In the summer of 2008, an SMS-based communications network was implemented for a rural hospital and its volunteer community health workers (CHWs) in Namitete, Malawi. Located 60 km from Lilongwe, St. Gabriel's Hospital serves 250,000 Malawians spread over a catchment area 100 miles in radius. Distance presents an often-insurmountable obstacle for patients seeking care at St. Gabriel's. Many patients walk up to 100 miles to the hospital; those with more resources ride bicycles or oxcarts. In order to report patient adherence, ask for medical advice, or request medical care for remote clients, CHWs had to travel similar distances to the hospital's doors.

In partnership with the Children's AIDS Fund, Josh Nesbit, a Senior in the Human Biology Program at Stanford University, traveled to St. Gabriel's with 100 recycled cell phones, a donated laptop and a copy of FrontlineSMS – a free computer program developed to act as a central text message hub. Over 8 weeks, a total of 75 CHWs were called to the hospital, given cell phones, and trained in text messaging. Stationed at the hospital, a laptop running FrontlineSMS coordinates the health network's activities. The day-to-day program operations were handed over to hospital staff within two weeks. Individual solar panels have been distributed to the CHWs, which provide a reliable power source.

As a result of the this inexpensive, community-based SMS network, the hospital now responds to requests for remote patient care, tracks distant patients, informs CHWs of proper drug dosages and uses, receives and records HIV and TB drug adherence reports, facilitates CHW-to-CHW communication and group mobilization, connects HIV-positive patients to support groups, and relays outreach HIV and CD4 testing schedules.

In March 2009, CAF will work with Mr. Nesbit to replicate the St. Gabriel’s pilot program with CAF partner clinics in rural western Uganda.