As the bottles of medication are carefully loaded into the body of the drone, a small crowd gathers to watch on the other side of the yellow tape marking out the grassy landing strip.
With a gentle buzz the drone rises, a little uncertainly, into the sky, on its 1.5-metre wings. The precious cargo leaving Bufumira health centre III, in Uganda’s Kalangala district, is critical drugs for people living in some of the most far-flung communities in the region. Kalangala is made up of 84 islands in Lake Victoria, the world’s largest tropical lake, which Uganda shares with Tanzania and Kenya.
The drone taking off last week was a pilot for a new project which will now see 20 scheduled flights a month, carrying mostly HIV medicines out to 78 community groups and health facilities across the widely scattered Ssese islands, which have the highest HIV prevalence in Uganda.
Located about 60 miles from the capital, Kampala, and home to more than 67,000 people, Kalangala district has an HIV prevalence rate of 18%, far higher than the national rate of 5.6%. The government’s HIV strategy estimates prevalence of the virus to be up to 40% in some fishing communities.
The delivery of antiretroviral drugs (ARVs) and healthcare is difficult, weather-dependent and risky for healthcare workers, as travel into the region is possible only by boat. The drones, it’s hoped, which cost about £4,000 each, carry loads of up to 1kg and fly for 150km, will “close that last mile”, said Andrew Kambugu, executive director at Makerere University Infectious Disease Institute (IDI).
“Closing the last mile of delivery and ensuring that people living in remote communities have equitable access to modern treatments for HIV is one of the most significant challenges in global health and in Uganda,” he said.
“Medical drones can help solve this challenge by safely and reliably delivering lifesaving medications, thereby empowering frontline healthcare workers to allocate more time and resources to performing other essential services, resulting in healthier and more resilient communities.”
Uganda’s ministry of health, the Academy for Health Innovation, Uganda, and IDI collaborated on the medical drones pilot at Bufumira, which carried ARVs to more than 1,000 people living with HIV.
The “overcoming geographical barriers with technology” initiative will ease challenges, said Henry Mwebesa, Uganda’s director general of health services, who watched the launch.
“Using medical drones is a huge step for us as a health sector in improving service delivery especially in hard to reach areas,” he said.
“It’s very useful. Once it’s successful we can adopt it for other facilities and replicate it in other places.”
The drones are controlled by locally trained experts who monitor the flight and landing.
“This is exciting. It will ease the transportation of vaccines to our health facilities in those landing sites,” said Jude Matovu, in charge of the Bufumira health centre. “So we expect our outpatient department coverage to increase.”
The Uganda Medical Association has welcomed the drones, but expressed concern over drug shortages due to inadequate funding. Its secretary general Mukuzi Muhereza said: “We are welcoming it. It’s very important and it could be a gamechanger. It would be nice to see whether it really works with our bad network and connectivity.
“While the distribution and delivery is welcome, the other biggest problem I see is that even other public health facilities get stock-outs even when they can be reached by road. So the stock-outs I don’t think would be because of the transportation or connectivity. The biggest stock-outs are because of the funds,” he said.
“Realistically I think we are not giving enough money to national medical stores to purchase drugs and supplies for every Ugandan that needs it. The biggest change would be if we can enhance the budget and make sure we have what [we need] to send.”
Other African countries, including Rwanda and Ghana, are also using drones to deliver blood and medical supplies, with the technology estimated to be serving more than 22 million people.
Rosalind Parkes-Ratanshi, director at the Academy for Health Innovation, said the programme will also be an important research opportunity to assess and quantify how effective drones are at delivering medications, data that will help scale drone technology and respond to emergencies.
“Thanks to the support and coordination of our partners, including Johnson & Johnson, this programme will help gather the information and data needed to help make this future a reality, while also helping to deliver lifesaving care to people in need,” said Parkes-Ratanshi.
The 78-year-old American president is known to be prone to verbal gaffes and slips of the tongue, for which he is usually criticized or mocked by some people on social media.
US President Joe Biden appeared to confuse former US President Barack Obama for another former US president, Donald Trump, in a Wednesday speech, but swiftly corrected himself and suggested that the mistake was a “Freudian slip”.
“Back in 2009, during the so-called Great Recession, the president asked me to be in charge of managing that piece, then-President Trump,” Biden said while addressing the public in Pennsylvania. “Excuse me, Freudian slip, that was the last president. He caused the…anyway, President Obama, when I was vice-president.”
Others argued that the 46th president does not know what a Freudian slip really is.
Biden was in Pennsylvania on Wednesday speaking at a Mack Truck assembly plant in Lehigh Valley, promoting his administration’s new measures to encourage US citizens and companies to “buy American”. Particularly, he announced plans to modify the 1933 Buy American Act that requires federal firms and agencies to purchase goods that have at least 55% US-made components.
Under the Biden plan, the threshold will be increased to 65% by 2024 and to 75% by 2029.
During the 11-day war between Israel and Palestinian militants in May 2021, Israeli airstrikes destroyed five multi-storey towers in the heart of Gaza City. The images of buildings crumbling to the ground flashed across TV channels around the world as Gaza faced the most intense Israeli offensive since 2014. At least 256 Palestinians were killed, including 66 children, and 13 in Israel, including two children. Israel claimed it was destroying the military capabilities of Hamas, who had fired rockets at Israel after weeks of tension in Jerusalem over the planned displacement of Palestinian residents and police raids on al-Aqsa mosque during Ramadan.
Each time Israel said it was targeting Hamas and that it had warned the residents first. But what is it like to have only a few minutes to evacuate before watching your life collapse into rubble?
In conjunction with the civilian harm monitoring organisation Airwars, the Guardian spoke with dozens of residents and gathered footage and photos to piece together the story of one building, al-Jalaa tower, demolished by an Israeli airstrike on 15 May 2021. These are the stories from inside the tower, of the Mahdi clan, who owned and lived in the building, the Jarousha family and the Hussein family.
Israeli airstrikes in Gaza hit a 12-storey building in the early hours of 12 May 2021. Clockwise from top left: Israeli airstrikes in Gaza hit a 12-storey building in the early hours of 12 May 2021; a 13-storey residential block collapses in the Gaza Strip on 11 May 2021; an Israeli airstrike on Gaza City, 14 May 2021; smoke rises following an Israeli strike on al-Shorouq tower in Gaza City, 12 May 2021.
The story of al-Jalaa tower
The upscale Rimal area of Gaza City and its multi-storey towers had suffered since the bombing began. Though al-Jalaa was thought to be safe, night-long bombing had terrified its residents, who struggled to sleep. Fearing the impact of blasts, families had been sleeping in hallways away from the windows.
Children from al-Jalaa tower get ready to sleep in the hallway of the building for safety. Photo: Issam Mahdi
Al-Jalaa tower was built in 1994 as part of a property boom sparked by the landmark Oslo peace agreements between the Palestinians and Israelis.
The first five floors were offices, with floors six to 10 inhabited by families. On floor 11, the top floor, were the Gaza offices of the Associated Press and Al Jazeera, two of the world’s largest media companies. The ground floor had two levels of shops and beneath it was a car park.
Many of the residents came from the Mahdi family, including the building’s owner Jawad and his son Mohammed.
After each marriage in the Mahdi clan the new family settled into the tower. Jawad, 68, had traded in Israel before 2007 when the Jewish state blockaded Gaza after the Islamist group Hamas seized control of the territory. Since then he has run his clothes company in Gaza.
The whole family had huddled together into a few apartments on the sixth floor for safety, but were about to be scattered as they rushed to evacuate.
As Jawad searches through the rubble he finds a single folder. It contains pictures of his wedding day.
Jawad Mahdi with a photograph of his wedding day, found amid the rubble of al-Jalaa tower. Photo: Mohammed Mahdi
Mohannad and Suzanne’s cats were never found. “I still don’t know their fate until today,” Mohannad says. “Every day from the moment it was destroyed I was going to the building listening for any sound.”
Suzanne says their lives will never be the same. “Everything you love is gone – it doesn’t matter about the cupboards and beds and things. There are things my kids had when they were babies, clothes that I had from when I was a child – these were memories. There was a box with all the things from my father, god rest his soul, his glasses and mobile and pictures. Where am I going to get things like that again?
“We have become people without memories or mementoes. What is a person without those? If you have no memories you feel like you never lived.”
Walid Hussein, the engineer who had returned with his family from years living in the US, has become like a ghost. He has not a single document to prove who he is. Sometimes he thinks about going back to the US for his children, but he has his elderly mother in Gaza to support. He doesn’t want to have to make a choice. He shares his hopes for a peaceful future in Gaza:
“This is all we are asking for, to live a peaceful life. Very peaceful life, it means security, it means no harm to anybody, it means don’t touch my kids – not because you have this technology and this kind of weapon you bomb all of us from the air.”
Joe Dyke heads the investigation team at the civilian harm monitoring organisation Airwars Anas Baba is a freelance reporter and photographer based in Gaza
UK prime minister Boris Johnson has said his government is in talks with its US counterparts to ensure that American citizens can enter the UK “freely” and “in the way they normally do,” Reuters reported on Wednesday. The Financial Times reported earlier this week that the UK was expected to announced the reopening of England for fully-vaccinated travellers from the EU and US this week.