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Using ‘spy planes’ to help rural health care

26 Nov 2008

Greer van Zyl

Source: Medical Chronicle (see original article)

Hand-launching of one of the ‘spy planes’.

South Africa’s National Health Laboratory Service (NHLS) is experimenting with unmanned aircraft as a new means of transporting samples from clinic to laboratory.

The problem of transporting clinical samples under challenging geographic and infrastructural conditions is growing in Africa and, until now, has been largely unresolved. The NHLS has 265 labs nationwide servicing more than 5000 clinical facilities. In many parts of the country, roads are substandard, placing further pressure on the link between clinics and labs.

With this problem in mind, Professor Barry Mendelow of the NHLS, has embarked on a ‘proof of concept’ research project to see whether unmanned aircraft, nicknamed spy planes used by defence forces, and which are guided by electronic systems could be used as couriers to ferry samples from clinics to labs.

‘It was only when I flew over these inaccessible areas in a helicopter that I realised the answer lay in air transport. A small project carried out years ago by medical technologists in Lusikisiki showed that carrier pigeons could carry blood samples, but this isn’t sustainable as the pigeons fly only in one direction – they don’t come back. Using military technology, electronic ‘carrier pigeons’ known as unmanned aerial vehicles (UAVs) – appeared to be a possible solution,’ explained Professor Mendelow.

Denel Dynamics developed the first prototype known as e-Juba (Zulu for flying electronic pigeon), capable of carrying 500g (or 8-12 sputum jars) over a range of up to 53km and able to perform an autonomous landing at the rural clinic via GPS co-ordinates and ultrasound.

In parallel with the development of e-Juba, molecular diagnostics was improving to an extent where tests for Mycobacteria, HIV, or any other microorganisms could be carried out on very small samples transported as dried paper spots.

‘A smaller and more robust UAV was developed independently by Mr Jaco Davel of MedicAir Couriers in Somerset West, who says ‘it has the energy of well-kicked football’. It weighs 800g and thus represents very little physical threat,’ said Professor Mendelow.

Tests were carried out where specimens were precision-dropped at a pre-determined point in wind speeds of up to 45km/h. Samples were processed at the NHLS lab and reports dispatched via SMS to the sender via innovative NHLS technology. Through PCR testing, results can be available within hours, as opposed to the culture route which can take up to 42 days,’ said Professor Mendelow.

‘Even more exciting is very recent work by Professor Hendrik Koornhof, Dr Gerrit Coetzee and Ms Esther Tsheola at the National Institute for Communicable Diseases (NICD) who have shown that by using a new chemical disinfectant, they can kill the organism but still render the sample testable.

‘Their work is ground-breaking, because apart from the aircraft application, it suggests that all TB specimens could be collected in this way, dramatically improving the safety of transporting or testing samples.

‘We have shown that unmanned aerial vehicle (UAV) s can be used to transport samples, but to make this a reality will require more than the technology. We have several hurdles to jump over, not least of which is funding. The Civil Aviation Authority (CAA) needs to give approval of the airworthiness of the aircraft; we have to show that the routes to be used are low-risk with little or no air traffic. We also needed to certify the biosafety of the cargo, which is why the NICD work is so valuable because they’ve shown the material to be carried is innocuous, and the paper samples make it possible for PCR testing.

‘The final hurdle is that the pilot-in-command (the laptop operator) needs to be certified for launch and recovery – basically a qualified pilot. There are no regulations yet for unmanned aircraft systems (the updated term for UAVs), but these are expected by 2015 – which is far too long for us. We have a serious TB epidemic and a concept and technology proven to work. We are negotiating with the CAA for a special case exemption,’ said Professor Mendelow.

‘What this means is that we could train young school-leavers to be pilots-in-command. We would want to select people in rural areas where there is a need to develop infrastructure and economies. Beyond the capital cost of the aircraft, running costs are very low. We can pay R10 per sample successfully delivered, which for a cargo of 20 paper samples means R200 per trip for the pilot-in-command.’

Apart from the health implications, the project could also improve awareness of science, engineering and technology (SET) among the youth in rural areas.

* Article published with permission by the Medical Chronicle.