Last week, in conjunction with the PopTech! conference, the Praekelt Foundation and partner organizations announced a new effort that will use the power of mobile messaging to help fight HIV/AIDS and tuberculosis in South Africa. Project Masiluleke will utilize the power of the mobile phones as a low-cost way to deliver health-related information and prompt call-ins to call centers for those affected by these health care crises.

As discussed here and elsewhere before, South Africa is a country with an amazingly high mobile phone adoption rate - around 90%. Unfortunately, South Africa is also a country that has around 1000 HIV/AIDS related deaths ever day. Project Masiluleke, which means "to give wise council" or "lend a helping hand" in Zulu, aims to use the mobile phone as a communication conduit between doctor's visits. The project's intent is to bring those with HIV and TB into the healthcare system earlier, when the diseases can be most effectively treated and/or slowed.

Project M, as it's being called, consists of four major components.

Drawing Perspective Patients In

First, the team behind Project M will use "Please Call Me" (PCM) messages to prompt citizens to call into a HIV/AIDS call center. Trained call center operators will provide healthcare information, counseling, and referrals to local testing clinics. Please Call Me messages are a wildly-popular SMS-like message that prompt a party to call the requesting party. PCM messages are used heavily in South Africa, roughly 25 million PCM messages are sent every day. PCM messages will be adapted by the Project M team to deliver advertisements prompting recipients to call into HIV/AIDS call centers if they are in need of health-related resources.

In the second part of the project, the Project M team will use TxtAlert, a text messaging reminder system developed by Praekelt Foundation, to send out SMS messages to remind patients of upcoming clinic visits. As it stands, only 10% of South Africans with AIDS are actively receiving anti-retroviral therapy. TxtAlert will help remind patients who are enrolled in these therapy programs to attend their visits, enhancing their care.

Reaching Out, Mobily

As a third part of Project M, a virtual call center will be initiated and built. Existing AIDS/HIV helplines will be enhanced by using teams of highly trained and committed HIV+ patients. This group of peer counselors will be made up of "gold star" patients who are knowledgeable about their about their illness and are committed to providing high-quality advice and guidance to those who are dealing with the emotional weight of an HIV diagnosis. The peer counselors will be selected and trained by NGO and government officials.

The virtual call center counselors will be available via mobile phone and will field questions remotely. Not only will the virtual call center create thousands of jobs, but those who call into the call center will be connected with a nurturing voice to help console and distribute quality information.

The fourth and final piece of Project M involves at-home HIV testing with mobile support. Unfortunately, with such a high population of HIV infected persons, the South African healthcare system isn't fully capable of handle the tremendous load. Also, South Africans who may be HIV positive avoid the lines to get tested because of the stigma of being seen in line.

To help battle this, the Project M team will employ mobile testing stations that can conduct the blood test in one's home, giving them privacy. Trained councilors will also be on hand to administer guidance and advice in case it is needed. The concept of an at-home test has been well received by the South African government and healthcare officials. A mobile testing solution would be welcome in rural areas where the testing resources are most needed.

Lots of Players Involved

The team behind Project M is made up of various organizations including businesses, NGOs and government agencies. The major players include the Praekelt Foundation, mobile network operator MTN, design firm frog design, National Geographic, and NGOs such as LifeLine Southern African and World-Class Advisors.

So Much At Stake

There is no doubt that the mobile phone represents a huge opportunity to disseminate information to huge groups of people quickly and cheaply. It is refreshing to see so many organizations involved with Project M including mobile network operators, mobile technology firms, NGOs and government officials, all united to help potential victims of dreaded diseases.

This time of effort and coordination, if applied to more social causes, would bring tangible change in many areas of need. We send kudos to Project Masiluleke and we will continue to track the progress of the project on an ongoing basis.

The series is based on a conversation I had with Gustav Praekelt, a mobile entrepreneur located in South Africa. In this post we explore how mobile technology is being used for social good in Africa. See also Part 1 here.

The Mobile Phone's Expansive Reach and The Massive Outreach Opportunity

Africa is an expansive and growing mobile market. With 300 million mobile accounts and more being added each day, the mobile phone presents a far-reaching outreach opportunity for marketers. However, Non-Governmental Organizations (NGOs) are also excited at the possibility of being able to send messages to 300 million people at the push of a button.

The Praekelt Foundation, a charitable outreach of Praekelt Consulting , is taking their knowledge of web and mobile technologies and finding ways to help Africa's needy. The Foundation finds, attracts, and incubates projects to reach out to Africa's under-served populations. Praekelt Foundation's current projects are all health-focused, but the organization is actively seeking other avenues to assist Africa's Mobile-based under-served people.

SocialTxt

SocialTxt is a project that utilizes Please Call Me (PCM) systems. To understand what a PCM message is, one must look at the nature of the African mobile market. In North America, the vast majority of cell phone customers pay on a postpaid basis, meaning most of us pay X amount of dollars for Y amount of minutes. However in Africa, the opposite as true, roughly 85-90% of customers utilize pre-paid SIMs to make and receive mobile phone service. In some African countries like Nigeria, pre-paid customers account for as much as 95% of the mobile market.

In these pre-paid dominant markets, when you run out of call credit, you can't make outgoing calls or SMS messages. To get someone to call you, you might ring them once or beep them. To respond to all this traffic generated on the mobile phone network, mobile network operators invented Please Call Me messages as a way to prompt your friends or family to call you back. A Please Call Me message is merely a SMS-like message that prompts the recipient to call the number of the requester. The PCM messages are free to send for mobile customers, up to 6 per day.

PCM messages are extremely popular in South Africa, of which 30 million messages are sent a day in a country with a population of around 47 million people.

PCM messages, in recent years, have been used by advertisers and marketers as a vehicle for marketing. Praekelt and his colleagues saw the PCM system as a tool for social change. The Praekelt Foundation thereby approached a network operator about a year ago and convinced the company to work with the Foundation to conduct a trial of positive social impact advertising.

The PCM message offers 120 characters that the Foudation and it's partners to utilize. For example, a message can be sent to encourage the recipient to call an HIV call center or medical center. The messages fill a need, as Praekelt said, "This is not fancy technology and most of the PCM message users are at the bottom of the social economic chain. These are people who don't have TV's, so programs such as SocialTxt give companies and groups a great way to reach these previously un-reachable portions of the population."

To enhance the PCM message, Praekelt Foundation, in partnership with health-focused NGOs, can insert a WAP link to a mobile website or a phone number to an interactive voice response system allowing for further health-related information to reach HIV-stricken patients.

With SocialTxt, the Praekelt Foundation has teamed up with partners such as the national HIV/AIDS Call Centeres, People Opposing Women Abuse, Netcare/Vodocom Cleft Lip Campaign, and Khomanani Zithande Campaign.

TxtAlert

HIV/AIDS is a health epidemic at the forefront of Africa's focus for health outreach. Of 33 million people in the world who are HIV Positive, 22 million of them live in Sub-Saharan Africa. Of those 22 million, 5 million are in South Africa alone. This means, as Praekelt points out, that roughly 10% of the world's HIV-positive population lives in South Africa.

TxtAlert is a project that uses SMS messages to remind HIV patients to go to the health clinic for their next visit. In addition to notifying patients of the upcoming appointments, TxtAlert also requests them to reschedule if they are unable to attend. These efforts are aimed at keeping patients engaged in their treatment programs and to deter them from discontinuing their HIV/AIDS treatment programs.

The Praekelt Foundation's research found that even though most of the partner clinic's patients were jobless, more than 90% of these patients have at least one working cell phone in their household. Naturally, SMS is a viable communication method in such a situation.

In addition to prompting patients to attend their appointments, TxtAlert is being used by health clinics to incentivize those who come to the clinic as well. After a patient attends an appointment, TxtAlert will send the patient a text saying "Thank you for coming to the clinic, remember your next appointment is coming up on ". The patient will then receive a reminder text 90 days before the appointment, 2 weeks prior and so on. Well performing patients get free airtime and cell phones as incentives for coming in.

The Praekelt Foundation and partner clinics are experiencing favorable results with SocialTxt. On average, a typical clinic will have a 15% no-show rate for patient appointments. However, when a clinic utilizes SocialTxt, those rates drop to around 3%.

Praekelt points out that a great factor about SocialTxt is that deploying the system doesn't require vast amounts of capital and infrastructure. The main building block is an electronic patient record system and the rest is done behind the scenes by the TxtAlert software. The system is highly scalable as usage and needs rise. The Praekelt Foundation is currently working with a pilot clinic with about 10,000 users on the system. However, they are adding more clinics and will soon be up to 120,000 users on the SocialTxt system.

A third project utilizing SocialTxt will be unveiled at the Pop!Tech conference in October. Pop!Tech gave funding to the Praekelt Foundation to send out thousands of PCM messages regarding HIV/AIDs education.

Mobilisr

Mobile messaging is a far-reaching conduit for reaching a mass audience. The Praekelt Foundation, along with co-lead organization Cell-Life, is working to build an open source, high speed and highly reliable mobile messaging platform called Mobilisr.

Mobilisr could be used for health-related outreach, but also be used by governments and public-safety organizations to send out messages relating to: human rights monitoring, elections monitoring, emergency alerts, conducting public surveys, or could even be used by a group to organize protests.

Prakelt also told me that Mobilisr is enabling customers to conduct SMS voting (much like American Idol's text messaging voting system). The problem with the existing SMS voting systems, as he explains, is that they are built on proprietary systems. Te Prakelt Foundation is working with NGO's (such as Cell-Life) to build SMS based pledge lines and incentive systems built upon WAP sites.

Mobilisr just launched on October 1st. It will be interesting to see how the technology is employed by NGOs and other groups for social good.

Conclusion

With mobile phone technology spreading so rapidly across the African continent, there are many opportunities to reach out to Africa's under-served population. Any vehicle that offers access to the population should be exploited. It's a shame that many people in these groups are being ignored, even though many of them have mobile phones.

It is great to see organizations such as the Praekelt Foundation working with mobile network operators, health clinics, and NGOs to connect Africa's under-served population with the care and services they need to be happy, informed, and perhaps more healthy.

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Photo: Paul Watson