Saving Lives in the Dark?

By: Logan Nagel, Associate Board Member, Green Empowerment

How many of an average day’s tasks and to-dos would you have to miss, if you lost access to electricity? Now imagine that your job was as a healthcare provider, delivering crucial medical care to an entire village? And how much would things change for you and your community if you finally received consistent access to electricity?

The Scope of the Problem

Almost a billion people globally receive healthcare from clinics that lack consistent access to electricity, if it is available at all. Every aspect of medical care is rendered difficult or impossible by the lack of electricity. Without refrigeration, vaccines go bad. Without power, life-saving equipment such as ventilators don’t work. Even something as simple as providing lighting for clinic staff becomes a matter of candlelight or using kerosene lamps. According to a recent study, health centers without electricity access see 64% lower rates of infant delivery, 39% fewer inpatients cared for, and 38% fewer outpatients. These challenges are literally a matter of life and death.

Under-electrification of health clinics was also a target issue for Green Empowerment in 2022. With Green Empowerment’s support, local project partners installed renewable solar energy generation systems at eight clinics in Myanmar and three in Uganda. Thanks to the collaboration, over 70,000 people in two different countries can now count on reliable energy access to keep their vaccines cold, power vital medical devices, and simply keep the clinic lights on at night.

How Was It Done?

Electrifying health clinics in regions where power delivery is far from guaranteed, and where instability is a fact of life, has many challenges. Green Empowerment’s involvement manifested in several forms, by helping healthcare providers identify their electrification priorities, by training community members to operate and maintain the equipment, and then by providing an ongoing energy monitoring capability.

The Dream Tool

One of Green Empowerment’s biggest contributions was the development of the Decision Response Energy Assessment Management (DREAM) tool. DREAM is a framework and methodology that allows organizations and their stakeholders to make decisions on which clinics in a region to prioritize for electrification, based on costs, needs, and the practicalities of project delivery. It relies on data collection from stakeholders, performed via an app that medical staff can access on their phones, followed by the organized development of priority ranking criteria and finally the use of dashboards to visualize the results and inform good decision making.

“It helps Green Empowerment and the partner to prioritize the energy needs that clinics have. It can also help design the system itself.”

Benaville Nagudi, Green Empowerment’s Uganda Program Coordinator, who has been closely involved in the healthcare electrification projects in the country.

Because the tool includes estimates of average power use and hours of use per day, for a wide range of medical devices. The DREAM tool does all this without the need for solar experts to visit these remote clinics, because medical staff without specialized technical knowledge are able to complete the survey themselves.

Local Solutions, Local Staff

Beyond informing clinic needs, Green Empowerment’s projects support medical staff at every step of the process, helping ensure adoption and long-term sustainability of the systems. Take for example the projects Green Empowerment executed in the Dooplaya and Hpa-An districts of Karen State, Myanmar. The clinics there were outfitted with a mix of 690-watt solar systems for general use and 1,380-watt systems implemented to power the refrigerators and freezers necessary to keep critical vaccines and medicines stable.

When it came time to actually install the systems, training and support was the name of the game:

“Instead of our partner the Border Green Energy Team (BGET) going to each clinic for the installation, they trained 17 medical staff from these clinics and spent two or three days together instructing them on everything, from how solar panels work and the foundation of renewable energy to ongoing operation and maintenance practices. They installed one full system together during the training, as well.”

Geo Corneby, Southeast Asia Program Director with Green Empowerment and one of the project staff involved in the Myanmar projects.

By collaborating and empowering community members themselves to operate and maintain the solar power systems, Green Empowerment is able to boost community ownership and system resilience for the long haul. 

The results speak for themselves. One month after the training all eight clinics had fully installed their solar systems and are now providing higher quality care for more hours each day. Plus, for the patients and workers who spend time in the clinic buildings, the days are both better-lit and healthier, too. “You no longer have to inhale the exhaust coming from diesel generators,” Geo said.

Monitoring for Longevity

In Uganda, Benaville explained that one of the most important parts of the projects she has worked on is the digital monitoring tool that allows staff to diagnose problems or track use of energy from anywhere. “You just need your phone and you can see if it is functioning properly or if there is a breakdown. Tracking performance and keeping on top of problems within the system has always been an operational and maintenance hiccup for us,” she said. Also, she explained, the monitoring tool allows for demand monitoring over time, giving clinic staff visibility into where energy is going. Data visibility is a critical component for sustainable operations and future improvement.

Partnerships to Overcome Adversity

Working with limited resources is a challenge, and there’s an extra level of difficulty when you consider the backdrop of these projects: logistical challenges stemming largely from the ongoing impacts of COVID-19, and ongoing political and critical security concerns.

In Myanmar political persecution and increasing authoritarianism since the 2021 military coup threatens the clinics we partner with. In Uganda, two of the clinics are located along the border with South Sudan and are expecting an influx of refugees given the recent escalation of conflict in the region. It’s in navigating these challenges that the strength of Green Empowerment’s partnership model becomes the most clear.

“Even in an unstable situation, you don’t know if a solar panel is going to get confiscated or if a clinic will have bombings or physical threats, people need healthcare.”

Geo Corneby

Through working with local partners, Green Empowerment is often able to continue projects even in extremely adverse circumstances, when other NGOs are pulling their staff out of the region. Now that these clinics have their own renewable energy sources and local staff are trained to maintain the systems, providing healthcare should be a little easier, more sustainable, and perhaps most importantly, accessible for the communities in Myanmar and Uganda.

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