One Person's Trash Could Save Another's Life

Feb. 15, 2011 — -- Josh Nesbit had a simple idea -- one that turns old cell phones into lifesavers.

As the goalie on Stanford University's soccer team, Nesbit earned a full scholarship. But it was his hustle off the field that makes him a superstar.

During his sophomore summer break four years ago, Nesbit volunteered at an AIDS clinic in Malawi, one of Africa's poorest, least-developed nations.

His idea was to use high-tech open source software on a laptop, along with some solar power and give away old cell phones so that local health workers can work on the frontlines of global health.

In Malawi, 85 percent of the people live in rural areas and most survive on a dollar a day. Nesbit volunteered at St. Gabriel's Hospital to help children with HIV.

"This particular hospital was serving about a quarter million people, spread a hundred miles in every direction. So you literally had patients walking 60, 80, a hundred miles to access care. Basically one nurse would get onto a motorcycle and drive 10 hours a day trying to track down patients," Nesbit said.

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Often community health workers, who travel miles to isolated African villages to see patients, have to lug boxes of medical records with them. Paper records can be lost or damaged, especially on long trips.

"The information you're collecting in the field might not make it back to the higher level medical staff," he said.

Nesbit realized that instead of biking or walking for hours on end, health workers and patients could instantly text each other if they just had the right technology.

Back at Stanford, surrounded by high-tech engineers, Nesbit found a software guru named Ken Banks who could help make it happen.

"There was a guy living out of a van on the edge of campus who was hacking away and creating this open-source software platform, called Frontline SMS. So basically, I took a copy of that software, a laptop, a hundred recycled mobile phones, and a plane ticket," Nesbit said.

Back in Malawi, Nesbit set up an ad hoc network using solar panels, a laptop and cell phones. With the software, paper records could be transformed into text messages. Soon the health workers were texting a hundred miles in each direction.

"So someone out in the middle of rural Malawi will break their leg, or have an adverse reaction to their drugs, and the community health worker who now has a phone, will text into the local health facility, which might be 20 miles away, which might be 60 miles away," Nesbit said. "[The workers are] texting from their homes or from their patients' homes."

The new technology allowed workers at St. Gabriel's to respond to emergencies, diagnose patients, and keep track of their medical records, all via texts -- saving time, resources, and lives.

"About 150 patients over six months received care who wouldn't have been seen otherwise. The tuberculosis officer came up to me and he said, 'Josh, we're doubling the number of patients we're treating for tuberculosis now,'" he said. "After six months at that point, we really were at the point of no return."

But there was a problem: there weren't enough phones to meet the demand. Then Nesbit had another great idea.