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Josh Nesbit: Bridging the Patient-Physician Gap with Technology

Medic Mobile founder Josh Nesbit was a pre-med student at Stanford in 2008 when he visited Malawi for the first time. Encountering the Malawians and their situation changed his life—and he’s been determined to return the favor ever since, by changing theirs.

Among the world’s least-developed and most-densely populated countries, Malawi is a landlocked southeast African nation where 85% of people live in rural areas. The Malawian population lives with the grim triptych of low life expectancy (50 years), a high infant mortality rate, and a huge percentage of deaths due to HIV/AIDS.

Yet amidst these massive health care impediments, Josh discovered something that astonished him: he had a better phone connection in the village of Namitete than at home in Palo Alto—six bars! Although Malawi had (and has) one of the lowest per capita incomes in the world, recent successes in infrastructure development had included making standard GSM telephone signals widely available.Interested in pediatric HIV care, Josh first volunteered at St. Gabriel’s Hospital in the village of Namitete. Every day, he saw literally hundreds of families waiting outside hoping to see the hospital’s one and only doctor. (Even today, the hospital serves 250,000 people with just 250 beds.) Some had traveled as far as 50 miles to wait in line. Suddenly those big abstract numbers cited in his pre-med textbooks – like the one billion people who have never seen a health care provider – became real people.

With his Stanford background, Josh naturally thought maybe technology could solve some of Malawi’s health care troubles. How much of the problem was pure logistics? When Josh met a local Community Health Worker who (on his own) provided basic care and supplies to more than 100 families in Namitete, the challenge had a face—and a case study. The village health worker, Dickson Mtanga, kept all of his handwritten patient records in a single notebook. Why not give Namitete a mobile phone version of the cloud? Make the information collaborative and actionable?

Josh started experimenting with a free software app to exchange texts and coordinate the efforts of health workers like Dickson with the hospital in Namitete. Using text and cheap mobile phones, health workers could explain patients’ symptoms and transmit medical records, in real time. Josh quickly took the idea of texting one step further.

In 2009 he founded Medic Mobile, developing an open source software application to support data collection forms that can run on any desktop and any phone. Health workers simply slide an SIM card (a paper-thin chip) into their cell phones to enroll patients for essential health care services. The chip is programmed to remind them of their follow-up visits and vaccinations, report on their conditions, notify clinics of danger signs, and manage stock levels of medicine. The latter is important: as Josh quickly discovered at St. Gabriel’s, getting to the hospital is only half of the battle. Imagine reaching the hospital after a 50 mile trek only to discover that the medicine you need is not available.

Since becoming a 2010 Echoing Green Fellow with his co-founder Isaac Holeman, Josh has been expanding the impact of Medic Mobile beyond Africa, to countries throughout Asia and Latin America where the technology can have the biggest impact.

By the end of 2014, Medic Mobile’s goal is to more than double its reach—from the current 9,500 health workers (who oversee 1 million people) to 22,000 workers. And they’re on target. By developing smart partnerships with companies like Mozilla—Medic Mobile will be the first community health app available via Mozilla’s Firefox web browser—more health workers can access data to service more people in remote and underserved communities. “We see harnessing the Web as our next big step,” says Josh.


Josh Nesbit is a 2010 Echoing Green Fellow, as well as an Ashoka Fellow, PopTech Social Innovation Fellow, Rainer Arnhold Fellow, Strauss Scholar, Haas Public Service Fellow, and most recently, a 2014 Skoll Awardee. He was named by Devex as one of 40 Under 40 Leaders in International Development and received the Truman Award for Innovation from the Society for International Development.


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