we care presentation ieee june 1 2009

67
Where There Is No Light Using 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

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Page 1: We care presentation ieee june 1 2009

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 SustainabilityUniversity of California, Berkeley

Page 2: We care presentation ieee june 1 2009

Maternal Mortality

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Maternal Mortality

http://www.worldmapper.org/display.php?selected=258

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Causes of Maternal Mortality, 2000

AMDD, Columbia; www.pphprevention.org

• Hemorrhage• Infection• Unsafe Abortion• Eclampsia• Obstructed Labor

Page 5: We care presentation ieee june 1 2009

Federal Republic of Nigeria

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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• Poverty• Early Marriage• High Illiteracy• Low contraceptive use• High Fertility

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The Three Delays

Home Transport Hospital

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The Three Delays

Home Transport Hospital

RecognitionDecision

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The Three Delays

Home Transport Hospital

RecognitionDecision

AvailabilityCostDistance

Page 15: We care presentation ieee june 1 2009

The Three Delays

Home Transport Hospital

RecognitionDecision

AvailabilityCostDistance

Facility SuppliesStaffingCost

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Municipal Hospital, Zaria

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Lack of Running Water

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Lack of Sanitation

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Pharmacy Stock Outs

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Medical Records

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Operating Theatre

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Labor and Delivery

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Labor and Delivery

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Life-Threatening Delays

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Lack of Blood Bank

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Inadequate Lighting

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Emergency Obstetric Care - Challenges

Facility

Supplies

Staff

Electricity

Light

Communication

Water

Medication

Equipment

Surgical supplies

Staff shortages

Deficient Training

Lack of Protocols

Page 28: We care presentation ieee june 1 2009

Emergency Obstetric Care – Intervention

Facility

Supplies

Staff

Electricity

Light

Communication

Water

Medication

Equipment

Surgical supplies

Staff shortages

Deficient Training

Lack of Protocols

Page 29: We care presentation ieee june 1 2009

WE CAREWomen’s Emergency Communication and Reliable Electricity

Solar Electricity to…

….provide reliable lighting….enable mobile communication….power blood bank refrigerator and surgical equipment

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Design Principles

Autonomous power Durable, Robust Reliable Simple to Use Easy to Maintain Affordable Scaleable

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Operating Room Design

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“Solar Suitcase”

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Demonstration to Hospital Staff

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Phase I

Solar Suitcase charging station for: LED Headlamps for maternity & surgical staff

Walkie-Talkies (short range) for physicians,

midwives, and operating room staff

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Impact of LED light Medical Documentation

Before After

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Impact of LED lightNursing Care

Before After

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Impact of LED lightsSurgical Care

Before After

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Testing Two-way Radios

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Phase I Outcomes

Improved Communication Immediate Contact Reduced Delays Patient Status Updates Less Referrals Out

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Phase I Outcomes Improved

Communication Immediate Contact Reduced Delays Patient Status Updates Less Referrals Out

BUT…. Inadequate Range Battery runs out during shift

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Phase I Outcomes

Improved Lighting Increased Visibility Increased Ease of

Procedures Increased Safety

Page 42: We care presentation ieee june 1 2009

Phase I Outcomes

Improved Lighting Increased Visibility Increased Ease of

Procedures Increased Safety

But…MORE Desired

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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

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LED Headlamps

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PV Installation

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Labor and Delivery Ward

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Maternity Ward

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Maternity Ward

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Operating Room

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Operating Room

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Solar Powered Suctioning using DC to AC Inverter

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Long-distance two-way radiosand solar powered charging

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Solar Powered Blood Bank Refrigerator

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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

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Nigerian Support

MINISTRY OF HEALTH, 2008

GOVERNOR OF KADUNA, 2009

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Impact

No patients turned away from L&D Increased capacity to deliveries Immediate assembly of surgical team Clinician feedback:

“Fantastic!” “Great Improvement!”

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Challenges

Fixed budget Vetting solar electric companies in

Nigeria Obtaining government buy in Ensuring Quality Products and Service When to delegate

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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

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Next Steps

Assessing health facility needs throughout Kaduna and other states

Optimizing “solar suitcase” prototypes Scaling this intervention to other facilities

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Special Thanks to Our Funders…

Big Ideas @ Berkeley Blum Center for Developing Economies Bixby Program in Population, Health and

Sustainability

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Contact info:

wecaresolar.com

[email protected]

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Maternal Mortality

http://www.worldmapper.org/display.php?selected=258

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Formal Commissioning

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Phase I Outcomes Improved Communication

Immediate Contact Reduced Delays Patient Status Updates Less Referrals Out

Improved Lighting Increased Visibility Increased Ease of Procedures Increased Safety

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Phase II Evaluation

Lighting Adequacy Survey Pre and Post LED headlamps

Communication Survey Who’s needed by whom? How was this person contacted? Time to locate and bring to facility

Obstetric patient triage and outcome Observation/Interviews