On a balmy Bangkok afternoon in March 2020, Professor Djitt Laowattana was sitting in his second-floor office in the Institute of Field Robotics (FIBO), watching the news out of Italy. Photos of doctors with faces marked from their masks spread across social media as the country rapidly became the epicenter of Europe’s Covid-19 outbreak. “I told my staff, stop what you’re doing and focus on this,” Laowattana told Rest of World. “I wanted to make sure the same thing doesn’t happen in Thailand.”
His concerns were correct. According to recent estimates by the International Council of Nurses, nearly half a million healthcare workers may have been infected by the virus. Thailand had already confirmed its first Covid-19 death by the end of February, and experts warned that the country could become the next Covid-19 hot spot in the region. Sensing the urgency, Laowattana, who is known as Thailand’s most prolific roboticist, asked his staff to drop working on the 20 or so prototypes they had in various stages in production and focus on helping him create an arsenal to fight what he called “the great virus war.” Together, Laowattana and his team of students and engineers created FIBO Against Covid-19 (FACO), a group of fully autonomous robots designed to protect doctors and nurses on the front lines of the pandemic.
Over the last 20 years, Laowattana has built nearly 300 types of robots for industries ranging from food processing to automobiles, half of which are still used today. His innovations have earned him the moniker “the Godfather of Thai Robotics.” His robots do everything from disinfecting rooms and delivering supplies to remotely monitoring patients’ temperatures and symptoms.
In hopes of rapidly scaling the use of these robots, Laowattana also added 5G connectivity, which will allow hospitals to add as many robots as they need without overloading their systems. “I don’t like the coronavirus,” said Laowattana, “but the pandemic is a fast-forward button.”
Since the pandemic began, hospitals around the world have adopted robots for everything from cleaning hospital wards to allowing patients to socialize with friends and family while quarantined. Recent estimates predict the medical robotics industry will quadruple to more than $24 billion by 2025, from around $6 billion in 2018. Thailand also faces a shortage of nurses, a problem that’s been exacerbated by the pandemic. Laowattana hopes his robots may be able to lighten their load and allow them to focus on more-critical tasks.
“The genie is out of the bottle,” Robin Murphy, a robotics professor at Texas A&M, told Rest of World. “It’ll get to a point where it’s not going to shock anyone that robots are wandering around a hospital.”
Thailand is keen to develop its medical robots. Last year, the government announced an eight-year tax break for manufacturers of medical robots and released statements encouraging hospitals to use medical robots. According to Laowattana, the virus came at a fortuitous moment.
After a month of blueprinting and prototyping, in early April, Laowattana introduced his arsenal to a select group of doctors from Thailand’s most prestigious teaching hospitals. He had two new robots.
The first was CARVER. Prototyped in FIBO’s headquarters and equipped with ultraviolet lights to disinfect wards as it moves, CARVER looks like a giant Roomba dressed for a rave. The robot’s 18 shelves also help carry medicine and other essential supplies to Covid-19 patients. Laowattana hoped CARVER would reduce the amount of exposure for nurses commonly assigned to routine but high-risk tasks.
The crown jewel of Laowattana’s arsenal, however, was SOFA: a 150-centimeter-tall humanoid with a conical lower half that gives it a feminized appearance. Its placid blue and white tones and three protruding high-tech cameras make it look both dainty and unsettling. One camera helps tell a patient’s temperature, while another is used for video conferencing. On its chest, a third high-definition magnifying camera allows doctors to examine a patient’s tongue or eyes without ever having to leave their offices. Like CARVER, SOFA can also be programmed to roam autonomously or controlled from afar.
While most telepresence robots help doctors consult with patients remotely, SOFA’s decked-out sensors also allow doctors to monitor a patient’s vitals. “When the crisis started, we didn’t have any solutions to help us examine patients from afar,” Dr. Sithakom Phusanti, deputy director at Chakri Naruebodindra Medical Institute in Bangkok, told Rest of World. Doctors at Phusanti’s hospital are among the first in Thailand to be able to examine patients in their Covid-19 ward from the comfort of their offices.
According to a study conducted by the University of Edinburgh, hospitals have traditionally been reluctant to introduce robotics in large part due to fears of worker displacement and the negative connotations of robots for healthcare workers and patients alike. To quell some of these anxieties, Laowattana stressed that SOFA isn’t here to take their jobs. His robots have no diagnostic abilities, and when interacting with patients, a doctor is always in the cockpit.
Designing robots to interact with patients also comes with its own set of challenges. While doctors can adopt a good bedside manner when dealing with vulnerable patients, giving a robot the appearance of congeniality requires both design and cultural considerations.
Laowattana created SOFA by redesigning a prototype of a greeting bot for one of Bangkok’s luxury malls. He thought its tiny stature and childlike appearance would help disarm otherwise vulnerable patients. He even tweaked SOFA to operate at 10% of its original speed.
“In Thailand, going fast doesn’t convey good meaning. It’s impolite,” he says. When roaming the wards, SOFA projects two baby-blue eyes and a pixelated smile on a small screen, though it can show a range of positive emotions, from surprise to love. A second screen sits on its waist, allowing doctors to remotely share a patient’s medical records. Its jointed arms and fingers serve no medical purpose, but according to Laowattana, patients would rather communicate with something that looks like themselves. When interacting with patients, SOFA replaces its digital smile with a video of the controlling doctor, reminding patients that a human is still in the driver’s seat.
SOFA robots have become something of a national treasure in Thailand. They have even earned a nickname from the country’s princess: “Mod Borirkasa,” or “Guardian Ant.”
There are also consequences for culturally inadequate design. In 2018, Bangkok’s Mongkutwattana General Hospital met with internet infamy after photos of its robots’ glowing red eyes spread across the web. Purchased from a manufacturer in China, where red is considered an auspicious color, the robots were perceived as menacing in Thailand. “People would joke, if they bring you to our hospital late at night, you better run away,” a doctor who worked at the hospital told Rest of World.
Despite their initial hesitance, doctors and nurses at his hospital have responded positively to their new mechanical colleagues, according to Phusanti: “They believe the system can help prevent viral transmission.” So far, none of Phusanti’s staff has been infected by the virus.
But while some doctors have been happy to adopt robotics in the wake of Covid-19, others have said the robots, at their $100,000 price tag, may be untenable for many Thai hospitals. A number of hospitals use cheaper, Chinese-produced robots, in part because they are able to receive them at low costs.
To address this concern, Laowattana has advocated for hospitals to obtain funding from the Thai government to purchase robots throughout the pandemic. While 40 have expressed interest in procuring them — pending government funding — bureaucratic delays have meant that only three hospitals have received the robots so far. The rest are still awaiting their funds to be approved.
Scaling the operation during a pandemic has also proven difficult, as parts have to be sourced from China and Europe. While FIBO was able to make the robots for three hospitals in-house, the institute partnered with Thailand’s Automation and Robotics Association (TARA), a consortium of industrial robotics manufacturers, to build more robots. But due to the pandemic, some essential parts have taken nearly three times longer to arrive. While Laowattana hoped to have the robots in eight more hospitals by the end of the month, such sourcing issues mean they may have to wait even longer.
For now, Thailand has successfully contained the virus. As far as his robots go, Laowattana sees their role expanding to treating other infectious patients, like those suffering from tuberculosis.
Two decades ago, Laowattana was considered a fringe scientist by his peers. But the pandemic has been a bittersweet validation of his life’s work. “I used to tell people that automation will happen over the next five years,” he said, “but today I tell people, it needs to happen now.”