The sky’s the limit

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Zipline’s medical drone delivery is set to transform Africa’s healthcare.

ANTON PRETORIUS

Last year, KPMG’s The State of Healthcare in Africa report suggested that when it comes to healthcare, the continent lags behind the rest of the world. It found that Africans live, on average, 14 years fewer than the normal world citizen and 21 years fewer than the usual European.

HIV/AIDS, tuberculosis and malaria together cause nearly a quarter of deaths (2.5 million) in Africa every year. But the real killer is Africa’s lack of adequate access to essential and basic medical products, often due to challenging terrain and poor road infrastructure. Because of this, nearly 2.9-million children under the age of five die every year and up to 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 life-saving 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.

In Rwanda, travel between towns and villages takes much longer than it should do, 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, however, to Rwanda’s road infrastructure is not to build new ones, and instead avoid them completely. US-based robotics company, Zipline’s recently launched drone blood delivery initiative is a quick, affordable and crucial innovation that could save thousands of lives and revolutionise both the healthcare and transport industries on the African continent.

Care by air

Zipline initiated its first commercial drone flight with a trip 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, postpartum 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, the 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.

Justin Hamilton, spokesperson for Zipline, 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 death where every entry was a life that could have been saved had they been able to get the medical products quickly enough. We have 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,” he explains.

Ordered delivery

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 1.5kg bag of blood (enough for a transfusion for one patient) on a 150km round trip.

They claim to be able to respond to orders directly from clinics within 30 minutes, and are 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 aircraft, 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 fulfil delivery requests across Rwanda in under an hour. “Zips are fully electric, releasing zero emissions and has a large environmental benefit over gas and diesel trucks. We have also sourced biodegradable materials, so our entire packaging is both recyclable or compostable.”    

The Zipline drone can 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 says that Rwanda plans to expand 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, the company has been able to communicate with hospitals as well as with the locals to convey 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,” he says.

Hovering risks

Drones or unmanned aircraft systems (UAS) have the potential to become a multi-billion dollar business and deliver problem-solving technologies across numerous industries. However, aviation insurer Allianz Global Corporate and 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.

These risks range from collisions and crashes to cyber-attacks and terrorism. To ensure safe UAS operations, systematic registration of unmanned aircraft as well as robust education and training of operators are necessary.

“UASs 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 that drones are used for two reasons: humanitarian or illicit. “Rwanda borders the Democratic Republic of the Congo (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 need to be considered too. “Drones raise a few safety concerns: mid-air collisions and the loss of control. Mid-air collisions could happen if the pilot cannot see or avoid a manned aircraft in time, especially those that fly below 500 feet, such as helicopters, agriculture aircraft or during landing and taking off.”

Loss of control can result from a system failure or if the drone flies beyond signal range. AGCS sees a major risk from frequency interferences and other factors. A pilot losing a drone during a building inspection could result in a total liability claim in excess of $5 million should that drone crash into a truck or shop, for example.

Even a small drone could cause as much as $10 million in damage alone when hitting an aeroplane 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.

Separate cover

Verpoort explains that Hollard offers cover for commercial drone operators, provided that the operators hold a remote pilot’s license (RPL). “With that as a starting point, we provide hull insurance of up to R2.5 million ($180 466), which covers accidental damage and any damage to the hull. Then there’s separate cover for the payload, which comprises the gimbal and other attached equipment.”

Hollard will also look at whether the drone is capable of carrying the payload. “If you want to attach a heavier camera or lens, is that drone designed to carry the lens? The more weight you add on, the greater the drain on the battery. It can affect flight time, wind speed and battery life,” he points out.

Verpoort adds that Hollard offers commercial drone operators’ liability cover of up to R20million ($1.4 million), but can go up to R100 million ($7.2 million) for aviation liability specifically. “Many brokers are under the false impression that general liability policies cover drones. They often exclude aviation risks.”

Any aviation accident or injury is subject to an investigation by the civil aviation authority. “It’s very much an aviation risk that’s excluded from traditional liability policies and needs a specific aviation extension, something that Hollard provides,” he says.

Apart from personal accident extension cover for the drone operator itself, Hollard also offers a cyber liability extension. Commercial drones fly for no other reason than to gather data or images. The data is then relayed to a base station – whether it be a laptop, control centre or iPad. Cybercriminals are able to replicate a drone’s radio frequency and hijack it mid-air.

“Quite often, the drone is grounded, and someone can hold it and extort it for money. Our policy will cover the extortion of the drone on the basis that it recovers the data on the drone. Hacking is a very real exposure for drones,” says Verpoort.

Other risks that Verpoort highlights include unauthorised flying into stricter airspace, such as nuclear installations (Koeburg Nuclear Power Station) or airports (Dubai International Airport). Unfortunately, criminals have adapted to the use of drones for illicit purposes like delivering contraband into prisons and attaching explosive devices. “A good counter-measure that makes sense is geo-fencing. It basically emits a signal that overwrites a drone’s radio frequency and intercept and grounds the drone. This kind of tech is available and used extensively.”

The use of drone technology to deliver life-saving medicine to people who need them the most can prevent millions of deaths each year around the world. However, this technology is evolving faster than the babysitter’s boyfriend leaving the house when the parent’s car pulls up. Government and regulation authorities in Africa are still playing catch-up with drones. But insurers neet to stay abreast with ever-changing trends and risks and keep innovating their product offering to stay ahead of the curve.