M-learning: Fighting dengue with your mobile phone

It was just this June that a large outbreak of Dengue fever hit Mombasa County in Kenya. At least 153 people have been affected by the fever, and health experts from both private and public hospitals deliberated frequently on how to contain further spread. This is most difficult because Dengue is a disease that is hard to recognise: with its early symptoms of fever, headache, body aches, Dengue is often misdiagnosed as other illnesses.

Dengue is the fastest-growing mosquito-borne viral infection. Someone can receive the fever by being bitten by the Tiger Mosquito (or Aedes aegypti mosquito). Many people that are infected by the virus for a first time show almost no symptoms. However, they can still contribute to the transmission of the virus. Once someone has been infected already, a second time he or she gets Dengue the symptoms become more severe.

Fighting Dengue

In many countries governments brought their focus on prevention, by encouraging the use of insecticides or reducing potential egg-laying habitats for the Dengue mosquito. However, according to various health organisations this is not enough. In 2012 the World Health Organisation (WHO) issued a Global strategy for the control of Dengue. Promoting specific objectives to reduce mortality, reduce morbidity, and to estimate the true burden of the disease.

A text message about Dengue

Amref Flying Doctors acts according to this Global strategy in Africa. Putting in all the effort to reach as many African people, we believe that an early recognition helps to treat the disease and prevents the virus to spread in an early stage. During this June’s outbreak we provided the Mombasa County residents with the urgent help it needed. According to the Chief Officer of the Department of Health Services of Mombasa County Amref “stepped in to intervene on escalation and spread of the same”.

This success is mostly due to the application of the mobile learning approach (m-Learning). It is by the use of the mobile phones of the Community Health Workers, that they receive sufficient information on how to recognise the virus infection and how to response. For example, Scholar Mwamburi, who is a Community Health Worker: “I got the message about Dengue Fever on my phone. I learnt that Dengue Fever is caused by mosquitoes that bite during the day.” Thanks to this text-message, Scholar was now able to recognise the disease because she was told the symptoms include fever, nausea, vomiting, and bleeding from body openings. Also, she learned that the mosquitoes that bite are black and white, making her able to recognise the virus carriers. “I benefitted from the information as I learnt how to prevent the disease. I also taught my community about Dengue Fever”.

It is because of these messages received on their mobile phones that Community Health Workers and other volunteers can response appropriately and quickly to an outbreak such as this one. Being connected to each other, health professionals can spread their knowledge fast and local information can be quickly collected. As a result all health workers can intervene together and apply the same help, and react in a similar way on different locations in a larger area.

Why use the mobile phone?

The use of the mobile phone to spread vital information on outbreaks, such as the Dengue Outbreak or other health issues, has been done for several years now. The choice for information exchange through the mobile network and mobile phones is highly supported by recent statistics of the GSM Association (GSMA). According to their latest report “the Mobile Economy: Sub-Saharan Africa 2017”, the number of unique mobile phone subscribers in Sub-Saharan Africa will grow from 420 million at the end of 2016 to 535 million in 2020.

Besides its growing use contributing largely to the region’s job creation, innovation and socio-economic development, the mobile phone is also able to connect people across the continent and even reach those living in the most remote areas of society. Also, a mobile phone can “offer sustainable solutions that address the lack of access to services such as health, education, electricity, clean water and financial services”. The report found that mobile operators and others are leveraging on this ubiquity of networks across the region to deliver such services that are working towards achieving the UN Sustainable Development Goals (SDGs). Meaning, more organisations are making use of mobile phones to reach higher levels of education and health care (among others), just like we did with the Dengue Fever outbreak.

Facts & Figures – Use of mobile services in Africa

By 2020, Africa will have 725 million unique subscribers to mobile services
Region’s dominant markets: Egypt, Nigeria and South Africa
Mobile broadband connections: from 28 % in 2015 to 60% in 2020
By 2020, there will be 720 million smart phones.
Mobile ecosystem supported 3.8 million jobs in 2015. In 2020, this is expected to
increase to 4.5 million.

Source: The Mobile Economy Africa 2016

Learning by mobile phone

Because diseases travel all over the country, and are not bound by cities or roads, it is critical in our work to also reach the most remote areas. Every year thousands of people die because of the lack of medical support in their close environment. For years, Africa has dealt with a pressing lack of medical professionals mostly due to the shortage of educational institutions to train these medical professionals. As a result many people die of diseases that could be easily treated or even prevented in the first place.

Training Community Health Workers with the latest technology and using an easy and accessible tool like the mobile phone, a community will have access to life-saving knowledge through this person. Encouraged by the growth in mobile phone use, the appliance of this mobile learning approach is chosen more and more in Africa.

Training nurses and other medical professionals does not only provide education for them, it also provides a collecting system for local knowledge, that is even easy accessible in the most remote villages. Being the motor of this collecting system, these Community Health Workers gather important information as they hold an authoritative position being people who are trusted and familiar to the community itself. They are able to provide basic care to those in need and are often the first respondents at hand.

The collected data like health issues in the community, family situation, vaccinations and infections get shared by medical professionals, the community, but also with government. Thanks to these sources, all the stakeholders become more equipped to improve the overall system and can anticipate on the issues ahead. Community Health Workers cannot do their work properly without the right training. It is because of the mobile learning-approach they are trained to collect the right data, what to do with the data, and how they can give feedback to their community.

The goal

The high burden of disease remains the main challenge to African health systems (Africa Union). Sub-Saharan Africa, home to 11 percent of the world’s population, bears 24 percent of the global disease burden and accounts for less than one percent of global health expenditure. Within the region, communicable, maternal, neonatal and nutritional disorders account for 67-71 percent of the disease burden (Murray et al. 2012) – IFC 2016.

By using m-Learning, we can improve the health of thousand African citizens and reduce this number of fatalities. Initiatives like this contribute to the third and fourth Sustainable Development Goals (SDG) as presented in 2015 by the United Nations. SDG no. 3, to ensure healthy lives and promote well-being for all at all ages, is supported by m-learning as it contributes to the quality of collected data-sets of the overall health in communities. Making it easier to collect and use data, trained health workers are now able to response correct and adequate to various situations. SDG no. 4, to ensure inclusive and quality education for all and promote lifelong learning, is supported by m-learning as it provides a practical, far-reaching tool usable for a large population in Africa. It provides health professionals and volunteers with the most recent information on outbreaks or present diseases in the area.

Community Health Worker Phanice Mangleni from Kenya is one of the volunteers who make use of mobile learning. “I wanted to help my community. Change was necessary, because too many young women and children died.” Phanice is one of the many who keeps up her education by m-learning, who volunteers to educate her community on various topics like clean water, mosquito bites and its prevention, and family planning. This makes her a true hero for her community and beyond.

*Patricia Vermeulen is CEO of Amref Flying Doctors in the Netherlands