Background India is 70% rural Most healthcare is city-based – Local MDs are stretched to capacity Limited access to affordable licensed doctors Public Health Center (PHC) in villages open only 6 hr/day during work hours

Challenges Easy and affordable access to healthcare Access to license medical practitioners Limited access to medical information Expensive transportation from villages to city hospitals Mobile phone technology provides a platform for access to care

Why Mobile Phones Compact, portable and widely accessible Proven effective internationally Any literate villager can become the Village Health Director (VHD) – Does not limit scalability Transportation costs minimized 24/7 access to free medical services Minimal time commitment Doctors need only 1 min to reply Contacts are village residents No need for traveling health workers Low cost < Rs. 1 ($0.02) per message Lowers future costs through preventative medicine Discourages unlicensed practitioners

How Does it Work - Health Care Access: Five Simple Steps Sick/injured patient contacts Village Health Director (VHD) who has a mobile phone VHD sends SMS to Communication Control Centre (CCC) laptop in hospital CCC doctor responds through system, offering immediate first aid advice CCC sends ambulance to bring patient to hospital for free of charge Ambulance returns patient to village IF PROBLEM IS SEVERE *MH has already piloted this program in India for three weeks*

MH Has Already Piloted This Program In India Udaipur, Rajasthan Pilot Stats Ran for 25 days in 8 villages Served 64 patients Together, these 64 patients saved 80 full working days Avg earns $0.80/day Approx $1/PCH visit

Case Studies DateInitial SMSResponse SMS with MHAction TakenIf No MH 7/8/ :50 38 year old female for 3 days has been having a headache. From yesterday she has had vomiting, diarrhea. She has had diarrhea 15 times until now. Take paracetamal 2x a day after eating. Also take the pill ranidon 3x a day and the pill Furazolidone 3x a day. Also mix ORS powder in water. Do all this for 3 days. Patient was informed of the medications she needed to take to cure the headache, vomiting, and diarrhea If the vomiting and diarrhea continued, there would have been a likelihood of dehydration. 7/11/ :47 M 9 year old child’s finger got cut by a blade. A little bit of blood came out. There is a bit of a cut. Put povidin ointment on the cut and wrap a bandage around it. Do this for 5 days. You can get a free injection at your village government hospital. Immediate first aid treatment from provided first aid box Possible infection of cut, potentially leading to gangrene 7/15/ :01 18 year old male’s finger got fractured from a falling pan. It is not a big hurt. The finger is not moving. Go to a nearby hospital and get an X-ray done by a doctor. Patient was informed of necessity of medical treatment and visited village Public Health Center Fracture could possibly worsen and result in permanent handicap without treatment

Keshu 12 yr-old boy with 8-year old burn that went untreated Resulted in gangrene and cancer Could have been prevented if a system like MH had been present Keshu

Cost Effectiveness Low-cost – proven economical Save villagers MD cost of private visits Long-term cost structure is efficient $7,500 $43,506 $26,809 -summer budget -needed June 1st budget -needed October 1st -raised before 2010 $22,500 Funding Progress for 2010:

Scalability & Sustainability The MH program is easy to scale – Most villages have cell phone connectivity and if not, will so in the next few years – Professional Health Workers are not needed Any literate villager can be trained and it opens up hundreds of villages that can have this service Options to creating a sustainable model – Village governments pay for the service in their village – Patients pay a negligible amount – Partner with local cell phone company – Micro financing VHDs

Improved Access to Health Care MH’s integration of Information Technology into the framework of hospitals creates sustainable health care

Expansion Will Impact Thousands Program successfully piloted in 8 villages in Summer 2009 In July, we will travel to 50 villages, connecting 50,000 people

Treatment – Access - Prevention