Drone delivery helps in Rwanda, but only so much

A U.S. company in Rwanda has been providing medical supplies via drone. But even state-of-the-art technology can't overcome a weak health care infrastructure.

JUANA SUMMERS, HOST: A decade ago, Rwanda faced a healthcare problem. It needed to make blood deliveries for medical emergencies, but the roads were unreliable. Part of the solution was drones. Drone deliveries became a big part of the country's healthcare system, and with new support from the U.S., there are plans to expand the service. But as NPR's Fatma Tanis reports, poor infrastructure and U.S. aid cuts risk undermining the progress the country's made. FATMA TANIS, HOST: Like most Rwandans, Noella Mukanoheli lives in a remote village. It's only 30 miles from capital city Kigali, but the drive there takes three hours because of Rwanda's many hills and impassable roads. The 42-year-old lives in a small home nestled in between a cluster of banana trees. She carries a baby boy in her arms. NOELLA MUKANOHELI: (Speaking Kinyarwanda). TANIS: About two months ago, just before her due date, Noella says she felt a sudden pain in her abdomen and was bleeding. She called a friend with a motorcycle to help her get to the nearest health clinic, 50 minutes away. MUKANOHELI: (Speaking Kinyarwanda). TANIS: "The nurse told me they couldn't help. I needed to go to a hospital, so they called an ambulance," she says. It took two hours to get there. At some point, Noella says she'd passed out. When she woke up, her hand immediately went to her belly. MUKANOHELI: (Speaking Kinyarwanda). TANIS: The doctor told her she'd given birth. The baby was alive. But she had nearly bled out, she says. They didn't have her blood type in stock and had to make a request. Within minutes, two drones carrying a total of five liters of blood arrived at the hospital in the nick of time. MUKANOHELI: (Speaking Kinyarwanda). TANIS: "The doctors told me I would have died," she says. (SOUNDBITE OF DRONE WHIRRING) TANIS: The drones that doctors say saved Noella's life came from a facility in the town of Muhanga. UNIDENTIFIED PERSON #1: (Inaudible). TANIS: It belongs to American robotics company Zipline. Pierre Kayitana is the country director. PIERRE KAYITANA: So this is Zipline. Where we stand is actually the very first Zipline distribution center in the world. So it started here in 2016. This place, just so you locate yourself - this is the exact center of Rwanda. TANIS: This is one of two distribution centers in the country. A third is set to open soon with a grant from the United States. It's part of the Trump administration's new approach to international aid, which aims to promote American businesses for global health work. At the same time, the administration has cut 200 million in funding for aid groups in Rwanda that provided food and health services for decades. In the announcement of the grant, the State Department said, there's a new era of diplomacy, quote, "one that uses American expertise to drive progress on global health foreign policy goals." UNIDENTIFIED PERSON #2: (Inaudible). Please open the door. UNIDENTIFIED PERSON #3: (Inaudible). TANIS: Zipline has been a vital part of the health system in Rwanda for a decade. At this warehouse, they receive orders from medical professionals all over the country and send out drones carrying medicine, vaccines, blood, diagnostic tests and more. KAYITANA: So this is our warehouse. It's the highest standard of a medical warehouse by FDA. Anything you may need in an hospital you can find in here. TANIS: The room is packed with shelves and boxes of medical products, property of the Rwandan government. Zipline is contracted to manage the logistics, the delivery and inventory. KAYITANA: All these on the screens are order to be fulfilled. TANIS: In one corner, technicians are preparing orders. UNIDENTIFIED PERSON #4: They are ready to go. KAYITANA: Which item is it? Blood reagent, so... TANIS: Blood reagent. KAYITANA: Yes, yes. TANIS: OK, so someone has ordered a test to find out their blood group? UNIDENTIFIED PERSON #4: Yes. KAYITANA: Yes. TANIS: And you're about to pack a test? UNIDENTIFIED PERSON #4: Yes. KAYITANA: Yes. TANIS: He places it in a package the size of a shoebox. It's OK? The weight is good. KAYITANA: Yes. It's about 1 kilogram. TANIS: What's the weight limit? KAYITANA: So the minimum is 1 kilogram, minimum because if it's less than 1 kilogram, the wind... TANIS: Ah. KAYITANA: ...May push the package. TANIS: Now it's ready to launch. The drone looks like a tiny airplane. It's made out of white styrofoam, and the wings are red. The battery is where a cockpit would be, and the package is in the belly. An engineer places the drone on the launching pad. He pushes some buttons. (SOUNDBITE OF METAL CLATTERING) TANIS: And it slingshots into the air. (SOUNDBITE OF DRONE WHIRRING) TANIS: That package is headed to Kabgayi Hospital, the biggest one in Southern Rwanda and where Noella was treated. It takes 30 minutes to drive. The drone makes it in four. It drops the package with a paper parachute into the courtyard of the hospital. They get dozens of deliveries a day, says Dr. Evariste Ufitihirwe. He's the deputy director general of the hospital. EVARISTE UFITIHIRWE: We are lucky. It takes, like, 5 minutes to bring blood here, but you - it is more faster than telling a person to go in stock to bring blood. TANIS: Just days ago, he says, a woman with postpartum hemorrhaging arrived. Also nearly died, if not for drone delivery of blood - it's a common story here. A decade ago, before the drones, doctors would have to pinch arteries with their hands to stop the bleeding, Ufitihirwe says. UFITIHIRWE: We used to be clamping blood veins or any other ways to stop bleeding. TANIS: Sometimes for hours while waiting for blood to arrive from a bank in Kigali. According to government data, 26 years ago, 1,000 out of 100,000 women were dying of childbirth. Today, that number is 87. Dr. Sabin Nsanzimana is Rwanda's minister of health. SABIN NSANZIMANA: It has been a great decade of transformation. TANIS: He says the grant from the United States will help Rwanda get to nationwide coverage of drone delivery. NSANZIMANA: We used to see drones in war zones taking lives, but now we're seeing drones in health system saving lives, which is really the best use of technology we could want to see as doctors, as patients. TANIS: There's a lot more work to do, though, he acknowledges. Road and electricity improvements are needed for Rwanda to achieve its aim of becoming an upper-middle-income country by 2035. The aid cuts from the U.S. have made it harder. Save the Children, which runs health facilities for pregnant women in Rwanda and partners with Zipline, told NPR that its locations were running out of U.S. funds in September and are at risk of shutting down. The Rwandan government doesn't have the resources to fill the gap. At a health post in a remote town called Ituze (ph), head nurse Rosaline Uwera opens her weekly vaccine package from Zipline. ROSALINE UWERA: (Non-English language spoken). TANIS: "I'm happy that we get regular stocks of medicines and vaccines," she says. Though she wishes she had more equipment to help patients who come here, like oxygen or an ultrasound machine. She's had to send so many of her patients to the nearest hospital 2 hours away. UNIDENTIFIED PERSON #5: (Non-English language spoken). UNIDENTIFIED PERSON #6: (Non-English language spoken). TANIS: Back at her village, Noella says she's recovering from the blood loss and still has some pain and fatigue. MUKANOHELI: (Non-English language spoken). TANIS: It would have been better, she says, if the drones could have delivered the blood directly to the health clinic she first went to and if there was a doctor on staff who could have helped her there. As she speaks, her son lies motionless in her arms. His breath is wheezing. He seems small for a 2-month-old. MUKANOHELI: (Non-English language spoken). TANIS: He's malnourished, Noella says. She doesn't have much to eat at home and has had to give him cow's milk. Soon, she'll have to make the trek back to the health clinic to get him checked out. A drone won't be able to help her with that, she says. Fatma Tanis, NPR News, Muhanga, Rwanda. (SOUNDBITE OF MUSIC) Copyright © 2026 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information. Accuracy and availability of NPR transcripts may vary. Transcript text may be revised to correct errors or match updates to audio. Audio on npr.org may be edited after its original broadcast or publication. The authoritative record of NPR’s programming is the audio record.