Africa’s first mHealth summit was held in June, in Cape Town, South Africa. As a result, the World Health Organization (WHO) produced a report entitled ‘mHealth: New horizons for health through mobile technologies’, which looked at the state of mHealth projects from 112 WHO member countries in 2009.

According to the report, currently over 85% of the world’s population is now covered by a commercial wireless signal. Furthermore, 5 billion people own cell phones, and 3.5 billion of them are in middle to low income countries, setting the platform for increase in opportunity for mHealth growth.

The majority of member countries (83%) reported offering at least one type of mHealth service. However, many countries offered four to six programs. The report also cited the four most frequently reported mHealth initiatives as health call centers (59%), emergency toll-free telephone services (55%), managing emergencies and disasters (54%), and mobile telemedicine (49%).

Although mHealth success was lauded by officials, there was no shortage of criticisms and concerns for the future. “Although the level of mHealth activity is growing in countries, evaluation of those activities by Member States is very low (12%). Evaluation will need to be incorporated into the project management life-cycle to ensure better quality results.” said the report.

The lack of evidence prevents policymakers from supporting mHealth infrastructure and as a result funding often goes elsewhere. “In order to be considered among other priorities, mHealth programs require evaluation. This is the foundation from which mHealth (and eHealth) can be measured: solid evidence on which policy-makers, administrators, and other actors can base their decisions,” claimed the report.

Competing health priorities was claimed as the greatest barrier to mHealth adoption by WHO member countries. The report also points out that mHealth services are not yet integrated and are mostly small scale projects targeted for specific communities. Going forward, mHealth will need to “adopt globally accepted standards and interoperable technologies” in order to facilitate effective growth in scaling up mHealth initiatives.

The report says, “Moving towards a more strategic approach to planning, development, and evaluation of mHealth activities will greatly enhance the impact of mHealth. Increased guidance and information are needed to help align mHealth with broader health priorities in countries and integrate mHealth into overall efforts to strengthen health systems.”

In an era where mobile communication is paramount, the services of mHealth may prove to be vital in the development of many low income countries. The report did itself justice by celebrating the successes of mHealth, and then laying down the hurdles to be cleared for sustainable growth. The next mHealth summit is in December in Washington DC.

HLL Lifecare Ltd, one of the largest blood bag manufacturers in India, launched a massive SMS blood donation campaign last month, targeting to reach over 5.5 million customers belonging to the top telecommunications company, BSNL.

The campaign, launched by state Health Minister Adoor Prakash on Blood Donation Day last month in Kerala, a southern state in India, wanted to highlight the virtue of blood donation as a civil responsibility for those who are able in order to help those in need.

Prakash also created a help desk called ‘Heart Beats’ designed to assist prospective blood donors. This was funded by the Hindustan Latex Family Planning Promotion Trust (HLFPPT), an organization affiliated with HLL Lifecare, in association with the Kerala State AIDS Control Society.

The purpose of the help desk is to funnel the donors to the patients. Individuals who want to donate blood voluntarily can register their details, including name, place, blood group and phone number either at the help desk or to the help desk via SMS. They are intended to be set up at local health care centers and can also assist patients during emergencies.

India has harbored SMS blood donation programs in the past. Indianblooddonors.com is  a website that serves as a database listing for thousands of blood donors from over hundreds of Indian cities. It was launched in 2000 with the SMS component implemented a few years later.

It works in the opposite way of HLL Lifecare’s system. A person in need of blood sends out a text message to a special number, mentioning, in a particular format, his name, city and the blood group required. Within a few seconds, he gets a return SMS with the name and number of a donor in that city.

Despite having the capability of saving lives, this was a little known service in India. However HLL Lifecare’s current campaign seems to be aiming for much more publicity and awareness on blood donating.

India frequently engages with shortages of blood supply. India usually faces deficits of up to millions of units of blood per year.

Furthermore, isolated populations usually have difficulties reaching out to blood donors and suppliers and often don’t get the blood they desperately need. India’s telecommunications industry is the fastest growing in the world. Nearly 75% of the population, about 900 million people, has mobile phones. Hopefully, this SMS campaign will bring light to the issue of blood donations and help curb the burden by taking advantage of mobile phone prevalence and growth in the country.

Social media may have helped fuel the 50,000 demonstrators who gathered in Kuala Lumpur this past Saturday demanding electoral reforms—despite the Malaysian government responding roughly and deeming the peaceful protests illegal.

Police fired tear gas and water cannons at the dissidents demanding change from a electoral system that they claim has unjustly favored the ruling party since the country’s independence from Britain in 1957.

The recent rally puts pressure on Prime Minister Najib Razak in the racially stimulated Southeast Asian nation, as Malaysia’s next general election is planned for 2013.

Peaceful protesters in Malaysia’s capital were met with police violence, and 1,667 arrests over the span of the weekend, according to reports. In lieu of the aggressive response, Amnesty International urged the UK government yesterday to press Najib to honor the freedom of assembly

“As a current member of the UN Human Rights Council, the Malaysian government should be setting an example to other nations and promoting human rights. Instead they appear to be suppressing them, in the worst campaign of repression we’ve seen in the country for years”, Donna Guest, Amnesty International’s Deputy Director for the Asia-Pacific. Amnesty International, states.

Bersih (The Coalition for Fair and Clean Elections) is the oppositional NGO that organized the electoral reform movement called Bersih 2.0.

The original Berish protests occurred on November 23, 2006 in the Malaysian Parliament, such attendees included political party leaders, civil society groups and NGOs, including People’s Justice Party (PKR) president, Dr. Wan Azizah Wan Ismail

The electoral reform demands of Berish 2.0, also known as 709, can be summarized in the eight following points:

1. Clean the electoral roll
2. Reform postal ballot
3. Use of indelible ink
4. Minimum 21 days campaign period
5. Free and fair access to media
6. Strengthen public institutions
7. Stop corruption
8. Stop dirty politics

Social media’s role in the Malaysian movement was to coordinate groups and record demonstrations.

As of today, the Berish 2.0 Facebook page had over 169,000 fans calling for Najib’s resignation, and the official Twitter account had close to 18,000 fans.

Though there are 10 million Facebook users in Malaysia, the preferred social media platform, protesters shared information over Twitter on how to circumvent sealed off roads and closed train stations to get to the protests.

While Facebook and Twitter were used for mobilization purposes, videos circulated on Youtube broadcast the movement to the world.

Over the span of the weekend 2,000 Youtube videos were uploaded with 2,774,812 total views based on the single keyword “Bersih 2.0″ on YouTube

As the case with the Arab Spring protests, the truth behind the movement is told by first hand perspectives of civil society, not the political parties. Social media is not a panacea current uprisings, but rather serve as a medium for organization and propagate that truth.

 

On August 11, Afghans will be able to receive free access to radio news broadcasts, cricket scores, and other informational audio content through their mobile phones.

The USAID project—named Mobile Khabar, roughly translated to “News” in Dari and Pashtu”—is made to improve Afghans’ access to information and empower local journalists.

With 28 percent illiteracy, and an estimated 60 percent of Afghans using mobiles, cellular phones are a widely used technology more accessible than radio and have a much wider reach.

Troy Etulain, the project’s architect and a senior advisor for media development in USAID’s Office of Democracy and Governance, says that when the system is up and running in a month, users will be subscribe to local radio reports by dialing a four-digit code on their cellphones.

The information will include everything from national cricket scores to English lessons offered through the Afghan foreign ministry. Additionally, audio bloggers will contribute to commentaries through a system similar to voicemail.

The system uses interactive voice response, or IVR and provides free, customizable menus of news and public information via mobile, making a variety of topics for the caller to choose from.

For example, a user could listen to a requested cricket update then hear a story about HIV/AIDS in her hometown, followed by the option to leave a message. The system can also be programmed to tell the user the number of AIDS patients nearby, letting her know that she’s not alone and creating a virtual community similar to other social media sites.

“If the technology connects, empowers or protects them or helps make other people who are not part of the community aware of them and their potential, then it’s doing profoundly new things,” Etulain declares.

USAID funding for the project runs on a $7 million grant that may increase to $16 million if option years on the main contract are fulfilled.

Mobile Khabar is just one part of USAID’s media development program in Afghanistan—the largest the agency has ever funded using new technologies, and regional journalism training centers, to seek and fill information not covered in newsrooms.

Within the centers, professional Afghan journalists and citizen bloggers are being trained in everything from Internet media skills and business management, to the reporting basics, such as ethical objectivity and story selection, Etulain says.

One of the common ways USAID utilizes these journalistic skills on the ground, is supporting community radio stations with the goal of making their operations solvent and the programming relevant to their audience, which encourages civil society participation.

For example, a call-in show that allows citizens to question their elected officials or covers topics that might not otherwise get airplay, like domestic violence or school dropout rates.

Mobile Khabar is a platform that allows local radio stations to become available on mobile phones, an innovative approach that extends the reach of information while encouraging sustainable economic development.

“From a media development perspective, this says to a local radio station in Mazari Sharif: ‘OK, now you have a national audience,” Etulain explains, “Wherever people have access to mobile phones, they can listen to you. And you get paid more the more people that listen to you.”

USAID funding for the project’s programs and bloggers are distributed based on their popularity: the more listeners they attract, the more money those programs and bloggers will earn, he says.

The Mobile Khabar project is a complement between old journalism and new technologies, providing an accessible avenue to inform Afghan civil society on relevant content. All while empowering local journalists to speak up and contribute information on what they see to their people.

 

 

As South Sudan prepares for independence, the celebrations will be tempered by the grim reality that awaits them. The nation is plagued by numerous health burdens due to decades of civil war resulting in a lack of trained health workers and poor infrastructure, and inadequate health and education systems. One such burden is HIV/AIDS. Dr. Wichgoah Piny, the state’s HIV/AIDS commissioner said that about 116,000 people are known to be infected by the virus in South Sudan, 46,000 of which are being treated at hospitals within the region. This number lies in the middle ground when looking at the rest of Africa. East Africa generally has a higher prevalence whereas West Africa exhibits a lower prevalence of the disease. Some estimates say up to 4.7 million in South Sudan are at risk of acquiring the disease.

But those numbers could grow exponentially in the coming years. The World Health Organization (WHO) has described HIV/AIDS prevalence in South Sudan as “a ticking time bomb” and a threat which needs a cooperative and collective effort to fight in the new nation. Dr. Olivia Lomoro, the GoSS Undersecretary in the Ministry of Health who spoke at a South Sudan AIDS conference warned, “HIV/AIDS is a real issue in Southern Sudan despite the efforts we have put to fight it. It remains a threat and a time bomb we are expecting.”

Dr. Mohamed Abdi, the WHO Director in South Sudan said that, “AIDS is a big problem in South Sudan and we need to fight it together.” He said that in more than two years he had worked in the region, very few people were getting treatment.

The consequences of a surge in HIV/AIDS could be catastrophic. The health infrastructure is already poor as it stands. An HIV/AIDS epidemic would paralyze the health sector for years and impair growth in other sectors. This could result in a crisis that no new government would be prepared to handle.

So in a sense, this is a defining moment for the future of health in South Sudan. As the new government establishes itself and its policies, it has the opportunity to be forward looking in the development of its health infrastructure. If HIV/AIDS is afforded a chance to “blow up” as WHO fears, the country will immediately be sunk further into a health crisis.

This presents an opportunistic entry point for the implementation of ICTs into the health sector in South Sudan.

Opportunities

A survey completed in 2006 by WHO revealed that over 910 health facilities existed in South Sudan. At the time, a majority of those facilities were claimed to be in a “deplorable state”.  However, Dr. Lomoro recently pledged that Lakes state now has a new hospital which is going to be used as a teaching hospital to help in delivering quality health. She also mentioned investments through the Chinese government will be used to build new health centers and rehabilitate old ones. Incorporating ICTs in the rehabilitation process will pay dividends for the health sector in the future.

South Sudan is being held captive by a number of health issues such as measles, yellow fever and tuberculosis to name a few. Furthermore, South Sudan has up to 80% illiteracy rates in some parts, which make communicating through ICTs invaluable. The most basic forms of ICTs like radio, television and mobile phones can build a communication bridge for the illiterate to keep them connected and informed.

Dr. Lomoro also pointed out that the first target for the Ministry of Health in the Government of South Sudan is the training of health personnel in all the ten states of South Sudan in order to deliver quality health services to the population in a professional standard. One way to go about this would be to include ICT training in that workforce development. Taking this route would build workforce capacity and bolster the development of ICTs in the country.

The population returning from Sudan proper and surrounding African countries are also coming back with health work force skills. So there is a hope that as people return, their skills will be used in improving service delivery.

Several factors exist that support the idea of integrating ICT into the health infrastructure of South Sudan

Present ICT Usage

The market for ICTs is ripe and growing in South Sudan. The initiatives that would make a big impact in fighting HIV/AIDS using ICTs utilize mobile phones and radios as the media for communication. These media platforms are the largest in South Sudan.

A 2007 survey entitled “Media Access and Use in Southern Sudan,” showed that radio was the main source of information for the population as a whole with 59% of respondents citing the radio as a source of information, the highest out of all forms of media. Additionally, HIV/AIDS awareness radio programs make up 17% of the most popular radio programs. This indicates that HIV/AIDS discussions already have a base in South Sudan media.

Mobile phones on the other hand don’t enjoy such high rates of usage as radio due to 30% coverage rates. However, the mobile phone network has expanded considerably since 2005 and is predicted to keep expanding in the near future. Also noteworthy is that only 14% of South Sudanese get their information from newspapers and 13% from television according to a report. It’s clear that radio and mobile phones are the most widely used avenues of communication in South Sudan.

Plans to expand broadband cables

As recently reported, South Sudan is on the shortlist to receive fiber optic broadband cables. Broadband services make it possible to interconnect affiliated healthcare facilities around the country so that they can utilize and share scarce human and technical equipment resources to deliver quality and affordable healthcare services. These cables can establish a foundation for ICTs not just in health, but for all sectors in South Sudan.

Past Successful HIV/AIDS Programs

South Sudan won’t be the guinea pig for using ICTs for HIV/AIDS either. There have been quite a few successful HIV/AIDS programs in the past that succeeded in similar environments:

• Targeting Nomadic Populations – USAID and other external NGO’s worked together in Nepal in 2005 to introduce a radio program on HIV/AIDS awareness by integrating entertainment into its programming

• Capitalizing on existing media penetration:

o        Radio – Tanzania also introduced the Tunajali HIV/AIDS Care and Treatment Radio Program in 2010 with the help of PEPFAR.

o        Mobile – Two mobile phone programs, Text to Change(TTC) and Freedom HIV/AIDS used mobile phones to reach thousands of people to educate them on HIV/AIDS

South Sudan should approach some of the major NGO’s on the ground to help implement these initiatives that use ICTs. Organizations like USAID, WHO, UNICEF and the UN have spearheaded many initiatives like the ones described above in the developing world. They should at the very least try to do the same in South Sudan. They need to realize the opportunity at hand.

Possible ICT Policy

So the framework to set South Sudan off on the right foot is present just as they kick off their sovereignty. However, an HIV/AIDS epidemic is a threat. The markets for intervention exist, proven initiatives exist and they can be adopted using the aforementioned plans to establish new broadband cables. All of the stars have aligned. The tricky part is getting officials to the table and churning out an action plan. This will involve NGO officials talking with South Sudanese Government officials and making this opportunity a priority.

South Sudan has already seen its darkest days. They want to move now from being a hub for relief efforts to a hub for development. The health sector can benefit tremendously from using ICTs to prevent an HIV/AIDS disaster. Once HIV/AIDS is under control, the ICTs can be utilized strategically to tackle other health issues, as they are being done all over Africa and the developing world. If not, it may not be long before South Sudan encounters its darkest days once again.