Delivery of healthcare in Africa is winging its way into remote areas, thanks to a revolutionary new medical drone delivery initiative rolled out into rural areas of Rwanda. While drones are a billion dollar industry, more can be done to apply it for humanitarian purposes.
Globally, the popularity of drones is soaring. Want to know just how popular? A bit of keyboard clacking (simply type ‘commercial drones’ in your Google browser) reveals an 11 million search result in less than a second.
Last year, e-commerce giant Amazon announced that it will roll out a drone delivery system capable of carrying and delivering 3 kg packages. Energy plants use them for oil and gas rig maintenance, conservationists for hunting down poachers and the real estate market have been using drones to sell property to prospective buyers for several years.
The commercial and recreational use of drones has become a lucrative industry, but how are unmanned aerial vehicles (UAVs) applied in the medical and humanitarian space to help those with limited-to-zero access to basic medical healthcare?
KPMG’s 2016 ‘State of Healthcare in Africa’ report found that Africans live, on average, 14 years less than the average world citizen and 21 years less than the average European. HIV/AIDS, tuberculosis and malaria together cause nearly a quarter of deaths (2.5 million) in Africa every year.
Some say that the real killer is Africa’s lack of adequate access to essential and basic medical products. Because of challenging terrain and poor road infrastructure, nearly 2.9 million children under the age of five die every year. A total of 150 000 pregnancy-related deaths could be avoided annually if mothers had reliable access to safe blood.
The ‘last mile’ problem
In many African countries the access to lifesaving and critical health products is hampered by what is known as the ‘last-mile’ problem. It’s the inability to deliver much-needed medicine from a city to rural or remote locations due to a lack of transportation and poorly maintained (or non-existent) road networks.
For residents in Rwanda’s rural regions, travelling between towns and villages can be a long and arduous journey, and the situation is exacerbated during the rainy season when dirt roads can become impassable. These delays can be fatal for patients in need of urgent medical supplies or attention.
The solution to Rwanda’s road infrastructure problem is not to build new ones, but to avoid it completely. In 2016, US-based robotics company, Zipline launched a drone blood-delivery initiative that could save thousands of lives and revolutionise both the healthcare and transport industries on the African continent.
Zipline spokesperson Justin Hamilton says the company got the idea from a project that researchers had implemented across Tanzania two years ago. By distributing cellphones to rural clinics, health workers were trained to send text reports every time a patient came in with a life-threatening condition that could have been prevented if the patient had access to basic medicine.
“The reality was terrifying. Researchers collected a database of deaths where every entry was a life that could have been saved had they been able to get the medical products quick enough. We’ve designed Zipline to solve this problem. We know who needs medicine, when and where. Now, we can get them that medicine as quickly as possible.”
Care by air
In October 2017, Zipline initiated its first commercial drone flight to a medical centre in the western region of Rwanda from the newly constructed drone base in the Muhanga District. The fixed-wing drone flew five minutes before dropping its package and landing safely on the lawn outside of the Kabgayi District Hospital. Inside the package were cartons of blood, needed for life-saving transfusions.
In Rwanda, post-partum haemorrhaging is the leading cause of death for pregnant women. Blood requires storage and transport at safe temperatures, and can spoil quickly. Because there are many different blood products and no way to accurately project future needs, many transfusion clinics do not often keep blood in stock.
Before Zipline’s drone delivery initiative, Kabgayi hospital had to dispatch a car to bring back blood from Rwanda’s capital, Kigali. This round trip takes a minimum of three hours, but usually much longer due to the poor (and often impassable) roads.
Hamilton says that drone delivery is the solution for delivering medical supplies across the challenging terrain of the ‘land of a thousand hills’. “The lack of paved roads makes it difficult, often times impossible, to reach hospitals and health clinics. Zipline flies over mountains and washed-out roads to provide on-demand delivery of emergency medicines to people who previously had no access to care. Every delivery is saving a life.”
Zipline currently operates 15 drones from its Rwandan base, each capable of carrying a 1.5 kg bag of blood (enough for a transfusion for one patient) on a 150 km round trip.
It claims to be able to respond to orders directly from clinics within 30 minutes, and is eventually planning on making 50–150 flights per day to 21 transfusion clinics in the region (right now, it only serves two). Each delivery will be charged at roughly the same price as a motorcycle courier.
“Our autonomous aircrafts, called Zips, were built from scratch. We developed a custom avionics system that manages all guidance, navigation and controls for the aircraft, capable of robustly tracking its position to within a few centimetres,” says Hamilton.
He adds that Zipline can fulfill delivery requests across Rwanda in under an hour. “Zips are fully-electric, releasing zero emissions and have a large environmental benefit over gas and diesel trucks. We’ve also sourced biodegradable materials so our entire packaging is both recyclable or compostable.”
Zipline drones are able to operate in any weather conditions. “Medical emergencies don’t wait for good weather, so the ability to operate in a wide range of meteorological conditions is essential to our mission. Zips can complete delivering through strong winds and heavy rain.”
Hamilton adds that Rwanda plans to have expanded Zipline’s drone delivery service to the eastern half of the country by early 2017, providing nearly every one of the country’s 11 million citizens within reach of instant delivery of life-saving medicines.
By partnering with the Rwandan government, Zipline has been able to communicate with hospitals as well as with the locals to explain how the Zipline system operates. “Every day, we have hundreds of Rwandans lining up along the fence of our distribution centre to watch. They call our Zips “sky ambulances”. The drone’s presence reassures them that if a member of a family has a medical emergency, they’ll have access to the medical products they need to save them.
Drones or unmanned aircraft systems have the potential to become a multi-billion dollar business and deliver problem-solving technologies across numerous industries. However, aviation insurer Allianz Global Corporate & Specialty (AGCS)’s new report, entitled ‘Rise of the Drones: Managing the Unique Risks Associated with Unmanned Aircraft Systems’ says that more drones in the skies raise a number of new safety concerns.
The report says that risks range from collisions and crashes to cyber attacks and terrorism. To ensure safe UAV operations, systematic registration of unmanned aircraft and robust education and training of operators is necessary.
“UAV in commercial use will increase greatly in the next decade because they are effective at carrying out menial or dangerous tasks,” explains Thomas Kriesmann, senior underwriter-general of aviation at AGCS. Work accidents such as employees falling off the roof on building inspections and workers’ compensation losses are expected to decrease as a result.
Bryan Verpoort, head of ITOO’s international division, an underwriting partner of Hollard Insurance, says: “Rwanda borders DRC, where civil unrest is rife. There could be challenges with drones flying into hostile areas. We’ve also seen cases where people mask drone usage as being humanitarian when in actual fact, it’s used for terrorism.”
Kriesmann says that new risks and the potential for misuse of drone technology needs to be considered too. “Drones raise a few safety concerns: mid-air collisions and the loss of control. A mid-air collision could happen if the pilot cannot see or avoid a manned aircraft in time, especially those that fly below 500 feet, such as helicopters, agricultural aircraft or during landing and taking off.”
A pilot losing control of a drone during a building inspection could result in a total liability claim in excess of $5-million (R70-million), should that drone crash into a truck or shop, for example. Even a small drone could cause as much as $10-million (R140-million) in damage alone when hitting an airplane engine. An emerging peril is the potential terrorist threat from drones targeting critical infrastructure such as nuclear power stations or live events.
“Other scenarios include hackers taking control during a flight, causing a crash, or hacking the radio signal and transmitting valuable recorded data from the aircraft from another control station (spoofing). There are also many public concerns over drones around privacy issues,” says Kriesmann.