WE CARE Solar

Birthday Reflections

Laura Stachel — Mon, 20 Feb 2012 04:43:01 +0000

It’s my birthday – a chance for reflection.

Three years ago at the same time of year, I faced a major challenge – how to install a solar electric system in a state hospital in Nigeria. My hospital research the year prior had alerted me to the fact that sporadic and unreliable electricity was a major impediment to the delivery of safe obstetric care. I had watched helplessly as critically ill mothers were turned away from the hospital when the labor room was without lights, the operating room was powerless, and when the laboratory had no refrigerated blood products for emergency transfusions. My husband, Hal Aronson, had come up with a solution –four large stand-alone solar electric systems targeting maternal health care in the hospital. But translating design into action from the other side of the world was a formidable challenge. We surveyed the hospital power needs, researched and interviewed solar installers in Africa, created a portable solar electric demonstration kit to our Nigerian colleagues, and picked out most of the electrical supplies we wanted to install. However, we struggled to raise sufficient funds for the task. We were at an impasse.

My birthday was approaching….and it occurred to me that I could use the occasion to put on a WE CARE Solar fundraiser. With the help of a talented UC Berkeley medical student who assembled musicians and dancers, we put on a wonderful event. We showed slides of Nigeria, danced to African music, and raised funds and excitement about the hospital solar project. Soon we were back on track – and a month later the state hospital had solar lights, power, and a new blood bank refrigerator.

Three years have ensued, and I never could have imagined how events would unfold. Our first solar installation resulted in a marked drop in maternal deaths at the hospital, sparking requests for solar electricity from surrounding health facilities. Hal refined his design of a suitcase-sized solar electric system, and assembly of these portable solar kits became a popular activity for engineering students from around the country. With scores of volunteer support, our Solar Suitcases made their way to clinics in Nigeria, Rwanda, Uganda, Haiti, Burma, and other nations. Brent Moellenberg, a wonderful engineer, joined Hal to design a Solar Suitcase that could be manufactured at scale. By the end of 2011, the Solar Suitcase had been placed in health facilities in 17 countries.

And now, a new chapter emerges. We are engaging with NGOs and Ministries of Health to map out ways to deploy Solar Suitcases to maternal health facilities on a regional scale. Our recent experiences in Sierra Leone and Uganda reinforced how important the provision of electricity is to rural maternal health care systems. We continue to see how crucial it is for maternal and child health workers to work with reliable light and to have mobile communication for emergency back-up care and hospital referrals.

So..…three years later…another birthday wish. As the UN has launched “The Sustainable Energy for All” initiative, we will continue to advocate for renewable energy solutions for maternal health care facilities throughout the developing world. Our commitment? Through collaborations with Ministries of Health and NGOs, we aim to significantly scale our efforts to bring light and power to frontline midwives and health workers for essential medical and obstetric care, improving health outcomes for mothers, their babies, and their families.

SAFE in Uganda with the Solar Suitcase

Laura Stachel — Mon, 23 Jan 2012 05:38:21 +0000

“There’s going to be a lot of babies saved, a lot of women saved,” exclaimed Ugandan midwife Esther Madudu, after receiving a Solar Suitcase. Until last month, Esther had been conducting nighttime deliveries holding a cellphone in her teeth. When the Solar Suitcase was installed, Esther immediately put it to good use. Under the newly mounted LED lights, she resuscitated a preterm baby, sutured a mother who was bleeding, and demonstrated how easily she could now read the labels on medicine vials.“I can’t explain the happiness. It’s a different world. This is something we never expected in Tiriri, but we thank God that it has come.”

Esther Madudu (in pink) holds the newborn she saved using the new lights. The SAFE-WE CARE team is on the left.

In December 2011, WE CARE Solar partnered with Safe Mothers, Safe Babies (SAFE), African Medical Research Foundation (AMREF), and UNICEF to deliver 21 Solar Suitcases to Ugandan health facilities. SAFE is an NGO working primarily in Eastern Uganda with the aim of reducing maternal and neonatal mortality through demand-driven, collaborative, sustainable programs. The community-based participatory health programs developed by SAFE provided an excellent context for our Solar Suitcase program in Eastern Uganda.

Richard Cutts (SAFE) and Nya Abaire (WE CARE) installing Solar Suitcase lights in operating theatre.

Armed with educational posters and suitcases full of tools and supplies, SAFE founder Jacqueline Cutts, Technical Director Richard Cutts, and intern Rachel Fisher met up with WE CARE Solar’s Kenyan engineer – Nya Abaji. This dedicated crew spent the next two weeks traveling around Uganda, conducting health facility needs assessments, Solar Suitcase trainings, and Solar Suitcase installations in hospitals and primary health care clinics.

The Solar Suitcases had an immediate impact, providing much needed light and power. At Iganga District Hospital, the Solar Suitcase was installed the same evening that a power outage interrupted a c/section. The surgical crew switched on the Solar Suitcase LED lights to complete the surgery and resuscitate the newly delivered baby. They then went on to provide care for three motorcycle accident victims.

Hospital power outages in Uganda are not an unusual occurrence. “There are so many stories about the power going off in operations, I can’t even tell them all, ” bemoaned Dr. Kato, the anesthetist at Iganga hospital. “When the power goes off during an operation, we use whatever is around – a torch. This is very stressful during an operation, and the light is not sufficient, but this is all we had.”

The Solar Suitcase provided much reassurance to the staff, who talked about the challenges suturing and monitoring patients without reliable lighting. A surgeon shared his perspective. “You can be operating and then power goes off. All of a sudden, total darkness. It can be very tricky, if you have just removed the baby, to tie the bleeders if power has gone off. But now that we have the Solar Suitcase, we can easily switch [it] on. Then we can continue with the operation.”

The interviews collected by the SAFE-WE CARE team echoed the stories we have heard in many other countries. Midwives and doctros workers cannot provide optimal care for mothers and babies when lighting is not assured. Procedures can be delayed or cancelled. Mothers in need of c/sections may be referred away from hospitals without power.

The importance of lighting was not overlooked by community members who would likely benefit from the Solar Suitcase. An expectant mother had this to say. “They have told me what you brought here—the Solar Suitcase, so that we have light at night, and now I know that my baby will be safe. I am so very, very grateful. So I thank you, madam. Thank you so much, thank you so much.”

Power to Save Lives

Laura Stachel — Sat, 31 Dec 2011 21:48:27 +0000

Dr. Jacques Sebisaho revealed the power of the Solar Suitcase to save lives this December, when he returned to Idjwi clinic in the DR Congo. The clinic has no power, and when night falls, it is impossible to provide adequate medical care. On this trip, Jacques had a Solar Suitcase, which was quickly put to use to illuminate a twin delivery! However, Jacques arrival coincided with the onset of a cholera epidemic. The clinic was flooded with patients needing intravenous fluids, antibiotics, and constant monitoring. The clinic could not house all the patients in need of care, and mats were placed outside on the ground, creating a make-shift outdoor infirmary. The Solar Suitcase was brought from patient to patient, and enabled the team to provide constant monitoring. Though Dr. Sebisaho feared many lives could be lost, he and his team achieved a near-miracle. All the patients treated that month survived – not a single man, woman or child was lost despite the severity of many of the cases. He said that 80% of deaths usually occur at night. Dr. Sebisaho reports that the Solar Suitcase was a life saver, boosting the morale of health workers and inspiring the entire community.

“I believe the light was the force behind everything. I have no words to describe how confident we all were knowing we could do anything anytime (day or night). This sounds obvious to a person here (in the US), but the light meant the world there. I really want to emphasize on light and life in Africa to whoever want to listen. I am grateful you have made sacrifices to make the solar suitcase to make our work easier and successful. I knew the solar would make a difference, but didn’t anticipate the magnitude of the difference it would make! As you can see on pictures, we don’t have much; the solar suitcase is huge for us in Idjwi!

We are so grateful that Dr. Sebisaho had the medical supplies, support, and reliable lighting necessary to treat the community and save so many lives. We anticipate that our little box sunshine will continue to help Idjwa Clinic and other communities in rural DR Congo in the years to come.

A Bright Light in Sierra Leone

Laura Stachel — Tue, 13 Dec 2011 07:29:21 +0000

I met Isha Daramy-Kabia less than a week ago, but I instantly knew she would be a friend for life. She sparkled from the stage of the Global Women Leadership Network last Thursday as she declared “No woman should die in childbirth in Sierra Leone!” and announced that she would build her second maternity center in Sierra Leone by 2013.

Isha is a midwife. Born in Sierra Leone and trained in England, Isha is committed to improving maternity care in a country that claims one of the highest maternal mortality rates in the world. Until very recently, 1 in 8 women of reproductive age risked dying from childbirth. Almost all births occur in villages, on dirt floors, without skilled care. Emergency care is often impossible to access – a combination of poverty, distance, and insufficient medical facilities create the perfect storm for pregnancy complications to lead to death.

Isha left a comfortable practice in England to develop a training program for traditional birth attendants in Sierra Leone. She shared her own knowledge while still honoring the indigenous techniques she observed that made medical sense. She taught the birth attendants to utilize all of their senses – to recognize when a woman was anemic, when to encourage a woman to push during the second stage of labor, or when transfer to a health facility was needed. The training program lasted months and ended with an oral exam, a certificate, and a joyful graduation. Isha next started the Friends of PCMH (Princess Christian Maternal Hospital), an organization to support the largest maternity hospital in Sierra Leone. She raised funds for better staffing, for better equipment, and soon for other hospitals. She went to markets with a bull-horn to advocate for skilled care during deliveries and to inform the public that maternal health care was now free. When a friend gave her money to buy a car for her personal use, she decided the money could be put to better use if she expanded the maternal and child health clinic she created in Port Loko. Her friend was upset that she hadn’t bought the car, but Isha said she believed something her father used to tell her, “Good comes from good.”

Isha’s clinic will serve women from dozens of villages. Women close to the clinic will come for prenatal care and deliveries. Those far away will move into the clinic in the last weeks of pregnancy to ensure timely access to obstetric care when labor begins. The clinic is beautiful, equipped with tiled floors, mechanical hospital beds, and obstetric supplies. However, the clinic could not yet open. There is no light.

I invited Isha to our Berkeley home before her return to Sierra Leone next week, and introduced her to Hal. He brought out a Solar Suitcase, and as the sun was setting, he turned on the LED lights. “Will this help you?” he asked.

“I’m dumb-founded,” she began. Her eyes filled with tears. “My problem is solved,” she continued, “Women die for lack of light. Midwives need to use their senses. They see, they observe, they feel. You cannot do anything in darkness…especially delivering a baby….This is a real life-saver.”

Isha heads back to Sierra Leone with an extra piece of luggage, packed with solar lights, headlamps, phone chargers and a fetal monitor. And in January, she will officially open the Magbil Mother and Child Health Center.

A World of Thanks

Laura Stachel — Thu, 24 Nov 2011 14:52:42 +0000

On this Thanksgiving, we thank health care workers around the world for their courageous efforts to provide skilled obstetric care to childbearing women and their families under the most adverse conditions. We are grateful for the opportunity to help them deliver safer care and save lives. Here are some photos and recent words from the clinicians whose lives we have touched this year through our international Solar Suitcase program.

From Betty Gebrian at the Haitian Health Foundation:

“The newly designed solar suitcase is fabulous – strong and sturdy! The resident village health worker has received the case…and the village people are thrilled!” This suitcase will be used by traditional birth attendants, village health workers, and mothers’ groups for obstetric and pediatric care. “You are bringing light to the villages of Haiti.”

From Dr. Mary Coleman, headed to a children’s hospital in Uganda this weekend with a solar suitcase to aid pediatric care: “The hospital staff jumped for joy when they learned that I was bringing the solar suitcase. When the heart gives, the hands open.”

From Somalia, where Intisar Ali is teaching mothers about reproductive health and bringing light to two health centers to reduce maternal mortality: “Thanks again and again for the solar suitcase. We use both suitcases daily. When I see the faces of the birth attendants, they feel like there are people who care about them. Before they felt like the can’t do anything. Now they feel like they can do anything!’

From Liberia, where we partnered with World Health Organization and the Liberian Institute of Biomedical Research (LIBR). Dr. Fatorma Bolay, director of the LIBR tells us: “The Solar suitcase is going to revolutionalize health care delivery in developing countries. I will continue to advocate for support. Thank you, I am very happy!

From Dr. Jacques Sebisaho, a physician who started a clinic in a remote island in East DR Congo. He received a solar suitcase this week in New York, and is traveling today with this “miraculous innovation” to the DR Congo: “Thank you so much for this gift of life. You have given the people of Idjwi hope. I don’t even have words to express how I feel.”

From our recent trip Nigeria, where we met dozens of midwives and doctors who have told us that health care was transformed by solar power. Aminu Abdullahi, a surgical nurse at a general hospital, had this to say: “When you brought out the suitcase in 2008, we thought you were bringing medical instruments. We had no idea you were bringing light. Thank you for changing and touching the lives of so many people in this country and around the world.”

And from the staff at WE CARE Solar:Thank you so much for supporting our work. This project would never have been possible without the generosity of individuals and families who have donated their time, their talents, their resources, and their money. You have shared our dream of improving health services for mothers and their families, and have let countless mothers and health providers know that they no longer need to suffer in darkness during childbirth.

The Color of Life

Laura Stachel — Sat, 19 Nov 2011 08:02:41 +0000

Our November 2011 WE CARE expedition to Northern Nigeria culminated with the installation of three Solar Suitcases in Wudil General Hospital in Kano. We targeted crucial areas in the fight against maternal mortality: The labor and delivery room received lights, a fetal doppler, and mobile phone charging; the operating theatre obtained surgical lighting to enable round-the-clock c/sections, and the laboratory was outfitted with blood bank refrigeration for transfusions. Wudil Hospital was selected because of its high patient volume, dedicated staff, and tragic statistics. Of the 180 to 200 births occurring every month, approximately five mothers do not survive. These somber statistics were made glaringly clear to us; we watched as a group of men quietly carried a motionless body out of the labor room within an hour of our arrival. We learned that this mother of 8 had been trying unsuccessfully to give birth for hours and had not survived labor.

With this chilling backdrop, the WE CARE Solar got to work. Our team on this round consisted of three Americans (me, Karina Garbesi, and Brent Moellenberg) and four Nigerians (Idris, Johnson, Hussaina, and Babamarie) who we have been training for the last 10 days. With three separate wards needing lights and power, we had to divide and conquer.

Our first priorities were the labor and delivery ward and the laboratory. Hussaina and I taught the maternity ward midwives about solar electricity and the optimal use of the Solar Suitcase, while Idris and Johnson attached the bright yellow WE CARE suitcase to the labor room wall. Brent and Karina assembled the solar electricity system for the blood bank refrigerator, a very special gift delivered in honor of my mother. The blood bank fridge required three 85 watt solar panels on the roof and a 200 amp-hour battery, a significant expansion over other suitcase installations.

As most of the team continued to mount solar suitcases, lights and solar panels, I spent time interviewing midwives and observing labor and delivery activities. The midwives were quite skilled at this facility, and despite the paucity of equipment, it was reassuring to see that appropriate protocols for mother and newborn care were administered. I enjoyed watching two babies slip through their mother’s birth canals, oblivious to the technology being installed around them.

By mid-afternoon, we had completed the blood bank installation and much of the two other systems. The laboratory staff, labor and delivery midwives and I joined Dije Abdul, from Pathfinder International, and the Zonal Director of this region for a small ceremony honoring my mother.

To be honest, it was quite an emotional moment. I had been planning this for months. My mother died in April, and I had established the “Evelyn’s Light” fund to honor my her memory with a blood bank refrigerator for a Nigerian hospital. I had met Dije Abdul in Kano in July, and she assured me that Pathfinder International would work with the community to ensure the success of the blood donation program. The Wudil Hospital lab director informed me that as many as 20 – 30 blood transfusions are needed a day during the warmer seasons. For a hemorrhaging mother, delays can mean the difference between life and death.

At the ceremony, I spoke to the group about my mother’s life, her dedication to helping others, and how her own life had been saved by a post-partum blood transfusion after the delivery of my older brother. She was so sick at that time that some of her doctors had literally given up. A blood transfusion by one very determined anesthesiologist had been her lifeline. My family has always been so grateful that my mother had a second chance at life, and with the improvements and support we are bringing to Wudil Hospital, we hope to give many many women the second chance they deserve when birth complications arise.

I returned unannounced to Wudil hospital early this morning to see what had transpired overnight. A midwife told me how easy it was to do deliveries the night before, an operating theater technician told me the new LED lights are the best lights they have ever used, and the laboratory tech proudly opened the blood bank refrigerator to show me they were already storing blood. I looked down with gratitude when I saw the bright red pints lining the refrigerator shelf – the “color of life.”

Changing Lives….One Suitcase at a Time

Laura Stachel — Wed, 16 Nov 2011 22:52:55 +0000

Nigeria, November 2011. It’s our ninth day delivering Solar Suitcases to maternal health facilities in Kano and Kaduna states. As we make our way from clinic to clinic, we have been overwhelmed by stories we have heard about the consequences of inadequate lighting on childbirth. It has been heartbreaking to hear midwives describe how difficult it is to provide quality care at night, to hear about the needless loss of life that has resulted from a simple lack of electricity. One midwife described her grief at losing a patient who bled to death after a vaginal delivery. The delivery had been hard, but was successful. She had told the family the joyous news that mother and baby were fine. She covered the mother with a blanket, and went back to caring for the newborn using her flashlight. When she turned to the mother with her light, she realized the woman was in a pool of blood. “With a torchlight, I can only see one patient at a time,” she lamented. She told me 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.” Another midwife described the difficulty providing comprehensive care at a hospital. Several days before we arrived, the hospital referred out a mother with obstructed labor. The woman needed a c/section at 8 pm. The surgical team was available, the operating room had equipment and supplies, but the public utility was down and the generator was without fuel. The midwife was forced to prepare the patient for a transfer and send her to another hospital, 40 minutes away. On the way to the hospital, the patient died.

When we deliver solar suitcases to hospitals and clinics, we are greeted with so much gratitude. “I have two patients to care for at once – now I can see both of them,” explains one midwife. “Now I won’t need to refer patients out of the hospital for c/sections,” remarked another. “Now I won’t have to work by candlelight,” a male health worker says 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.”

Passing the Baton

Laura Stachel — Fri, 11 Nov 2011 23:19:32 +0000

One of the things we love about working in other countries is that it gives us an opportunity to train others to become competent with solar electricity. On this trip, in addition to training dozens of health workers to use and maintain the solar suitcase, we are expanding our team with new trainers and installers.

For health workers unfamiliar with solar amps and battery volts, we find ways to make these concepts accessible. We have created games to reinforce key concepts, such as the energy consumption of different devices. We use analogies to help clinicians understand when to charge their phones and laptops and when to conserve energy. Storing water in a bucket and consuming water when needed is a familiar concept in rural health clinics; these principles are easily translated to storing energy in a battery. We created picture-rich posters and manuals that reinforce how to read the charge controller and optimize solar suitcase performance.

In addition to working directly with health workers, we are also training a local team to continue our work in the future. On this trip, we are cultivating new trainers and installers. Martha Hussiana is a young Nigerian physiologist who works with eHealth Nigeria. She is fluent in Hausa, a real asset when it comes to training health workers less familiar with English. She has been helping me teach classes in rural health facilities, and will be follow the progress of each clinic as we conduct research on the function and utility of the solar suitcase in maternal health settings.

Idris Jibrin has been my long-time driver and has been helping me with the Solar Suitcase project since its infancy. His experience as a former auto-mechanic has come in handy, since cars and solar suitcases both use DC electricity. US Lead Engineer Brent Moellenberg and LBNL Staff Scientist Karina Garbesi are training Idris in proper installation techniques. Along with the other Nigerians working with us, Idris and Martha are soaking up everything they can during our non-stop deployments. Their enthusiasm and new skills will be instrumental in the long-term success of this program.

Special Deliveries

Laura Stachel — Thu, 10 Nov 2011 23:56:49 +0000

Today was magical. Our team left the city of Kano to reach Minjibir General Hospital, where we were scheduled to bring light and power to the Operating Theatre, Maternity Ward, and Labor Room. The staff was excited about our Solar Suitcase training, and quickly assembled a group of midwives, doctors, and hospital administrative staff, including the hospital accountant. Labor and delivery was busy, and if we were going to include the midwives in our program, we had to do the training in the maternity ward. As I started to teach about solar, the head of the hospital asked me why an American obstetrician had helped to create a Solar Suitcase. “Don’t you have light and power in America?” he asked. As I described my 2008 research in northern Nigeria, where I repeatedly witnessed how women failed to get prompt emergency obstetric care when electricity wasn’t assured, all heads in the room nodded. The staff members were all too familiar with epilectic power supplies. They, too, had turned away patients needing surgery when the generator was without fuel, had delivered babies into the dark of night, and had strained to conduct procedures by cell phone lights. My audience was captive.

I made the training as interactive as I could. After providing an overview of solar electricity and describing the function of solar panels, charge controllers, and batteries, I had the class turning on power switches, plugging in LED lights, cell phones, and batteries, and marveling over the fact that the brightest light they had ever seen was only 4 watts!

Over the next few hours, as we completed three installations, a total of four mothers delivered! In between mounting solar panels and suitcases, teaching about energy budgets and securing lights to the ceiling, we’d hear a groan from the next room, and a midwife would run over to attend to a young mom in labor. The day was filled with cries of joy. We’d hear a newborn’s lusty cry as it took it’s first breath, a mother’s squeal of relief as she learned that her baby had survived. And then, another cry of delight, as the head midwife reacted to her new solar gift. This woman was so happy to finally have light in her maternity ward that she literally sang and danced in front of the Solar Suitcase…and we shared her joy.

ABC News: Let There Be Light – World News’ Person of the Week

Laura Stachel — Fri, 04 Nov 2011 18:30:48 +0000

ABC News featured WE CARE Solar tonight: “Let There Be Light – World News’ Person of the Week: Dr. Laura Stachel of WE CARE Solar”. Our story is part of ABC’s Million Moms Challenge project to raise awareness and funds to address pregnancy issues and children’s health. ABC shows footage taken when they joined us in Liberia earlier this year. It highlights the extreme issues faced by childbearing mothers in rural clinics in Liberia and illustrates how the WE CARE solar suitcase enables safer childbirths and a more productive environment for healthcare workers. This is a great glimpse into the powerful impact of WE CARE Solar.

Please see the news clip and the related articles:

ABC NEWS CLIP
ABC News: Let There Be Light
World News’ Person of the Week: Dr. Laura Stachel of WE CARE Solar

STORY
Million Moms Challenge: Let there be light
REPORTER’S NOTBOOK
By SEEMA MATHUR, ABC News

OPINION
Million Moms Challenge: Let there be light
By LAURA STACHEL, WE CARE Solar

Also learn more about our trip to Liberia
Liberia – the power of light