Photo essay of Click Diagnostics' July 2010 visit to Friendship

1. Bringing Mobile health to river islands in Bangladesh Our Bangladesh team recently visited the “char” communities where Friendship and ClickDiagnostics are launching a pilot program to empower community health workers with mobile health technology www.clickdiagnostics.com www.friendship-bd.org

2. Bangladesh has hundreds of temporary river islands called chars. They are formed by currents carrying silt from upstream, and destroyed by the same currents every few months or years. For millions of ultra-poor people, settling on these no-man's islands is the only option short of homelessness.

3. Homes on the chars are not built to last, since the river inevitability washes away the soil underneath. More than once a year, families have to abandon their flooded homes and move to another char. Not surprisingly, there are limited social service available to these temporary communities.

4. Friendship, one of ClickDiagnostic's partner organizations, has made significant investments to understand the geography, ecology, economy, and culture of char communities in order to design programs tailored to their needs. Currently, Friendship is serving over 4 million beneficiaries. In this picture: Friendship staff showing Dr. Sami, our Technical Advisor, a map of the chars created with the aid of satellite images.

5. The char health system that Friendship has built consists of three tiers – 1. two floating hospital that provide primary, secondary and tertiary care; 2. weekly or fortnightly satellite clinics that provide services in the chars; 3. Friendship Community Medics – over 200 trained char women going door-to-door to dispense basic medicine and collect health information. In this picture: Patients waiting to visit one of Friendship's floating hospitals.

6. ClickDiagnostics is partnering with Friendship to design and implement mobile health technologies for the chars, so that all tiers of health services become connected and Friendship Community Medics can better take care of their communities. In this picture: Our CEO Mridul, Bangladesh Program Manager Maya, and Friendship Paramedic Nagma heading to a focus group in a char village.

7. Friendship Community Medics shared their knowledge of common diseases found in the chars and helped us understand ways in which mobile technology can make their daily work more effective. In this picture: Dr. Bashar, our Head of Medical Intelligence, listening to Friendship Community Medics share their experience.

8. We shadowed a Friendship Community Medic to observe her visits to households and interview the beneficiaries. The residents talked to us about their health conditions, challenges they face in seeking medical treatment, and services they would want have near their homes. In this picture: Maya chatting with a pregnant young woman and her mother-in-law.

9. We demonstrated our maternal health risk screening module for a group of Friendship Community Medics. We hope over time, mobile health technology will enable them to become the primary agent for health service delivery in their communities. In this picture: Maya explaining the features of the module to a Friendship Community Medic holding a Click-enabled mobile phone.

10. Our user interface is written in Bangla for basic java-enabled Nokia phones. The extensive data network in Bangladesh allows patient medical data to be transmitted very cheaply to a central server, analyzed by our medical algorithms, and viewed by doctors as needed.

11. The ladies were excited about our technology. Within minutes, they learned how to use the software and started testing the features. Our team will return to the chars soon with mobile health solutions designed for Friendship. We are excited to start training Friendship Community Medics and launching the pilot in just a few weeks!

12. We hope that through this partnership, ClickDiagnostics can help Friendship expand the incredible work it is doing in char communities, so that hundreds of thousands of children and their families can lead healthier, more prosperous lives. In this picture: Children from the char and Ayeleen, Friendship’s lead on our mobile health pilot program