Drones Deliver Medicines to Distant Health Centers in Rural Meghalaya

For a week Eltira Sangma from the West Khasi Hills in Meghalaya, India, noticed she had no energy. “I was feeling tired all the time and did not feel like cooking  for my family or doing any chores at home,” said the mother of an 11-year-old boy.

Worried, Eltira visited the Shallang Primary Health Centre (PHC) 1.5 kilometres away to seek medical advice. After some tests, she was given an iron injection.

Earlier, it would not have been so easy for her to get the injection at the health center near her village of Rongkhugre, tucked away on a distant hillside amidst green foliage and banana plantations. Crucial medicines and injections were often in short supply or too expensive at the far-flung centers.

But ever since a new drone service was introduced by the Government of Meghalaya under the World Bank financed Meghalaya Health Systems Development Project, essential injections and medicines are brought over once a week by a drone from Jengjal District Hospital over 100 kilometres away.  

The medicines are also free of cost.  Otherwise, the injection, which needed to be administered three times a week, would have cost Eltira Rs. 280 each time. 

Prioritising Women’s Health

Supplying inexpensive quality healthcare to hard-to-reach areas has long been a challenge for Meghalaya. People living in rural areas find it difficult to access health services, especially during the rainy season between June and September.  

“In these circumstances, women’s health often does not become a priority,” said Dr Alisha G. Momin, Medical Officer at the Shallang PHC. “They avoid visiting healthcare facilities unless it is an emergency.”   

Reaching the Unreached

The Shallang PHC covers 91 villages in the West Khasi Hills district and receives some 20-30 patients every day; this can go up to around 70 patients on a “market day.” On the day we visited, the PHC received three cases of road traffic accidents, unfortunately, a usual occurrence on the winding hill roads. But thanks to the stock of medicines brought over once a week by drone, there were enough tetanus injections to administer to the injured villagers.

At the same PHC, 53-year-old Merina Sangma was getting treated for hypertension. “Earlier, I would have referred her to the Nongstoin Civil Hospital 80 kilometres away,” explained Dr Momin. “But just last week, the drone dropped off a supply of injectables for hypertension—a surprisingly common disease in these parts—and we can treat Merina here itself.”

Some 150 kilometres away, 31-year-old Lamina Sangma was admitted to the Dadenggre Community Health Centre (CHC) for gastroenteritis. She, her husband, and their seven-month-old baby girl travelled 15 kilometres from their village Jengjanggre in the West Garo Hills in a pick-up van. “The baby needs to be with the mother, so we all had to come,” said her husband. Lamina was also getting treatment from the medicines delivered by the drone.

The Dadenggre Community Health Centre (CHC) is some 150 kms from Shallang.  Dr Dimpy Angel Kmarak, the Medical Officer at the center feels the drone service is a lifesaver.   “The 12-13 villages under this CHC are very hard to reach, and in fact, are unreachable during the rainy season. The drone service has at least ensured that we have adequate supply of medicines to serve pregnant women who are the focus of the Chief Minister’s Safe Motherhood Scheme,” she says.

The drones don’t return empty-handed but take patients’ blood samples for testing. The results are sent in less than 3 hours through WhatsApp, considerably reducing the turn-around time for patients. “These services have been very helpful in increasing the access and quality of healthcare to villagers in this area,” added Dr Momin.

The bird in the sky

The drone service, started in December 2022, works on a hub and node basis, where the Jengjal Sub-Divisional Hospital is the hub where the drone station is based. All the medicines and injections are procured here; there is a laboratory to run tests as well. There are currently 12 nodes, including the Shallang PHC and Dadenggre CHC.

The drones fly to these nodes on a weekly basis, taking medicines and injections based on the needs of the different health centres, and bringing back blood samples for testing.

“We started with six PHCs in December 2022 and expanded to 12 within the next two months,” explained an elated Vineeth Pandalai, Operations Manager at Tech Eagle Innovations, the company that is conducting these flights. “Our aim is to bring in another five PHCs by July 2023. Currently, one drone, supervised by a manager and two pilots, serves 12 PHCs and CHCs. Several sub centres around the area are also being served tangentially.”

The drone landing spot at the Shallang PHC is marked by a big red cross on a round concrete landing pad. “The flight takes exactly 46 minutes from Jengjal more than 100 km away and is optimized each time to use less battery and carry more load,” Pandalai explains.

At the Dadenggre CHC, the absence of any open area for a landing pad was a challenge. “The drone ideally needs a concrete surface to land, as it can throw up a lot of dust when landing. So, we are using a nearby basketball court. This is not ideal as every time the drone needs to land, they need to flash a light and blow a siren to clear people from the area.”

Immediate future plans for the drone services include creating a blood bank at the Jengjal Sub-Divisional Hospital and providing matched blood during critical emergencies.

By using drones, Meghalaya is showing how technology can be reimagined to bring quality services to the people.

Since 2021, the Meghalya Health Systems Strengthening Project with World Bank support of $40 million has been helping the north-eastern state of Meghalaya strengthen its public health system where access to quality health services, remains a challenge, particularly in rural areas.  The project is expanding the design and coverage of the state’s health insurance program; improving the quality of health services through certification; and enabling efficient and improved access to medicines and diagnostics. 

The project’s performance-based financing system is aimed at bringing more accountability at all levels. It is benefitting the health sector staff at the primary and secondary levels by strengthening their planning and management capabilities and building their clinical skills. The project is also enabling women to better utilize healthcare services at the community level. 

More than 3 million people across all 11 districts of the state are expected to benefit from the project.