Who says texting can’t change the world? Or at least make a difference.

When Josh Nesbit was confronted with a fundamental health care problem in Malawi, he turned to modern technology for a creative solution. With a simple text message, Nesbit was able to transform the entire organization of the hospital where he volunteered last year.

Nesbit first traveled to Malawi in the summer of 2007 to volunteer at a rural hospital called St. Gabriel’s, which serves a quarter million people dispersed 100 miles in every direction. While there, Nesbit volunteered with the mobile HIV testing unit, helping with immunizations and counting pills in the pharmacy. The hospital only has two physicians, so it relies on a network of more than 400 volunteer health workers to be home-based care providers in their communities. But this means that these volunteers are disconnected from their patients and the hospital.

Nesbit thought of a solution to this problem when he was first introduced to Ken Banks, the founder of a free mobile communications organization for nonprofits called FrontlineSMS. “The hospital wanted and needed to be connected to the communities,” Nesbit says. And FrontlineSMS could make that a reality. Although never before applied to the health sector, Frontline SMS’s free software allows users to send and receive text messages with large groups of people through mobile phones. To Nesbit, the software seemed like a natural fit. “People were ready, and it made a lot of sense,” he says.

A grant from Stanford University’s Haas Center for Public Service enabled Nesbit to return to Malawi in the summer of 2008. With a donated laptop, 100 recycled cell phones, and a copy of the FrontlineSMS software, Nesbit set up a text message-based communications network for St. Gabriel’s Hospital and its community health volunteers. In eight weeks, Nesbit trained 75 community health volunteers to text message.

The project, Mobiles in Malawi, expands the hospital’s capabilities. The volunteers now use text messages to respond to requests for emergency medical care, track patients, record HIV and TB drug adherence, stay updated on patient status, mobilize remote communities for outreach testing, provide instant drug dosage/usage information, and connect HIV/AIDS support group members.

After leaving Malawi, Nesbit jumped right into replicating the Mobiles in Malawi pilot for worldwide expansion. An international health and bioethics major, Nesbit has juggled being a full-time student, a soccer player at Stanford, and an advocate for his mobile project. He spends about six hours each day spreading awareness of his project to heads of NGOs, CEOs of corporations, government officials, in-country project managers, university faculty, and friends.

The program was relaunched in February 2009 as FrontlineSMS:Medic, which is made up of a team of people committed to using technology to support community health workers in the developing world. One reason FrontlineSMS works so well is because it doesn’t require new phones, new computers, or even a better Internet connection. Instead, it uses the resources already available in-country.

For his spring break this year, Nesbit spent 10 days in Uganda setting up FrontlineSMS:Medic programs at two clinics, which collectively serve 800,000 people in 29 communities and 2,304 villages. “The trip to Uganda reinforced my belief that a successful health program stems from local ownership and the utilization of simple tools,” he says. “The energy and excitement in the room on the third day, when we brought in 80 community health workers for SMS orientation, reminded me why this work is valuable.”

Nesbit is now dedicated to the project full-time . He is currently working with his team on continuing software development, and they already have firm implementation plans with more than 15 partner clinics in Africa, Asia, and Latin America. They hope to implement the program in 35 countries within the next six months. The group has multiple grant applications and recently received its first major organizational funding, which adds up to more than $40,000. It’s a long way from the typical 10-cent text message.

This article appears in Abroad View’s fall 2009 magazine written by Molly Lister.