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Wednesday, 29 January, 2003, 12:12 GMT
Text messages prove a life-saver
Mobile phone
Text messaging is a cheap way to communicate
A scheme using text messages to remind patients to take their medicine is proving a hit in South Africa, as Dan Dickinson reports from Cape Town.
It is two o'clock in the afternoon in the Cape Town suburb Woodstock, and 47-year-old Avril Skiffers has just received a text message.

This is no ordinary message, but one which in theory could save her life. The message is simple but crucial. "Take your Rifafol now," it says.

Avril suffers from tuberculosis, or TB, a disease which in some cases is fatal and Rifafol is her medication.

She is on a six-month course of the drug, a course which is only successful if it is taken on a consistent and regular basis.

World Health Organisation rules state that all TB sufferers have to be observed by a doctor to ensure they take their medication. For many this means time-consuming daily trips to a health centre.

But Avril, along with 60 other TB sufferers in Cape Town, is different. They are part of a small but significant revolution which has been made possible by mobile phone text messaging services.

Lifestyle hints

Instead of making those daily trips to her local clinic she is allowed to take her medication at home.

Text message on phone
Messages come with jokes
"I receive my SMS every day at two o'clock which tells me to take my medication, which is what I do," said Avril.

"It means I don't have to go the clinic any more which was very inconvenient."

The message in English, Afrikaans or Xhosa is sent at a specified time on 22 days of each month over a period of six months.

To begin with, it was straightforward reminding patients to take their medication. But patients complained it was not engaging enough.

Now each reminder comes with TB information, lifestyle hints and a joke on Fridays.

"You get a lot of different type of messages," said Avril, "like 'Did you Know Nelson Mandela had TB' or 'Beware TB is contagious'. They keep you informed and mean you never forget to take your drugs."

Cheap reminders

The service, called On-Cue Compliance, was set up in January 2002 by Doctor David Green, a Cape Town family doctor.

The people most likely to benefit from the service are poor and they are more extensive users of cell phones than wealthier people in South Africa

Dr David Green, On-Cue Compliance
He bought a second-hand computer for around US $200, downloaded free software from the internet and rented cheap space on a server. Altogether the set-up costs were less than US$3,000.

He told BBC News Online that the service is an answer to a problem which can affect all patients who have to take medication on a consistent basis.

"There is a problem with non-compliance of medication. Evidence suggests that most people simply forget to take their medicine," he said.

"Many reminder devices have been tried and many have failed. It struck me that a cell phone was a reminder device that would always be with the patient."

Sending the reminders costs around US $1.50 per patient per month, a cost which has so far been borne by the Cape Town health authority.

Worldwide service

Concerns were raised that TB patients who are generally from lower income brackets wouldn't be able to afford mobile phones. But Doctor Green is dismissive.

"The people most likely to benefit from the service are poor and they are more extensive users of cell phones than wealthier people in South Africa because landline access is still difficult to come by," he said.

"The prepaid cell phone packages available make the technology relatively affordable."

On-Cue Compliance is providing reminders in Australia, Belgium, the UK as well as South Africa and is set to expand into the United States.

The internet and mobile technology is universally applicable. As long as there is enough server space, Dr Green can continue to provide a worldwide service from his second-hand computer in Cape Town.

Its ultimate success is dependent on the take up of SMS by mobile subscribers.

You can hear more on this story on the BBC World Service programme, Go Digital.

See also:

12 Apr 02 | Business
21 Jan 03 | Technology
08 Dec 02 | Health
18 Feb 02 | Asia-Pacific
01 Apr 02 | Business
12 Nov 01 | Business
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