In its trail, Freddy, perhaps the deadliest and strongest storm to ever hit Malawi and the whole of the Southern Hemisphere, razed down critical infrastructure.

It ate out a bigger chunk of an already rickety economy, pushing millions into their lowest depths of poverty. It cost the country about K110 billion.

In the twelve most-hit districts, infrastructure for roads, bridges, electrical and sanitation suffered heavy damage.

It was a critical moment where health services were needed the most, either to treat survivors or ensure that those seeking temporary shelter in camps were protected from disease.

However, tens of thousands of people in the hard-hit areas found themselves cut off from access to health facilities, as they were either destroyed or unreachable due to damaged roads.

Cyclone Freddy aggravated the challenges that health facilities in the country already faced.

Transport had already been a challenge with most district health facilities operating with one or two ambulances, in some cases none.

Zomba District, for instance, has less than five operational ambulances.

The damage to roads would make it inaccessible, as explained by Benson Matiki, a Health Surveillance Assistant at Magomero Health Centre.

“The road that leads to Magomero Health Centre was in bad condition in the aftermath of Cyclone Freddy. This affected our access to essential medical supplies such as medicines and vaccines here,” said Matiki.

Drone Tech Eases Friday

But this narrative is gradually changing. Malawi adopted the use of drones for medical supplies.

In the past two years or so drones have facilitated automated on-demand and timely availability of medical products in different parts of the country.

They fly autonomously and can carry about five kilograms of cargo. The drones can cruise at 110 kilometers per hour.

A drone would zoom above the hospital, release its package attached to a parachute, then zip back to base without landing.

Low access to medical supplies, especially in Malawi’s rural communities, hinder the country’s effective implementation of universal access to healthcare for its citizens.

But since the introduction of drone technology, health delivery has improved greatly in the country.

In Mangochi, for example, the district is boasting of reduced cases of tuberculosis by almost half through drone services.

The district health office now sends medical supplies to Makanjira where the road is in bad shape and takes almost four hours to reach by vehicle, but now a drone flies there in just under 30 minutes.

Dr Innocent Lanjesi is Mangochi District Hospital In-charge. However, he laments capacity challenges of the drones.

“We have a lot of medical supplies to transport but we are limited by the capacity of most of our current drones. They cannot carry more than 2 kilograms. That limits our ability to transport a lot more supplies. Nevertheless, we have been able to reach areas that have proved to be hard to reach,” said Dr Lanjesi.

The sentiments are shared by Dr Gilbert Chapweteka, Director of Health and Social Services at Nsanje District Hospital.

He says at the height of Cyclone Freddy, his office would still send medical drugs and other supplies to Tengani, Makhanga and other areas that were not accessible by road.

Dr Chapweteka says drones made life easier as well during the recent mass administration of polio vaccines.

“There are areas that are extremely hard to reach by road. We have the East Bank and Westbank. The East Bank is an area which is hard to reach. Drones have been the solution in such a precarious situation. The drones were initially brought to ease transportation during the emergency but now we use them regularly to transport items to Magomero Health Centre located about 120 kilometres from the main hospital.”

On the road, it takes more than an hour to access Magomero Health Centre but the cyclone made it even worse as floods cut off bridges, rendering it inaccessible.

During the recent special cholera polio vaccination campaign, people from the community were, however, saved by drones that delivered the doses just in time.

The facility’s Health Surveillance Assistant Matiki says the situation has now improved.

“We usually rely on government vehicles and the roads are always in a bad state. The most worrying thing is that we are at the mercy of availability of a vehicle at the district health office. Vaccine administration was always delayed. But now the use of drones has simplified transportation,” says Matiki.

On a car, one would take about four hours or more to reach the only medical facility at Chisi Island on Lake Chilwa in Zomba.

One would have to use a vehicle first; then a boat to reach the island.

This was, however, simplified and children at the island got the vaccine in time and without any hiccups.

Lissy Makuwira is a mother of one living on the island.

She says her son got all vaccines that the Ministry of Health has been administering recently.

“For one to reach here, one has to use a vehicle for about two hours, then a boat and a motor bike or a bicycle. That would take a minimum of four hours. We used to spend some time at the hospital here without medicine or vaccines. We have, however, seen an improvement recently. We are told they now use small planes called drones which I think are ideal in reaching us with health services,” said Makuwira.

During the polio vaccination campaign, Swoop Aero was tasked to oversee the exercise, especially to hard-to-reach areas.

The company works in 11 districts but hopes to reach to almost all districts with its services in the near future.

Bernard Ndawala is the hub operator for Swoop Aero.

He says drones are a new technology that Malawi should embrace in the delivery of medical supplies.

“Health service delivery requires speed and in times of need of supplies like drugs and other supplies, drones have been effective. We have reached areas that are extremely hard to reach using drones. Areas like Makanjira in Mangochi, Chisi Island in Zomba and many more in the Lower Shire are extremely hard to reach,” says Ndawala.

With the country witnessing the benefits of drones in the delivery of health services, what is the future of the emerging technology?

Symon Kondowe is vaccine and supply chain consultant at UNICEF.

He thinks the emerging technology is ideal in addressing low access to essential medical services.

“As long as we still have issues of accessibility in hard-to-reach areas, we will continue using drones in the delivery of health services. We want to bridge the gap that is there in transportation and delivery of health services in the country,” says Kondowe.

Kamuzu University of Health Sciences Epidemiology Professor Adamson Muula concurs with Kondowe.

He says Malawi should fully adopt the use of drones to ensure universal access to health as a means of achieving sustainable development.

“Drones have also been used in towns like Lilongwe where issues of traffic jams have cropped in and affected timely delivery of health services. It is a technology that its importance cannot be overemphasized,” says Professor Muula.

Health rights activist Maziko Matemba thinks Malawi should start incorporating procurement, service and the use of drones in its budget as the technology is key in improving health services.

“If we check the use of drones, it is funded by well-wishers, we have not had a proper budget for such kinds of technologies. I think it's high time we started budgeting for these emerging technologies. In that way, we will achieve universal health access,” says Matemba.

At the moment, following this success story, Malawi is a training hub for drone operators from 28 countries across Africa.

Malawi hosts the African Drone and Data Academy (ADDA) which aims at providing education programmes that advance expertise in drone technology and entrepreneurship.

The programme was officially launched on January 13, 2020 at the Daeyang University in Lilongwe but is now hosted at the Malawi University of Science and Technology - MUST.

Since its inception, 800 drone technology scientists from different countries have been trained, of which 100 are from Malawi.

Dr Chikondi Chisenga, the Head of the Academy, says on top of training experts in drone operation, they plan to build their own drones that will aid in several sectors, including agriculture.

“We know that drones in use at the moment have low capacity. As an institution, we are working towards developing drones that will have a capacity beyond 5 kilograms. We are also working on developing drones that will be used in agriculture, among other sectors,” he adds.

Director of Health Technical Support Services in the Ministry of Health Godfrey Kadewere acknowledges that use of drones for medical deliveries has eased transport problems in the sector.

Kadewere says drones now operate in over 90 hard-to-reach health facilities in 11 districts in southern and central Malawi.

The ministry is currently scaling up to additional districts and facilities to cover the rest of the country following evidence that the drones are leapfrogging the traditional barriers in the use of ground transport.

“The drones have so far been used to transport vaccines, including for routine immunization, cholera, anti-rabies and polio, lab samples, emergency obstetric medicines, ARVs, TB medicines and other different products, including cold chain products.

As the Ministry of Health, we continue working closely with partners in this space as we move to generate evidence on impact, costs and sustainability of this technology so as to ensure that it continues to be deployed in our health service delivery. There are also middle-range drones that have come into the ecosystem with capabilities of moving bulkier products of 50 kgs or more which we are eager to explore. The regulatory environment, with leadership from the department of civil aviation, also continues to evolve forward around this,” said Kadewere.

Ahead of yet another unpredictable rainy season in Malawi, drones might yet again be the solution to transportation of medical supplies.

The benefits of drones in improving health services in Malawi is well-documented. They are a game changer if well utilised.

It is clear that they will be crucial as Malawi is moving towards Universal Health Coverage by 2030 through the implementation of the essential health package which the government and its development partners will endeavour to make accessible to every Malawian free at the point of care.

In this quest, drones cannot be left out for Malawi to be on track towards achieving universal healthcare coverage.