Five years and no maintenance: Reengineered medical technology saves mothers and infants in remote, off-grid communities.
Imagine this: Your partner is about to give birth. It's night, and just as you arrive, the hospital's lights go out. What would you do?
You’d go somewhere else, immediately.
Hundreds of thousands of mothers and fathers around the world don’t have that option.
They might travel for miles through the countryside, often at night, to find a one-room clinic with few medical instruments and no reliable power. The only light available to the doctor or midwife comes from a kerosene lamp or a mobile phone flashlight.
In many places, there’s no light source whatsoever once the sun sets. You must bring your own candle, or they won’t let you come inside to deliver your baby.
Worldwide, more than one billion people live without electricity. In 2018, the World Health Organization shared that an estimated 830 women die every day from preventable causes related to pregnancy and childbirth. Nearly all maternal deaths happen in developing nations, with the highest percentages occurring in rural and poor communities.
Dr. Laura Stachel is trying to improve those grim statistics with her Berkeley, Calif.-based nonprofit, We Care Solar. The nonprofit partners with leading healthcare organizations to bring renewable, portable light and electricity to last-mile health centers in developing regions, saving the lives of mothers and babies.
And they do it using a suitcase-sized, sun-powered energy system that can run all night long.
The Solar Suitcase
A retired obstetrician-gynecologist, Stachel co-founded We Care Solar with her husband, solar energy educator Hal Aronson, building early prototypes by hand in their backyard with the help of friends and neighbors. But the latest “Solar Suitcase,” version 3.0, is the progeny of a close collaboration between We Care Solar and Arrow Electronics — an engineering partnership between a small humanitarian nonprofit and one of the world’s leading end-to-end technology companies to lower cost, enhance the device with more power and make it easier to manufacture at scale, install and operate.
At a black-tie gala in New York City on April 4, 2019, We Care Solar and Arrow won gold in the category of Humanitarian Technology at the Edison Awards, one of the most prestigious accolades in the innovation community, for their work on Solar Suitcase 3.0. More than 3,000 professionals in product development, design, engineering, science, marketing and education comprised the independent judging panel this year.
A widespread issue
In 2008, Dr. Stachel traveled to northern Nigeria to study causes of maternal deaths in health facilities. "One night I was in an operating theater when the lights went out in the middle of a Cesarean section," she recalls. It was an all-too-common occurrence — even state hospitals, she found, might go without electricity for up to 12 hours at a time — and the outcomes were often tragic.
As a result, critically ill patients waited hours or days, procedures were delayed or cancelled entirely, and expectant mothers in remote rural areas would at times endanger their health by not coming to the hospital at all if they had to deliver at night.
Stachel dug further and discovered that the problem wasn't limited to Nigeria, or even to Africa. To be effective, comprehensive obstetric care requires continuously powered bright lights and operating room equipment, immediate communication between providers, timely interventions, and amenities such as refrigeration for blood transfusion products and medications. In many health centers around the world, that just wasn’t the case.
From demo to difference
When Stachel told Aronson about the situation in Nigeria, he designed a large-scale, off-grid solar electric system for the hospital. He also built a solar-powered demo kit that could easily fit into Dr. Stachel’s suitcase. During her first trip back to Nigeria with the kit, hospital workers immediately saw ways to put the smaller, more practical unit to work saving lives. They asked if she would leave it with them.
"This was our lightbulb moment," Aronson remembers, "that this small system could make a difference right now." So they began building the original Solar Suitcases from off-the-shelf components … screwed to a piece of wood as a class project by volunteers.
Those early units weren't made to a single standard, and the variation led to multiple prototypes and many opportunities to observe everyday usage. This provided ample data for Brent Moellenberg to design a more robust, institutional-grade medical product when he joined the nonprofit in 2010 as director of engineering, bringing more than a decade of industry and international development experience. By then, Solar Suitcases had been delivered to hospitals and smaller clinics in sub-Saharan Africa and Haiti, and demand had increased.
A solar panel was fitted to a 12-amp-hour lithium ferrous phosphate battery, which in turn fueled medical-quality lighting, a fetal heart rate monitor, battery charger, rechargeable headlamps, 12-volt outlets and a universal mobile phone charger so that remote health workers could make emergency referrals. Circuit breakers replaced light switches, high-quality connectors were added that could withstand many mating cycles, and cords strong enough to be run over by hospital gurneys were integrated into the model.
The redesign also made manufacturing more replicable, and the nonprofit began using a local contract manufacturer for assembly.
The birth of Solar Suitcase 3.0
Arrow in 2017 offered to help improve the Solar Suitcase by donating in-kind services to make the technology better and more effective. Several engineering and business departments provided their time, expertise and supplier relationships.
"Arrow took Brent's design and said, ‘How can we make it cheaper, streamline it and make it easier to produce at scale?’" said Dr. Stachel. As a nonprofit, she noted, We Care Solar relies on grant funding — the more suitcases they can get into the world for each grant amount, the better.
Longevity also factored heavily. In remote, rural parts of the world with no supply chain and limited technical support, when things break, they're unlikely to get fixed. Which meant that Solar Suitcase 3.0 would need longer-lifespan lithium batteries and a more reliable design to last at least five years in the field with virtually no maintenance.
Arrow's engineers matched the entire design to their inventory for more readily available components and better pricing. They swapped out key components to take advantage of Arrow's reach and scope. These changes made the unit 20% less expensive to build and 15% more powerful for all-night operation. Arrow also redesigned the lights as highly efficient medical-grade LED lamps — cool enough for clinic staff to hold in their hands on the fly — which lowered cost and improved performance.
Making version 3.0 easier to install was another important part of the product reboot, one that involved human-centered design firms. In addition to making a robust, reliable product, We Care Solar invests time in making sure local technicians understand how to install Solar Suitcases and they can easily explain how it works. User testing was conducted in Uganda in 2018, and expanded manufacturing in the United States is planned for 2019.
From the beginning, Arrow treated We Care Solar as a customer, not a beneficiary. "Arrow's approach is that technology helps make life better, and every social need can also be a business opportunity," said Joe Verrengia, global director of corporate social responsibility.
"If nonprofits work only on the conventional philanthropy model, it will be hard to really address problems and needs, like We Care Solar's needs in helping expectant mothers and healthcare workers."
What's next
To date, We Care Solar has served 3.6 million mothers and infants, and 3,900 health centers and emergency response teams in 20 developing nations and trained 15,940 health workers. Their goal now is to ensure more mothers and newborns are born in skilled healthcare facilities that have adequate lighting and power to save lives, and they’re measuring success by ambitious standards:
• Complete saturation of Solar Suitcase in five countries in the next five years (Liberia, Uganda, Sierra Leone, Zimbabwe, Tanzania)
• Reach 100,000 clinics globally by 2030
We Care Solar has launched the Light Every Birth 2030 Campaign to work in partnership with ministries of health, non-governmental organizations, renewable energy innovators and donors to ensure that every maternal health center has access to clean, reliable electricity.