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Last Updated: Wednesday, 13 April, 2005, 08:58 GMT 09:58 UK
Texting to help SA HIV patients
Nick Miles
BBC News, Cape Town

Mobile phone text messaging is being used to help South African HIV patients with the complicated process of taking anti-retroviral drugs in an initiative by Cape Town University.

South African Matsidiso Madondo is HIV positive
Fifteen per cent of South Africa's population is infected with HIV

Some six million South Africans are HIV-positive - the largest number of any country - that's 15% of South Africa's population.

After a slow start the government has recently started offering widespread anti-retroviral drugs.

Those people receiving the drugs are beginning a lifelong treatment - which can mean taking up to 30 different pills every day.

Often they fail to take all their medicines and that can ruin the impact of the treatment.

Hugs and kisses

Thembek Shole is part of the Cell Life project, run by researchers at the University of Cape Town.

Noxola Hans, South African HIV patient
Often I forget to take my medicine so it's good to have someone to remind me and find out when I'm feeling bad
Noxola Hans

She works as a counsellor for people living with HIV/Aids in Gugulethu, one of the former township areas of Cape Town, where potholed streets and bare concrete homes stretch as far as you can see.

The residents in Gugulethu are exclusively black and almost all poor - unemployment runs at 60% and some estimates put the number of people with HIV at three out of every 10 people.

Thembek knocks on the front door of Noxola Hans, where she's greeted like an old friend with hugs and kisses.

Noxola has been HIV positive for four years; she's frail and can hardly talk. She's being looked after by her parents because she is too weak to work.

Thembek visits Noxola and more than 100 other people like her every week.


She asks some basic questions, in the local Xhosa language: "How are you feeling? Have you been taking your drugs? Are there any new side effects?"

South African HIV councillor Thembek Shole
We used to have to write everything down, using the mobiles is simple
HIV councillor Thembek Shole
Throughout this informal interview, rather than making notes in a pad, Thembek is tapping away at her specially customised mobile phone.

Each category of question has a separate entry in the phone's menu, once one's filled in Thembek just scrolls down to the next question.

Perhaps the most crucial category is "adherence" - checking the patient been taking the drugs.

Thembek asks Noxola to get out her medication so that her pills can be counted. A vast array of white pots filled with brightly coloured capsules fills the tray in front of her: Noxola is taking 10 different types of medication.

It all appears a bit intrusive, having someone check up so strictly on your behaviour, but Noxola doesn't mind.

"I trust Thembek and the other counsellors," she tells me as we wander round her tiny front room looking at photographs of her five-year-old son.

"Often I forget to take my medicine so it's good to have someone to remind me and find out when I'm feeling bad," she says.

Thumb flick

Counsellors like Thembek are working across Africa. What's different here is the way the information is being gathered.

Celllife technical manager Dirk Diago
The data is transferred to a website for analysis

It's quick, reliable and - most importantly for the cash-strapped health clinics in the townships - cheap: Each message costs just four US cents to send.

"It's much easier for us now. We used to have to write everything down, using the mobiles is simple, the programme is easy to follow," Thembek says.

With a flick of her thumb she despatches the latest information and almost immediately it arrives at Cape Town University where Dirk Diago, the technical manager for the Cell Life project, takes over.

He set up the computer software that takes in all the mobile phone messages and automatically puts them on a website. He monitors the programme from his lab, surrounded by computer screens.

"What this system does is enable the clinic managers to focus on the patients who really need help urgently. It's an entirely paperless system," he says.

Doctor alert

The Cell Life website is secure - the only people with access to its information are health workers in Gugulethu with a special password.

Elizabeth Seabe, a manager of 50 HIV councillors in Gugulethu, is one of them. She is able to scan the site for worrying signs and if she finds any she alerts the doctor on call.

"Before when all the information was gathered in handwritten note form it was often unreliable and even lost before if could be properly analysed," she says.

"Now I can check the status of all the people who are HIV positive by logging on. It's totally changed how we work".

In a resource-poor clinic like Gugulethu's, it's small improvements like this that make a significant difference to the day-to-day treatment of South Africa's ever growing HIV population.

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