MSF logisticians are resourceful people. But when a hospital has no mains electricity and is inaccessible by road for a large chunk of the year, even they can find things a bit of a challenge. Technical logistician Per-Erik writes about the struggle to keep the lights (and everything else) running at a hospital in DRC…
I had only been in Shamwana for two months when it was decided that we would be handing over the running of the hospital to the Ministry of Health.
MSF had been working in Shamwana for ten years overall, supporting the Ministry of Health hospital as well as seven surrounding health centres. In cooperation with the Ministry of Health, our teams had been providing primary and secondary health services, including the treatment of malaria, diarrhea, malnutrition, respiratory tract infections, HIV/AIDS and TB, as well as surgical, reproductive and mental health services.
I was the technical logistician for the project (often known as the ‘tech-log’), which means that, among other things, I had responsibility for the facilities and energy system for the hospital. When we first got the news, in April 2016, the general anticipation was that it would reduce its activities substantially, perhaps even close down.
Shamwana is an extremely off-grid location with no transport access during the rainy season. The main challenge was that the hospital had to have electricity for lights, medical oxygen, and to operate a cold-chain. Many medications have to be kept cool in order to be effective, which means finding ways to keep them refrigerated, even in hot conditions like Shamwana – this is what's known as the ‘cold chain’. The current energy supply system completely relied on continuous shipments of diesel – approximately 1000 litres per month. We very quickly concluded that this would not be sustainable.
However, inspired by the dedication and compassion of the Ministry of Health staff, most notably the hospital director Dr. Daddy, together we searched for solutions to leave the most sustainable system in place.
Although Shamwana has no mains electricity, as with many other locations in the DRC, the sunshine is nearly endless and quite reliable. Together with my medical colleagues I therefore determined the minimum energy requirements and started to design a minimal, yet operable, solar energy system.
This was my first assignment with MSF, and I had never done anything really similar to this, i.e. a completely stand-alone off-grid solar power system. But back home I had worked a little bit at the research institute in Sweden to integrate solar panels in building design, and luckily my colleagues there were willing to help me with the very first estimates on what we would need.
So I had a basic idea about the feasibility, even before I suggested the idea to our technical team at HQ. When I did, they had just done a similar calculation for another project in DRC, so the idea was already ‘on the table’ and we could start work on a more detailed design relatively quickly. This was in May, and the handover of the hospital was planned for the end of August. There wasn’t much time.
Luckily we had some equipment (primarily batteries) in the project that could be reused. We managed to get some of the solar panels at a very low cost from an earlier batch donated to MSF by a manufacturer. So gradually, this really high-odds idea turned into a go-ahead which really made my last months in Shamwana worthwhile!
In a race against time, a feasible solar power system was designed that will be able to power lights at night-time, some medical equipment, and most importantly, one oxygen concentrator to run non-stop every day.
The production of medical grade concentrated oxygen is vital for many patients with respiratory diseases, particularly for newborn children and during surgery. This is highly energy consuming and to run just one of the concentrators continuously requires twelve large solar panels and twelve batteries. Making sure we could do it was the biggest challenge of the whole project.
There were a few points of despair along the line. The time-frame was extremely short in all respects and particularly since it involved getting the equipment from overseas. Although we made the decision to build the system in May, it was not until one week into July that the last pieces of equipment were ready to be shipped from Amsterdam – just over a month before the handover of the hospital and only seven weeks before we were supposed to finally leave Shamwana.
At that point, I did not think we would finish in time and had started negotiating with our project coordinator about the possibility of leaving a bit later.
We were trying to think of ways we could start the installation work a bit earlier, even if we didn’t have the final pieces of equipment. Being experienced with wood construction, I designed an installation platform for the panels, which we could fabricate out of the locally available and very durable hardwood. The problem was only that the team in Lubumbashi (the nearest big city) couldn’t find the screws we needed. After a little bit of further improvisation and a shopping tour in Lubumbashi (during R&R…), this was also solved.
The last of the equipment arrived on the 29th of July, four weeks before we were due to leave. It was tight, but the installation work went better than I could ever have imagined. It took just two weeks for the fantastic assistant tech-log and electrician Jean-Murck, together with Pablo, the mission electrician, to rewire the whole electricity system of the hospital to the new limited layout.
So finally, to my surprise, we had he whole system up and running on the day of the hospital handover – the 12th of August.
“With the solar power system, the very difficult task of continuing to provide quality healthcare to this vulnerable region has been made possible,” said Dr. Daddy at the handover ceremony. “It will still be a challenge to keep operations going in this remote location, but the most vital parts are here.”
I was very, very proud that day! The evening before we had switched on the first part of the system and we could really say that the hospital was operating on solar power.
MSF’s flying electricity adviser arrived, and we then had two weeks to test-run and verify the system.
Compared to the former system, the capacity is roughly one third. As well as the panels and batteries needed to run the oxygen concentrator, an additional four panels and four batteries have been installed to power the rest of the equipment. This makes it a fairly large installation in total, with a maximum power production of close to 4 kW. In addition to this, we kept the current system for supplying the electric water pump and installed a new solar fridge.
By the time we left Shamwana as planned on the 29th of August, we were confident that the system was serviceable.
Now that the handover is complete, we all wish the Ministry of Health and the population of Shamwana strength, courage, and a lot of sun!