Powering rural health centers : Solar energy in Mulindi

Bob Langfelder, a retired teacher from the US picked interest in supporting the health development in rural Rwanda. His choice was to intervene in providing electricity to power health centers. As part of research, I visited Mulindi health center in Kirehe district to get for Langfelder first hand information on whether the health center would put to use batteries for solar power. After the 3 – hour trip that comprised of both a bus and motorcycle ride, I finally saw a billboard reading ‘Centre De Sante, Mulindi’, in blue print with logos of USAID, ‘Twubakane’and the Ministry of Health. I greeted the receptionists who were busy receiving patients on the veranda. I had a plan of being anonymous, but that never worked, because there was someone waiting to show me around. I was referred to Vivens Nsabimana, who appeared to know all the details of the clinic. Nsabimana, a nurse with the clinic also introduced me to Jean Paul Ndasabumuremyi, Kirehe district’s health projects manager. The health center’s compound was neatly kept and the grass was impressively green considering the long spell of the dry season. There were budding flower gardens and creeping plants on the walls along the walkways, providing visitors with a homely atmosphere. It is hard to differentiate the rural health center from the busy centers in the city. The buildings looked well-kept, and strong, its walls were painted with cream on the inside and the roof was covered with iron sheets. Hooked onto the roofs were pipes for harvesting rain water which is stored in big black tanks. “They were a donation by President Kagame to all health centres in the district to enable them to store enough water,” Nsabimana said, pointing at one of the water tanks. The centre has 4 wards - pediatric, maternity, women and men. Each ward is split up into small rooms, each having 3-4 beds. During my visit, the maternity ward was full with either pregnant women or mothers with newly born babies. The center also has an administration block with a pharmacy. The show at the health centre is run by 13 nurses, 2 lab technicians, 2 data managers, an administrator, accountant, cashier, 2 health insurance attendants and close to 10 support staff. The Centre serves more than 18,000 people from Mulindi, Kayonza and Kabera and according to Nsabumuremyi, an average of 100 patients visit the clinic daily. After the brief tour, I started off with my assignment. Batteries and Solar Panels Mulindi Health center uses solar energy for its operations. However, one of the challenges they face is keeping the batteries that help store the solar energy up and running. According to Samuel Rugororoka, the solar technician at the health center, without a strong battery supply system and powerful charger, the solar energy is insufficient. “The batteries were working well for only the first year,” Rugoroka said. “I realized that the battery storage system was probably spoilt because it only stored power for 3 hours.” Rugoroka says that the solar system is not being used to its potential making the operation of the health center more expensive because they have to rely on a generator. Even after bringing in other technicians, the problem has prevailed, he says. “I still do not understand what the exact problem is. I literally followed all the instructions and requirements as I was taught but the solar storage is still low.” In 2006, The Solar Electric Light Fund (SELF), a US non government organization that provides solar energy to rural clinics installed the system in Mulindi Health Centre. The solar system is composed of 54 solar panels powering 48 batteries with 2 volts and 648 amps each. These are stored in a compartment room that has an alarm which goes off as soon as the solar charge is low This alerts the technician who then turns on the generator. Also, inside is a wired controller and charging system that is fastened well on a wooden background. Located in the corner is a small white plastic box that is meant to automatically switch on the generator as soon as the solar power is low. “Unfortunately, it has never worked since it was installed,” Rugoroka said. Generator According to Rugoroka, the generator that was donated from Global Fund is way more expensive to maintain compared to using solar energy. The big Hassanein TE802 Model generator consumes 1.5 litres of diesel per hour and if it was to run for the whole day, the health centre would need to spend Rwf 15 million a year on fuel alone. “That is high and can’t be compared to using solar energy.” Rugoroka said. With the solar system being under utilized, the health centre is forced to use the generator most of the time. However, according to Rugoroka, there is a compatibility problem between the two power sources. “These are technical issues beyond my knowledge to resolve,” he says. “A follow up must be done to properly identify the problem because all the maintenance people assume that the problem was with the batteries.” The power problems have continued to affect the operations of the clinic. “At night, we cut off power from some blocks and tell those with computers to shut them down,” Nsabimana said. Internet Due to the strong support and partnership with Partners In Health (PIH), another American NGO, Mulindi health centre enjoys full access to the internet. However, the power problem has limited the use of the internet. Technology at the center is used as a tool to help eradicate disease and poverty. The clinic has a satellite dish and has adopted from PIH, an electronic Medical Record System called the OpenMRS. Experts have argued that the OpenMRS is so far the biggest stride toward achieving success in healthcare for Rwandans. According to the Ministry of Health, there is a plan to have all health facilities in Rwanda using the OpenMRS system by the year 2020. Mulindi Health Center is right on course. Medical Equipment Mulindi Health Centre’s has 7 desktops computers, photocopiers, 3 refrigerators and laboratory equipment like electric sterilizers and centrifuges. All these require electricity if they are to run. While the refrigerators can use kerosene in case of power shortage, all other equipment stop operating. This is just one of the issues that affect the progress of the health center and according to Ndasabumuremyi, the capacity of the health centers is compromised. Patients with serious conditions are then transferred to larger hospitals, for the case of Mulindi, the patients are referred to either Kirehe district hospital or Rwinkwavu hospital which are over 20 km away. By the end of the tour, there is no doubt that if the solar system is restored, there would be improved health care delivery at the health centre. anyglorian@yahoo.com