3D opportunity for life: Additive manufacturing takes humanitarian action Deloitte Review issue 19

The humanitarian crisis in Syria, currently in its fifth year, is the direct cause of one of the largest refugee migrations since World War II.¹ Crises of this magnitude require massive amounts of humanitarian aid.² And, in fact, humanitarian aid totaled $24.5 billion globally in 2014, up from $20.5 billion in 2013—an increase of 19 percent year over year.³ In 2016 alone, it is expected that 89.3 million people will receive aid—but sadly, many more in need will not.⁴ In the days immediately after a disaster, humanitarian groups rush in to help those affected, but the magnitude of the devastation can limit aid workers’ ability to reach those who are most in need.

The demand for aid shows no signs of slowing. Indeed, in 2015, 346 natural disasters occurred, impacting 98.6 million people.⁵ Former UN High Commissioner for Refugees António Guterres noted that, with “the exponential increase in needs we have seen just in the last three years, the humanitarian financing system is nearly bankrupt.”⁶ Delivering aid is an expensive endeavor. Aid is delivered via “channels of delivery”: mobilized groups that set up supply chains and deliver assistance, with associated costs in both time and money.⁷

While the use of advanced technologies in the service of humanitarian aid is relatively nascent, they are still proving valuable.⁸ Digital and smart card-based technologies have revolutionized the delivery of financial aid for Syrian refugees,⁹ while drones can speed delivery of goods to remote areas.¹⁰ Advanced technologies can not only drive more effective aid efforts but may also have a ripple effect, transforming local economies and companies alike and addressing many of the challenges current aid efforts face.¹¹

Less explored in the technology space—but no less significant—are the impacts that additive manufacturing (AM) can have on humanitarian endeavors. The ways in which AM technologies can provide solutions to humanitarian challenges are many, and they are profound.¹² Indeed, the attributes that make AM so attractive for manufacturers also make it well suited to improving the lives of the world’s most vulnerable populations: AM’s ability to print physical objects anytime, anywhere, has tremendous potential impact on the speed of aid; its lack of reliance on traditional manufacturing constraints enables design optimization for the situation at hand. In addition, AM can break performance trade-offs, freeing aid providers from challenges related to economies of scale or scope.¹³ AM is also versatile enough that it can be used in tandem with traditional approaches to aid where required.

This article explores how organizations are using AM in the field to augment their humanitarian efforts: redefining the supply chain, producing customized goods that address situation-specific needs, creating a blueprint for future AM-related on-site efforts, and potentially promoting an engine for economic development. We will also consider some significant takeaways from these efforts, which can enable companies to develop capabilities that can offer competitive advantage more broadly.

The additive manufacturing framework

AM’s roots go back nearly three decades. Its importance is derived from its ability to break existing performance trade-offs in two fundamental ways. First, AM reduces the capital required to achieve economies of scale. Second, it increases flexibility and reduces the capital required to achieve scope.

Capital vs. scale: Considerations of minimum efficient scale can shape supply chains. AM has the potential to reduce the capital required to reach minimum efficient scale for production, thus lowering the manufacturing barriers to entry for a given location.

Capital vs. scope: Economies of scope influence how and what products can be made. The flexibility of AM facilitates an increase in the variety of products a unit of capital can produce, reducing the costs associated with production changeovers and customization and, thus, the overall amount of required capital.

Changing the capital vs. scale relationship has the potential to impact how supply chains are configured, and changing the capital vs. scope relationship has the potential to impact product designs. These impacts present companies with choices on how to deploy AM across their businesses.

Companies pursuing AM capabilities choose between divergent paths (figure 1):

Path I: Companies do not seek radical alterations in either supply chains or products, but they may explore AM technologies to improve value delivery for current products within existing supply chains.

Path II: Companies take advantage of scale economics offered by AM as a potential enabler of supply chain transformation for the products they offer.

Path III: Companies take advantage of the scope economics offered by AM technologies to achieve new levels of performance or innovation in the products they offer.

Path IV: Companies alter both supply chains and products in pursuit of new business models.

AM’s progression in humanitarian relief: A potential market transformation

AM can impact the way organizations provide aid by addressing the single largest challenge in humanitarian relief: getting the aid on site. Viewed through the lens of the AM framework, use of AM in humanitarian aid progresses along a continuum (see figure 2), depending upon the need on the ground. This progression begins with more fundamental uses—establishing or redefining a supply chain through the downstream relocation of the point of manufacturing (path II). It evolves into a more complex approach to providing aid, via producing customized parts and products produced at or close to the point of need (path IV), and using lessons from aid experiences to inform future aid endeavors and promote sustainable approaches that can empower locals.

While there are applications for AM along path I, in rapid prototyping of aid supplies, AM’s most dramatic potential lies in its ability to deliver economies of scope at the point of use; therefore, we focus our analysis along paths II and IV.

Once a functioning 3D printer is in place, it can be used to produce small-batch goods that address a specific requirement at, or close to, the point of need. The next stage of path II can be to use AM machines as an ongoing production point: creating standardized goods—such as medical tools—on an as-needed basis, obviating the need to wait for shipments. This longer-term use can exploit some of the manufacturing capabilities of AM machines, such as the ability to produce multiple products without machine changeover or retooling time.¹⁴ Progressing beyond path II to path IV can produce goods tailored to specific, local needs at or near the point of use. Finally, it can lead to a fully sustainable system; in essence, AM technology can empower those on the ground and drive a new, sustainable approach to aid.

As with commercial manufacturing, AM can coexist with conventional methods to both augment them and replace them in areas in which it is uniquely suited to do so. Organizations can deploy AM strategically for situation-specific needs while using traditional aid approaches, such as food drops and monetary relief, to fulfill more universal relief needs.

All of this, however, is preceded by the very first, initial step: getting a 3D printer in place, on the ground, and ready to go.

Getting AM capabilities to the ground

Humanitarian aid, at its core, is centered on delivering goods and services to local populations in need. Thus, the successful delivery of aid begins with the establishment of a functional supply chain. Establishing such a supply chain is costly: 60 to 80 percent of humanitarian aid is spent on logistics and shipping, adding up to $10–$15 billion annually to aid costs.¹⁵ The process is complicated, as locations may be remote; typical shipping routes may be impassable or nonexistent due to aftershocks, flooding, or conflict; and infrastructure may be limited. (See sidebar, “Sidestepping infrastructure challenges for AM response.”) Due to these challenges, the last-mile problem—getting goods to the exact point of need—can prove challenging.

60 to 80 percent of humanitarian aid is spent on logistics and shipping, adding up to $10–$15 billion annually to aid costs.

Organizations using a traditional aid model struggle to deliver supplies and often cannot accommodate unexpected, yet sometimes inevitable, surges in demand without a significant lag time, spelling potential disaster.¹⁶Even in situations where the supply of aid has been accurately matched to demand, challenging environments mean that equipment can break down at any time, leading to a need for spare parts on demand, or parts may arrive broken due to unfavorable shipping conditions.¹⁷

AM can provide significant benefits here. Creating a deployable AM solution can move the point of production further down the supply chain, addressing many of the challenges organizations face as they seek to transport humanitarian aid, particularly cost and lag time.¹⁸In other words, AM can enable aid organizations to address the last-mile challenge by creating some goods on-site.¹⁹

SIDESTEPPING INFRASTRUCTURE CHALLENGES FOR AM RESPONSE

A recent study demonstrated two printers outfitted with solar panels, capable of printing in any location—even one lacking access to an electrical grid.²⁰ One of the printers, a mobile machine meant for use in schools or local makerspaces, uses RepRap technology, allowing it to print continuously while also providing power to several computers for design purposes. The second printer can be “completely packed into a standard suitcase, allow[ing] for specialist travel from community to community to provide the ability to custom manufacture . . . as needed, anywhere.”²¹

Both of these approaches offer ways to potentially sidestep supply chain challenges. They not only move production directly on-site at the point of need, but also adapt to local infrastructure challenges, making their functions more self-sufficient. They can also teach organizations how to utilize new local materials and understand how differing production technologies and techniques may be better suited for certain environments.

Thus, the first step in using AM to address humanitarian needs is the most straightforward: getting the printer and printing materials on the ground, at or close to the point of need. Using AM to bring the point of production further down the supply chain in this way can simplify many of the logistical and distribution challenges that humanitarian aid providers face: Production equipment will only need to be transported once, and raw materials such as printing filament can be used to produce a variety of products on the ground. This translates into fewer goods to track during the logistics process—cutting down on costs—and potentially the ability to ship other, previously deprioritized goods to the site given the newly available space on shipping pallets. Further, raw materials in the form of powders and filaments are denser and therefore can be shipped more efficiently, as they can often be transported with less protective packaging, and with no parts to break.

Introducing production of a single, standard good as needed, close to the point of need

AM-enabled supply chains in humanitarian zones can take a variety of forms. Thus, organizations should consider the needs on the ground as they prioritize when, where, and how to use AM to provide aid. Often, the first application on the ground can be addressing an unexpected, urgent need—one in which waiting for aid to arrive via traditional means can lead to greater casualties or risk.

The nongovernmental organization (NGO) Field Ready’s work in Nepal is an example at the far left of the continuum (figure 2), where the organization was able to take AM capability directly to the source of need, assess the need, and address it. During the 2015 earthquake in Nepal, aftershocks destroyed water pipes, hindering the community’s access to potable water. Water pipe fittings provided via traditional relief efforts arrived missing parts, leading to leaks. Using the battery of a Land Rover as a power source, Field Ready was able to print a replacement part and fit it within two hours, restoring functionality and avoiding a wait of several weeks for new parts (figure 3).²²

Producing standard multiple goods on an ongoing basis, close to the point of need

Beyond producing single parts, established 3D printers already at the point of need can produce a range of goods and services—profoundly impacting the way in which aid is distributed. Put simply, it is extremely difficult for organizations to get the right aid to those in need. Crises come without warning, leaving little ability to plan not only for on-the-ground conditions but for location-specific needs. And once a crisis occurs, communication channels are often impacted, creating disconnects in the flow of information to central supply hubs.

Beyond producing single parts, established 3D printers already at the point of need can produce a range of goods and services— profoundly impacting the way in which aid is distributed.

Disconnects make planning a challenge. In the view of humanitarian aid professionals, “It is almost inevitable that, to a greater or lesser extent, there will be a mismatch between the demand and supply situation.”²³ This often translates to a one-size-fits-all approach to aid, in which NGOs stockpile inventories of goods they think will be most broadly useful. The International Federation of Red Cross and Red Crescent Societies (IFRC), for example, maintains a catalog of about 10,000 items—mostly medical equipment—that it uses for any humanitarian condition it encounters.²⁴

AM offers hope for a solution to this challenge. For example, 3DforHealth established a 3D printing lab in Haiti to aid in earthquake relief. The organization identified 16 objects that could be printed to meet the specific, immediate needs of medical professionals on the ground. One aid worker observed a shortage of umbilical cord clamps, so doctors had to tie off umbilical cords post-birth with rubber gloves, which then led to a shortage of rubber gloves for sanitary treatment.²⁵ 3DforHealth worked with locals to develop an additively manufactured umbilical clamp prototype. Designs were rapidly and iteratively tested in the field until an acceptable design was found that met local needs.²⁶

Expanding upon this example, organizations can employ a flexible production system—one of the core benefits of AM—to maintain a larger product catalogue that addresses the needs of each crisis. This system might take several forms. To maintain a more stable, ongoing AM production process, organizations can adopt a hub-and-spoke approach similar to one proposed by Griffith University in Australia, in which equipment is set up close to the point of need and is operated by a local operator, but design files are sent from engineers and specialists at “intelligent hubs” situated in more developed locations.²⁷ Alternatively, to address simpler, day-to-day needs via rapid response, printers on the ground can be used to print simple devices and replacement parts at the point of use.

Having a production point capable of producing a diverse range of products, however, will create new challenges for organizations: prioritizing which products to print out of a wide range of options, and anticipating and responding to unexpected surges in demand or the sudden need for wholly new objects that must be designed or iterated on the spot. Addressing these challenges can provide organizations with important lessons around manufacturing flexibility, leading to new insights in demand planning and inventory management, both in the field and on a commercial factory floor.

Further, unforeseen events that impact and potentially disrupt production will likely be the norm rather than the exception in aid situations: Power may be intermittent, printers may break down, and there may be an AM learning curve for those on the ground. As organizations resolve these situations, they can take these challenges as opportunities to learn, to create more self-sufficient production facilities, and to develop response mechanisms to production crashes. Such lessons can then be applied to production in other extremely remote environments, such as oil fields, ships at sea, or even space.

Producing customized goods at the point of need

Beyond supply chain considerations, AM has the potential to alter what is actually produced to support humanitarian and developmental aid efforts, in particular at the point of consumption. In this way, organizations can exploit AM’s strengths to address specific local needs. This approach can have the added benefit of teaching an organization how to manage large-scale local development—maintaining a network of production points, with each producing goods uniquely suited to its immediate population.

A case study from the University of Auckland examined the ways in which AM could be used to address water and sanitation issues after a natural disaster, as clean drinking water and proper disposal of wastewater pose significant health concerns following a crisis. Reviewing Oxfam’s field catalog of aid supplies, researchers demonstrated how they could print an elbow joint on a desktop fused deposition modeling printer in 45 minutes with no post-finishing required. The project also explored other options using different materials and printer types. They further noted the ability to use AM to make ad-hoc customizations to original designs as needed—changing a 90-degree bend in a pipe to 120 degrees in order to address local vagaries in water pipes, for example. Researchers also noted AM’s potential for altering internal geometries of the design to add water filtration capabilities to 3D-printed pipe fittings. The researchers estimated that a customized, in-field print would take two to three hours, a notable improvement over traditional shipping methods.²⁸

The Auckland study also demonstrated how AM can join disparate parts from two different equipment suppliers. The lack of standardization and communication across aid suppliers can present a major challenge in the field; when replacement parts do arrive, they may not fit the system for which they were intended, making repairs difficult or impossible. Mechanical couplings are one approach that aid organizations currently use to solve this problem with regard to remote water supply systems.²⁹ AM can make the process faster not only by sidestepping shipping lag times, but by potentially offering an open-source design file that users on the ground can customize as needed, enabling greater communication between organizations. (See sidebar, “Addressing the communications challenge with an aid playbook.”)

By sharing AM ideas across an impacted zone, aid workers—or even different organizations—can communicate designs across production sites. In this way, providers can better coordinate, download designs, and customize them as needed. In Nepal, Field Ready partnered with World Vision to create an “open-source online supplies catalog” of designs to be used in other crisis situations.

Creating a sustainable approach that empowers those on the ground

After addressing supply chain and product customization, organizations using AM for social impact and aid can use lessons learned from each field experience to transform aid beyond the initial post-disaster push, making it more sustainable over the longer term. They can do so by teaching AM technical skills to locals, and by supplying open-source software and part designs to enable them to continue to produce parts and products on-demand once organizations have left. This type of education and training can develop a local, sustainable talent pool that can design and produce goods on site in new markets—which, in turn, encourages economic development, potentially helping to break the cycle of unemployment and poverty.³⁰

For example, AM processes in post-earthquake Haiti moved from supply chain to customized products to product sustainment. The process of printing and testing umbilical clamps and other medical supplies had other benefits beyond design: It allowed aid workers and local clinicians to identify and address challenges around sanitation, durability, and materials’ reuse for new parts and products; and taught those on the ground how to use AM technologies.³¹ Field Ready leaves behind its printers; makerspaces such as Communitere offer 3D printing training.³²

In another example, the country of Jordan is planning to launch a pilot program at the Zaatari Refugee Camp to train Syrian refugees to work outside the camp, with the goal of turning the area into a manufacturing “hub.”³³ With access to a new manufacturing technology, locals have the opportunity to address problems and potentially create solutions to problems outsiders cannot see. This can enable organizations—and locals themselves—to uncover and meet local, heretofore unforeseen demands. Refugee Open Ware, a startup in Jordan, is hoping to bring a FabLab to the camp, similar to one it has opened in Amman, and one planned for Irbid, a city near the camp.³⁴

ADDRESSING THE COMMUNICATIONS CHALLENGE WITH AN AID PLAYBOOK

A major issue in disaster relief situations is the lack of communication between the myriad agencies that respond to crises. This is evidenced in the lack of standardized tools and parts, where fittings from one organization may not work with those from another. AM can bridge these gaps, printing replacement parts on the ground, and generating design files and on-the-ground information that can be shared across locations between organizations and workers. Taken a step further, it can lead to the design of a collaborative AM playbook for subsequent humanitarian efforts—serving as a customizable model for future aid.

In 2014, Oxfam partnered with file-sharing platform MyMiniFactory to solicit AM solutions to “design solutions . . . to solve unique problems that occur during humanitarian emergencies [where] traditional design and procurement processes are inefficient.”³⁵The project solicited AM design ideas to address hand sanitization, a serious challenge that, if appropriately addressed, could help prevent disease and illness among Syrian refugees living in crowded quarters in Lebanon (figure 4). Several customized designs were then sent to a printer in the field in Lebanon to be tested and iterated, with the goal of identifying solutions that could be applied on a wider scale.³⁶

By sharing AM ideas across an impacted zone, aid workers—or even different organizations—can communicate designs across production sites. In this way, providers can better coordinate, download designs, and customize them as needed. In Nepal, Field Ready partnered with World Vision to create an “open-source online supplies catalog” of designs to be used in other crisis situations.³⁷

This strategy can transform aid, not just by providing a customizable set of disaster preparedness skills to deal with future crises transformation, but also by providing AM-related skills to locals to promote economic sustainability.³⁸ Organizations can even learn from such efforts in the developing world and apply the capabilities learned to build sustainable skills in developed regions. In the United States, open-source software and AM-related initiatives aimed at building technological skills have helped individuals develop a sense of entrepreneurialism, build new engineering skills, and pave the way for new jobs.³⁹ The University of Illinois, for example, has introduced a course focused on AM through its extension program that is aimed at addressing poverty by providing marketable skills to underprivileged youth. The four-phase program is based on similar programs in Tanzania and India.⁴⁰

This strategy can transform aid, not just by providing a customizable set of disaster preparedness skills to deal with future crises transformation, but also by providing AM-related skills to locals to promote economic sustainability.

Preparing for AM-driven humanitarian aid

As organizations consider adding AM to their aid capabilities, they will need to ensure they are well-positioned to scale the technology to their needs. Depending on the organization’s aid priorities and objectives along the AM-driven aid continuum, they can consider the following:

Consider where and how AM fits into the wider aid mission. Not all aid situations will need the same level of AM. By assessing the level of AM actually needed in any given situation, organizations can ensure that they match capabilities and investments in resources, technology, and talent to the specific needs on the ground. Likewise, organizations can recognize that needs can change in each and every aid situation—or even during a single mission. Even within a single crisis event, organizations may find that multiple approaches along the continuum may be needed, while in others, one will suffice. Thus, organizations can regularly assess and adjust their AM capabilities to meet current realities.

Train a sustainable workforce based on the level of need. Simply put, organizations cannot implement AM in humanitarian aid without trained workers on the ground who can use 3D printers—but the required skill set will depend on how AM will be used. For initial uses, such as printing a replacement part, workers may get by with a relatively basic skill set. As AM applications progress further along the aid continuum, individuals will need to possess deeper skills, such as manipulating designs to create customized parts, and designing new parts and goods.⁴¹ In order to create a sustainable approach that empowers locals, organizations should consider developing a team that is not only capable of implementing AM, but also training locals for long-term use.

Address and ensure quality at the appropriate levels. Quality assurance remains a crucial aspect of AM; parts need to work, and they need to work well enough.⁴² Organizations should consider what level of quality each part will need to obtain, based on its intended use, starting with production of a single, standard good as needed, all the way to a long-term, sustainable approach to AM and aid.⁴³ In some cases, basic functionality in the short term may be enough for an AM-produced object; for others, long-term use may be the goal.

Consider the technology requirements needed to operationalize AM aid delivery. As organizations spool up their AM use in the field, they can consider the technologies they will need to meet their objectives. At their most fundamental, these requirements can include a printer, power source, materials, and design file. As use of AM evolves along the continuum, technology needs might grow to include a design repository, additional material types and printers, complementary technologies including CNC machines and other manufacturing tools, and a data management system to enable organizations to continue improving upon and adjusting designs for future use—in short, a fully functioning digital thread.⁴⁴

AM technologies can have a profound impact on humanitarian challenges. The lessons can stretch far beyond simply serving immediate relief needs. The ripple effects of a customized, immediate response to aid can inform future humanitarian responses, enable more efficient and faster responses, evolve the supply chain—and create ongoing benefits, building skills that extend well beyond the immediacy of disaster toward sustainable growth and development. DR