Mission to Mars: The healthcare challenges facing NASA

At the Space Health Innovation Conference on Saturday, NASA scientists, astronauts and partners discussed the future of space health.
By Laura Lovett
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Photo by NASA/Getty Images

Mars — it’s the subject of countless science fiction novels and has long been a fascination amongst us earthlings. Today NASA is setting its sights on making a human Mars landing a reality within the next two decades. Located on average 140 million miles away from Earth, distance is just one obstacle in sending humans to the red planet.

Maintaining the health of the astronauts venturing to Mars is another major challenge scientists and researchers are grappling with today. However, the advancements and technologies that come from these challenges could have implications for future healthcare.

“When you think about it, it’s really for humans exploring deep space on behalf of all of humanity. Everything that we do creates a new way to do healthcare,” Dorit Donoviel, director at Translational Research Institute for Space Health, said at the Space Health Innovation Conference on Saturday.

Historically, space exploration has led to medical advances that impact the world in general. In particular, space travel has allowed researchers to look at the effects of aging on the human body.

“What we learn about space health is relevant to you and I, especially as we age. So, aging on Earth is not that unlike going to space for a long period of time,” former NASA astronaut and Professor of Mechanical and Aerospace Engineering at UC Davis Stephen Robinson told HIMSS Media. “That gives us potential for insights that can really influence everyone here on Earth.”

Robinson gave the example of osteoporosis. In space, astronauts are at a higher risk for losing mass in their bones “in a process similar to osteoporosis.”

“If we can learn to counteract that in space for people who are experiencing that onset very rapidly, maybe we can take that back to Earth for the rest of us,” he said.

One giant leap

Traveling to Mars poses a new set of health challenges for NASA. For one, the planet is further than any to which humans have traveled before. Unlike other missions, due to the orbital mechanics of the journey, astronauts won’t be able to come home if there is a health emergency.

“So, the round trip to mars is nearly three years, and maybe one of [the crew] will be a physician and they are going to have to contend over that long duration mission far away from Earth without any possibility of return or abort, or any ways of replacing broken parts with normal health concerns,” Donoviel said.

Far away from Earth the stakes are high. Common conditions can have devastating impacts.  

“Having a simple kidney stone in space for example can be life threatening,” Donoviel said. “In addition to those regular concerns that could occur in that mission, we are going to have the extremely hostile environment of the space environment and the craft. So, we are going to have to contend with situations where they are going to have to provide their own healthcare.”

The challenges aren’t just physical strain on the body, but psychological and social. The crew going to Mars will spend three years in a tight space with less than a handful of companions.

“How do you relieve that concept of, I can’t have those things I had before? I have no access to that, and maybe you haven’t even anticipated how that confinement was going to affect you,” Jennifer Fogarty, chief scientist at the NASA Human Research Program, said during the conference. “How do you give people self-awareness when they are going down a road where they are going to struggle, and then have tools available when it is actionable that can help them? … It could be virtual reality, it could be augmented reality.”

While crews generally have a physician on board during the mission, if the doctor needs care it will be the rest of the crew, predominantly engineers, who will have to step up.

“We know we need something in the vehicle, and we know we need something on the ground, and we know it has to talk to each other. We know that [during the] Mars mission, we don’t get to bring anyone back,” Erik Antonsen, assistant director of human systems risk management at NASA and an emergency medicine physician, said at the conference. “So all we have the option to do is to move knowledge, not people. We have to figure out how to enable those data systems to provide that knowledge or capability that support in an appropriate way if we want to enable something like a Mars mission.”

But implementing technologies like telemedicine and remote monitoring is easier said than done. In Mars there is no cloud network or WiFi. There is a deep space network, but technologies will have to be built specifically to work within it.

Onboarding new technologies is also a risk for crews with limited space.

“There is a lot of talk about 3D printing. Sure, it’s possible — but again that is going to be measured against resources such as food and water,” Fogarty said. “You start seeing trade-offs.”

NASA is also looking at a number of other niche issues that will likely impact the crew's health, including radiation, hostile closed environments and altered gravity fields.

The right gear

While there are countless challenges that come with putting humans on Mars, NASA is partnering with innovation organizations and reaching out to entrepreneurs to problem solve.

“So what kinds of solutions do we need? No doubt autonomous, light, lean, robust,” Fogarty said.

One of the organizations that NASA is partnering with is the Translational Research Institute for Space Health (TRISH), a consortium which includes the Baylor College of Medicine, California Institute of Technology and Massachusetts Institute of Technology. The program is focused on translating biomedical research and technology into space health. 

“TRISH is designed to go do cutting-edge stuff. High risk — fail fast, fail often, running it through, see[ing] what they need,” Fogarty said.

Due to the limited space, by the time any technology makes it into a mission it needs to be heavily vetted.

“When you go into a space flight vehicle, that is not where you need to be cutting edge. That is a very scary thing because you don’t have the data to support it,” Fogarty said. “You may not be able to fix it, and now that thing you chose to take instead of more water gives you a zero. That is really a worst-case scenario from a NASA perspective for how you plan missions.”

Fogarty said that in many ways NASA is looking at challenges that are similar to those facing home health.

“We have a lot in common with home healthcare — untrained people that aren’t going to have real-time communication to operate a device,” Fogarty said. “Can they do it? Are your instructions good enough and easy enough? Is your user interface friendly enough so that person could operate that without mission control and 40 people helping you with a procedure? So definitely we are continuing to push on it.”

But unlike on Earth where room is plentiful, innovators need to consider space configurations.

“It is really great that we can develop 50, 60, 100 point-of-care devices and they are all using different techniques and different reagents. Guess what — somehow in space flight you got to bring that down to probably one item,” Fogarty said.

There remains a lot of work to be done before the first person steps onto Mars. But the groundwork is rolling and the mission has the potential to change the future of humans.

“We may need to leave this planet and how do we learn? This is one of the stepping stones,” Fogarty said. “It may not be Mars where we are going to go and colonize permanently — we’ll learn though. These are really amazing opportunities.”