Saving Lives, One Small Question at a Time


It’s Kiswahili for “How are you?”—a simple and innocuous question that Dr. Richard Lester knows is helping to save lives across rural Africa.

Lester’s research team recently secured a $2 million investment to expand a program that uses cell phones and texting to improve healthcare in Kenya.

“Cell phones are everywhere in Africa and usage costs are very low,” says Lester, a member of UBC’s Faculty of Medicine and director of the Neglected Global Disease Initiative. “This makes them a great tool for patient care in resource-limited settings.”

Half of the program’s funding comes from the African Medical Research Foundation, which is a partner of WelTel, the groundbreaking non-profit Lester helped set up to develop his mobile health strategy for widespread clinical use. The other half comes from Grand Challenges Canada, a federally funded organization formed in 2010 to support initiatives that have an impact on both domestic and global health problems

WelTel itself started after Lester, working in concert with the University of Manitoba and the University of Nairobi, conducted a successful clinical trial that found a single weekly text to patients on anti-viral therapy for HIV allowed nurses to more effectively manage their follow-up care.  The patients themselves felt better supported and 12 per cent were more likely to stay on their drug therapies. In turn, this led to a nine per cent increase in the number of patients with full viral suppression.

“It was one of the first trials that demonstrated improved HIV treatment behaviours,” Lester says. “Given that there are almost 30 million people living with HIV/AIDS in Africa, these small but significant changes can be amplified to massive impact if brought to scale.”

WelTel has also been used to great effect in Canada, with the text messages revolutionizing the notion of house calls for women and families living with HIV. The simple phrase, “How are you?” has helped British Columbia doctors stay connected to their patients between clinic visits and efficiently find solutions for problems in real time.




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