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Where There Is No LightUsing Solar Energy to Improve Emergency Obstetric Care in West Africa Laura  Stachel, MD MPH Bixby Center for Population, Health and Sustainability University of California,  Berkeley
Maternal Mortality
Maternal Mortality  http://www.worldmapper.org/display.php?selected=258
Causes of Maternal Mortality, 2000 ,[object Object]
 Infection
 Unsafe Abortion
Eclampsia
 Obstructed LaborAMDD, Columbia; www.pphprevention.org
Federal Republic of Nigeria
Why Nigeria? 11% of the world maternal mortality >1100 deaths per 100,000 live births Lifetime risk of dying as high as 1 in 13 ,[object Object]
Early Marriage
High Illiteracy
Low contraceptive use
High Fertility,[object Object]
The Three Delays 	Home		Transport		Hospital
The Three Delays 	Home		Transport		Hospital Recognition Decision
The Three Delays   	Home		Transport		Hospital Recognition Decision Availability Cost	 Distance
The Three Delays 	Home		Transport		Hospital Facility  Supplies Staffing Cost	 Recognition Decision	 Availability Cost	 Distance
Municipal Hospital, Zaria
Lack of Running Water
Lack of Sanitation
Pharmacy Stock Outs
Medical Records
Operating Theatre
Labor and Delivery
Labor and Delivery
Life-Threatening Delays
Lack of Blood Bank
Inadequate Lighting
Emergency Obstetric Care - Challenges Electricity Light Communication Water Facility Supplies Staff	 Medication Equipment Surgical supplies Staff shortages Deficient Training Lack of Protocols
Emergency Obstetric Care – Intervention Electricity Light Communication Water Facility Supplies Staff	 Medication Equipment Surgical supplies Staff shortages Deficient Training Lack of Protocols
WE CAREWomen’s Emergency Communication and Reliable Electricity 	Solar Electricity to… ….provide reliable lighting ….enable mobile communication ….power blood bank refrigerator       and surgical equipment
Design Principles Autonomous power Durable, Robust Reliable Simple to Use Easy to Maintain Affordable Scaleable
Operating Room Design
“Solar Suitcase”
Demonstration to Hospital Staff
Phase I Solar Suitcase charging station for: LED Headlamps for maternity & surgical staff Walkie-Talkies (short range) for physicians, midwives, and operating room staff
Impact of LED light  Medical Documentation   Before                                             After
Impact of LED lightNursing Care Before				       After
Impact of LED lightsSurgical Care Before				       After
Testing Two-way Radios
Phase I Outcomes Improved Communication Immediate Contact Reduced Delays  Patient Status Updates Less Referrals Out
Phase I Outcomes Improved Communication Immediate Contact Reduced Delays  Patient Status Updates Less Referrals Out BUT…. Inadequate Range Battery runs out during shift
Phase I Outcomes Improved Lighting Increased Visibility Increased Ease of Procedures  Increased Safety
Phase I Outcomes Improved Lighting Increased Visibility Increased Ease of Procedures  Increased Safety But…MORE Desired
Phase II LED headlamps for all night duty staff Installation of permanent PV system in maternity ward, delivery room, and OR Long-range walkie-talkies for all emergency staff
LED Headlamps
PV Installation
Labor and Delivery Ward
Maternity Ward
Maternity Ward
Operating Room
Operating Room
Solar Powered Suctioning using DC to AC Inverter
Long-distance two-way radiosand solar powered charging
Solar Powered Blood Bank Refrigerator
WE CARE Accomplishments…. Solar electric system in hospital in maternity, delivery, & operating theatre Solar powered blood bank refrigerator LED headlamps for all night duty staff Walkie Talkies for Emergency Obstetric Staff
Nigerian Support Ministry of Health, 2008	 Governor of Kaduna, 2009
Impact No patients turned away from L&D Increased capacity to deliveries Immediate assembly of surgical team Clinician feedback: “Fantastic!” “Great Improvement!”
Challenges Fixed budget Vetting solar electric companies in Nigeria Obtaining government buy in Ensuring Quality Products and Service When to delegate
Lessons Learned Let the user drive the product Field testing is important Design to be “idiot proof” Create redundancy in system Interdisciplinary collaboration Be Patient ….and persistent
Next Steps Assessing health facility needs throughout Kaduna and other states Optimizing“solar suitcase” prototypes Scaling this intervention to other facilities
Special Thanks to Our Funders… ,[object Object]

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We care presentation ieee june 1 2009

Editor's Notes

  1. The hospital relies on the support of family members to provide dietary services, linen and intimate care of patients.