Dial a doctor

When asked in a recent survey whether kissing or holding hands caused pregnancy, a startling 41 per cent of girls in rural Karnataka and 57 per cent in urban Karnataka said yes or that they didn’t know. It was this kind of evidence that drew Nandu Madhava’s attention to the dearth of basic healthcare information not just in rural, but, more surprisingly, in parts of urban India too.
"Large numbers of deaths from easily preventable illnesses happen because of this lack of knowledge," says Madhava, who worked as a translator for doctors when he was in the Peace Corps in the Dominican Republic. "All the medicos I met said that people in emerging markets suffer deeply because of this," he says.
"People aren’t aware of things as fundamental as being inoculated for polio or hepatitis. You don’t have to reinvent the vaccine; you just have to get the information to people." Finding himself drawn to the idea of starting his own socially conscious enterprise, Madhava began to research public health issues after he moved back to India and found some surprising results.
"The challenges I observed in India were even greater than in Latin America," he says. "According to most World Health Organization statistics, the trouble lies at the bottom of the socio-economic pyramid. However, I found that there are tremendous health challenges throughout the pyramid. Diseases like diabetes are exploding in urban areas in higher income demographics." Realising that increasing access to accurate and relevant information is the simplest way to make a substantial improvement in public health, Madhava official launched mDhil, a mobile phone-based healthcare service in 2009.
Mobile healthcare is gaining in popularity in many emerging markets as an empowering tool. While the national government in Malawi uses mobile phones to track juvenile malnutrition, phones in the Philippines have been outfitted with microscopes that help trace malaria. In countries with higher internet penetration like the US, health information websites such as WebMD, Everdayhealth and Revolution Health are hugely popular. Aiming to combine these uses, mDhil provides everyday healthcare advice via text messaging, desktop and mobile web browser and digital content. The start-up capitalises on the exploding opportunities provided by the growing mobile industry. As teenagers as a group are active users of cell phones and the internet, it allows them to find reliable information about normally taboo subjects such as sexual health and contraception.
As of last month, mDhil announced that it was collaborating with Bharti Airtel to provide SMS-based health packs at the rate of about one rupee per message. Though originally only focused on SMS subscriptions, the launch of 3G data networks in India and the proliferation of low-cost smartphones are enabling mDhil to move towards a web browser where content is free and advertising-supported. "We work with experienced doctors and physicians to provide quality content and put in a lot of effort into being creative," says Madhava. "So it’s not a doctor sitting at a desk—we think, for instance, about how we can make a discussion on say, HIV, engaging." The website offers advice on topics such as cardiac care, stress management, diabetes, maternal care, sexual health, exercise and weight reduction. "I think it’s a very good thing if people have a source to give them advice that helps them lead healthier lives," agrees Dr Samrat Shah, who is a cardiologist, diabetologist and specialist in internal medicine. "Preventive medicine is much better than curative."
The most innovative part of the website is the videos that cover topics ranging from fitness advice from an IPL cricket coach to family planning. "It’s difficult to talk about some things—like cervical cancer—in the 160-character limit on SMS," says Madhava. "When we launched our videos in January 2010, we had about 50 views a day, and today we have about 500." They are looking to soon dub the videos in vernacular languages, starting with Hindi, to reach out to rural markets. mDhil’s reach is growing exponentially; in January 2011 it had only 200 fans on its Facebook page but now boasts a whopping 40,875. While in last September, the service counted more than 2,50,000 paid users, Madhava is looking to reach a few million users in five years as the mobile phone market continues to expand. However, Madhava believes that alternate healthcare services such as these will not be sufficient for plugging the healthcare gap. "I wish I could say that there was one silver bulletlike magic solution that could solve everything," he says. "The government also needs to have a greater reach in its healthcare efforts. In the United States, health is a trillion dollar industry and there are still a lot of things that need to be done. It’s not a one-day effort; we need to look at health as an evolving problem."