Using Technology in the Fight Against Cholera in Zimbabwe

This week we gave our first targeted demonstrations of Freedom Fone, aimed at encouraging local health organisations to use Freedom Fone as one of the communications tools in the response to Zimbabwe’s cholera crisis. We believe that given the rapid spread of the cholera epidemic in Zimbabwe, greater use should be made of the country’s most ubiquitous communication tool – the mobile phone – to share information that can help address the suffering and limit the number of deaths.

Since August last year, WHO reports there have been over 80,000 cases, and over 3,615 people have died. This is an entirely avoidable tragedy. The best way to prevent cholera is to provide good sanitation and clean water – standards in most democracies. But in Zimbabwe, the economic and political collapse have resulted in infrastructural decline and malnutrition, and this entirely preventable disease has become an epidemic.

In the long term, only the rebuilding of Zimbabwe’s infrastructure, health care system, and food security can stop cholera. But local and international health agencies are doing what they can to combat cholera through providing Oral Rehydration Solution, clean water in bowsers, setting up cholera treatment facilities, and nation-wide information campaigns.

The information campaigns have included radio and television advertisements, print flyers, and SMS messages to mobile subscribers. But organisations coordinating this response recognise the limitations of these approaches. Thus, at our initial meeting with a social mobilization group including representatives of UNICEF, the Ministry of Health, the World Health Organisation and Oxfam GB, we were invited to present at a much bigger meeting.

The larger group included over 60 representatives from the Ministry of Health, WHO, UNICEF, DfID, USAID, MSF, IOM, Red Cross and dozens of other local and international organisations and donors.

In these meetings, we presented how a national cholera hot line using Freedom Fone’s Interactive Voice Response (IVR) menu system could reach greater numbers of Zimbabweans efficiently and cost effectively, becoming an excellent complementary information outreach tool alongside the more traditional methods which are currently in use.

We also shared a demonstration of what a sample cholera information service might sound like. We ran various channels in English and Shona (the main indigenous language of Zimbabwe) to give the audience a taste of how Freedom Fone works.

For example:

Press 1 to learn about cholera symptoms and prevention
Press 2 to learn more about treatment options
Press 3 to find out where to go for help
Press 4 to hear an audio feature
Press 5 to leave a message

This larger meeting approved of the idea of incorporating Freedom Fone into their communications strategy, but its success will still depend on a few key factors:

Telephony – The service will be most readily scalable to a nation-wide service if it can be connected to VoIP numbers. At present, VoIP is in a grey area in Zimbabwe. Access isn’t illegal, but it’s also not readily available. We are hoping that companies that provide VoIP termination will recognise the severity of Zimbabwe’s cholera crisis, and open up numbers to this service as part of their corporate social responsibility.

Connectivity – If the service runs on VoIP numbers, its availability as a 24/7 information source will depend on constant power and connectivity uptime. We will need to find an organisation – such as an ISP – which is willing to host the Freedom Fone server on its premises, where its power and connectivity can be guaranteed.

Content – Even more interesting than these technical challenges will be the issue of developing the content. Zimbabwe’s cholera epidemic has brought diverse agencies together around a common crisis, but organisational politics and preferences are likely to still play out in developing the content callers would phone in to hear. This will be an important learning experience for us in how to work with multiple partners to agree on content collectively.

Marketing – Once the service is up and running, the call-in number(s) will have to be promoted. This will need to be done in an expansive and diverse way, to reach a wide range of Zimbabweans. Our suggestions for this include traditional media as well as more creative approaches, such as promoting the Freedom Fone cholera number on airtime cards and specially printed packets of safe water and Oral Rehydration Solution.