What you need to know:
- Using torches at night in maternity wards and theatres have become the norm for many rural health centres countrywide. Most remote areas are either not connected to the national grid or some cannot afford electricity.
- Previously, the health unit registered between 25 and 35 births a month but after installation of the solar, they now have between 70 and 75 deliveries a month.
On the night of September 4, 2002, Ruth Kyakuwa could not take it anymore. Kyakuwa, 15, stood at the crossroads to joining the countless number of teenage mothers in Uganda, or worse, women who die while ushering in new life into the world.
The timing of her unpredictable labour pains was the worst; coming in the dead of night.
Her parish, Iringa, now found in Buyende District, was part of Kamuli District, and enveloped in darkness because both solar power and electricity grid were unheard of here.
Amid her labour contractions, Kyakuwa had to walk several kilometres in the night to Iringa Health Centre II, which was also swallowed up by darkness. Upon reaching the health centre, both the nurse and mid-wife on night duty only had draining news for her.
“They told me since the health centre had no electricity to enable them to assist me during delivery, I had to either buy dry cells for their torch or I get my own torch,” Kyakuwa narrates while seated on the shade of this facility.
She adds: “I had no money to buy the dry cells to power the torch, so the health workers resorted to using the torch on their phone to assist me give birth.”
Fortunately, Kyakuwa had a safe delivery and her daughter has since grown up.
However, in 2019 when Joyce Nabwire came to give birth to her second-child, at Iringa Health Centre, which serves about 12,000 residents, the facility had gone through some transformation.
“You know, when you are going to give birth, you go through a lot of pain. But this time round, the pain was lessened the moment I found the whole place well-lit. The nurse didn’t ask me to get a torch or buy dry cells as had previously been the case. I just walked in and was helped to deliver my baby,” the 35-year-old mother says.
Elsewhere, connection to a sustainable source of power might not be surprising but to many rural health facilities it’s a major milestone.
The reason pregnant mothers and other people are seeking basic treatment at Iringa Health Centre II without much fuss is attributed to interventions by Innovation: Africa (I: A), a nonprofit organisation that has been operating in eastern Uganda and Karamoja sub-region for the last 12 years.
The organisation aims at introducing Israeli solar, water and agricultural technologies in rural African villages.
In Uganda, an estimated 100 projects had been completed by mid-2020.
When a team of technicians and field officers from I: A found its way to Iringa parish in 2019, the health facility had just received one solar panel from the Ministry of Health.
But the singular solar panel didn’t take long before it dimmed out.
“It worked for one month and then the security lights stopped working. The officials from the ministry came back once to repair it and have never returned,” Ziria Timugibwa, a mid-wife who has been stationed here for four years reveals.
“But Innovation: Africa came in with solar and now we can work both during day and night,” she adds.
The significance of installing a reliable solar system now goes beyond merely lighting the health centre as the facility is now fully utilising its refrigerator.
“We can now immunise children anytime because the refrigerator safely stores the vaccines since the solar never goes. Before we got solar power, we used refrigerators of other health facilities. Now our immunisation numbers have since gone up,” Ms Timugibwa said.
She says they now have a functioning laboratory after I: A donated them a microscope. “We can test for malaria, typhoid and many other diseases. We also have rapid diagnostic testing kits, too. Our testing capacity has improved tremendously,” she adds.
Although solar energy has helped to improve the services at Iringa Health Centre, access to clean water remains a problem.
“Borehole water isn’t the best because it’s hard, but also moving up and down all the time to fetch water isn’t ideal. We improvise with putting water in the bucket for the maternity ward. We need running water inside,” Ms Timugibwa says.
Unlike the Health ministry that abandoned the solar equipment it installed at Iringa Health Centre II, Mr Dennis Sserunkuma, the Innovation:Africa’s electrical field officer, says the organisation’s policy requires them to inspect their projects every two to three months.
“We have to check to see if there are loose connections or the devices have depreciated,” Mr Sserunkuma says.
He adds: “If the administration of the facility thinks the equipment needs maintenance, they can call us and we sort it out.”
A couple of metres from Iringa Health Centre II, is Nkondo Health Centre III, also in Buyende District.
Here, the impact of Innovation: Africa efforts is more apparent. Just like Iringa, Nkondo also received solar panels and a refrigerator from the organisation.
Ms Cissy Magoba, a nurse at Nkondo, says before getting a refrigerator in 2015, they used to store their vaccines at Kidera Health Centre IV.
Kidera is about two kilometres away from Nkondo and this crippled service delivery of this health centre which serves roughly 17, 820 people from surrounding villages.
“We used to just immunise once a week because we never used to store vaccines here, but now we immunise every day,” says nurse Michael Mubeezi, who has served at Nkondo Health Centre III for four years now.
Mubeezi, to put matters into perspective, says years back, a child who he believes could have been saved, died because the facility had no light.
“The child was shivering terribly, but I wasn’t seeing anything because it was dark. This area has electricity poles but it has never been connected [to the national grid],” he sadly recalls.
But on a sunlit August 22, Scovia Byali,35, had a couple of hours earlier safely given birth to a baby girl.
Ms Byali arrived at the health centre at 4am. “The whole place had light,” she says with a smile . “Before we got solar, we were told to buy tadooba [oil candles] if you happen to experience labour pains at night,” Ms Byali adds.
Statistics at Nkondo show that since solar panels were installed in 2018, the number of pregnant women giving birth from the facility has gone up.
Previously, the health unit registered between 25 and 35 births a month but after installation of the solar, they now have between 70 and 75 deliveries a month.
“Because of those challenges, pregnant women used to frequent other far away facilities or go to TBAs [ Traditional Birth Attendants], but now they feel it’s safe here,” Magoba says.
“We actually no longer have space. So we end up discharging women who have just delivered, which is dangerous but we have no choice since we have no beds.”
The refrigerator too has come in handy, but the medical officers here say it can’t do all the work.
The staff say the refrigerator’s space isn’t enough since it used to store vaccines for two other nearby heath centre IIs, Kigingi and Mukudi, which have none.
“Reagents can’t be put in the same place as vaccines. The two contaminate each other. We now can’t store reagents and that means our laboratory can’t work well,” says Charles Kirevu, the officer in-charge of Nkondo Health Centre III, who also doubles as a clinical officer.
Despite the significant improvement at both Nkondo and Iringa health centres, complaints of lack of reliable safe water are dominant.
But this isn’t the case in Buwumba parish, Gadumire Sub-county, and in Busia District on the Uganda-Kenya border.
In Buwumba, Innovation: Africa has mounted a 10,000 litre water tank that serves five villages and is powered by solar energy.
For easy monitoring, the water system is connected to the organisation’s offices in Uganda’s eastern town of Mbale and Tel Aviv, Israel.
“Without coming here, we can tell how many litres have been pumped into the tank every day and how much has been consumed,” Mr Robert Khakhosi, the I: A’s project manager in Uganda, reveals.
“I can easily know if the pump has a fault by just logging onto our systems in our offices. So we can respond quickly, even before people here alert us,” he adds.
The community’s involvement in the project is apparent.
In order to build the tower, I: A didn’t buy land, rather Godfrey Wafula, 48, surrendered a portion of his land.
As quid pro quo, Mr Wafula doesn’t fetch water from the 13 community taps that are fed by the central tank; rather I: A provided him his own tap in the middle of his compound.
“Because of this water, I now rear my pigs without any problems,” Wafula said whilst pointing at the pigsty.
I can also lay bricks, as you can see, and also engage in waragi (local gin) distilling.”
Before the organisation intervened, in 2018, almost everyone decried the lack of access to clean water in Buwumba parish. Residents fetched water from an unprotected stream which is many kilometres away from homesteads.
Ms Veronica Aguttu, a businesswoman, says the water crisis forced her to flee Busia Town in 1997.
“When I heard that water had been installed, I returned,” the mother of four reveals.
“I’m using this water to irrigate my banana plantation and also brew local gin,” Ms Aguttu reveals.
Her only misgiving of the water facility is that the pressure tends to oscillate during rainy or cloudy days; an issue that Ibra Asera Lumye, the I: A’s engineering field officer, concedes to.
“We explained to them from the very start that during cloudy or rainy days, the water pressure goes down because the system is enabled by solar energy, which is basically the sun. But the good thing is that they can also harvest water during rainy season so you can’t say there can be a crisis,” Lumye said.
Unlike Buyende District Health Centre that are struggling with water, Buwumba Health Centre II, has both solar energy and a refrigerator from I: A, with the water facility capacity estimated at Shs30 million.
“We get free water which flows all day long without interruptions,” says Dinnah Alepus, a nurse at Buwumba Health Centre III.
“Water is very important when you are helping pregnant mothers to give birth, and water is no longer a problem here,” she adds.
To ensure sustainability of the water project, the community under the supervision of I: A officers, have instituted a seven-member water user’s committee, which is superintended by Mr Joostin Ojambo, a 44-year-old farmer.
“At every tap, the users of the water have to pay Shs1,000 every month into our bank account,” Ojambo says.
“If the taps or the pipes get a problem, we don’t have to invite Innovation: Africa officials, straightaway. We can get money from our account, hire a plumber to fix the problem. We can only call them [ I: A officers] when the problem is beyond us,” he explains.
The overriding impression here is that though health centres in rural Uganda habitually experience regular scarcities of indispensable drugs and staff, they have few beds, they have ramshackled if not inadequate infrastructure; but the provision of solar energy, safe water and equipment such as refrigerators, as I: A is doing, will go a long way saving people’s lives.
“They told me since the health centre had no electricity to enable them to assist me during delivery, I had to either buy dry cells for their torch or I get my own torch,” Ruth Kyakuwa, mother