Friendship and ClickDiagnostics are launching a pilot mobile health program to serve riverine island communities in Bangladesh called "chars". Char residents face unstable living conditions as the islands are regularly destroyed by river currents. Friendship has built a three-tier health system for the chars but aims to integrate services using mobile technologies. ClickDiagnostics partnered with Friendship to design maternal health screening software for community health workers on basic phones, allowing remote data collection and analysis to better serve char residents.

1. BRINGING MOBILE HEALTH TO RIVERINE
ISLANDS IN BANGLADESH
Our Bangladesh team’s recently visited the “char” communities where
Friendship and ClickDiagnostics are launching a pilot to empower community
health workers with mobile health technology

2. Bangladesh has hundreds of temporary riverine islands called chars. They are formed by
currents carrying silts from upstream, and destroyed by the very 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 from homelessness.

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

4. Friendship, one of ClickDiagnostic's partner
organizations has spent immense efforts to
understand the geography, ecology,
economy, and culture of char communities,
in order to design programs tailored to their
needs.
Currently, Friendship is serving ~300,000
beneficiaries
In this picture: Friendship staff showing Dr.
Sami, our Bangladesh Country Director
a current map of the chars created with the
aid of satellite images

5. The char health system that Friendship has built has three tiers - hospital ships that provide
secondary and tertiary care; biweekly satellite clinics that deliver primary care; and
Friendship Community Medics, trained char women going door-to-door to give health advice
and dispense basic drugs.
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 integrated., 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 mobile technology can make their daily work more
effective.
In this picture: Dr. Bashar, our Head of Medical Intelligence, listening to Friendship
Community Medics during a focus group

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 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 demoed our maternal health risk screening module for a group of Friendship Community
Medics as an introduction to mobile health technology.
In this picture: Maya explaining the features of the module to a Friendship Community
Medics holding a Click-enabled mobile phone

10. Our user interface is written in Bangla for
basic java-enabled Nokia phones.
The wide-spread 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.
They learned how to use the software within five minutes, and started testing the features
and teaching each other.

12. We hope through this partnership, Friendship will further 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.