In 30 of Mozambique’s rural health centres, the 2016 installation of solar suitcases— devices that connect to a solar panel and provide nighttime light and fetal Doppler—has substantially increased the number of births the centres see after sunset, says PWRDF Executive Director Will Postma. Installations are planned in 50 more clinics. Photo: PWRDF
Welcoming a baby into the world involves making a seemingly endless number of decisions, all of which become increasingly urgent and important when childbirth arrives. For parents-to-be in the rural Nampula province of northeastern Mozambique, one of the hardest choices has come with labour that starts in the dead of night: Do we stay in our safe, familiar home, where we may have very limited access to medical care if complications arise? Or do we venture into the night to an off-the-grid rural health centre that will have a traditional birth attendant and even a doctor—but that will be shrouded in total darkness? Will it be safe?
In recent years, this decision has become easier to make, thanks to an expanding program, supported by the Primate’s World Relief and Development Fund (PWRDF) to bring solar-powered light and equipment to rural health centres in the Nampula region.
Nighttime illumination of rural health centres has been made possible by the installation of solar suitcases—wall-mounted yellow plastic cases kitted out with rechargeable lanterns, phone-charging ports and even a fetal Doppler, which measures a baby’s heartrate in utero and can indicate complications during labour and birth— connected to a small rooftop solar panel. Will Postma, executive director of PWRDF, says the first phase of the project was very successful and that phase two has begun.
In the first phase, 30 health centres were selected to receive the solar suitcases, which are manufactured by California-based We Care Solar. Working with local partner Association of Community Health (EHALE), PWRDF and We Care Solar helped train 12 people in the installation, maintenance and use of the devices.
Postma says the program has brought “some really impressive changes in terms of more and more women who have given birth at night in the health facilities,” where 80,000 women delivered their babies between 2016 and 2020. “In the first phase, a number of the health facilities saw twice as many deliveries at night, and some actually went to 17 times as many night deliveries after the solar suitcases were installed.”
This substantial increase in nighttime births, Postma says, indicates how the solar suitcases have reshaped the discussion families might have around going to a health centre, moving them away from plans of “giving it our best shot” at home or trying to wait until morning. “In the past, many women did not want to go to the health facility at night because it was dark,” he says.
“It wasn’t great for them and it wasn’t great for the health workers that would have been there,” Postma says, citing imagery of birth attendants or doctors holding cellular phones in their teeth in efforts to shed even a bit of light on their work.
‘They can hear the heartbeat’
The solar suitcases—installed as part of PWRDF’s All Mothers and Children Count program five years ago—have changed this equation. A few hours of sunlight will charge two lanterns for an entire night of use, bringing light to any medical interventions that could be needed during childbirth. The addition of a fetal Doppler has also proved attractive to parents. The device is charged by the suitcase.
“You can imagine how nice it is for women living in rural areas far from town,” Postma says. “They can hear the heartbeat of their child, both the mom and the dad, and the grandparents, perhaps.
“If the rural health facility is seen as increasingly credible and compelling, women and their husbands and their family will double efforts to make use of the health facility and the new gadgetry that comes with the solar suitcase. It’s contributed to decreased maternal mortality, decreased infant mortality.”
The second phase of this project aims to install 51 more solar suitcases—50 more in off-grid rural health centres and one as a demonstration unit in EHALE’s offices. Postma says two people will be trained in support and maintenance for each facility.
Parishes and individuals will be able to contribute towards the costs of these new solar suitcases. For those who remember the first phase—in which substantial matching funds allowed individuals to support the installation of a solar suitcase for less than $1,000 through the Gifts for Mission gift guide (now World of Gifts)—Postma notes that the funding formula has changed. The first 30 solar suitcases, as part of All Mothers and Children Count, benefitted from a six-to-one funding match from the Government of Canada. The second phase, however, is not part of a government matching program, so PWRDF is funding the full cost. Per suitcase, that’s between $5,000 and $6,000, plus another $2,000 or so in shipping, training and other costs. PWRDF is also funding the replacement of some of the lithium batteries in the existing units.
A pandemic-friendly project
Another difference from the first phase of the project, however, is that locals who were trained back in 2016 are still around and are ready to train others. This means that no one need travel to Mozambique to ensure the installation and operation of these new units—that knowledge is already held by local people who have kept all 30 units operational over the past four years. “There are trained people on the ground— and people who know how to troubleshoot, people who know how to set up … the panels and suitcases. So we don’t need folks from the States or Canada to accompany the suitcases or panels,” Postma says.
As this article was being written in February, the 51 new suitcases were being assembled, with the aim of shipping them to Mozambique in May. There, EHALE will receive them and see to their installation.
“That’s pretty good from our vantage point—we don’t have to go there, we can just support them remotely. And maybe when the pandemic lifts, we can go there and have a celebratory time together, when all 51 solar suitcases will have been set up.”