Text Messages Used to Combat AIDS in S. Africa

Tasha Eichenseher in Camden, Maine
for National Geographic News
October 24, 2008
As South Africa reels from the HIV/AIDS epidemic, health workers are turning to cell phone technology to get the word out about testing for the virus.

An ambitious text messaging campaign is expected to reach a million South Africans daily with information about HIV/AIDS counseling services and testing centers throughout the country.

The effort, called Project Masiluleke—which means "hope" and "warm counsel" in the South Africa's major language, Zulu—"is one of the largest ever uses of mobile phones for health info," according to Andrew Zolli, executive director of Pop!Tech, which helped coordinate and fund the project.

The initiative was announced this week at the annual Pop!Tech technology conference in Camden, Maine, and is expected to officially launch in South Africa next February.

"Please Call Me"

Cell phones are abundant in South Africa, with nearly 90 percent of the population using some kind of mobile technology, according to Zolli.

The majority of South Africans have prepaid phones, whose plans include free "please call me" text messages. Users send them when they are out of minutes.

The developers of Project Masiluleke struck a deal with South African cellular company MTN to send out one million "please call me" messages each day for the next year.

One message reads: "HIV + & being mistreated by your family of friends? For confidential counseling call AIDS Helpline on 0800012322."

Another says: "Frequently sick, tired, losing weight and scared that you might be HIV positive? Please call AIDS Helpline 0800012322."

The use of text messaging to spread this information isn't necessarily new—similar campaigns have launched in recent years. "But this campaign is the most ambitious we are aware of," said Robert Noble of AVERT, an U.K.-based AIDS charity that works in South Africa.

During three weeks of usability testing in October, Project Masiluleke helped increase average daily-call volume to the National AIDS Helpline in Johannesburg by nearly 200 percent, said Pop!Tech's Zolli, also a National Geographic visiting fellow. (National Geographic News is owned by the National Geographic Society.)

Fresh Message

Grietjie Strydom is a medical doctor in South Africa and head of private programs for Right to Care, a health care provider funded by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).

Cell phone campaigns should take off in South Africa, she said.

"This is a very important communication avenue that has not been exhaustively explored," said Strydom, who is not directly involved with Project Masiluleke.

"As long as the message is fresh and original, I think it will have a big impact."

The call centers can help people find testing facilities, overcome depression, figure out how to effectively use their medication, or refer people to medical experts.

Callers to help lines always remain anonymous—a critical consideration in a country where people generally don't talk about HIV/AIDS, said Zinhle Thabethe, a South African who co-founded iTeach, an HIV/AIDS education organization that is part of Project Masiluleke.

"The more HIV and AIDS is discussed through as many different communication channels as possible, the less it will be stigmatized," PEPFAR's Strydom said.

AIDS in South Africa

Thabethe, who was diagnosed with HIV in 2001 and told she had a year to live, calls South Africa "the epicenter of the epidemic."

The U.S. Agency for International Development (USAID) estimates that of 47 million South Africans, nearly 6 million adults and children are infected with HIV—one of the highest rates in the world.

HIV/AIDS patients face poverty and unemployment, an overburdened public health system, crowded medical facilities that spread tuberculosis, and serious social stigmas—particularly for men, said Thabethe, who is also a National Geographic emerging explorer.

Though testing is widely available and treatment is often free, only 5 percent of South Africa's population has been tested, she said. Even then, it is usually only when they are dying that they seek help.


South Africa is one of the most resource-constrained regions in the world, said Pop!Tech's Zolli.

Challenges include funding call centers, distributing free home HIV tests, and putting in place text messaging to remind patients of their medical appointments.

One solution, according to iTeach co-founder Krista Dong, may be to train unemployed AIDS patients to field requests for information and help via cell phone, creating what she calls a "virtual call center."

Zolli added that Project Masiluleke was "designed to serve as a scalable, high-impact model that can be replicated worldwide."

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