NEW TAFO, Ghana — A very sick 7-year-old boy was recently admitted to a rural hospital in Ghana. He needed a transfusion of O-negative blood — and fast.
Ordinarily, the staff would’ve been hard-pressed to help him in time. But that day, all they had to do was send a WhatsApp message.
About 15 minutes later, a drone appeared in the sky. It parachuted a box containing a package of blood onto the hospital courtyard. The staff immediately used it and were able to save the boy.
“If we hadn’t gotten that, the child would have lost his life,” said Dr. Kobena Wiredu, the medical superintendent of New Tafo Government Hospital in Ghana’s Eastern Region.
New Tafo is one of several hospitals making use of the country’s new medical drone program, which aims to prevent deaths by quickly getting blood and medications to remote areas that otherwise have trouble accessing them.
The drones come care of Zipline, a for-profit San Francisco-based startup, which piloted a similar delivery program in Rwanda in 2016. Reviews have been generally, but not universally, positive: Some critics say the high-tech program is a vanity project that allows the government to distract from its failure to invest in basic infrastructure, like roads. Nevertheless, the Ghanaian government has agreed to pay the company $12 million to run drone deliveries for four years out of four distribution centers. The first of them, located in Omenako (68 kilometers north of Accra, the capital), opened in April.
I had the chance to visit that center on a trip sponsored by the Global Partnership for Sustainable Development Data, hosted at the United Nations Foundation, which supports UN causes. I found a handful of staffers seated at computers, ready to take any orders that come in by phone call, text message, or — most commonly — WhatsApp.
When they receive an order, they grab the requested product from a large storeroom stocked with everything from yellow fever vaccine to oxytocin, from blood platelets to antivenom. They pack it into a box outfitted with a parachute, and then pack that into the body of a sleek white drone with a 3-meter wingspan, which they carry outside to a launching area.
It was pretty amazing to watch a drone lift off, knowing that once it’s airborne, no human directs it; its flight to the hospital is preprogrammed. It can fly day or night, in fair or stormy weather. Eventually, the Zipline center aims to carry out 150 flights a day to around 500 hospitals in Ghana.
Around 45 percent of Ghanaians live in rural areas, according to World Bank data, and they suffer from a higher incidence of diseases like malaria than urban Ghanaians. (Looking at Ghana’s entire population of 28.8 million people, the World Health Organization estimated that in 2017, there were around 270 cases of malaria per 1,000 people.) Although malaria is preventable and curable — in fact, in late April, Ghana piloted a new malaria vaccine for children — rural Ghanaians often lack timely access to the treatments that could save their lives. That’s why the drone delivery program inspires so much hope.
But this model also raises knotty questions about spending priorities in developing countries. Should Ghana and Rwanda pay for-profit Western companies millions of dollars to serve them for a short period, rather than investing those millions in long-term improvements to their own basic infrastructure? The former yields flashy results now, but the latter may be more sustainable and impactful. For example, if governments choose to invest not in drones but in building better roads, they could create jobs for many unemployed locals, giving them an income that could in turn improve their health prospects.
The desire for immediate solutions is entirely understandable — who wouldn’t want to save children’s lives right now? But there is also the risk of falling prey to Silicon Valley-style techno-solutionism, where tech is used to address all problems at the expense of simpler, more enduring solutions.
Ghana’s competing priorities
As I drove from the distribution center to New Tafo, a stomach-churning 45-minute journey along a bumpy dirt road, the benefits of sending medicine by drone rather than car became more obvious. The drone got there in a third of the time it took me.
For patients, that efficiency can make the difference between life and death; especially now, during Ghana’s rainy months, when roads can be unusable due to flooding.
“During the rainy season, we have a lot more malaria cases. We tend to use a lot of blood,” said George Appiah Boadu, a medical laboratory scientist at New Tafo. “Now we are not going to have to rely on the roads. It’s a huge relief to us and our patients.”
But not everyone is in favor of the drone program. Some health organizations and citizens have opposed it, saying the government is spending millions on a glitzy, high-tech imported American solution when the money would be better spent on more basic needs, like hiring more doctors for understaffed clinics, buying more ambulances, or improving those uneven roads.
The Ghana Medical Association, a major network of health professionals that plays a role in shaping national policy, has argued that some of the hospitals receiving drones don’t even have enough trained health professionals on the ground to administer the medications once they arrive. “The use of drones without the necessary improvement in the human resource capacity will not inure to the benefit of the country,” it said in a statement.
But Ghana has found the drones too attractive to resist. They’ve got both the cool factor of cutting-edge gadgets and the practical appeal of saving lives that are in immediate danger.
Ghana’s President Nana Akufo-Addo said the drone program “represents a major step toward giving everyone in this country universal access to lifesaving medicine. No one in Ghana should die because they can’t access the medicine they need in an emergency.”
He has acknowledged that the country’s health infrastructure is plagued with problems, and he recently announced that Ghana will get 275 new ambulances this June (for now, there are reportedly only 55 ambulances serving the whole country). But he continues to tout the drones as a worthwhile investment.
It’s entirely possible (though it’s hard to know for sure) that investing $12 million in larger infrastructure projects may save a lot more lives in the long run than investing it in drones. But overhauling infrastructure takes time. And this sort of reasoning doesn’t mean much to the doctors at New Tafo, whose job it is to deal with the emergencies of today.
They’re not thinking about how to save the greatest number of 7-year-old boys over the long term. They’re busy trying to save the 7-year-old boy who’s in front of them right now.
That’s a type of short-term thinking for which you can hardly fault the doctors, but it’s in tension with the long-term thinking of some policymakers. The way tensions like these get resolved will have a major impact on the future of development.
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