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“With a torchlight, I can only see one patient at a time,” the midwife lamented. She said that without lighting for the whole room, she hadn’t recognized what was happening. “I would have looked for the source of bleeding, arranged for a blood transfusion…she didn’t have to die.”
When I first traveled to Northern Nigeria in 2008 to study the high rate of maternal mortality in state hospitals, I thought I’d encounter clinicians in need of medical advice. Instead, I found deplorable hospital conditions that impaired obstetric care. Among the challenges were the lack of clean water, equipment and supplies. But most glaring was the lack of reliable electricity. Without adequate power, health workers struggled to provide care. Nighttime deliveries were attended in near darkness, cesarean sections were cancelled or conducted by flashlight, and critically ill patients were sometimes turned away.
My solar educator husband, Hal Aronson, set about designing a stand-alone solar electric system that was easy to deploy, simple to use, and effective for medical settings. The result was a “Solar Suitcase,” a portable, rugged, complete solar electric kit packed with solar panels, a charge controller, batteries, medical LED lights, phone chargers, headlamps, and a fetal monitor.
Healthcare workers using the Solar Suitcase report greater facility and ease in conducting nighttime procedures. Improved lighting allows health workers to identify and treat complications such as obstetric lacerations and hemorrhage, nurses to locate and administer intravenous medication, and emergency Caesarean sections to be performed 24 hours a day. Solar-powered mobile phones allow on-call doctors to be alerted when obstetric emergencies require surgery. With augmentation, the solar suitcase powers blood bank refrigeration, permitting life-saving transfusions to occur without delay.
An estimated 358,000 maternal deaths occur worldwide. “The majority of maternal deaths occur during or immediately after childbirth,” states the 2011 United Nations Millennium Development Goals Report. Common medical causes include bleeding, high blood pressure, prolonged and obstructed labour, and infections. Although most obstetric complications are not predictable, the majority can be treated by skilled health providers. Reducing childbirth deaths depends, in part, on providing adequate emergency obstetric care. However, a lack of health facility power translates to an inability to perform life-saving care.
At Makarfi hospital in Nigeria, I interviewed another midwife who told me that a few days before my arrival the hospital had referred out a mother with obstructed labour. The woman needed a c/section and, as medical conditions go in Nigeria, the health care odds seemed to be in her favor – a surgical team was available and the operating room had equipment and supplies. But the public power supply was down, the generator was without fuel, and it was 8pm – too dark to operate. The midwife was forced to prepare the patient for a transfer to another hospital, 40 kilometers away. On the way to the hospital, the patient died.
When we installed two Solar Suitcases in her delivery room and operating theatre, she was elated. “We will never refer patients out of the hospital for c/sections,” she exclaimed. “Now I won’t have to work by candlelight,” another midwife said with relief. The Solar Suitcase provides hope for these health workers, and a chance to provide better care.
While so many of us take for granted that light is always available, it is painfully clear that much of the world does not have this luxury. “You have given us the greatest gift possible,” an operating room nurse explains, “and with this we will save many lives.”
Laura Stachel is an obstetrician-gynecologist and the Co-Founder and Executive Director of WE CARE Solar, a non-profit working to save maternal and newborn lives utilizing solar powered solutions. She holds an M.D. from University of California, San Francisco and an M.P.H. in Maternal and Child Health from University of California, Berkeley. Since 2008, she has been conducting research on maternal mortality in the developing world. Laura is the Associate Director of Emergency Obstetric Research in West Africa for the Bixby Center for Population Health and Sustainability and is conducting research in northern Nigeria. Laura co-chairs an international working group on Energy and Health for the UN Foundation.
Posted by Ken Banks of National Geographic Emerging Explorer