 Moving on to the next session. So this is the last session of the day. It's innovation in extreme environments in extreme situations and we are very lucky that we have Robin Vincent Smith here with us also having a very rounded sort of a profile having studied modern languages having been involved in tuberculosis and logistics in training and Currently involved in Brussels in order to be able to help Change project projects move forward and for them to be completed in a successful manner So I'm pretty sure he will be successful here too Vince. Oh, please go ahead Good afternoon everybody last session of the day We're gonna try to get a bit more exciting a bit more Pepsi and show off and have fun And keep your attention before the beer is arriving in half an hour. So why? Why extreme why do we call this the extreme session because all of the environments in which people have done the innovation? Have been extreme. So in terms of Pat Winnigini where we had the unmanned aerial vehicles That's because the access is one of the most inaccessible places on earth Really, it's very very difficult to get to a very long time to get there Why a Niger where we had the the boreholes, which we'll see coming up It's very hot in Niger and also there was serious security constraints So there was difficulties that access in terms of security as well And finally the Ebola context what I think is pretty obvious But it's the infection control very very strict infection control procedures mean it's very very difficult to access The inside of the high-risk zone of the Ebola treatment centers But on a lighter note this had consequences for the footwear of the people presenting So for example, John Eva his flip-flops actually melted in Niger while he was sitting in the truck in the bohan Ivan his flip-flops also melted in the core chlorine solution that was used to clean Well, and I think it's probably safe to say that Eric and Isaac lost their flip-flops in the mud in Papua New Guinea But you can see behind us a photo taken from that. So without further ado I'd like to invite Eric and Isaac from the desk in in Tokyo to present and Ladies and gentlemen, it's Not easy for some of us who are not used to this kind of foreign to present And so in order to encourage them to help them a huge cheer and round of applause, please Thank you very much Thank you. We needed that. That's why we are tag team We're going to present to you a project a pilot project We did in Papua New Guinea on the use of unmanned area of vehicles in the transport of TB transport specimen for from peripheral health facilities to Central diagnostic lab It's a tag team presentation. I'm presenting with my colleague Hi, I'm Eric and I'm the program manager for the desk in Tokyo story for my very big fresh French accent I'm Isaac. I'm the deputy program manager for the desk in Tokyo So just a background for those who don't know where Papua New Guinea is. It's just north of Australia They are separated by the Torres Strait It's a country of seven million people across different islands 80% of the population is largely rural in very remote Areas not easily accessible. There's more than 800 different ethnic groups. So each village is a different ethnic group sometimes with different languages We have been in Papua New Guinea since 1993 doing different things But we moved into tuberculosis In May last year with the first project in Gulf province, which is highlighted in yellow. Is that yellow orange? and Just a few months ago. We opened the new project in the capital district national capital district a small little red dot there So PNG has some of the highest TB incidences in the world with an estimated 25,000 new cases Every year if you're to compare it with the famous 22 hybrid and countries It's not a hybrid in country But in terms of incidents and prevalence you can see where it would be on the on the world map It's the third cause of mobility in the country and mortality But I mean the HIV rates are not that high. So the HIV TB confection is only 10% There's been an increase in the number of drug resistant TB cases which are estimated to be 5% of new cases and 23% of Retreat one key characteristic of the national TB program in Papua New Guinea is the amazingly poor program outcomes with Lots to follow up rates going as high as 90% in some health facilities. So patients just disappear So we have a project where we work closely with national TB program in Papua New Guinea So we will talk about the Karima projects in Gulf province because it's the rural Project where we have the challenges So it's the project is set up with the central Hub the Provincial Hospital where we do TB diagnosis and management and then we have a decentralized team that follows up the patients in the In the peripheral health facilities either directly through community treatment supporters or through the peripheral health facility Medical staff since we started we've had an enrollment of about 50 TB patients per month One key characteristics that More than 25% of the patients are children the youngest patient we had with drug-resistant TB was only 18 months old 75% of the patients are new cases, but already we have lost Maybe 60% of them they just disappear into the community after a couple of weeks on treatment What are the main challenges we're facing in fact you have two things that the Gulf province There is only one road between Portmore SB to Karima, which is a capital of the province and after you're in the biggest swamp of the world So access is very very difficult There is on top of that to access to different location. You have to use boats, but Unfortunately, the sea is very bad for several months per year So it's also limiting our capacities to reach to reach your places We are thinking about dropping teams for weeks or months there just to be able to perform their work So it pushed us to be innovative and to and to find a solution to be able to bring diagnostic sample to our laboratory For that it's really a logistic and a medical medical work It came from a medical request is how to move tuberculosis diagnostic sample from a remote health center to MSF laboratory in the shortest time possible We've of course from the logistic sites and prerequisites system to raise easy to use Able to work all season and robust enough to face difficult weather condition and Something safe to be able to transport tuberculosis sample. The thing is it's it can be contaminating sample For that we have been in touch with a company called maternet. It's an American company based in California they met some tests in 18 2012 and Their technique is relatively simple. It's a quadroptare. So four rotors UAV with an electrical system that go up to 28 kilometers so far and that you can manage for cell phone We'll show you a short video about the The tests we we did After months of rain many of the track roads around Karema have turned into deep clay mud But neither the sea too dangerous nor the rivers infested with crocodiles offer feasible alternatives In such conditions, how can we reach out to remote communities and people who may be suffering from tuberculosis? MSF decided to trial an innovative approach and used unmanned aerial vehicles to send sputum tests for diagnosing TB to Karema Hospital The impact is to improve considerably and drastically the The diagnostic capacity to be able to react quickly and to have a clear idea of What is the situation for the person even if she is or he is in a remote place far from any referral hospital? It's very new and it could be a real revolution for us in terms of Effectiveness of diagnostic and system The use of UAVs is still in its trial phase Operated using a smartphone. They are currently capable of traveling at a speed of 60 kilometers an hour with a range of 28 kilometers The MSF team also works in Karema Hospital The aim is to establish within five years an effective model of care adapted to the context that can then be replicated in other affected areas in the country So in terms of in terms of results of this trial phase the first thing that has been very good is that Health authorities on the civil aviation of Papua New Guinea were really supportive So it's quite a good thing and they allowed us to make this kind of a phase In terms of feasibility tests, we managed to move until 500 gram payloader and With a good resistance to win up to 36 kilometer, which is not bad for this kind of very light light equipment And we got a very good acceptance from from the population We managed to make one one very successful test in between 1L Center and on Karema with of course a dummy dummy payload, but we We managed to to make it and we are supposed to work four hours by car We make it in one hour by drone. So the technology is quite interesting But so far our problem is that the the short is it's a short range it needs to human action to swap batteries and It's not a completely mature technology The picture there really sums up the reactions we got from the community You've got all the possible range of emotions you can get when you see a drone flying above you So we've got excitements We've got fear and we have amazement So there's still some question from internal question an external question in fact the internal is MSF is it is a bold or not under this kind of technology are we able to deploy it on on the field and Are we able to afford it because it's quite expensive the external question is what will be the acceptance of the population and What will be the authorization we can get to use this kind of technology in other countries? Where are we now today? We are still in contact with with maternity but also with other companies We are working on this technology and hopefully we'll make another test This year with our maternity or other other companies. We are working with us on this on this topic finally just to acknowledge everyone who was involved the Papua New Guinea authorities for allowing us to do this the maternity for bringing the technology They actually had their team in the field for two weeks They could what we briefed them is totally different from what they saw on the ground now They appreciate what we do and also the MSF teams that were involved in the field. Thank you. Thank you Questions questions so here we have number one question at the bottom and number two question You said it's quite expensive How does it compare to the cost of sending a very small sample vial via a car with staff Over really rough roads. It's gonna cost to maintain the car and so on and so forth I mean, do you end up actually saving even if it's expensive? We we didn't do the the comparative cost For a couple of reasons just was was you were only speaking about a trial phase So that's one of the one of the fact after to compare the time of One hour by drone on the four hours by car with the risk of accidents the risk of of not accessing to the place It's it's not only the cost It's also the time we can save and how easy can be for us after And also just to add that in Papua New Guinea is Eric said the only road. There's only one road. That's from the From the capital district to the hospital after the rest of the province you walk for five days Or you use boats and half a year. There's no access So there's probably no other option. We can't compare with cars because I Have a very short. Yeah, I have a very short question I hope I did it did not miss it during the presentation How high can they fly the drones because I was wondering you were saying that it was well accepted by the Population, but I don't know if you can grasp them or they are Because it might it looks like a toy Maybe also for some I don't know how big it is, but it seems to be small and light It's relatively small, but it fly several meter above above the ground and say it's not actually you cannot get it when it's flying So several meters is how much one hundred or two hundred. I will remember it's around 100 meter. Okay? And it are just with the Terry So if it goes in a mountain region, it goes 100 meters above Sorry, I would like to add one more question as an anthropologist. How did you? Check on the acceptance of the population In fact, it has been very basic is that in Keremah? There is one football field and we invited the population of the city to come and we met a demonstration About about the technology. So while you have the picture of the three kids It was exactly during the time of the presentation So we made it very clear about what what has been our purpose and why we are using it and people understand it because to be honest we lost couple of them in the jungle and One of them was bring back by the by the population saying oh, I think you love that Thank you a lot person here down the front Yes, very exciting work. What have you come across in terms of application of this technology for? Refugee camps for assessing population numbers for assisting with the mapping that we heard of earlier this morning It would with the proper GPS and cameras one could imagine this would have multiple uses for MSF I should say for us. It's two different topics There is a mapping which is Which is run by some of our colleagues and there is a transportation part So it's really a two different topic and the type of UAVs is completely different Because us we need UAVs that are able to take off and to land and logically for for mapping You just need something to fly above and to land back to your to your official area So it's it's making the difference in terms of Technology and in terms of what we want to achieve Thank you very much ladies and gentlemen