The expansion of mobile access has been a common refrain in international development for years now. It plays an important role in supporting human development, from economic and educational opportunities to political freedoms and human rights. Increased access to mobiles has been linked to positive social outcomes in dozens of countries.
Over the past couple years, I’ve had the privilege of co-managing World Vision’s Speed Evidence Project, which seeks to improve information management in the immediate aftermath of a disaster. After most disasters, reliable field data is significant challenge - what we can find is normally incomplete and/or inaccurate.
It’s a simple idea: provide smallholder farmers with information via SMS to improve farming practices and thus increase their yields. In fact it’s a concept that has been replicated by NGOs and MNOs across the developing world, with varying degrees of success. However, the real challenge in launching such a service lies in building a business model that is both commercially viable to the provider whilst remaining accessible to the poorest populations.
By Ashley Mannes FrontlineSMS was recently included in an academic paper, written by Ashley Mannes, of Georgetown University, USA, and titled ‘Interoperable Technologies in International Development: Access to FrontlineSMS.’ In the below guest post, Ashley introduces the main themes of her paper and what compelled her to write about FrontlineSMS:
"When I first got the opportunity to travel to different parts of the world, I began to understand and appreciate the beauty and unique qualities of the cultures that unite our global community. My interest in development flourished during my master’s degree program in Communication, Culture, and Technology at Georgetown University. The program helped me to realize that a great opportunity is provided by today’s technologies; to communicate with and connect to cultures and climates that once seemed so distant. In this manner, I discovered the work of organizations like FrontlineSMS that are using technology to help people to connect and communicate across the world.
I actually came across FrontlineSMS by chance, as I was preparing to write a paper on Networks and International Development. I knew I wanted to explore how open lines of communication and access to technology were helping NGOs connect with local communities in order to give them a more global voice, and it was when I began searching for organizations with this type of a mission that I discovered FrontlineSMS. Through my research I saw how technology was positively impacting local NGOs and communities around the world due to FrontlineSMS’ work. Therefore, it seemed ideal to focus on FrontlineSMS as the case study for my paper.
I chose the title Interoperable Technologies in International Development: Access to FrontlineSMS to tie together ideas of access to technology and economic development. My paper explores the “bottom billion”, an idea proposed by Paul Collier that addresses the specific needs of the populations of least developed nations that have been left out of the discussion, and the struggle to prosper in today’s economic climate. I suggest that in order for these countries to rise from the “bottom”, they must build upon their own bonding capital and reciprocity in order to use the communication networks that are available to them.
In this sense, struggling nations must focus on the local connections that they have in order to expand their voices to a more global platform. I stress that new technologies, such as mobile phones, are fostering much more crosscutting communication; these new technologies have the ability and potential to aid development goals and economic activities. However, in order to take advantage of these new technologies, these networks must be interoperable and open.
FrontlineSMS is utilizing both the technology of mobile phones and the networks of communities to spread information, communicate, and affect lasting change. I focused on two case studies in particular to demonstrate how FrontlineSMS can be flexible and accessible technology, used by NGOs to accomplish both their local and global missions. In Pakistan, for example, the global NGO, the International Organisation for Migration is using FrontlineSMS software to send mass text messages of health and sanitation information to countless displaced refugees who need this information to remain safe and healthy during natural disasters. The ability of these NGOs to access this technology and reach out to local Pakistani citizens through text messages is a huge step for development, and one that allows for an open line of communication with those who may need it most.
The second case study I looked at focused on the response to the HIV/AIDS epidemic in the Hubli-Dharwad district of India. Here FrontlineSMS was utilized to connect a network of development groups to the local sex-workers infected by, or at-risk of contracting, HIV/AIDS. The FrontlineSMS data collection tool FrontlineForms allowed field workers to quickly collect important information on their mobile phones and export it to their headquarters to be gathered and documented for further development purposes. Interoperable technologies have helped development practitioners collect more information faster and more easily.
It has become clear that openness and flexibility are necessary components of technologies that can help to successfully promote development. Access to technologies that harness the network capability of a common mobile phone can provide the needed link and physical line of communication to isolated communities. Interoperable technologies can be used to network a group of development practitioners or to distribute mass amounts of information and assistance to a local community. They can be used to collect information in the field or to simply communicate between individuals.
Regardless of the manner in which the technology is utilized, the accessibility of this technology can help to open up a path of communication between the local and global, ultimately building social capital at the local level and cultivating a more global sense of capital and reciprocity through working together and expanding these development networks. I enjoyed exploring how FrontlineSMS is helping communities and NGOs to interact, and hope that I have done justice to this in my paper."
Read Ashley’s paper here - Interoperable Technologies in International Development.
“Nearly 90 percent of Tanzania's residents live in rural areas, work primarily in the agricultural sector, and lack access to information, technology and markets,” Technoserve state on their website. Technoserve is an organisation which focuses its work in Tanzania on supporting farmers, cooperatives and suppliers in order to help develop rural industries. Whilst working towards these country-wide goals, keeping track of their impact is essential. Here, FrontlineSMS Community Support Coordinator, Florence Scialom, speaks with James Hangaya, Monitoring and Evaluation Analyst at Technoserve Tanzania, about how he is using FrontlineSMS to help collect the data he needs for monitoring Technoserve's Coffee Initiative project in Tanzania.
Training for farmers is a key to Technoserve’s strategy in Tanzania, and forms a large part of their Coffee Initiative project. Training sessions help small-scale coffee farmers produce better quality coffee, thus helping them to secure higher prices in the international marketplace. “Sessions are based on different topics, and include practical lessons on, for example, how much fertilizer should be used to produce the best yield,” explains James. The farmer trainers hold multiple sessions on agricultural best practices, helping farmers to use their equipment and run their farming practice more efficiently.
One of the key steps in monitoring and evaluating the success of training is to measure the changes in farmers’ behaviour. “We train approximately 12,000 farmers every year” James tells me, “and there are nearly 60 farmer trainers across the country at the moment, running courses for groups of 15 to 20 farmers at a time.” There is certainly a lot of data to keep track of, and this is where FrontlineSMS proves very helpful Technoserve's work.
After experiencing the challenges of monitoring and evaluating their training programmes using extensive paper surveys, James and the Technoserve Tanzania team decided that there must be a more efficient way. This is when they came across FrontlineSMS data collection tool, FrontlineForms. Using this tool Technoserve farmer trainers are now able to conduct all post-training evaluation via SMS.
James explains how they manage this process: “Each farmer that attends a training session is allocated an individual ID. When filling out FrontlineForms, the farmer trainers use this ID to identify which individual farmer they are collecting data on. They answer set survey questions about farmer behaviour, using a pre-defined scale of 1-10 to indicate responses. They then send them back to me in the office to analyse the data.” This gives Technoserve Tanzania the data they need, to indicate whether the training has had an impact on the way the farmers manage their crops.
In addition, farmer trainers are provided with scales to measure a sample number of farmer’s harvest weights. These weights are compared with the farmer’s previous yield, and show how much farmers are able to produce before and after Technoserve training courses. Collecting these kind of direct indicators of impact is key to monitoring the success of the Coffee Initiative training sessions, and FrontlineForms is allowing this data collection process to be done much more quickly, and at a lower cost to Technoserve Tanzania.
The transition from paper to SMS has made a great difference to work flows, as James explains; “it saves us so much time and money, because our field staff no longer have to travel from the field to deliver paper survey results to our office, which can be a journey of more than 1,000 kilometres.”
This use of SMS technology makes the data collection process more efficient in error detection, too. As James says, “If I had picked up a potential error or if there was any data missing in a paper report then I would have to send it all the way back to the field to check whether the data needed to be edited; now I am able to this much more quickly and simply, via SMS.” These efficiency savings help to demonstrate the value of using FrontlineForms as a data collection tool.
Technoserve Tanzania plan to continue using FrontlineSMS for monitoring and evaluation, and are looking at ways to optimise and extend the ways they use the software, too. “In future we are looking to use FrontlineSMS to register farmers for training sessions and track their attendance. This will allow us to provide real-time reporting from the field,” explains James.
As Technoserve get accustomed to using SMS in their day to day work flows it is clear they are finding out more and more ways for it to help them make their work quicker, easier, and more efficient. James summed up this fact well by saying, “my boss agreed that we should change to FrontlineSMS for all the things that it can do for our work!”
“TechnoServe makes a commitment to businesses and industries, working in the field with entrepreneurs and other industry stakeholders to build enterprises able to thrive on their own and generate continuing benefits for the rural poor.” You can read more about their work on their website: www.technoserve.org
em>By Lisa LaRochelle, FrontlineSMS Project Assistant FrontlineSMS is being used for social change in many different ways across the world. Common use case examples include election monitoring, provision of health information, and agricultural support – these kinds of use cases have direct positive impact on people’s lives. Yet here at FrontlineSMS we have seen increasing numbers using FrontlineSMS for organisational management, which has indirect benefits for people which are
far harder to measure and demonstrate; helping organisations to work more efficiently, communicate more easily with their staff, and move information around more swiftly. Examples include using FrontlineSMS for monitoring and evaluation, data collection, and internal communication. It is this latter kind of FrontlineSMS use case that we recently discussed with Sanjay Rane, Information Management Officer at the United Nations Office for Coordination of Humanitarian Affairs (OCHA) in Kenya.
Mobile phone penetration is high in Kenya, and the UN OCHA staff members that Sanjay works with all have their own mobile phones. The convenience and accessibility of SMS appealed to the team, and FrontlineSMS is a low-overhead way of managing text messages to and from groups. “For the last couple of months we have been using FrontlineSMS as an in-house communication tool,” Sanjay explains “and it has certainly helped foster better information sharing among the OCHA Kenya team.”
SMS offers an immediacy and intimacy that can be seen as unique from other methods of communication. People always have their mobiles close to them, and generally read messages quickly. This has certainly shown to be the case in OCHA’s experience. They have found that using SMS helped them to reach staff, especially during an emergency occurring in off hours, when most of the staff do not check their emails. OCHA Kenya can use the tool to send out urgent updates to the team.
One of the major benefits of using FrontlineSMS is the ability to manage SMS more easily than using a simple phone handset. When trying to send out messages using a handset, Sanjay found it difficult and time consuming to add and delete people’s contact information, send messages to multiple contacts at the same time, and maintain groups of contacts. FrontlineSMS offers a simpler solution: the ability to sort contacts into groups so that, for example, an emergency alert text can be sent out to a large group of staff at once. It is also possible to set up key words and automatic replies with FrontlineSMS, so the system can automatically send people important advice and information.
The OCHA Kenya team had such success with their experience that they decided to implement FrontlineSMS to facilitate communication with a larger group of humanitarian partners in Kenya, as a preparedness tool for the referendum in 2010. They are now exploring the possibility of using SMS to help coordinate with agencies responding to the current East Africa drought. This is an indication that FrontlineSMS is enabling improved communications management in a way that was otherwise not possible.
It was the capacity to manage data in combination with the popularity and simplicity of SMS which led Sanjay to FrontlineSMS. “At OCHA Kenya, using SMS for internal communication is very popular, as it is a familiar communications tool. We have found it really valuable to use SMS for communicating with colleagues on important humanitarian developments in Kenya,” Rane says. Organisational management, although behind the scenes, can provide huge social benefits by enabling those working for NGOs and INGOs to communicate more effectively and do their challenging jobs more efficiently
Although I find myself intrigued by the convergence of computer science, human computer interaction (HCI) design and international development, it's not often that I find myself in a room of experts. They're just not places I tend to mix, most likely because I have no professional IT qualifications, let alone a computer science degree, and I've done most of my own software design off-the-cuff, much to the dismay of people who hoped there was a robust process behind it. Last August I got my first taste of the very real challenges that the computer science world faces when it comes up against the equally real challenges of international development. The meeting - convened at UC Berkeley - was an eye-opener for me to say the least, and as I left I blogged about how thankful I was that it wasn't me who had to come up with the answers. You can read that post here.
A little later in the year I was invited to speak at the First International Workshop on Expressive Interactions for Sustainability and Empowerment, held at one of Vodafone's London offices. The topic of conversation was similar, but here the focus was on how to build mobile tools that work in difficult, challenging, 'foreign' environments. Following my talk I was invited by the Editor of Interfaces, John Knight, to contribute an article to the next edition of their magazine.
For the article I teamed up with Joel Selanikio, co-founder of DataDyne.org and the creator of the EpiSurveyor mobile data collection tool. It made sense working with Joel for a number of reasons. Not only have I known and admired him and his work for some time, but Joel is first and foremost a paediatrician. For him - like me - understanding the problem takes priority over the technology, consideration of which should always come last. FrontlineSMS and EpiSurveyor have both evolved from time spent in the field - observing, experiencing and understanding before designing, developing and building.
You can read our thoughts on the process - "Ten things you might want to know before building for mobile" - in the current edition of Interfaces magazine (PDF, 2.5Mb).
The timing of this article could not have been better, given the discussions last week on the merits of mobile-based "cloud computing" and the clarification of our position a couple of days later. Despite advances in mobile devices and data connectivity, the need for mobile tools to also be able to work in less than optimal conditions is still as strong and as relevant as ever, as this use of FrontlineSMS by Telecoms Sans Frontiers in Nicaragua shows us all too well. "TSF - No Bugs In This Software That Fights Disease" (re-printed with the kind permission of SatNews.com) November 5th, 2009
"Since the beginning of October, Nicaragua is facing a huge rise of dengue cases, which has become a major public health concern in the country. The Health Ministry of the Central American nation (Minsa) has a crisis unit (SILAIS) which currently focuses its activities in response to both the dengue and H1N1 plagues. An Internet monitoring system has previously been set up to control the health situation in the country; nevertheless access to computer is often difficult in some regions where only few health centers are equipped.
Due to this serious situation, and the necessity to improve the collection of information, TSF, in collaboration with PATH (an international non-profit organisation that aims at enabling communities worldwide to break longstanding cycle of poor health) is reinforcing SILAIS’ capacities in Information and Communications Technologies.
In order to monitor the spread of the dengue in Managua and to conduct mobile health actions, TSF has been implementing for the first time a very innovative system based on a widespread, cheap and solid technology, GSM.
To set up the program, TSF uses FrontlineSMS software. Developed by a TSF partner NGO, FrontlineSMS is free, open source software that turns a laptop and a mobile phone into a central communications hub. Once installed, the program enables users to send and receive text messages with large groups of people through mobile phones. Thus, GSM technology is used to reach as many geographical zones as possible to control health issues in those areas. The server in SILAIS is connected with the 32 health units in Managua.
Each health unit has been delivered a mobile phone by TSF, so that they can send different kinds of information through SMS to the server. Hospital and health centers fill in predefined forms from their mobile phones and send them by SMS to SILAIS. Designed by PATH and the SILAIS, those forms provide data about the classic and hemorrhagic dengue cases, about the H1N1 2009 ones and the need for medicines when the stock nearly runs out. Once the forms received, the server stores information and puts them in databases in order to facilitate statistical analysis, on Excel format for example.
TSF provides two-way communication to health units enabling SILAIS to receive a daily report and gather messages from the health units and will have an updated situation in each center. At the meanwhile, SILAIS will also be able to communicate important information to them through SMS (such as an alert or a warning about coming meetings for example) or give them automatic answers to predefined questions sent by the health units.
By providing communication links between health structures and the SILAIS, TSF will allow the Health Ministry to have more accurate information about the diseases spread within Managua and quickly survey and assess the needs in affected areas. TSF helps health professionals use advanced methodologies such as smart phones and open-source software. Mobile devices are great tools to track and transmit crucial data in order to detect an epidemic threat at an appropriate time. Through this program, TSF participates in strengthening health systems in Nicaragua.
Following the installation of the system, on October 24th, TSF organized training for all the beneficiaries of the project. The health units and SILAIS staff were trained on the application’s functionalities and available services".
For a related article on FrontlineForms, the FrontlineSMS data collection tool used by TSF for the project, go here.
In this, the second of a series of guest posts on how FrontlineSMS is being used around the world, Dr. Mohammad Akbar and Kenneth Adam - Director and Business Advisor respectively at Media Support Partnership Afghanistan (MSPA) - talk about their current and planned uses of the platform, and the impact it is having on their work "A recent special edition of a radio programme for young people in Afghanistan was devoted to one topic – the shocking recent acid attack on girls attending school by violent extremists allied to the Taliban. The impact on the audience was recorded in some 300 phone calls from listeners – a record for the long running programme "Straight Talk", produced by a team of young broadcasters from Media Support Partnership Afghanistan (MSPA).
This audience response provides an example of what is possible given the enormous growth in mobile phones in Afghanistan, well over 6 million and rising at over 100,000 a month. Young people in the troubled south often feel isolated and bored, trapped in a conflict which shows no sign of going away. Development activities have largely been suspended because of insecurity. They want to hear and view programmes on issues important to them, and to contribute to the debate, and with 84% of households possessing working radios and 38% TVs, there is great potential in this approach.
MSPA will be using FrontlineSMS as one of the tools in a new project as part of a British Government-funded media initiative to engage with young people specifically in conflict affected regions though interactive radio programming, tied in with a national competition for young people to produce short video films on their mobile phones. FrontlineSMS will play a key role in the competitive process of selecting the individuals to be given the new mobile phones and trained in their use. This project is planned to start in April 2009. Initial trials using the software are underway, with a view to collecting information on listeners’ views on a variety of topics and feeding these back to them with the help of FrontlineSMS. This will allow active dialogue on issues as varied as the activities of NATO forces in the country and whether Afghans should bear arms, to commenting on education and health services.
Another important application this year will be in the run up to the Presidential Election in September. The media is key to informing the population about the rights of voters, and about the policy of different candidates. FrontlineSMS could be used to elicit the views of listeners in different categories and feed back the results to listeners, prolonging the debate and in so doing capturing the interest of people who are actively engaged in the debate".
Dr. Akbar, MSPA Director Kenneth Adam, MSPA Business Adviser Media Support Partnership Afghanistan (MSPA) www.mspa.org.af
Four years ago was a very lonely time. Not for me personally, understand, but in the social mobile space. The wider non-profit world was just beginning to take a serious interest in what the technology had to offer, and in 2004 I'd just co-authored one of the earlier reports - funded by the Vodafone Group Foundation - on the use of mobile technology for conservation and development. To give some context, these were the days when it was widely believed that "poor people in developing countries" would never be able to afford a phone, and the days when concrete case studies on the application of mobile technology for positive social and environmental change were few and far between. Most evidence was anecdotal. A revised report would look very different today, but with one exception - many of the conclusions would likely still stand. If that's the case, how far have we really come?
Four years ago this week I came up with the concept of a laptop-based group messaging hub. The software I ended up developing is better known today as FrontlineSMS ("ProjectSMS" was the working title for the first few months). When I eventually got the resources together to write the first version in the summer of 2005, there was zero chance of reinventing any wheels. The "social mobile applications" shop was quite literally bare. After extensive research for a project I had been working on with South Africa National Parks (SANParks), there were simply no appropriate technology mobile solutions they could easily pick up and run with. The situation seemed crazy, and I had a hunch that SANParks were not alone in their need for an appropriate, portable, GSM-based communications tool. The rest is history, as they say.
Things are not quite so lonely today and 2008 - for me, at least - goes down as the year things really began to change. For what seemed like an age, FrontlineSMS was one of the few appropriate technology-based mobile tools aimed at - and openly and freely available to - the grassroots non-profit community. For a while it was the only one. It was also likely the first to be developed specifically with the NGO sector in mind - most other solutions were commercial offerings which found their way into the hands of NGOs, quite often the larger international variety with the funds, expertise and resources to use them. The frustration for me was that - until last year, at least - many of the emerging 'non-profit' mobile solutions seemed to be following that same model.
Enter "The Social Mobile Long Tail", my attempt at mapping out the social mobile applications space (you can read the original post, which explains the thinking in detail, here).
The basic rationale behind it was this. The majority of emerging mobile solutions, platforms or tools (call them what you will) were settling in the red area, and as such were technically and financially out-of-reach of many grassroots NGOs, many of whom sit in the green space. Tools at the higher end of the graph are generally more complex, server-based systems aimed a multinational NGOs or government departments. Tools in the lower end are simple, low-cost, appropriate and easily replicable solutions. My experiences working with NGOs in Africa over the past fifteen years has strongly influenced and steered the focus of my work towards the long tail, and I would have it no other way.
But let's just destroy a few myths for a minute. There are many out there. Here's my top three (feel free to add to these in the comments section below).
Firstly, wherever your tool sits on the graph, there is no right or wrong place for it. It's all about the context of the user. There is just as much a need for $1 million server-based, high bandwidth solutions as there are for free, SMS-only tools. In your typical scenario, national governments would likely go for the former, and grassroots NGOs for the latter, but not always. Both are valid, and tools shouldn't ever be described as "being better" than another because of it. This is a big mistake. We need there to be solutions all along the tail so that the users have a healthy applications ecosystem to dip into, whoever and wherever they may be. If you're trying to park a car into a small space, a Mini is much better than a Rolls Royce.
Secondly, let's not get all hooked up on scale. Just because a tool in the long tail might not run an international mobile campaign does not make it irrelevant. Just as a long tail solution might likely never run a higher-end project, expensive and technically complex solutions would likely fail to downscale enough to run a small communications network for farmers from a small NGO office with no mains electricity, for example.
Thirdly, we don't yet have any complete, polished mobile tools. I would argue that everything that we see in the social mobile applications ecosystem today is "work in progress", and it will likely stay that way for a very long time. Speaking with my FrontlineSMS hat on, I'd say we're probably only about 40% there with that solution right now. There is much to do, and the mobile technical landscape never stands still. Our challenge is how we all move with it, how we stay relevant, and how we all work together to share technical resources and know-how. A fragmented mobile landscape is a problem for all of us.
There have been many positive blog posts calling 2009 the "Year of Mobile". I think they could be right. I also think 2009 is going to be the "Year of the Searcher" (see my earlier blog post). As I argued back then, let's never forget it's the users of our tools who we answer to. Social change happens on the ground, often through them, and not online.
For the first time in four years things don't feel quite so lonely. I for one am hugely honoured to be working in a space alongside some of the most dedicated and talented people in the mobile and development fields, all of whom are trying to apply a range of practical solutions - all the way along the "social mobile long tail" - to some of the most pressing problems in the world today. We have a great opportunity in front of us if we stick together, remain focussed, and do not lose sight of the big picture.
After all, we don't want to be reading blog posts in twelve months time calling 2010 the "Year of Mobile", do we?
Today, all eyes are on the United States with one of the most anticipated Presidential elections in decades. Amidst the excitement lurks the ever-present concern over potential election day chaos, and fears of a repeat of what happened in Florida eight years ago. Once again, mobile technology is also being touted as one way of smoothing election day progress and how it's reported, as it has been in almost every election around the world in recent years. The proposed use of Twitter is perhaps the one key addition in USA'08.
In the coming months three West African countries also go to the polls - Ghana, Guinea and Cote d'Ivoire. Sadly, access to balanced and unbiased election information is often a key problem in these countries. The logistical challenges of running nationwide elections is often compounded by a lack of election-specific knowledge among local media, which can often lead to misreporting, misinformation and - in worse-case scenarios - civil unrest. Availability of ICT tools for local journalists can also be problematic, compounding the problem yet further.
To address some of these challenges, the International Institute for ICT Journalism, in partnership with the Open Society Initiative for West Africa (OSIWA), are embarking on the "West African Elections Information and Knowledge Project".
The project seeks to strengthen the role of the media in election reporting through the training of senior editors, journalists and reporters; developing and disseminating an 'Election Reporting Guide for the Media'; the use of text messaging in election coverage and monitoring with FrontlineSMS; and the creation of a Knowledge Online Portal.
The use of mobile technology in election monitoring may be nothing new, although promoting the use of text messaging specifically as a media enabler represents something of a departure from its usual use by official election monitor groups. The choice of FrontlineSMS is also significant. The software has already been successfully implemented in Nigeria to enable what is widely believed to be Africa's first citizen election monitoring project, and it was used in the last Philippine elections to help organise official monitoring teams around the country. In recent weeks it has also been lined up to help register 135,000 overseas Filipino workers in advance of the upcoming 2010 elections.
A few months ago Josh Nesbit, a Senior in the Human Biology Program at Stanford University, travelled to east Africa where he spent the best part of his summer introducing FrontlineSMS into a rural hospital in Malawi.
St. Gabriel’s Hospital, where Josh worked, is located in Namitete. It serves 250,000 rural Malawians spread throughout a catchment area one hundred miles in radius. With a national HIV prevalence rate of 15-20%, children orphaned by AIDS will represent as much as one tenth of the country’s population by 2010. With tuberculosis (TB), malaria, malnutrition and pneumonia ravaging immuno-compromised populations, the health system - including St. Gabriel’s Hospital - faces a disquieting burden. Malawi’s health challenges are compounded by its devastatingly low GDP per capita, by some measures the lowest in the world, and with just two doctors and a handful of clinical officers, St. Gabriel’s Hospital is also strikingly understaffed.
With woefully inadequate communications exacerbating the problem, Josh - with the help of the Haas Center for Public Service at Stanford University and the Donald A. Strauss Foundation - implemented kiwanja's FrontlineSMS software to connect the hospital with its community health workers (CHW). Now, drug adherence monitors are able to message the hospital, reporting how local patients are doing on their TB or HIV drug regimens. Home-Based Care volunteers are sent texts with names of patients that need to be traced, and their condition is reported. The "People Living with HIV and AIDS" (PLWHA) Support Group leaders can use FrontlineSMS to communicate meeting times. Volunteers can be messaged before the hospital’s mobile testing and immunization teams arrive in their village, so they can mobilize the community. According to Josh, FrontlineSMS has essentially adopted the new role of coordinating a far-reaching community health network.
The hospital sees intense promise in the formidable duo of FrontlineSMS and the cell-phone-yielding health worker. The usefulness of a well-managed communications network is undeniable, particularly when the information is so vital. In the first hours of the pilot program, a deceased patient’s extra ARVs were secured, the Home-Based Care unit was alerted of ailing cancer patients, and a death was reported (saving the hospital a day-long motorbike trip to administer additional morphine).
Since returning to Stanford, Josh has continued his work, speaking at a number of conferences and workshops and producing a user manual - "Building an SMS Network into a Rural Healthcare System" (available here as a PDF, 7Mb). According to Josh, the guide "provides an inexpensive way to create an SMS communications network to enable healthcare field workers as they serve communities and their patients".
Not only has FrontlineSMS enabled a significant improvement in healthcare delivery for St. Gabriel's, the project is infinitely scalable and replicable. Coming in at just $2000, Josh has clearly demonstrated what is possible with just three basic ingredients - a single laptop, one hundred recycled mobile phones, and local ownership and engagement. Now, with his step-by-step user guide and the minimum of investment in time and money, rural hospitals the developing world over can easily implement their own SMS communications network.
Josh Nesbit - a Senior in the Human Biology Program at Stanford University - spent the best part of this summer working in a rural hospital in Malawi, where he also implemented FrontlineSMS. Here, Alexander Ngalande, the Home-Based Care nurse at St. Gabriel's Hospital in Namitete, talks about his experiences of the software, and how it has impacted healthcare delivery for 250,000 people (video courtesy of Josh Nesbit)
The October 7th, 2001 invasion of Afghanistan didn't only mark the beginning of the "War on Terror". It also paved way for the introduction of the first mobile phone networks into the country, networks which today find themselves pawns in a game of cat-and-mouse between the Taleban, the government, security forces, mobile operators and aid agencies working to improve the lives of hundreds of thousands of people.
Afghanistan is rarely out of the headlines. Just this morning news broke of three women aid workers and their driver being killed near Kabul, demonstrating in the most graphic terms imaginable the huge dangers faced by so many NGOs working there. Decades of invasion, war and fighting has run the country ragged. There can be fewer more dangerous places on earth to work. As recently as July 2008, the Crime and Safety Report described the security situation as remaining "volatile and unpredictable":
"No part of Afghanistan should be considered immune from violence, and the potential exists throughout the country for hostile acts, either targeted or random, against American and other western nationals at any time. There is an on-going threat to kidnap and assassinate U.S. citizens and non-governmental organization (NGO) workers throughout the country. Afghan authorities have a limited ability to maintain order and ensure the security of the citizens and visitors"
In such a challenging and hostile environment, non-profit organisations rightly spend considerable amounts of time and effort doing everything they can to limit their exposure to risk. With improved communication often at the heart of security strategy, many have turned to the growing influence and availability of mobile phone networks in the areas where they operate, and to tools which give them the potential to communicate quickly, widely, efficiently and effectively.
Within months of the US-led invasion in late 2001, the first Afghan mobile networks began to appear. Today, Afghanistan has four privately-owned networks and, according to a recent report by the BBC, mobile phones are the "only way most Afghans are able to communicate, especially in remote areas where they are used to summon medical help or contact relatives". The importance of mobile technology hasn't gone un-noticed by the Taleban either, who have recently been destroying towers in an attempt to stop security forces using the technology to co-ordinate night-time attacks against them. That particular game of cat-and-mouse continues.
Mobile masts aren't the only target either, for the Taleban or invading 'liberating' forces. As is often the case in conflict situations, infrastructure - and innocent civilians - are among the early casualties. Power lines are also a target, presenting further challenges not only for the wider civilian population but also for operators and mobile users alike (photo above of a destroyed power pylon courtesy of Jan Chipchase, "Future Perfect").
Facing a continued and growing security threat, in January 2007 a major international humanitarian organisation approached kiwanja.net and within days started using FrontlineSMS as a field communication solution in their Afghan operations. Today they continue to use the Windows version in their main operations room (see image below), and the newer Mac version is used as a backup by a senior Security Officer. The software is primarily used to quickly pass time-sensitive security information to staff in the field via SMS.
According to the NGO:
Drivers receive updates on traffic congestion, road blocks, police operations, VIP movements, local minor security incidents and anything else that might be useful as they travel. Senior staff receive SMS messages regarding larger security incidents that may require them to modify program activities for the short term. Incidents that influence activities in other areas are sent to the sub-office group. Finally we have an 'All Staff' category for those situations where we need to notify or account for everyone as quickly as possible
As this use of FrontlineSMS demonstrates, the software continues to prove remarkably versatile, and its increasing use in a growing number of non-profit activities is testament to kiwanja's approach to building tools for NGOs, and not to try and build solutions to specific problems. As a forthcoming "Publius Project" guest article argues, communication is a fundamental yet often overlooked NGO need, whether they be working in Afghanistan, Zimbabwe, Pakistan, Nigeria, Aceh or the United States, or working in human rights, activism, environmental protection, health, economic empowerment or education.
Promoting the use of FrontlineSMS among the wider NGO community - particularly those working in conflict zones - whilst at the same time trying to protect identities is a fine balancing act. After the reported killings this morning, I decided to remove the name of the organisation using FrontlineSMS in Afghanistan from this post, even though I was given permission to use it.
However keen I might be to help other NGOs in similar situations get their hands on FrontlineSMS, some things simply aren't worth the risk...
An update following today's attacks outside Kabul:
"... FrontlineSMS was essential for us getting the word out quickly. E-mail was down, voice was spotty but SMS still worked. We had two female staff at a school near the incident and were able to tell them to stay put till things quietened down. All my staff made it home safe today"
International press interest may be on the wane following the heady heights of recent months, but the daily struggle continues for millions of people living in Zimbabwe. An inflation rate of over two million percent - usually a leading headline in itself - merely serves as a backdrop to the political manoeuvring taking place following the recent flawed presidential 'elections'.
It would be all too easy for people to lose hope, particularly in such a disempowering and disenfranchising environment dominated by fear, government harassment and a largely state controlled media which pushes out its own unique version of the truth. Freedom of speech is only freedom of speech when it comes with freedom from fear, something that many people don't yet have.
But hope, it turns out, is one of the few things many people still do have, and freedom of speech has found an ally in the humble mobile phone. I recently blogged about the use of mobile phones during the ongoing troubles, and highlighted the work of Kubatana.net, a grassroots organisation who have been pioneering the use of mobile technology in civil society work. Since 2005, Kubatana have been using a combination of kiwanja's FrontlineSMS platform, and a couple of other custom applications developed around the technology. Kubatana continue to use it, and continue to reach out to everyday Zimbabweans through the mobile channel - one of only a few available to them.
Back in April, at the height of the troubles, Kubatana asked everyday Zimbabweans: "What would you like a free Zimbabwe to look like?". Zimbabweans answered the call through their mobile phones, texting in their hopes for the future. Many people said that the question gave them hope in uncertain times.
Last week, while doubts lingered over the newly signed MDC/Zanu-PF deal, Kubatana reached out again to their SMS subscribers, asking them: "Kubatana! ZPF and both MDCs agree to talk to resolve crisis. Send yr thoughts on this & give us yr postal or email addr if u want a copy of their agreement". Zimbabweans responded with a range of comments and opinions, including:
The talks is good but MDC must be very clever - Zanu PF wants to swallow the MDC
Yes it’s a brilliant idea which shall help end crisis, poverty and all tribulations in Zimbabwe united we stand divided we fall Tsvangirai showed qualities of being a leader by agreeing to talk
Free and fair elections tomorrow with international observers!
It is long over due but we want justice
May be worth the effort but MDC must keep their eyes open. You can’t trust these guys. I agree with Tsvangirai that people have suffered enough
I believe it’s a good idea if they can reason together in order to solve this crisis. But they must recognise the results of the election done on 29 March
We don’t need masters, colonial or nationalist. We want public servants. So respect our votes of March 29. You asked for them
That’s better because we are suffering. We are stuck and something must be done to save the lives of Zimbabweans
The talks are okay but Mugabe must not lead the government & must step down
For as long as it is something that will result in the fulfilment of our wishes and solve our problems no hard feelings
I think it is a very bad idea for ZPF and MDCs to talk coz they are like water and oil as far as policies are concerned. What happened to ZAPU when it merged with ZPF? I dnt approve of the talks unless they start on the March 29 election which means MDC T would be the winner
No problem as long as the talks result in the formation of transitional authority & fresh, free & fair run-off being conducted thereafter
The talks are very important but MDC must not at all accept a gvt of national unity. They must go 4 a transitional gvt and pave way 4 fresh elections. Zanu PF plans 2 destroy MDC just as they did to ZAPU
In addition to direct comments and opinions, over 300 requests came in for the document to be posted to people, and over 200 for it to be emailed. This, according to Kubatana, is a small indication of just how starved most Zimbabweans are for news about their own country.
The numbers may not yet be huge, but mobiles are certainly beginning to make their mark.
A few months ago I finally got round to diagramming what I thought mobile applications development in the not-for-profit space looked like. I came up with this, and called it "Social Mobile's Long Tail". It was based on the original Long Tail concept, first talked about by Chris Anderson in a Wired Magazine article, when he used it to describe consumer demographics in business (something quite different).
(A larger image is available via the kiwanja.net site here)
My thinking was this. Looking at the mobile applications space today we have a number of high-cost, well-publicised, large-scale mobile-related projects which tend to cover national (and sometimes international) needs. These "large" systems play a crucial role in helping larger bodies, sometimes as big as government departments, provide mobile services to their target audiences. They are generally aimed at the higher-end of the market, where only the larger or resource-rich NGOs reside. Way out there on price, complex to develop (assuming you wanted to) and near-on impossible to replicate, they're almost completely out-of-reach of your average grassroots NGO. These applications and platforms sit in the red part of the Tail.
In the orange section we move into the more mid-range systems - solutions developed by individual NGOs for a specific need, campaign or project. These are generally less complex, which makes their chances of replicability slighter better, but still difficult for many grassroots non-profits with few technical resources or hardware at their disposal.
Finally, in the green section - the truly long part of the long tail - we have the low-end, simple, appropriate mobile technology solutions which are easy to obtain, require as little technical expertise as possible, and are easy to copy and replicate. From my own experiences the number of NGOs present in this space is by far the greatest, making it the area to focus on if we want to create the highest amount of mobile-enabled social change. Add up all the value here, and it easily outweighs the rest along the higher (more lucrative) parts of the tail.
I use this diagram in many of my conference talks and presentations, and it seems to go down very well. It was interesting to see some of the staff at Nokia Research, where I spoke last month while I was in Palo Alto, grabbing their camera phones to snap a picture of it. I'm always thinking about ways I can refine it though, and Jim Witkin - a colleague - suggested adding an extra axis. This is now the one on the right, representing the number of NGOs in each of the Long Tail segments.
There are probably better ways of depicting this, but for now I'm happy with this. Suggestions, however, are always welcome.
What a week for FrontlineSMS. Activity was already on the rise - we're preparing for the launch of a new version of the software at Global Messaging 2008 in Cannes next month - but with news breaking this week on its use in Zimbabwe by Kubatana.net has come an additional flurry of press and user activity.
A number of Africa, technology and mobile blogs picked up on the latest report after I wrote about here earlier in the week. The sites quickest to the news included SmartMobs, Global Voices, DigiActive, Black Looks and Kabissa, with numerous other personal blogging sites continuing to link through.
Yesterday, a news item on "The World" also went out across public radio in the United States, where their Technology Correspondent interviewed kiwanja and Kubatana about how the software has been used in Zimbabwe. A three minute audio is available here (MP3, 2Mb).
Interestingly, this increase of interest has lead a number of sites to re-visit the use of FrontlineSMS in providing coffee prices to farmers, a subject I covered a couple of weeks earlier, here. The more notable sites to pick up on this has again been Global Voices, Ode Magazine and none-other than The Independent, who list kiwanja's blog entry on the subject among its "Pick of the Blogs" for 9th April ("From conception to replication").
All of this has lead to a flurry of activity from the non-profit community, with enquiries coming from far and wide - the United States, Cameroon, Trinidad and Tobago, Fiji, France and Uganda among many others. FrontlineSMS users around the world are slowly beginning to connect.
With so much already achieved with what is still technically the Beta release of the software, next month is very significant not only for FrontlineSMS, but also for the global NGO community who desperately need these kinds of tools in their work.
Tonight, a hundred and fifty farmers and their families who I have never met will be going to bed better off. Not only is this significant for the farmers, it's also significant for me. Because without FrontlineSMS, which is being used to provide coffee prices to these smallholder farmers, this would not be happening.
There's a tendency to think that, as a free entry-level texting solution, FrontlineSMS is only relevant for smaller, grassroots non-profits who are most likely to lack the funds or in-house expertise to develop their own solutions. Over the past couple of years I've begun to see otherwise. As a case in point, this coffee project is being run by the UN. Not the suited, New York-based UN you see on TV, but a field-based team of UN staff and volunteers who simply wanted to try something. All they needed was a simple, low-cost tool which allowed them to rapidly prototype their idea.
Today, using FrontlineSMS, their pilot project is distributing prices from five large buyers to about 150 farmers, village leaders and farmers groups by SMS in a classic "market transparency" intervention. And it's working. Prices are going up for farmers, and the buyers are getting access to more quantity and better quality. Prices are collected via phone once a week and within ten minutes are entered into FrontlineSMS and sent out. The project has been successfully running for several months.
What's notable is the benefit this project brings to the coffee dealers, the middlemen. Usually tarnished as unscrupulous and exploitative, they also have families and also need to make a living. Rather than cutting them out altogether they have been brought on board, and their reward is better quality coffee and access to larger quantities of beans.
Of course, there are countless "market price" examples out there, but what makes this significant, for me at least, is that they used a tool that any organisation working on economic empowerment or market issues could use. Unlike the Kerala fishing example, where mobile phones helped fishermen in southern India increase their profits in a similar way, this latest UN project is using freely available, NGO-specific, easy to implement named software. Interested NGOs simply have to Google "FrontlineSMS" and - if they choose - learn about it, download it and use it themselves. Barriers need to come down, and they are.
But issues of cost, replicability and knowing what's possible remain three of the biggest hurdles to mobile adoption among the grassroots conservation and development communities, something I regularly blog about. As yet, this UN project is undocumented (which is why I can't be more specific), so the knowledge is largely confined locally to where they work. Hopefully this will change. For the hundred and fifty coffee farmers involved in this project the concept has been well and truly proven, but for countless thousands of others, it hasn't. Our challenge is to make it so.
Winston Churchill once famously remarked that it was "better to be making the news than taking it. To be an actor rather than a critic". But there are times when this simplifies, and trivialises, the complementary roles that 'actors' and 'critics' can play. Half-a-century on, modern technology has empowered 'critics' in ways Churchill could never have imagined.
In 1984 a BBC news crew, accompanied by reporter Michael Bourke, travelled to Ethiopia and brought news of a growing humanitarian crisis to the worlds' attention. "A biblical famine in the 20th Century" and "The closest thing to hell on Earth" was how he described it. The international community were shocked into action, and the following summer saw Live Aid - Bob Geldof's massive mobilisation of the music industry which helped raise hundreds of millions for the famine victims. Michael Bourke - 'critic' turned 'actor'.
Today, modern-day blogging is creating mini-Michael Bourke's the world over. Human rights violations, environmental vandalism, political killings, oppression against citizens, animal cruelty and unlawful detentions make the news from all corners of the globe, made possible by brave souls empowered by mobile and internet technologies. The line between 'actor' and 'critic' is becoming increasingly blurred, if it exists at all anymore. Recent events in Kenya - which have spurned the creation of Ushahidi.com - is a perfect case in point.
A few short days ago, good friend Erik Hersman (who Blogs as the widely read and highly respected White African) aired his frustration at the lack of news coming out of the country from the man and woman on the street. In "It's Not About Us, It's About Them", Erik noted:
"While blogging, emails, Twitter and the internet are doing a great deal of good getting the news out of what’s going on in Kenya to the rest of the world, I find myself troubled. You see, the communication that needs to be happening is at the grassroots level. Everyday Kenyans do not have access to any of these services. Let’s put our minds and capabilities towards solving real problems for people beyond the technologically elite"
True to his word, just five days later saw the launch of Ushahidi.com, a site which allows Kenyans to report acts of violence via the web and SMS, incidents which are then aggregated with other reports and displayed on a map. Ushahidi - which means "witness" in Kiswahili - provides an avenue for everyday Kenyans to get their news out, and news of its launch has been widely hailed in the mainstream press (and the Blogosphere, funnily enough). Putting Ushahidi together is a textbook study in rapid prototyping and collaboration, and Erik takes a huge amount of credit for blurring the 'actor' and 'critic' distinction yet further by pulling his finger out and actually doing something. As he says, when all the dust settles in Kenya, he doesn’t want to be one of the ones saying “I should have done something”.
From a personal perspective, Bloggers such as Erik have been hugely supportive of kiwanja's work, without which there would have been little chance of initiatives such as FrontlineSMS and nGOmobile ever getting off the ground. nGOmobile alone has generated interest from over seventy grassroots NGOs, all of whom are now in with a chance of winning equipment to run their own text messaging services. FrontlineSMS has empowered NGOs in over forty countries from all corners of the globe. Essential to this has been a dedicated band of supporters, including White African, ZapBoom, Tactical Tech, ShareIdeas, Textually.org, Ore's Notes, Total Tactics, Black Looks, Saidia.org and 160Characters, among many others.
Whether or not we're 'actors' or 'critics' - and whether or not it really matters - we all have a valuable role to play. Ushahidi shows us just how valuable that role can be.