• Unmanned Unplugged: Isaac Chikwanha, Medecins Sans Frontieres

    Isaac Chikwanha of Medecins Sans Frontieres, or MSF, is experimenting with using unmanned aircraft to transport medical supplies and samples in the remote regions of Papua New Guinea, where access to clinics for treatment of diseases like tuberculosis is difficult. Increasing Human Potential recently talked with Chickwanha to learn how UAS could be used to bridge this gap.  

    Could you describe the work that MSF does in Papua New Guinea?

    We have actually been in PNG since 1993 when we responded to the Bougainville conflict. That project started as an emergency medical/surgical project but evolved into a maternal and reproductive health project, which was eventually closed in June 2014 because we felt we had met our objectives. MSF also had family and sexual violence and emergency surgery projects in Lae and Tari areas of PNG. The Lae project was handed over to another organization in 2013. We opened our first TB [tuberculosis] project in Gulf Province in May 2014, and the second one is currently being set up in the National Capital District.

    Papua New Guinea has an alarmingly high prevalence rate of TB, with approximately 30,000 people newly infected every year and with a rate more than 12 times the global average. What makes it so difficult to treat in Papua New Guinea?

    There are several factors, but one of the most difficult challenges is that of access. Eighty percent of the PNG population lives in remote rural communities, making it a challenge for patients to go to health centers or for healthcare workers to live and work there. There are reports of patients walking for days to get to the health centers, and you can imagine what that would be like if you are sick.
    Another factor is that sometimes when patients go to the health centers, there is no staff, no drugs or not enough services, like a laboratory, to confirm the diagnosis of TB and start treatment so patients have to be referred further on or have to wait for weeks.

    Another factor is traditional beliefs on the cause and transmission of TB, which impact the health-seeking behavior of people.

    Last year, MSF partnered with Matternet to use UAS as part of your work in the region. Can you walk us through how you are using this technology?

    We did a pilot program to assess the feasibility of the technology in this kind of context. We had some success in that we could transport dummy samples in less than 25 percent of the time it could have taken a car, but there are some challenges that need to be ironed out so, unfortunately, we are back to the drawing board.

    We need the UAVs to be able to fly longer distances, because some of the health facilities are much further than the distance we could cover during the pilot trial. We also need the UAVs to be robust enough to be all-weather and have bigger carrying capacity. These are just a few examples of the things we are working on before we try it out again. The technology also needs to be affordable to low- and middle-income countries if we are thinking of scaling up.

    What are some of the biggest challenges to treating TB in Papua New Guinea, and how has using UAS helped address some of these?

    We need to be able to confirm TB diagnosis with laboratory tests as early as possible so we can initiate treatment early and give patients a better fighting chance. UAVs could be that bridge between the remote health centers and a central lab, especially in this context where road access is not an option.

    What challenges have you faced in using UAS? What changes in regulations or technology are needed to use UAS on a larger scale?

    Luckily in PNG, the authorities were more than willing to try this, because they also appreciate the access challenges in their own backyard, but we also need to be able to ensure safety of the public as we are transporting potentially infectious samples, so this is another area that we will need to look into to make sure the UAVs have this safety mechanism in place. But I don’t think this would be a major issue really. More infectious substances are being flown around already. We just need to make sure we have safety guidelines in place.

    How are UAS a more effective transportation method in your efforts than, say, a plane, boat or car?

    There is one main road linking Gulf Province to the outside world, and you can only access two or three health centers via that road. The challenge is with the rest of the province, where there is no formal road network, so even 4X4s are useless here. Boats are an option, but the seas and rivers are rough and impassable half the year. Planes only fly to two hubs, but not frequently enough. So this is the kind of context where you have very few options if you want to ensure a reliable and speedy laboratory service to the population.

    What do you see as the future of using UAS in humanitarian work? Do you see potential for MSF to use this technology in other ways or locales in the future?

    I believe there is great potential in this technology in health care. We can think of transportation of emergency medicines and telemedicine. Already it’s being used in mapping populations and services in disasters. We can extend that to cover disease outbreak monitoring. It’s just a question of adapting it to the context, making it affordable and we also have to fight the image that UAVs are war machines. This image might make them not appropriate in certain areas of the world.

    Is there anything else you would like people to know about the work you are doing?

    I just want to challenge the technology world that anybody can come up with a UAV that can meet the challenges we mentioned above that could potentially be a major breakthrough in how we respond to healthcare challenges in areas with difficult access. UAVs can save lives. 

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