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SMS for Life:Tanzania's solution to healthcare

17 July 2012

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SMS for Life, an initiative of Novartis, IBM, Vodafone, the Roll Back Media Partnership and the Ministry of Health and Social Welfare of Tanzania uses SMS and mobile technology to process monitoring the availability of drugs in remote health centres.

Dalila knows about malaria. It killed her father and her daughter. She knows the debilitating fever that wracks her body two or three times a year. And the fear her three other children will suffer the same. She knows too that there are medicines that can cure her disease and protect her children. She knows she can't get them. She would like to know why.

Dalila lives in Lindi a remote farming district in southern Tanzania. A district of small villages and dusty roads. Of farming and fishing. Where the harsh reality of wresting a meagre living from the land is accompanied by the ever-present threat of disease. For the same fields and rivers that sustain life in Lindi are also the breeding ground for the malaria carrying mosquitoes that can take life away. In this Lindi is not much different from the rest of Tanzania where malaria is endemic and where one person dies from the disease every five minutes. It is the same in Ulanga and Kigomo the two other districts that are part of the SMS for Life team's pilot project. In May, representatives from Novartis, Vodafone and IBM, all partners in the Roll Back Malaria Initiative, visited the three areas to see for themselves if they had the answer to Dalila's question.

The team had worked on it for the previous six months. They had talked with the authorities in Tanzania. They had discussed the health questions with professionals and malaria specialists. They had looked into the supply problems with Novartis, Central Medical Stores and multiple NGO's. They had researched the technical issues with Vodafone, IBM and Google. Their work had shown that the problem was not political, or bureaucratic, or even financial. It was essentially logistical. "We knew from our research that the barriers were in the supply chain and the solution was technological", said Jim Barrington, the Program Director for SMS for Life, on special assignment from Novartis. "We have the medicines. We can get them to Tanzania. But they aren't getting through to the people who need them in time and in sufficient quantity. What we wanted to see on this trip was if the solutions we designed back in our organisations could work on the ground".

The idea was elegant and simple - to harness text messaging over mobile phones with Google maps to manage stocks of anti-malarial drugs and diagnostic tests in public health facilities. Vodafone had designed a system that would automatically send a weekly text message to health posts requesting reports on stock levels. Google maps could then be used to provide an overview of stock status and needs. With this information medicines could be supplied when and where they are needed.

Accompanied by Winfred Mwafongo, Senior Health Officer from the Ministry of Health, the team travelled more than 2900 kms on the three week visit. Their trip took them into remote rural areas mainly on dirt roads that were at times almost impassable. They visited hospitals, health posts and clinics. They discussed the problems with District Medical Officers, with doctors and health workers, with community leaders and aid professionals. They spoke with villagers and patients. They saw the debilitating effect that malaria has on individuals and on communities. In many of these clinics, under corrugated iron roofs beside dusty roads they met people in similar circumstances to Dalila. They offered them the hope that the system they had designed could deliver the medicines that their children so desperately need.

A key finding of the visit was that mobile phone networks covered the vast majority of health facilities even in the remotest rural areas. "The insights we gained from talking to those directly involved and the technical information we gathered have allowed us to fix a date to start the pilot project", says Kevin Ferriday the team member from Vodafone. IBM team member, Pete Ward, agrees, "with what we have learned on this trip we can go ahead with the pilot in September".

"It was an exciting and somehow humbling moment", said Jim Barrington, "the knowledge that everyday technologies – mobile phones, the internet, web mapping – technologies that are in almost every household in the developed world - could be used to save lives here in Africa. I think all of us were inspired by the resilience of the people threatened by malaria, and moved by their hope that we could help them. And we were impressed by the commitment of the officials we met in Dar es Salam and in the districts as well as by their determination to make the system work."

Soon we will know if Dalila's question has been answered. And if the promise carried by the title of the project – SMS for Life - can be fulfilled.

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