A Bull Market in Social Entrepreneurs

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Tech Help for Malawi's Health Care

A year ago, Nesbit took 100 reconditioned cell phones and a laptop computer to St. Gabriel's Hospital in rural Malawi. There, two doctors were attempting to care for a dispersed population of 250,000 people, many of them infected with HIV. But efforts to stay on top of patients' conditions were hampered by an expensive, inefficient, and not always reliable means of communication: messengers on motorbikes.

To help physicians get more frequent status updates at a lower cost, Nesbit and his co-workers distributed cell phones loaded with an open-source software, Frontline SMS, which enables phones to broadcast 160-character text messages to a network. After handing out the phones and training 75 community health volunteers in the area to use the tool, updates poured into the laptop at St. Gabriel's. Doctors there were able to respond to emergencies, get health updates, and follow the medicine regimes of patients suffering from AIDS and tuberculosis. According to Nesbit, the cost for the first six months was $250—and the system saved $4,000 in motorbike fuel alone.

Notably absent from those calculations are salaries. Nesbit's company is run entirely by volunteers and students, six of them at Stanford. Nesbit says that he and the others graduating have landed fellowships and small grants to support themselves over the coming year. But the burn rate is low. "I could run this out of my parents' basement (in suburban Washington, D.C.) if I had to," he says.

Stopping the Next Swine Flu

In recent months, Nesbit's team has raised money, winning $45,000 in prizes from the NetSquared Mobile Challenge Conference, and another $5,000 from the William J. Clinton Foundation. The company submitted funding applications to foundations and is hoping to land $300,000—next year's projected operating budget—that it could use to set up cell-phone health networks in 20 countries. "Until we get that kind of breakthrough, we'll keep doing what we can," Nesbit says. In the meantime, the company hopes to keep collecting used cell phones through an Internet campaign.

This summer, Nesbit is setting up another network in Malawi. Then he's traveling to Cameroon, where he and his medical director, Lucky Gunasekara, are using their technology to roll out a pilot for the Global Viral Forecasting Initiative. This is a project financed by Google, the National Institutes of Health, and others to identify and respond to early-stage epidemics. Nesbit's idea is to use mobile messaging to track bush-meat hunters and high-risk patients—and to catch the next HIV or swine flu before it spreads.

Much like the famed Stanford Internet alums, Nesbit and his colleagues are launching a startup with global ambitions. The only thing small about Frontline SMS:Medic is its operating budget. It seems to be in step with the times.

Baker is a senior writer for BusinessWeek in New York.

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