American drone healthcare distribution company Zipline has been enjoying great success supplying life-saving emergency medicine and equipment in the East African states of Rwanda and Ghana, delivering blood and other emergency medical services where they are needed. But now the drones have been called in to saves time and lives in an entirely different way.

The emergency health supplies distributor has expanded its services to flying COVID-19 samples from inaccessible remote rural areas into the capitals for testing. It also now holds stocks of emergency personal protective equipment (PPE), and rushing them wherever they are needed within the radius of its fleet of red and white drones, affectionately known among the Zipline workforce as Zips. In its small way, Zipline is contributing to the fight against the coronavirus pandemic by shedding hours and even days off the time it takes to transport COVID-19 tests from suspected cases in rural areas to urban laboratories with delivery drones that were primarily used for transporting vital medical supplies from urban centres to the rural areas.

For those new to earth, now is a really good time to inform you that staying outdoors for humans has been a really dangerous gamble of late; there is a virus called Coronavirus Disease of 2019 (COVID-19) that’s prowling the streets in search of lungs to deprive of oxygen. It is especially fatal to the elderly and people with chronic health conditions, and the world is doing everything it can – in the absence of a cure – to keep people safe and healthy. Economic activity has had to be halted in most countries, as people were encouraged to stay indoors, so as not to contract the virus. At the time of writing, the COVID-19 pandemic had killed at least 500,000 people and infected nearly ten million worldwide.

In East Africa, Ghana has done well to embark on a massive testing spree of its population, but it had a special kind of conundrum in the first days; for the country has thousands of far-flung rural clinics, and only two places in the entire country where the swabs can be analysed – the Noguchi Memorial Institute for Medical Research in Accra, and the Kumasi Centre for Collaborative Research in Kumasi. All these tests had to be transported to the laboratories by road, a journey that can take up to six hours. Some remote clinics, loath to dispatch an ambulance for just one test, would wait a few days in order to collect enough samples to make the trip worthwhile, prolonging patients’ anxiety and delaying the contact tracing protocols necessary to stop the virus’s spread.

As highlighted by Daniel Marfo, Zipline’s general manager in Ghana. “The problem isn’t the lack of tests; it’s the distribution that was the nightmare. The government wanted to ensure that testing would have the same level of confidence in rural areas as it does in the city.”

That’s where Zipline stepped in

“Now we are stocking a whole bunch of Covid-19 products in our inventory, and delivering them to hospitals and health facilities, whenever they need them instantly,” Kelly Rinaudo, Zipline founder and CEO, told CNN recently, adding that they will be adding vaccines and test kits as soon as they become available.

The expansion into delivering critical COVID-19 supplies – which is being done in collaboration with governments of Rwanda and Ghana – has not been hard for Zipline, which has already been on the ground, traversing the rough terrains of Rwanda and Ghana, delivering over 60,000 units of blood, critical medicines and vaccines for measles, polio and other diseases since they started operations four years ago.

Rwanda is oftentimes referred to as the country of a thousand hills; and that nametag is well-earned, for the Rwandan terrain is so hilly and undulating negotiating it by road is a nightmare. Of the 14,008km of road that connect Rwanda, only 2,662km are paved; the rest are only as good as the dry season persists. When the rains come, roads become muddy to tricky to use and, in any case, the hilly terrain has ensured that even getting to the nearest town will be a timeous effort.

But emergency hospital situations do not care for the state of a country’s roads – hospitals and other remote health centres will still need supplies, like blood and other medical products, which have a short shelf life and strict storage requirements. Since they cannot store them in place, they need a reliable delivery service as and when they need these supplies. It is also unpredictable how much of each supply will be needed at any given time.

Sadly, even in an emergency, it can take up to five hours for a Rwandan hospital to receive a delivery via road, which could mean the difference between life and death for a patient in need. And with tests for COVID-19 added to the list, the need for speed has never been greater.

The Zipline way reduces the delivery hours to just a matter of minutes. The company works from delivery ports, with each port is responsible for covering an area up to 22,500 square kilometres around it, with a radius of 80km. Delivery ports have a steady supply of all the emergency requirements that health centres need; and recently Zipline added personal protective equipment to its inventory. Doctors order products via messaging services on their phones (WhatsApp or SMS), or via an email from the website portal.

Everything at the station goes into a rush then – a worker wraps the needed packs in padding and stuffs the bundle into a bright red box parachute attached to a paper parachute (the maximum package weight the drone can carry is about 1,8kg). A technician arranges the box and parachute carefully into the hollow space of the specially made drone behind a spring-loaded hatch, then snaps a modular battery pack into the drone’s nose.

Zipline design and build their own drones, which have three main components – the lightweight form chassis (which includes a tail and rotors, to keep the drone flying in case of a mechanical failure); the fixed wing (better suited for bigger payloads than quad copters) and the battery unit. It is on the battery that the Global Positioning System (GPS) circuitry is attached, to reduce the time lag experienced on other drones, where the GPS is on the drone itself. The latter takes its sweet time booting up, and loading the GPS system – time that is simply not available during an emergency. For Zipline, moving the GPS to the battery meant it is always on and connected.

With everything locked and loaded, a phone application runs through the pre-flight checklist on the Zip. Zipline confirms the drone’s flight plan with the local civil aviation authority and requests flight clearance. When the go-ahead is given, the drone is ready to leave its runway – a 13metre long catapult powered by a host of supercapacitors.

The process from order to launch take about five minutes.

As soon as the Zip takes flight, it knows where to go, because it is fully autonomous. It follows a predetermined flight plan, relaying data back to base on its position and status through Rwanda’s wireless network. Take-off in windy and rainy weather can be nigh impossible, but once in the air, the drone can withstand wind and rain up to a point. When bad weather becomes too much, the drone will unfurl its parachute for a safe landing. In full flight, the ZIP can reach speeds of 100km/hour and heights of 500metres above ground. The furthest it has gone in Rwanda was an 80km journey it took from the collection centre at Muhanga to Butaro District Hospital, Burera District in Rwanda’s Northern Province. This journey took 45 minutes.

About 5 minutes before the drone arrives at its prescribed destination, hospital staff get an automatic text alerting them to send someone outside collect their delivery. Once there, the drone does not land; rather it opens its bottom doors, releasing the package, which floats down using its parachute.

Another delivery complete. The Zip will then circle back home where the final and no less exciting ritual awaits: landing. With no in-built landing gear in place, getting the Zip back on the ground is a challenge on its own. So Zipline designed a recovery they call Tall Bob. Tall Bob is two 10-meter-high towers facing each other, each with a spinning arm attached, and the arms hold a loose cable between them. As a returning Zip flies between the two towers, the arms rotate upward, in a fraction of a second, tightening the cable between them, so it snatches back the drone by catching the hook at the end of the Zip’s tail and pulling it to a stop by swinging the drone back between the towers.

Zipline claims its Ghana fleet is equipped to transport up to 15,000 tests a day, in 300 flights, from their two collection points at Omenako in the East and Ashanti-Mampong in the South. Newly opened ports at Sefi Waiwso (North-West) and Kukua (North-East) could be brought online as well, serving some 2,000 rural health clinics and between 10-15 million residents. Authorities though, are praying that their situation will never such alarming levels.

Zipline says delivering medical supplies to local clinics has helped to keep hospital beds free for coronavirus patients who need them, because people with other health conditions can get treatment, such as blood transfusions for example, closer to home.

Rinaudo hopes his organisation’s drones will soon be able to deliver directly to designated neighbourhood drop-off points and even to people’s homes.

“With what’s happening in the world right now, there’s a clear need to extend the reach of the hospital network and the healthcare system closer to where people live,” said Rinaudo. “You can do that – via instant delivery services.”

Rising out of the ashes of robotic toy company Remotive, Zipline came to life in 2014 and has over the years grown its staff to close to 300 employees. ​Rwanda was their first test bed in 2016, before they expanded to Ghana in 2019, transporting some 200 different medical products, including vaccines, blood, plasma, personal protective equipment (PPE) and antivenins, to health facilities that otherwise would have to depend on long and perilous road journeys to obtain lifesaving medical supplies. Now all small-scale deliveries are done via drone, to minimise human contact and virus transmission.

The company’s success in the two African countries should be an inspiration to other countries on the continent, many of whose citizens are among the more than two billion worldwide with no access to essential medical services, due to bad roads and non-availability of other transport infrastructure.