This special series focuses on important community issues, innovative solutions to societal challenges, and people and non-profit groups making an impact through technology.

The notion of getting your Amazon order whisked quickly to your doorstep by a drone might sound delightfully convenient. But in developing countries facing urgent and deadly healthcare challenges, the advent of cargo-carrying unmanned aerial vehicles (UAVs) could save lives.

Just as cell phones have leapfrogged the use of landline telephones in many impoverished communities, some are hoping that drones will be able to bypass the use of trucks and motorcycles on rutted, impassable or even nonexistent roads in order to provide timely healthcare via air.

Tech companies and international health organizations are testing the use of UAVs around the globe, from island nations including the Dominican Republic, Papua New Guinea and Madagascar to isolated populations in Nepal to Peruvian jungles. The devices typically are battery-operated, remotely-controlled and can autonomously navigate their routes using apps and GPS.

Seattle’s VillageReach, a global health nonprofit, is working on a project in Malawi whose partners include UNICEF and Matternet, a leading drone company in Silicon Valley. In a trial this spring, the group used drones to carry simulated dried blood samples from a small community to a hospital in the nation’s capitol in order to test the technology. If the project is expanded, the drones could one day take blood samples collected from babies born in rural areas and transport the samples to labs so they can be tested for HIV.

“Time is of the essence,” said Carla Blauvelt, country director for VillageReach in Malawi, in a Skype interview. “Even if there are many factors that delay the [testing] process — even turnaround times for results — reducing any layer of that is helpful. If the transport is two days and it can be reduced to 30 minutes or an hour, every little bit counts.”

While there is a lot of excitement around the potential for UAVs to carry life-saving medical supplies and lab work, many of those most active in the field — including folks at VillageReach — warn that it’s harder than it looks. They worry that some companies and organizations who are eager to get involved are underestimating the challenges.

The hurdles include complying with, and even helping create, regulatory systems in developing countries to permit the use of UAVs. It can be difficult to find narrowly defined projects where a drone makes economic sense compared to alternative modes of transportation. And there’s the matter of designing drones that can safely and repeatedly perform in harsh environments under a variety of weather conditions.

“A lot of people think that because they can fly a platform [or UAV] in California on a beautiful, blue-sky day that they can save the world,” said Patrick Meier, founder of the Humanitarian UAV Network (UAViators), a website that shares information about humanitarian drone use. “But it’s far, far more difficult.”

Bypassing snake-filled forests



Traversing Malawi’s forests full of snakes — including some venomous varieties — by motorbike in an effort to deliver time-sensitive medical tests is just one example of the transportation challenges faced here.

In this landlocked, agriculture-dependent African country, more than half of its 9,600 miles of roadways are unpaved and the population is largely rural. But healthcare needs are urgent: more than 10 percent of the population has HIV/AIDS and nearly 40,000 babies were born to HIV-positive mothers in 2014, according to researchers.

Currently it can take about 11 days to transport babies’ dried blood samples taken at a healthcare facility to a lab for HIV testing, according to UNICEF. By road, it can then take up to eight weeks to get the results back to the facility. If untreated, almost one-third of the infants with HIV will die before turning 1, and half will die by age 2.

So in March, UNICEF led a project to try to speed up HIV testing of infants using helicopter-style drones designed, built and programmed by Matternet.

“It went great,” said Paola Santana, company cofounder and head of network operations. There were stumbling blocks, including finding an appropriate place to launch the UAV — the hospital site initially selected turned out to house an incinerator for medical waste and a tent for treating cholera patients — but the team was able to resolve the issues.

Having UNICEF as a partner was a big plus, said Santana. “If not for their expertise, we would not have been able to pull off this project,” she said.

Now VillageReach is doing an analysis of the project to better understand the costs involved and the feasibility of using drones versus road transportation to carry the samples.

UAV projects must pencil out and offer a reliable solution for government health officials and donors if they’re going to invest in the cutting-edge technology, said Emily Bancroft, vice president for VillageReach, from their offices in Seattle’s Eastlake neighborhood.

“You are not going to go out and get a contract with the government tomorrow, no matter how cool and amazing your technology is. It’s not going to happen,” Bancroft said.

“There is so much proof-of-concept work that needs to be done before a government will be in a position to take a risk,” she said. “Basically, all of the risk needs to be removed.”

An opportunity to have a really big impact

Zipline, a UAV startup operating from the San Francisco Peninsula, made news last month with its announcement that it has a deal with the government of Rwanda to transport blood for infusions between sites covering half of the country.

“It’s an opportunity to have a really big impact,” said Keller Rinaudo, CEO and founder of Zipline. The blood is in high demand for women suffering post-partum hemorrhages and for children. “It’s so precious and such an expensive commodity.”

Rinaudo said their UAV design, which is a robotic airplane, is built to do remotely-operated, high volumes of deliveries over many months.

“This kind of technology will ultimately be more cost effective than motorcycles by a lot,” he said. “It’s so much more efficient because you don’t have a human who needs to be in the loop, or gasoline that costs four times what it does in the U.S.”

Matternet has done healthcare cargo projects in the Dominican Republic, Haiti, Papua New Guinea, Bhutan, Switzerland and now Malawi. They’ve used drones to carry a variety of medical supplies. Their goal, said Santana, is to create networks between clinics and hospitals so patients can get the care they need in local clinics without traveling to distant and overloaded hospitals.

“We’re targeting three networks by 2017,” Santana said.

By connecting the facilities, providers can move medical supplies and resources more easily between sites when they’re needed, she said.

Meier, of UAViators, is taking a slightly different approach to testing drone use through WeRobotics, a nonprofit that Meier cofounded to accelerate the use of robotics solutions in humanitarian efforts.

WeRobotics is co-creating a global network of ‘Flying Labs’ to bring UAVs and other robotics to local partners in developing countries. The nonprofit works with UAV companies that want to field test and demonstrate their devices in humanitarian projects. The idea is for multiple technology companies to participate in the labs in order to build local capacity and give partners a chance to identify the best devices for their own projects.

The nonprofit is exploring multiple sites for the labs, including Cuyo, Philippines, where partners need to transport healthcare providers need to transport medicines and vaccines to impoverished, remote islands. Another potential site is in Nepal’s Himalayas where health clinics are only three miles apart, but the journey by land takes five hours through mountains and valleys without roads. There are two prospective lab sites in Peru, including an Amazon location that needs delivery of medicine, vaccines and brochures addressing public health issues. The fourth site being considered is in Madagascar, where they need a way to deliver first-aid kits and life-saving supplies in emergencies.

Meier is excited about the potential for UAVs to carry medical cargo, but cautions that this is still a very new application for UAVs. The devices have been used for humanitarian efforts, but that has mostly included collecting images after natural disasters — not transporting supplies.

The Malawi project focused on dried-blood samples is “a great ‘use case,’” Meier said. The samples are light and not monetarily valuable, putting less is at stake if they go missing or are lost somehow.

“This could really be a game changer,” Meier said. When VillageReach finishes its cost analysis, “it’s another data point we can all learn from. It’s about helping to document the evidence base — it’s very thin right now.”

Learning from past mistakes

In an effort to further share information among those interested in UAVs for humanitarian and healthcare efforts, VillageReach recently organized the UAV for Payload Delivery Working Group. UAViators is one of the group’s founders, and Matternet and Zipline are participants, as well as other non-governmental organizations, UAV companies and donor groups.

A big concern is making sure that UAVs deliver on the promise of improving healthcare, without overselling it or experiencing too many failures.

VillageReach’s Bancroft recalls some of the hype around the potential for tablets and smartphones to transform global health. The devices have yielded benefits, but not on the scale that some hoped for. The movement has shifted towards digital health in general, and away from a focus on the gadgets themselves, Bancroft said.

“The same thing could happen in UAVs for sure and it’s a more expensive proposition,” she said. “If there are going to be investments made, they need to be made in a smart way.”

For his part, Meier isn’t focused exclusively on flying robotics as the way to bypass poor land-based infrastructure. Some of the manufacturers that WeRobotics are working with are developing maritime robotics that are powered by wave action and solar energy.

The important point, he said, is the shift from manually controlled technologies to increasingly intelligent autonomous systems.

“That is the crux of the whole revolution,” Meier said. “Whether it flies or drives or swims, I couldn’t care less.”