Josh Nesbit: Help through SMS

Josh Nesbit ’09 (Human Biology) has been making international waves in service, including the provision of recent aid after the earthquake in Haiti. As a Haas Summer Fellow for two consecutive years (with St. Gabriel's Hospital in Namitete, Malawi, in 2008 and Partners in Health: Malawi in 2009), Nesbit has spent significant amounts of time aiding and researching children’s public health in developing countries.

“I was first connected to the Haas Center in 2008, when I was a Haas Public Service Fellow. The project I completed at a rural hospital in Malawi with support from Haas and the Donald A. Strauss Scholarship led me to co-found a nonprofit organization, FrontlineSMS:Medic,” says Nesbit. “Since then, we have spread operations to ten countries, mostly in Sub-Saharan Africa, but also India, Bangladesh, Honduras, and Haiti. With a second Haas Summer Fellowship, last year, I implemented an SMS project with Partners in Health in Neno, Malawi.”

Nesbit’s organization, FrontlineSMS:Medic, is a public health enterprise that connects remote health workers in developing countries to central health facilities, clinical staff, and resources with text messages or Short Message Service (SMS). Ninety-five percent of the remote health workers are volunteers who live in the community. Since cell phones are common to patients worldwide, receiving medical advice via text is often easier and quicker than locating a doctor able to navigate to remote locations. SMS technology can be used to assist mobile doctors with information from their clinics by connecting them to medical records or other forms of support.

When the 7.0 Haiti Quake occurred, Nesbit was in Washington, DC and felt the call to apply his public health expertise with technology to create a SMS-based network for Haiti. Reaching out via Twitter to his network of FrontlineSMS:Medic affiliates, he was able to find a partner in Haiti who could help him set up a network for emergency health text messages. In the wake of the disaster, these messages became the equivalent of an emergency health dispatch.

“Hours after the earthquake in Haiti, I got in touch with someone at Digicel—the largest telco—and worked with the US State Department to secure a short code, 4636, that could be used for emergency response,” says Nesbit. “We created an ‘SMS Logistics’ team, pulling in organizations across sectors and continents to create a system to process the messages.”

“Within 48 hours of the disaster, we had a fully-functioning system: SMS were pulled to a website accessed by Creole-speaking volunteers from around the world, where they were translated, categorized based on type of need, and mapped," says Nesbit.

Location is done by crowdsourced volunteerism as well as a group of students at The Fletcher School at Tufts University. The Office of Innovation at the State Department helped facilitate discussions with mobile operators, the Haitian government, and the United Nations.

“The message sent out via local radio to Haitians was, ‘Text your needs and location to 4636.’ It was an unprecedented, bottom-up system to map relief needs—school children were pulled from rubble, overlooked IDP camps were delivered food and water within minutes of texting in,” remarked Nesbit.

From AOL News:

One woman was in labor and bleeding. She texted her situation to 4636 and her location was conveyed to the Coast Guard who arrived to help her deliver her baby. The locations of the people making these texts are found with help by the Office of Innovation at the State Department, allowing the Red Cross or Coast Guard to use GPS technology to track the patients.

Further aiding Nesbit’s vision were San Francisco Companies CrowdFlower and Samasource, who enlisted the help of volunteer translators to help interpret the messages from the Creole. Via Samasource, FrontlineSMS is now employing fifty Haitians outside of Port-au-Prince to process incoming SMS.

According to AOL News, the 4636 number receives 2500 messages daily, each of which takes 2-10 minutes to translate and forward to medical help services. In a post-disaster situation where phone service may be spotty and unreliable, this fast turn-around can mean the difference between life and death.

“Reading the individual reports of needs from the ground was not easy—60% of current messages mention water shortages—but we remain fueled by a collaborative spirit and the knowledge that the system is helping,” says Nesbit. “The 4636 project made it clear that technology groups, government, and relief organizations could make an impact, together.”

—Amanda Gelender '10