“An informal, but very insightful, first-person account of how cell phones are rapidly changing the way USAID implements health programs in the field. With a bit more focus and targeted resources, USAID could dramatically accelerate the mainstreaming of mHealth interventions, helping us achieve our GHI targets more rapidly, and leaving behind a legacy with enduring returns.”- Adam Slote, USAID/Global Health
By: Natalie Campbell, Management Sciences for Health
The most important item in Amon Chimphepo’s medical kit is a small cell phone. This single piece of technology has proved to be a lifeline for people living in one of the most remote regions of Malawi. Its power to reach and initiate help immediately from the closest hospital is saving lives and improving health outcomes. In fact, I met a woman, alive today, because Mr. Chimphepo and his cell phone were there to make an emergency call to the district hospital and get an ambulance.
I traveled to Malawi in December to take a closer look at our pilot project — K4Health Malawi — we launched in February 2010. One of its main interventions equips community health workers with cell phones and solar chargers. In his capacity as a community health worker, Mr. Chimphepo makes regular door-to-door visits in his area delivering HIV tests, and health and hygiene counseling. We knew this kind of outreach provides important health support in remote areas but had no idea how the rapid response component of cell phone communication was transforming health outcomes across the area.
Fast changes in health status are rare in this line of work. My background is food security and nutrition programs, and my timer was set to long-term changes from poor nutrition into better health status and, with any luck, the slow parallel development of sustainable food sources. Timeframes run in years. That a knowledge management project could lead to fast, life-saving aid and an immediate improvement in health and well being across this hard-to-reach population was highly impressive.
21st Century Communication Saves Lives in Remote Areas
When you connect community health workers by cell phone to the people, information and resources of a hospital you open a conduit of immediate aid that can save lives. Time telescopes — what took days and weeks before wireless communication, now takes minutes and hours. Visiting with Mr. Chimphepo, we were able to meet the people and hear the stories of injuries and conditions and sicknesses treated quickly and correctly because Mr. Chimphepo has access to professional advice and direct health services through the district hospital.
I talked with women who met Mr. Chimphepo on door-to-door visits. She told me how he conducted routine HIV testing and then counseled her and her husband on contraceptive options. Many couples opt for the Norplant device to control the size of their families. However, before sending the woman on a long journey to the hospital in Salima, which could take days from the farthest reaches of this area, Mr. Chimphepo uses his cell phone to contact medical staff at the facility. He makes sure that Norplant is stocked and that staff will be on hand to administer the contraceptive. In a place where women cannot afford to be away from their families, the smooth efficient courtesy of these basic arrangements alleviates much hardship. Mr. Chimphepo met us at his home, where he also sees patients. But the door-to-door interactions are the core of his daily practice. Most families don’t have the time or ability to travel, so the immediacy and regularity of his presence is vital.
I will never forget the conversation I had with a woman in Salima who explained how she began to bleed heavily one day. Running a high fever, her symptoms were worsening by the minute. The woman went to see Mr. Chimphepo, who called the hospital immediately. An ambulance arrived; the woman was treated and, today, enjoys good health. She affirms that it was this fast action on Mr. Chimphepo’s part that saved her life.
Natalie Campbell is a Knowledge Manager at Management Sciences for Health and works on the Knowledge for Health Project, which is funded by USAID and implemented by the Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs, MSH and FHI.