Powering Health Care with Solar
By Audrey Desiderato, cofounder and COO
In Tanzania, it is estimated that less than 30% of healthcare facilities are electrified. The strong linkages between energy and healthcare are obvious. Access to energy means access to improved health care since energy is a requirement for lighting, machine operation, refrigeration, communication, safety, etc. The impact is particularly felt by women. Imagine a midwife in a rural clinic delivering a baby while trying to hold up her cellphone for light. In Malawi, a doctor told me that women are advised to bring 3 candles when arriving at the clinic to give birth--incase this takes place at night.
If you’re more into data than stories, then here are a couple:
On a global scale 44% of the 6.3 million child deaths every year occur due to neonatal issues.
In Sub-Saharan Africa, a woman’s risk of dying from treatable or preventable complications of pregnancy and childbirth over the course of her lifetime is 1 in 38 compared to 1 in 7,300 in developed regions. Example complications include hemorrhage, infection, eclampsia, and obstructed labor.
Last week in Dar Es Salaam, during the UN Foundation’s conference on Powering Healthcare, I met a few practitioners offering solutions. For example, Laura Stachtel, a doctor who identified the critical energy need while working at hospitals in Nigeria, developed The Solar Suitcase with her solar engineer husband and founded We Care Solar. Laura shared with us her experience of working in a hospital in Nigeria. The hospital, while connected to the grid, had electricity for less than 12 hours per day. In times of distress, communicating and finding doctors becomes an issue due to uncharged cellphones. A donated ultra sound machine sat unused in a corner. Patients requiring a blood transfusion arrive with their own source, typically a family member, in hopes that their blood types match. Laura and her team installed a solar system at this hospital. Within a week, maternal death rates dropped by 70%.
Today, the Solar Suitcase, which costs $1,645, is a complete system that includes high-efficiency LED medical task lighting, a universal cellphone charger, a battery charger for AAA or AA batteries, and outlets for 12V DC devices. The basic system comes with 40 or 80 watts of solar panels, and a 14 amp-hour sealed lead-acid battery to power mobile communication, laptop computers and small medical devices such as a fetal Doppler. The maternity kit comes with a fetal Doppler. It is designed to support timely and efficient emergency obstetric care in a range of medical and humanitarian settings.
Photo credit: We Care Solar
For large facilities, a health center’s needs hierarchy is as follows:
Lighting (particularly task lighting)
Refrigeration (However the need for battery replacement poses a challenge)
Sterilization (not possible with solar off grid)
So how does one decide whether to meet these by connecting a center to the grid, or answering to these needs through a solar system? While the grid should be the long term answer, immediate solutions are needed. This study suggests that using cost considerations, a health center less than 5km from the grid should be connected. As you can imagine, this is still subject to debate as it’s not just about being on or off-grid, but as the Nigerian example demonstrates, grid reliability is just as much of an issue.
While there is some donor money being directed at powering health centers with renewables, the current procurement-driven approach is ineffective. It is estimated that almost 50% of the off-grid health centers with solar systems are either not working or working poorly. Companies bid for tenders, install the systems, and then leave. In few cases are there O&M contracts are budgets to replace batteries. This isn’t just a waste of money but it can also spoil the market. Neha Misra from Solar Sister pointed out to me that in many rural communities, a solar system on an institution like a hospital or school is the communities’ first contact with solar technology. When they see these systems fail after just a few years, their trust falls with it.
Guaranteeing health, as a public good and human right, belongs to the state. But when these current approaches fail (and dare I say, mismanagement of public funds by certain ministries occurs), to what extent can businesses step in to power health care? Solar entrepreneurs call for shifting the paradigm away from procurement (i.e., deliver equipment, walk away) to a more business oriented model (i.e., only pay for services that work). For instance, Great Lakes Energy currently builds and maintains solar home systems at health facilities in Rwanda. If the system isn’t working under the company’s watch, the company will pay the clinic a penalty fee rather than receive its monthly O&M payment. In addition, it is applying entrepreneurial innovation to address the uniqueness of a health facilities’ energy needs. GLE is combining hardware with software that can be integrated into any system to ensure high-quality remote monitoring and communication with clinic staff to preempt misusage and optimize the systems that are on loan management.
A few initiatives were discussed during the conference to strengthen primary healthcare through solar energy and innovative business models. While not commercially viable (and scalability still needs to be tested), they offer hints at what an improved paradigm might look like:
Cordaid Health Investment Fund in Rwanda and Burundi works through a solar lease model to promote business modeling within each clinic and ensure maintenance of the solar system.
Philips Community Life Centre uses the health center as an Anchor tenant, selling excess supply to neighbouring businesses. The extra income, they hope, will help support operational costs.
Koko Medical Facility, health clinic maintained by Great Lakes Energy in Rwanda. (Photo by Sameer Halai/SunFunder)
Lastly, I invite you to tweet me your comments topic of solar and health care at @sunfunder. Thank you!