Mobile phones help tackle cholera in inaccessible parts of Somalia

13 November, 2012 | Conflict & Emergencies
Women receiving health messages by mobile phone. Photo: Oxfam
Participants say that receiving health messages by mobile phone has been helpful.

In Somalia, one of the most difficult and dangerous places for aid agencies to work, the conflict has left many communities hard to reach. Mobile phones offer an innovative way of educating such communities with life-saving information.

Oxfam and our partner Hijra started a pilot project to provide public health information to people’s mobile phones, timed to coincide with the peak cholera season, when many displaced families living in crowded camps in Mogadishu are particularly at risk. Despite the many challenges in Somalia, there is good network coverage and phones are cheap and available. Many Somalis use phones to receive remittances from relatives overseas.

A messaging center was set up in Hijra’s office, capable of sending 10,000 messages an hour – as long as there is power. The messages can be received on any ordinary phone. 10,000 people took part and received five “sessions” of messages explaining cholera prevention and control.

A recent evaluation of the pilot phase found notable impact among the youth, who are most keen to use new technology to connect to the outside world. Young people were talking about the project at school, and said it was seen as “cool” to get involved and learn about cholera in this new way. Peer pressure got many new youth involved.

The main expense was setting up the platform and software. But the software can be changed to fit the context, local language and subject matter without an IT expert, so program staff are able to manage it. The sessions cost about 60 cents. Although many people have phones, not everyone has credit – so users are refunded $1. Just like traditional public health campaigns, (where staff and volunteers go out into communities to engage face-to-face) the software is interactive, allowing people to text questions for staff to reply.

Feedback has been mostly positive. Unlike traditional health promotion campaigns, people said they liked being able to store the messages to look at in their own time – particularly women who were at home looking after children. One said it was like “attending a workshop in your own home.” People remembered the text messages more than radio bulletins (which cannot be saved) or posters.

One man said he made up an Oral Rehydration Supplement (ORS) for his sick child after referring back to the text messages. One woman had wanted to use chlorine but did not remember the dosage and had to refer back to her text message.

There were many recommendations for us to take forward:

  • Youth said they would like to receive “private” information about HIV/AIDS and sex education, as well as health songs as downloadable ringtones
  • Other suggestions included using e-vouchers for aid distributions, and community feedback via text to help us increase our accountability.
  • While the youth liked to receive text messages, older generations – particularly women – preferred a real voice, so a Voicemail component was recommended.

Mobile phones are not a perfect solution on their own, but done in coordination with traditional methods they have so far proved successful. Traditional public health promotion may be more participatory, but youth are increasingly engaged with new technologies and, in areas where access is not guaranteed (whether due to security or weather), the mobile phone based platform offers a new way for Oxfam to engage with communities.

A second phase of this project is now underway, comprising a fully fledged mobile phone Water, Sanitation and Hygiene (mWASH) platform, with the capability to undertake rapid assessments, distribute non food items (NFIs), conduct community education, and conduct monitoring.

Related links

Food crisis and conflict in Somalia

Oxfam's work in Somalia

Read more about mWASH in this report by Pacific Institute and Nexleaf Analytics: mWASH: Mobile Phone Applications for the Water, Sanitation, and Hygiene Sector (pdf)

Comments

So much potential in mobile phones..

Mobile phones are definitely the way forward with regard to much development innovation nowadays, such as this transferring of valuable information to otherwise isolated people, often in dangerous areas that aid workers are nervous to enter. The pilot project described here providing useful information during cholera season sounds like a great initiative. It would be interesting to see the results of an impact evaluation of this project, particularly its effect on IDPs in camps. It will be exciting to watch the progress of the mWASH phase of the platform.

Mobile phones are a versatile and far-reaching medium, and there is much potential for expansion of their use into other areas of development, such as:

-Important security-related messages

-Other health lessons, such as the education part of mWASH. Perhaps a system could be set up with many options, and interested people could sign up for topics they are interested in. This would address individual needs, including the request from some youth for sex education.

-Work could be done with awaaz.de, perhaps connecting people directly to health advisors whom they could ask specific questions. Information could then also be spread using spoken voice rather than text, which is a preference for some people, including the illiterate.

-M-Pesa style mobile payment, as is huge in Kenya, could be a future possibility

-Mobile phones could be used for the expansion of the economy and higher efficiency in areas such as agriculture, connecting farmers to experts, or simply providing similar education to farmers as has been done with health issues. Again, awaaz.de is a good reference point

-etc!

Looking forward to hearing more about the progress of such initiatives.  

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