Qualitative healthcare is dependent on power. Whether it be a simple vaccine cold-chain system, blood banking, or complex brain surgeries, electricity has an immense role to play in healthcare delivery in the 21st century so much so that the U.K Department of Health – reputed to oversee the world’s best primary health care delivery service – named electricity as the ‘most vital of all infrastructure services’ because ‘without it most other services will not function’.
Electricity is huge. Power is a big issue. We mustn’t fail to discuss it.
The nation’s electricity demand, according to figures from the Federal ministry of power/works and housing, was placed at 12,600 megawatts(MW) while current supply still hovers below the 4,000 MW line. Thus we have an obvious shortfall which most people living in the country are all too familiar with.
One of my most vivid memories of neurosurgery posting as a medical student in Nigeria was of flashing a torchlight into the spinal chord of a patient…
Someone’s SPINAL CORD!!! Wait, let that sink in…
…because the generator had developed a fault again, and this time it caught us in the OR in the middle of a (laminectomy) procedure. The switch over from ‘NEPA’ to ‘Gen’ was taking longer than usual and our industrious nurses happened to have rechargeable lamps handy just for this purpose. At least that was an upgrade. Before the lamps came we were using our phone flashlights.
Despite the enormity of this issue, it is still a wonder that very little has been published to date on it in the literature despite the fact that power outages have been identified as a significant public health issue.
Power affects everything, from sterilisation of medical equipment to sewage disposal, intensive care to the provision of clean water and it has even been linked with mental health.
Thus solutions in the Nigerian healthcare industry, especially tech solutions have to as a matter of necessity, factor in our relative lack of power.
What type of interventions are we talking about?
- Battery Assisted Devices: What if one cool engineer just sat at his workstation one day and designed a rechargeable battery-powered CT-scan or ultrasound scan machine? What if someone decided that the autoclave must have a backup power store so that many more surgeries could be conducted in rural areas without having to go back to the ‘city’ where there is electricity to sterilise your equipment. Truth be told, a lot of the medical equipment in use in Nigeria today were not manufactured with our epileptic power situation in mind. While researching this post – the few times when data on power failure and its effects on healthcare was available – it was always attributed to terrible natural disasters such as hurricanes, wildfires, widespread flooding and other natural disasters. Our disaster is obviously man-made.
Anyway, do we currently have any battery-powered devices in circulation in our health facilities? Yes. And guess what? A cool engineer somewhere has already designed a rechargeable battery-powered CT-scan and battery-powered Ultrasound scans. The trick is to keep these in mind and know where to look.
2. Alternative power sources: Solar. Solar energy first comes to mind amongst the numerous renewable energy sources available, for several reasons among which is the fact that it is one of the easiest to deploy locally and it has a track record of successful outcomes.
The down-sides of solar include:
a. Relatively low power generation; the average-sized solar PV does not generate enough power to juice up an entire health facility, however, the electricity generated could be focused on one or two essential/choice devices which our health facilities cannot do without. This model is currently being deployed in several health facilities across the country and the rest of Africa to power electronic health records(EHR) solutions, blood banks, morgues, medical devices, etc.
b. Maintenance issues; solar panels are not your everyday gadget and thus are not for your everyday electrician to maintain. If anything goes wrong, the solar installation company has to be on site to maintain it for best results. What if they’re unavailable e.g in Lekki and your Solar powered EHR solution is in Ijebu-Igbo, Ogun state?
These and a few more are the issues with the solar solution but they are being overcome e.g by e-Health Africa, a tech company based Kano who deployed a solar-powered EHR solution in some parts of Northern Nigeria.
3. Generators (Fossil fuels): This is what we are used to. It is terribly expensive to run and maintain and in an ideal environment, should only be called upon as a last resort. Why? It was not designed to be your mainstay of electricity supply. It was initially designed as a stopgap measure. As a means of tying you over until when the main power supply is restored. Its become the reverse in this environment and in most health facilities, fueling and servicing of the generator accounts for a huge chunk of their overhead costs. In startups? The story isn’t different. So what’s the way out?
- Adequate financing: Healthcare is a business. We are in the business of healthcare and empathy, and like all businesses, it does not run on goodwill. It runs on money. Plenty of it. for many reasons including those alluded to in previous paragraphs. Thus to successfully overcome the power hurdles in the health and/or tech environment in Nigeria, a SOLID CAPITAL BASE is essential to your survival.
Notice very little mention has been made of government intervention so far, even though the provision of electricity and affordable healthcare delivery are primarily the functions of government? Well, from 1999 to date, over 2.8 trillion naira – about $7billion – has been spent by government on power alone, yet no tangible results. Why? Cronyism, corruption, lack of skill, among others have been blamed, but even if the ministry of power, works and housing suddenly becomes led by Saints, it will still take years and billions and billions of dollars to fix our power issues. And that’s not going to happen – I mean the saints thing.
Sadly, ours is a country in which entrepreneurs still succeed despite the government rather than because of it.
So, in summary,
- Solutions must be developed in the light of our current power challenges.
- Search for available sources of renewable energy that suit your unique needs.
- If you’re gonna get medical equipment, look for the rechargeable, battery operated, or other sustainable options.
- And finally, in all thy getting, get enough capital.