In Kasese district, Charles Kabagambe Bwambale is a volunteer health worker at the rural Mukathi Health Centre, in Maliba Kasese, miles from a paved road and power grid.
Bwambale says the facility delivers as many as 50 babies a month to mothers who have often traveled for miles on foot to reach one of the few health facilities in the area.
It also handles over 50 patients on daily but on specific days, he says it carries out immunization yet only a few years ago, the facility would be enveloped in darkness once the sunset.
Instead, he and his colleagues often resorted to using the kerosene-powered light or candles to illuminate their patients in the operating room.
Bwambale could see how scared the patients especially pregnant and accident victims felt, gripped by pain in the pitch-black darkness.
“Mothers would die while giving birth at night,” he says, noting that up to now, many midwives in some parts of Kasese and other areas are forced to deliver babies without any overhead lights, relying instead on the glow of a candle to illuminate the operating room.
This, he says, makes deliveries and treatment more difficult and dangerous for mothers and children.
Lack of sufficient lighting increases the risk of infection and birthing complications. The World Health Organization says up to 18 women in Uganda die every day from preventable causes related to pregnancy and childbirth.
“There were times when mothers would come here at midnight and find darkness, and become afraid to be admitted,” Bwambale recalls.
As a result, some pregnant women would instead choose to wait until morning to enter the health facility or walk to the distant facility that offered sufficient lighting — putting their lives and the lives of their unborn babies at risk.
Bwambale’s experiences scratches the surface of the struggles faced every day by health care workers who lack access to reliable power.
In clinics and hospitals without electricity, such difficult working conditions mean turnover rates among midwives, doctors, and nurses can be high, disrupting the availability of health care for patients in need.
Bwambale also remembers how he and his colleagues used to be afraid to walk home at night.
Without adequate access to energy, health care workers can’t take advantage of critical technology like ventilators to supply oxygen for small and premature newborns, refrigerators to preserve vital vaccines, microscopes to make diagnostics, or laptops to keep digital records.
With such a worrying trend, World Wide Fund for Nature (WWF) in Uganda with funding from the European Union (EU), two years ago installed 51 solar Photovoltaic (PV) systems to different 20 health facilities and 31 schools in six districts including Kasese, Arua, Rubirizi, Kagadi, Maracha and Masindi to improve the quality of health services offered to mothers and other patients.
For Sarah Kabugho, a nurse at Isule Health Center III, another facility that sits miles from the nearest power grid in Kasese, the solar panels installed by WWF are now powering the centre’s lighting and a fridge, which means the facility has a more reliable way of storing vaccines.
“When we had the gas fridge, it was quite difficult. The gas would run out anytime and we then had to quickly pack the vaccines in ice packs and rush them to another health centre,” said Kabugho as she removed vaccines from the solar fridge, as almost 40 parents waited outside for their children to be immunised.
She also recalls that at times they would fail to treat patients that would present with symptoms of malaria because they didn’t have a functional microscope to take their blood samples and check whether or not they were suffering from the suspected disease.
“But now the microscope is working. We can’t treat any malaria patient before confirming that it’s malaria. Life has become simpler and better for patients now,” says Kabugho.
Since the installation of the powerful solar systems by WWF, Bwambale says that their refrigerator for vaccines has never gone off and tgat all the drugs are stored safely.
“Solar electricity is always on; it never goes off. We now hold our immunization programmes without any hindrances, and we are saving money that we used to spend on buying kerosene and candles,” he says, adding that: “as a result of having a reliable source of electricity which is at the same time free, the number of expectant mothers to the health centre has since increased”.
“We now days get between 12 and 20 patients who seek our services at night, including expectant mothers, and we work on all of them. Some even get admitted because we have enough power to light the whole place,” Bwambale says.
Sarah Musoki, a resident of Malib village told this website that before the solar system at Mukathi she used to carry her sickly son at night with a candle and walk to the health facility for treatment.
What Musoki can’t forget is that in most cases, she would find the health center closed because the nurses would be unable to work in darkness at night.
“Since this solar [system] was brought here, this health center works every day and even at night. They don’t close. I even immunized my child from here, we are really happy about it,” Musoki says.
Elsewhere, connection to a sustainable source of power might not be surprising but to many rural health facilities, it’s a major milestone.
In high-income countries, hospitals are among the largest commercial consumers of electricity, relying on power for everything from a water supply, temperature control, lighting, and ventilation to a huge range of clinical equipment.
In contrast, many hospitals and clinics across Uganda don’t have access to reliable electricity?if they even have any access at all. This leads to serious problems, including the spoiling of medicines and the inability to use essential medical and diagnostic devices; even the lack of basic lighting and communications can complicate treatments—especially emergency procedures.
Lack of electricity limits working hours and inhibits the deployment of medical technology; recent reports have highlighted the importance of technology in health care and its potential to transform how health care is delivered in Sub Saharan Africa. But most technology requires a reliable source of electricity, and that is often lacking.
Electrifying health facilities lies at the nexus of energy and health challenges. When health clinics have electricity, care for mothers and babies is safer. With adequate lighting, fewer infections occur, blood transfusions happen more rapidly, and deliveries are more successful. Increased power also allows doctors to use electric diagnostic and medical equipment to be treat life-threatening diseases.
Powering rural health clinics lies at the core of the United Nations Sustainable Development Goals. Achieving progress on providing quality health care — Sustainable Development Goal 3 — directly relates to increasing sustainable energy access — Sustainable Development Goal 7.
Stories like these from electrified clinics across Uganda highlight the importance of energy access for health care facilities.
Global investment in, attention toward, and effort to power health clinics must be increased to continue improving the quality of health services for all and save lives.