How healthcare delivery is taking to the skies
Drones are starting to save lives in emergency situations where timing is everything. They’re also coming into their own delivering Covid-19 vaccines across developing countries, which don’t have the cold chain infrastructure to store them.

We’ve all seen old war films and survival documentaries where vital supplies are parachuted in by plane. But more often that not, they don’t hit the right spot, or have to be dropped en masse to ensure that enough gets though.

However, recent advancements in drone technology mean that this no longer needs to be the case. Drones are starting to deliver health and medical supplies where and when they’re needed with pinpoint precision and rapidity.

They can already mount search-and-rescue operations. In the not too distant future, they may even be able to successfully navigate the insides of our homes, making drop-offs to the elderly, or incapacitated while they sit in their armchair, or lay in bed.

Over the last couple of years, the list of firsts has grown rapidly: donor organs flown across cities, vaccines delivered to remote communities and life-saving medical equipment arriving before the ambulance does.

In a world first this December, for example, a drone helped to save the life of a Swedish man called Sven who’d collapsed from a heart attack while shovelling snow from his driveway.

When passers-by made an emergency call, an ambulance was despatched. But so too was a drone with an automated external defibrillator (AED) on board. It arrived three-and-a-half minutes after the initial call and before the ambulance.

This enabled a passing doctor, who’d been performing cardiopulmonary resuscitation (CPR), to use the AED to re-start the 71-year-old’s heart. A life was saved.  

AEDs can increase survival rates by 50% to 70% and there are now a lot more of them in public settings. But they’re often not close enough to make the difference between life and death in those few crucial minutes after someone goes into cardiac arrest. It’s estimated that survival rates drop by 10% for every minute without help.

Sweden’s real-life success story followed a four-month pilot study using drones in an area around Säve airport in Gothenburg, the country’s second largest city. A dozen AED-carrying drones were sent off following 14 separate alerts, with 11 arriving successfully, seven before the ambulance. Once they’d dropped off the AED using a small parachute, they returned to base.

Researchers concluded that drones can rapidly decrease the time before a patient gets access to defibrillation, potentially saving many more lives.

Door-to-door organ transplants

This is another area of healthcare delivery where every minute counts. In developed countries, it’s also the one where drones have been used most widely, so far.

That’s because one of the biggest issues for organ transplantation concerns delivery logistics: how long it takes to transport an organ from donor to recipient and how to keep it stable en route.

In 2019, America’s University of Maryland Medical Centre was able to complete the world’s first live kidney transplant via drone delivery (hyperlink 2).  

Temperature, pressure and vibration gauges monitored the organ while it was in transit. There were also two human pilots monitoring the drone from the ground, ready to override its automated flight plan in the event of an emergency.

Last year, a further two landmarks were recorded.

In May 2021, doctors at Mercy Hospital in Coon Rapids, Minnesota, completed a test flight with a donor pancreas that was flown a 10-minute circuit over the Mississippi River and then back again (hyperlink 3).  On its return, a biopsy revealed no sign of organ deterioration.

Then at the end of September, the first lung transplant via drone delivery took place in Toronto, Canada (hyperlink 4).

A carbon fibre drone weighing 15.5 kilograms flew the donor organ 1.2 kilometres from a hospital on the Western side of the city to downtown Toronto General Hospital, the setting for the world’s first-ever lung transplant back in 1983.

In this instance, the recipient was a 63-year old man. Two days later, he was well enough to attend his daughter’s wedding by video-link.

Drone deliveries where the roads don’t reach

In developed countries, drones are just starting to be deployed in real-life scenarios. But in some developing ones, notably in Africa, they’re already a familiar sight.

Many countries on the African continent suffer from poor or non-existent roads, plus inadequate cold chain infrastructure. This makes it extremely difficult to deliver life saving medical supplies on time.

But this lack of physical infrastructure does have one advantage. In many developed countries, line-of-sight regulations require drone operators to be able to see them at all times.

There are understandable fears about the buildings that drones might fly into, or peoples’ heads they might drop supplies on top of. This limits current usage in densely populated countries, although the regulations are slowly changing.

But it’s far less of an issue across the African savannah. As a result, two of the world’s first major initiatives were established in Sierra Leone and Rwanda in 2016. Since then, there’s been a flurry more in: Malawi, the Democratic Republic of Congo and Ghana.

In Rwanda a partnership between the government and Bill Gates-funded drone company Zipline began delivering blood, plasma and coagulants to remote clinics six years ago (hyperlink 5). The drones had an initial range of 93 miles, flying 500 feet above the ground, up to 62 miles per hour.

By 2019, the system had been rolled out nationwide to deliver three quarters of the country’s blood supplies.

One of the main end-uses is to improve maternal mortality rates. Blood loss from postpartum haemorrhages (PPH) is responsible for one third to one half of all maternal deaths in Sub Saharan Africa, where women have a 0.5% to 1% chance of dying from childbirth (hyperlink 6).

Timing is a critical factor. Doctors have between 30 minutes to four hours to administer a blood transfusion, depending on the severity of the haemorrhage (hyperlink 7).

Over the past two years, drones have also been a vital addition helping to roll out Covid-19 vaccines across Africa.

Some of the biggest success stories have been in countries with drones in operation. At the end of 2021, nearly 58% of the Rwandan population had received a first vaccine dose, above the World Health Organisation (WHO’s) 40% target.

By contrast, only half of the overall continent had managed to breach the 10% mark. Many countries had either been forced to send vaccines back, or destroy them because they didn’t have ultra cold chain storage facilities.

Nigeria one was such country: getting rid of one million doses. At the end of the year, it had administered first doses to just 6.2% of its 206 million population.

On the other side of coin is Ghana, where the first dose figure stood at 20% at the end of 2021. In mid-January, Zipline announced that it had delivered 500,000 doses by drone across the country, roughly 12% of the total (hyperlink 8).

This success built on a programme to distribute yellow fever vaccines, which began in 2019. The start-up now hopes to pull off a similar feat in Nigeria where it’s in the final stages of setting up centralised distribution centres in Cross River and Kaduna states.

Drones are fast. But they can also help governments to save money. Sending supplies from central distribution hubs means that they can be dispatched when they’re needed, negating the need for end-use refrigeration facilities and reducing unnecessary waste.

Over in America, researchers at the University of Cincinnati have also developed a prototype semi-autonomous drone that’s flexible enough to go inside a house, (hyperlink 9). The drone has sensors to navigate around tight spaces and cameras allowing patients to talk to healthcare workers.

It wasn’t long ago that doctors made house calls in person. Now many consultations are held remotely over computers and Smartphones.

But the day isn’t far off when houses connected through the internet-of-things can open front doors, letting drones through to the human that needs medical attention at the other end. 

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