COOL! VR Goes to Kabale Hospital, Uganda

Torin Lucas, Firsthand Advisor (UK)
May, 2017

The invitation to collaborate with an African University really came out of the blue. Like most us in the West, Africa paints a picture for me. It conjures up a leafy jungle imagery interrupted by fantastic hopscotch steps over crocodile heads bobbing like foot stones across a lagoon. I have a collection of family photographs taken during the Ugandan civil war when my parents were doctors attached to a Canadian Aid mission.  I have one favourite photo with me and my mum and a few African friends. I was a baby.  There was a war. This was Africa. Parents did that sort of thing back then. It was the 70s!

I received a late night email from my Father around Christmas to say that he’s going back to Uganda. With all the jungle adventure imagery floating in my mind I replied to the email to say, “I’m coming”.

I was put in touch with Jones Murangira, head of IT at the University.  Jones and I quickly saw the potential of my bringing the bag of skills that I’ve assembled over the years in technology management and developing university curriculum. We drafted a quick agreement and arranged with the Chancellor to sponsor my collaborative visit. It was set. I was going and I was very nervous. My main concern was the potential of becoming swamped by the sheer magnitude of the challenges I was likely to face. The leafy jungle imagery was fast being replaced by dreams of out-stretched hands.

But together Jones and I had developed a solid plan. I was being asked to provide technical consultation for the development and training of computer assisted teaching, use of e-learning and the development of computer literacy curriculum for the University’s graduate Communication program. But my other mission was to introduce Firsthand Technology and VR pain relief. My Father’s work in the anaesthesia department and my work with IT made a really perfect storm – you might call it a VR storm.

I landed late at night in Rwanda in a prop plane with a backpack full of computer equipment. You might be thinking, not my idea of a safe holiday. I found Milton the taxi driver waiting outside waving a cardboard sign with the words ‘Torin Lucas’. This was a very good sign. If anyone were to ask now whether I’d recommend Milton to trust with their life to drive over the Virunga Volcanic Mountain range in the dead of night I’d say, “Yes sure. Why not? Milton is trustworthy, helpful, speaks Rwandan, Rukiga and passable English, and definitely drives straighter on the left-hand side of the road (on the Ugandan side of the border).

In the light of day, Uganda was full of color, very welcoming, and yes has lots of need and want. But somehow what I was able to accomplish made a difference. I quickly came to learn that while there is suffering and want, challenges that make simple tasks difficult, actually making a contribution is quite easy. This is the wonderful thing. And technologies such as the Firsthand approach to pain will have a way of leapfrogging the people of Africa forward quite quickly. It’s exciting. And it was obvious to me that the members of the IT department were delighted by the experience of exploring the VR environment. They were quick to see its potential and both willing and keen to see it introduced to the doctors on the Medical side of the University.

The current health care situation in Uganda and throughout Central Africa remains rudimentary and physician anaesthetists are scarce and simply not available at first referral level health facilities. In fact, according to the World Health Organization Dr. Henry Bukwira is one of only thirteen anaesthetists (excluding expatriates) in the country of 27 million people. In comparison, in the United Kingdom of Great Britain and Northern Ireland there are 12,000 physician anaesthetists for a population of 64 million. These are stark numbers making any alternatives to traditional medical solutions essential. One approach to meeting the overwhelming need is training anaesthetic nurses. A focussed vocational approach to training nurses has achieved good success through Dr. Bukwira’s work, first during his time in Rwanda, and now through the new anaesthetics nurses program at Kabale University.

In this context, any serious non-drug approach to pain remediation like the Firsthand ‘Cool’ intervention holds a very promising alternative to acute pain management. The needs are  obvious and despite the many logistical challenges, the potential here for creating a positive lasting contribution through this technology is very exciting.

Torin gives Dr. Jones Murangira his first VR experience – and his first experience of snow!

While the positive potentials presented by the Firsthand solution are clear, the logistical and cultural challenges remain. This would include reliable access to power outlets and perennial power outages – especially problematic during the rains. Power outages are a problem throughout Uganda, but are minimized in some cases with the use of battery-bank backups. Computer literacy is also a real challenge making the administration of a multimedia equipped computer and VR technologies a technical support challenge. On the cultural side, the representation of snow within the ‘Cool’ simulation, while indicative of coolness to many of us, is not necessarily familiar to a Central African –  yes, many will simply never has seen or felt snow. This seems obvious to me now, but I have my own entrenched Western perspective. It’s great when Africa knocks your assumptions like that! The rendering of a 3D environment is also a novelty for many Africans whose exposure to mediated computer environments may not extend beyond their mobile handsets. Neither of these cultural aspects necessarily minimize the effect of the VR experience and its potential from a clinical point of view, but the cultural divide certainly made for an amusing challenge that everyone could laugh about.

There’s a sense of movement forward. There’s an accelerating growth in Uganda and you can feel it. The growth of mobile technologies in particular will allow this country to leapfrog infrastructure what took the West many decades to develop. Opportunities are growing and there’s a vast well of optimism, among the youthful population especially. Life is not mediated here through a device or a technical support call.  That was a strong, lasting impression for me. People talk to one another. Solutions are found through collaboration. They reach out to involve those who are ready to help. The needs are so great, it’s hard not to make a positive impact. We will bring Firsthand technologies to Africa, because we can. And the Ugandans themselves are ready for it with open arms.

– Torin

Firsthand VR Joins The National Theatre for Ugly Lies The Bone – Press Release

March 1, 2017



Available in the National Theatre’s Lyttelton Lounge for an hour after Ugly Lies the Bone Performances

UGLY LIES THE BONE, a new play by US playwright Lindsey Ferrentino, makes its European premiere in the Lyttelton Theatre tonight and runs until 6 June. The production examines the use of virtual reality in treating soldiers experiencing PTSD.

‘Beauty is but skin deep, Ugly Lies the Bone; beauty dies and fades away, but ugly holds its own.’

Jess, a soldier returning home to Florida after three tours in Afghanistan, experiments with a pioneering virtual reality therapy. She builds a breath-taking new world where she can escape her pain. There, she begins to restore her relationships, her life and, slowly, herself.

Thanks to a unique partnership between Firsthand and the National Theatre’s Immersive Storytelling Studio, with technical partner HTC Vive, audiences can experience COOL!, a VR Pain Control Therapy similar to that which Jess experiences in Ugly Lies the Bone in an immersive installation front of house after performances. Firsthand has been working at the forefront of VR pain research for many years, collaborating with leading scientists including Dr. Hunter Hoffman, Dr. David Patterson, and Dr. Thomas Furness to create SnowWorld, the VR pain control therapy which inspired Ferrentino’s play Ugly Lies the Bone.

Studies show that VR can provide effective pain relief, often better than drugs, and immersion is the key to that relief. In experimental trials with SnowWorld it was typical for at least 60% of patients to experience a more than 30% reduction in pain. Comparatively, a dose of morphine is often calibrated to reduce pain by 25%. The more that people feel that they are present in a virtual world; the further it takes them from their pain.

Peter Frolund, Vice President of VR (Europe) at HTC said: ‘Jess’s story in Ugly Lies the Bone is really powerful and it is a brilliant way of showcasing some of the amazing things that people are using Vive for right now. It is important that people realise that VR can be and is already used for so many purposes other than gaming. Whether that is in medicine, treatment of PTSD or education, we want people to broaden their horizons and make the most of VR to improve and enrich lives.’

The full cast of Ugly Lies the Bone is Kate Fleetwood (last seen at the NT in King Lear and in the feature film London Road), Ralf Little (BBC’s The Royle Family, Two Pints of Lager and a Packet of Crisps and most recently Dead Funny at the Vaudeville Theatre, making his NT debut), Kris Marshall (BBC’s My Family and the feature film Love Actually), Buffy Davis (BBC Radio 4’s The Archers) and Olivia Darnley who recently toured in Filter Theatre’s Twelfth Night.

Award winning playwright Lindsey Ferrentino’s honest and funny drama was a New York Times Critic’s Pick and played a sold-out run at Roundabout Theater Company. This UK production is directed by Indhu Rubasingham, who last year directed the award-winning ‘The Motherf**ker with the Hat’ at the NT and is Artistic Director of the Tricycle Theatre. Set design is by Es Devlin whose work crosses a wide range of genres: opera, dance, film, theatre, concerts and fashion. Her recent work includes Light Shining in Buckinghamshire at the NT and stage sets in collaboration with Beyoncé, Kanye West, U2, Jay Z and Adele. She designed the London Olympic Closing Ceremony and the Rio Olympic Opening Ceremony; video design is by Luke Halls; costume design by Johanna Coe; lighting design by Oliver Fenwick; music and sound by Ben and Max Ringham; and fight direction by Rachel Brown-Williams and Ruth Cooper-Brown of RC-Annie Ltd.


COOL! A free, immersive installation Available in the Lyttelton Lounge at the National Theatre for an hour following Ugly Lies the Bone performances. For performance schedule, click here. Images of Cool here. 




For the National Theatre: Emma Hardy 020 7452 3231 /

For Firsthand: Howard Rose +1 415 877-4773 Notes to Editors


About Firsthand

Firsthand Technology has been working at the forefront of VR pain research for over 20 years, in collaboration with leading scientists to create VR pain control therapy. They are creators of SnowWorld and VR PTSD therapy that inspired the Lindsey Ferrentino to create ULTB.

Firsthand’s evidence-based approach maximizes VR’s high-bandwidth channel to the brain to deliver adaptive, clinically validated solutions for a wide range of health conditions, inspire healthy lifestyles and increase treatment regimen adherence.

Decades of studies underlie Firsthand’s solutions. Our VR applications, like COOL! and GLOW!, maximize VR’s mechanisms of action for health: immersion, interaction, sensory engagement and mental focus. In a recent study with chronic pain patients using Firsthand’s COOL!, patients reported 60-70% pain reduction during treatment, with benefits lasting up to 48 hours post treatment. The company is releasing additional applications for: post-operative recovery, anxiety/stress, flare-ups, PTSD, addiction and other conditions.

About VIVE

VIVE is a first-of-its-kind virtual reality platform developed by HTC and Valve for total immersion in virtual worlds. Designed from the ground up for room-scale VR and true-to-life interactions, VIVE delivers on the promise of VR with game-changing technology and best-in-class content. VIVE has been recognised with over 65 awards and wide critical acclaim since its unveiling in 2015. For more information, visit

 About HTC

HTC Corporation aims to bring brilliance to life. As a global innovator in smart mobile devices and technology, HTC has produced award-winning products and industry firsts since its inception in 1997, including the critically acclaimed HTC One and HTC Desire lines of smartphones. The pursuit of brilliance is at the heart of everything we do, inspiring best-in-class design and game-changing mobile and virtual reality experiences for consumers around the world. HTC is listed on the Taiwan Stock Exchange (TWSE: 2498). 

About the NT’s Immersive Storytelling Studio

The National Theatre’s Immersive Storytelling Studio examines how Virtual Reality (VR), 360⁰ film, augmented reality and other emerging technologies can widen and enhance the NT’s remit to be a pioneer of dramatic storytelling and to ‘enable an audience to stand in the shoes of another’. The studio forms part of the National Theatre’s New Work Department, in collaboration with the NT’s Digital Development Team.


 About the National Theatre

The National Theatre is dedicated to making the very best theatre and sharing it with as many people as possible. We produce productions on the South Bank in London each year, ranging from reimagined classics to modern masterpieces and new work by contemporary writers and theatremakers. The National’s work is seen on tour throughout the UK, in London’s West End, internationally (including on Broadway) and in collaborations and coproductions with theatres across the country. Across 2015-2016, the NT staged 34 productions and gave 3,134 performances in the UK and internationally. The NT’s award-winning programme had a UK audience of 2.5 million, 700,000 of which were NT Live audiences.

The Clore Learning Centre at the NT is committed to providing programmes for schools, young people, families, community groups and adult learners, including the nationwide youth theatre festival Connections and playwriting competition New Views. In 2015-2016, we engaged with over 181,000 participants through the NT Learning events programme. Further, over 2,200 secondary schools have signed up to the free streaming service, On Demand in Schools since its launch in September 2015. @nationaltheatre @NT_PressOffice



The Impact of Virtual Reality on Chronic Pain

Focus Forward: In Your Head

Can virtual reality control chronic pain? Dr. Diane Gromala and DeepStream VR are mixing virtual reality with biofeedback and mindful meditation to deliver a powerful cocktail alternative to opioids – called the human mind.

Wounded Soldier Uses VR To Ease Pain

Watch Lt. Sam Brown’s Inspirational Story

After being severely injured in Afghanistan by an IED, Lt. Samuel Brown found himself in a Texas hospital facing a long, painful recovery.  But things started to change when Sam began using the virtual reality game, SnowWorld, developed by Dr. Hunter Hoffman and Firsthand’s founders. SnowWorld helped Sam escape the pain of treatment and physical therapy. Sam’s doctors even found that VR was more effective and better for Sam than using morphine.

The Biggest and Boldest at Fortune Brainstorm Health

“Entrepreneur Arianna Huffington took a trip inside virtual reality and learned how the immersive tech can help ease physical pain. Howard Rose, CEO of DeepStream VR, had Huffington place her left hand into an ice bucket; the minute-long bath proved a painful experience. But when she dipped her hand again in the chilly water, this time donning a VR headset and playing a game, she barely felt any discomfort. “That was amazing,” Huffington said. —”

Fortune Magazine: Report from Brainstorm Health Conference

Hey, Howard here. It’s not every day that I get the chance to inflict pain on celebrities in the name of science, especially not ones as charming and affable as Arianna Huffington. Thanks to Fortune Magazine, I got this rare chance to do just that, on stage in front of a room full of top thought leaders from across the healthcare arena. The Fortune Brainstorm Health conference was an exceptional gathering that illuminated the huge challenges and the fantastic opportunities we face to keep this planet alive and healthy.


But you don’t want to hear about that, you want to hear about the ice bucket.


It was cold. Very cold.

Arianna toughed it out for 60- seconds…and rated her pain a SIX on a scale of ZERO to TEN.

While warming up her hand for round two, we chatted about Arianna’s new company, Thrive Global. Arianna also offered to take our VR show on the road. We are definitely following up with her on that, so stay tuned.

For Round 2, Arianna put on the VR helmet and dove into our VR game, COOL!

She was off and running before I could get the helmet all the way on her.

Then the hand back in the ice water. My part was painless giving the play by play to the audience.

After leaving her to chill for a good minute, Huffington emerged saying “That was amazing,”  Her pain went from a SIX in round 1 down to a TWO. Two-thirds less pain with VR than without. And she really looked like she could have stayed in COOL! chasing otters all day.

So there you have it. That was my day at work last week. But the story isn’t over…

Thank you so much, Arianna, for playing along, and braving the cold in the name of health and wellness.

Virtually Yours,


VR Healthcare Innovation – Ari Hollander

KEYNOTE: Ari Hollander, CTO, gives a well received keynote to technology professionals at the GWATA Innovations Awards. Watch at YouTube 

Reprogramming Your Brain

Ari Hollander speaking at the MIT Enterprise Forum Northwest tells a story about how VR can be used to change the way the brain works.  This is an example of the vast potential for using the sensory system for “white hat hacking” our brains to help fix problems caused by disease or injury.

See more of this exploration of The Future of Fun on the MIT Enterprise Forum’s site.