrontlineSMS:Medic

Today sees the launch of an exciting new initiative - FrontlineSMS:Medic - by a growing team of students mobilising around the practical application of mobile technology in global healthcare delivery. FrontlineSMS:Medic combines Josh Nesbit's pioneering work on "Mobiles in Malawi" with a mobile version of OpenMRS - an open source medical records system - and an exciting new remote diagnosis tool. In this guest blog post, Josh Nesbit and Lucky Gunasekara talk about the origins of the project, and their plans in the coming months.

Josh: I should be heading off to class, right about now. I'll go, but not without telling a story, first. A convergence of ideas and people marks the launch of FrontlineSMS:Medic and the team's embarkation on a quest to do mHealth the right way.

Many of you are familiar with the role FrontlineSMS, a donated laptop, and a bag of recycled cell phones have played in connecting community health workers (CHWs) in Malawi to a rural hospital and its resources. Text messaging is now an integral component of the hospital's infrastructure. FrontlineSMS has proven intuitively easy to use with strong user buy-in. The program is horizontally scalable, and incredibly cheap to run, matched with indisputable savings in time and costs. Enter Lucky.

Lucky: I am the bewildered South Asian guy in the photo. Back in 2008, I was sitting in an office in Tokyo reading about cellphone penetration in developing countries, wondering if mobiles couldn't also be used for boosting healthcare delivery in resource poor settings. When I wasn't wearing a suit and riding to work in a packed Tokyo subway car, I was wearing a t-shirt and khakis and working in clinics in Sri Lanka - accepting an offer to attend  Stanford Med, this year. I worked out that SMS could be used in tandem with an open source electronic medical records system called OpenMRS, allowing for continuity in patient care from the community health workers to the clinic.  Meanwhile, Josh was sweating it out in Malawi, actually learning this the hard way. Just to prove that good ideas are obvious, Isaac Holeman and Daniel Bachhuber, two students at Lewis & Clark, had the same realization and began working on a project called MobilizeMRS to get this underway.

Josh: Long story short, we're all working together now. Lucky is pictured on stage with Bill Clinton, as his CGI U commitment is announced on the group's behalf.

Lucky: The commitment is, briefly:

To build on kiwanja's CGI commitment of an Ambassadors Program within FrontlineSMS, by developing a new version of FrontlineSMS - FrontlineSMS:Medic - for use in clinics in developing countries. That Medic will have end to end of continuity of electronic medical records by fusing FrontlineSMS with OpenMRS in a modular click-to-add format. I will be taking a year off from medical school (a decision infinitely popular with my folks) to work on this system and develop new partners on the ground with Josh, and do research on a new breakthrough medical diagnostic system at UCLA, that we feel will be the "Killer App" of FrontlineSMS:Medic. More on that to come. We're also going to be fully open source with wiki user manuals and off-the-shelf healthcare packages for download, so setting up a DOTS-TB program doesn't have to be any harder than buying a song on iTunes... OK, maybe a little bit harder... but not by much.

Josh: We're planning to pull this off within a year, operating in more than 25 pilot study and partner clinics by the summer of 2010. The system will be free and so will the hardware. Check http://medic.frontlinesms.com regularly to learn more and get involved.

TSF, FrontlineSMS and humanitarian assistance in Niger

In this - the third in our series of FrontlineSMS guest posts - Grégory Rebattu, Télécoms Sans Frontières (TSF)’s Niger Representative, and Oisín Walton, Head of TSF Communications and International Relations, talk us through their thoughts on the software, and its potential for emergency relief in Niger. "I work for Télécoms Sans Frontières (TSF), the leading NGO specialising in the deployment of telecommunications in emergencies, and head-up TSF’s base here in Niger. In emergencies, telecommunication networks are often seriously damaged or destroyed. Some humanitarian crises also strike in areas with no existing communication facilities. Today, TSF plays a key role in strengthening coordination and communication by deploying telecommunications centres within 48 hours of an emergency.  These centres offer broadband Internet access, voice communications, fax lines and all the IT equipment needed for a field office.

Our base in Niger is more involved in longer term projects particularly in strengthening food crisis prevention systems. Niger is ranked 174th out of 177 nations on the United Nations Development Programme’s Human Development list - making it one of the least developed countries on Earth. The living conditions in the Sahel desert are extremely harsh and recurrent drought leads to almost permanent food insecurity. Less than 12% of the territory is cultivable - so the widely reported current food crisis hits Niger particularly hard.

Telecommunication networks are also very much in their infancy, although GSM coverage is now on the rise and bringing infinite new opportunities for the humanitarian and development sectors. In particular, we believe that text messaging – used in conjunction with cutting-edge tools such as FrontlineSMS - are particularly powerful, enabling the collection and dissemination of data quickly and easily with very low running costs. Over the past few weeks we have been working closely with the FrontlineSMS team, putting the software through its paces and assessing its suitability in our work. We have been particularly excited by the new “FrontlineSMS Forms” data collection functionality which we helped test and which is being released next week.

Crucially from our perspective, FrontlineSMS is extremely user-friendly, allowing partner organisations on the ground to rapidly deploy a data collection and dissemination system from scratch. This simplicity is crucial for organizations which may lack technical skills, and users can be up and running in a matter of minutes with the minimum of mouse clicks. The intuitive nature of the software also means that little technical support is required once they’re up and running.

I have already presented the application to a group of NGOs and UN agencies who are very excited. These organizations - who work in a wide range of sectors including health, nutrition and agriculture - immediately saw the immense potential of FrontlineSMS and how it might enhance their capacity to save lives and develop local economy, not to mention their capacity to improve the security of their own staff.

On that note, our first FrontlineSMS initiative is about to launch, and will provide an SMS security alert forwarding service to Niger’s NGO community. This will allow aid workers to instantly warn the community about security issues in real time.

Concretely, we see other immediate applications for FrontlineSMS in Niger. These include the use of the new Forms feature for data collection for the National Health System which collects and monitors the number of cases per pathology in health structures. FrontlineSMS could also be used to collect market prices, and even to disseminate those prices to small farmers.

We are also planning to test its interoperability with satellite phones which will allow us and our partner organizations to extend its usage into areas not covered by mobile networks. We also plan to use it in our responses to sudden-onset emergencies where mobile networks are often disrupted.

Summing up, FrontlineSMS is a fabulous tool and one which presents huge opportunities to non-technical NGO users. Saying that, don’t be fooled by its simplicity – as well as standard incoming and outgoing group messaging, it has plenty of advanced and extremely powerful functionality. From our testing and evaluation, and our discussions with partner organizations, it looks like FrontlineSMS has infinite applications in the humanitarian world, and this is great news for those we are trying to help.

As we often say here, it’s now no longer a question of technology, it’s a question of imagination!"

Grégory Rebattu, Niger Representative Oisín Walton, Head of Communications & International Relations Télécoms Sans Frontières www.tsfi.org

FrontlineSMS: Peacebuilding in Afghanistan

In this, the second of a series of guest posts on how FrontlineSMS is being used around the world, Dr. Mohammad Akbar and Kenneth Adam - Director and Business Advisor respectively at Media Support Partnership Afghanistan (MSPA) - talk about their current and planned uses of the platform, and the impact it is having on their work "A recent special edition of a radio programme for young people in Afghanistan was devoted to one topic – the shocking recent acid attack on girls attending school by violent extremists allied to the Taliban. The impact on the audience was recorded in some 300 phone calls from listeners – a record for the long running programme "Straight Talk", produced by a team of young broadcasters from Media Support Partnership Afghanistan (MSPA).

This audience response provides an example of what is possible given the enormous growth in mobile phones in Afghanistan, well over 6 million and rising at over 100,000 a month. Young people in the troubled south often feel isolated and bored, trapped in a conflict which shows no sign of going away. Development activities have largely been suspended because of insecurity. They want to hear and view programmes on issues important to them, and to contribute to the debate, and with 84% of households possessing working radios and 38% TVs, there is great potential in this approach.

MSPA will be using FrontlineSMS as one of the tools in a new project as part of a British Government-funded media initiative to engage with young people specifically in conflict affected regions though interactive radio programming, tied in with a national competition for young people to produce short video films on their mobile phones. FrontlineSMS will play a key role in the competitive process of selecting the individuals to be given the new mobile phones and trained in their use. This project is planned to start in April 2009. Initial trials using the software are underway, with a view to collecting information on listeners’ views on a variety of topics and feeding these back to them with the help of FrontlineSMS. This will allow active dialogue on issues as varied as the activities of NATO forces in the country and whether Afghans should bear arms, to commenting on education and health services.

Another important application this year will be in the run up to the Presidential Election  in September. The media is key to informing the population about the rights of voters, and about the policy of different candidates. FrontlineSMS could be used to elicit the views of listeners in different categories and feed back the results to listeners, prolonging the debate and in so doing capturing the interest of people who are actively engaged in the debate".

Dr. Akbar, MSPA Director Kenneth Adam, MSPA Business Adviser Media Support Partnership Afghanistan (MSPA) www.mspa.org.af