Feb 20, 2010
Posted by Erica Trauba
I ni ce and hello from Bamako!
My name
is Alex Harsha, and I am from New Ulm,
Minnesota. I am a recent
graduate of Lewis & Clark College in
Portland, Oregon, where I
studied international relations and
bio-chemistry. It was an
interesting, challenging (and odd) combination,
and it allowed me to
deepen my interest in global healthcare issues.
While at Lewis &
Clark, I became a member of an organization
called SMS:Medic
(http://medic.frontlinesms.com/"Frontline), an
organization
that I believe will have a major impact on
global health systems
through its pioneering use of a simple,
low-cost mobile technology
program. In May, MHOP decided to pilot
FrontlineSMS:Medic with their
CHW program, and I jumped at the chance to join
the team as Infotech
Coordinator.
So what will I be doing, and why?
Few would deny that this is now a critical time
in global health. While
epidemics of HIV/AIDS, tuberculosis and malaria
continue to claim
growing numbers of lives, the world faces a
shortfall of 4.4 million
health care workers. To close this health care
gap, many clinics in
developing areas now rely on community health
workers (CHWs) to extend
their reach. A CHW is a trained member of the
local community who
serves as a link between peripheral villages
and central clinics,
providing home based care and educational
programs to those who might
not otherwise access any medical care.
Unfortunately, these community
health workers are often as disconnected from
the clinics as the
communities they serve; CHWs must walk long
distances to relay urgent
messages or deliver paper health records,
making both rapid emergency
response and general program oversight costly
and difficult.
FrontlineSMS:Medic seeks to address this
problem by empowering CHWs to
access and record patient data in a central
automated medical records
system via text message. The team is also
working on geospatial mapping
tools to allow clinics to visualize coverage or
monitor disease
outbreak and on integration of the software
with a revolutionary
cell-phone camera diagnostic tool called
Celloscope. Over the next few
years, CHWs will not only be able to record
patient visits, send
requests for information or emergency
assistence, map disease burden
but also provide automated diagnosis of
malaria, tuberculosis or even
HIV from the back of a cell phone. While
internet access is often
unavailable or prohibitively expensive in the
world's poorest regions,
mobile phone usage is now nearly universal and
relatively cheap; by
focusing on basic cell phones rather than
smartphones (like your iPhone
or Blackberry), FrontlineSMS:Medic is thus
developing an accessible,
sustainable, low-tech answer to a critical
need.
Our team of young entrepreneurs (the oldest a
first-year med student at
Stanford!) recently had the opportunity to
pitch their ideas at a
mobile technology conference in San Jose, and
we were honored to
receive $45,000 in seed funding for the
software development this year.
Money for implementation, however, must still
be raised by each
clinical partner -- a difficult prospect when
these cash-strapped
organizations already face huge resource
barriers.
Few countries have fewer human resources for
health than Mali. Here,
there are only 0.6 health care workers (nurses,
physicians, midwives
and CHWs) for every 1000 people – one quarter
the recommended number of
health care workers, and one seventh of the
world’s average. This
shortfall compounds the major barriers to
health care access in a
country where nearly 95% of the urban
population lives in slums and
only 36% of the entire population live within 5
km of a healthcare
center. In the face of these barriers, Mali’s
population health
indicators are staggeringly poor: 20% of
children die before the age of
five, and 90% of those deaths are attributable
to preventable or
treatable illnesses such as malaria, diarrhea,
malnutrition, and
respiratory infection.
For this reason, I was offered – and gladly
accepted – the opportunity
to spend the next year implementing a
FrontlineSMS:Medic program with
the Mali Health Organizing Project. The program
will pilot with MHOP's
cadre of twelve CHWs trained in the prevention
and identification of
life threatening illnesses. These CHWs make
bi-weekly visits to provide
health education and care to over 600 children
under the age of five,
including early identification of malaria,
diarrhea, malnutrition and
respiratory infections. Since the beginning of
this program in 2007,
more than 2,000 people have been enrolled. With
the CHW initiative
aimed at reducing child mortality by 90%, this
means nearly 150
children’s lives saved every year! The
implementation of
FrontlineSMS:Medic promises to increase this
capacity to reach all
60,000 members of Sikorono by 2014, giving
another 3,500 children
life-saving education and treatment.
I am thrilled to begin implementing MHOP's (and
Mali's) first mobile
electronic medical records program, but we need
your help. MHOP relies
on the generosity of its donors and volunteers
(me!) to make big
projects like this happen. Thanks to the
generous support of family and
friends, I raised the $5,500 needed to support
my work here and am
hopeful that we will raise another $7,000
within the next few months to
cover FrontlineSMS:Medic program
costs.
Mobile technology can dramatically improve CHW
programs all over the
world, and MHOP is very excited to be among the
first to test it. Since
arriving in Bamako, we have had some promising
discussions with the
health offices of USAID and Millenium Village
Projects – both of whom
will be watching our work closely. We will also
participate in
knowledge-sharing through partnerships with the
Direction Regional du
Sante, Doctors Without Borders,
GrameenHealth, Partners in Health and
the Clinton HIV/AIDS Initiative. What we do in
Mali has the potential
to impact health care delivery
worldwide.
Please consider a generous contribution to help
us make this project a
reality. A $240 donation will give 50 children
access to better medical
care through FrontlineSMS:Medic patient
records, $475 will fund our
first month of implementation, and $1,440 will
pay for the program's
text message fees for the first six months. The
Mali Health Organizing
Project is a registered 501c3 organization, and
all donations greater
than $20 will receive a receipt for tax
purposes. And remember, if you
donate online between November 10 and November
30 using the Global
Giving program, your gift could be matched by
up to 50%! Please check
out their website for details.
If you have any questions about
FrontlineSMS:Medic or our Infotech
Program here iat MHOP, please do not hesitate
to get in touch. It is
going to be an exciting, challenging year, and
I am looking forward to
sharing my experiences both here and on
my personal blog
(http://www.akharsha.blogspot.com). I do hope
that you
will continue to follow along, as your support
makes all the difference.
Sending my best wishes from Bamako,
Alex Harsha
Project Coordinator for the Mali Health
Organizing Project
FrontlineSMS:Medic
alexh@malihealth.org
alex@medic.frontlinesms.com
(011) +223 76 63 85 55
