Common barriers to sustainable health facility electrification Carolina Barreto, D. Eng | Renewable Energy Manager Tetra Tech | Complex World, Clear Solutions ™ USAID Contractor 1 Powering Healthcare Webinar. | July 19 th 2016
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Main issues with energy infrastructure in Haiti Electrical Power Availability Power Quality Installations • Unreliable grid • Low voltage • Poor, even • Off grid • Voltage dangerous, wiring • Diesel generators • Lack of fluctuation • Need for battery • Surges maintenance • Bad habits back-up systems; • Sensitivity of • Unskilled possible solar laboratory PV… equipment technicians • Ad hoc solutions 2
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Poor, even dangerous, wiring 3
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Electrical load distribution panels: unhelpful and unsafe The protection covers of load distribution panels are often missing and the wiring is messy. 4
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Lack of maintenance Batteries terminals are corroded. The generator room is not clean, Distilled water may or may not be causing a potential fire hazard and added occasionally. making it difficult to identify leaks. 5
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Burned generators or equipment Example at Saint Antoine de Jérémie Hospital, Grand’Anse 6
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Battery rooms are often not appropriate Need ventilation (battery gases) and access space for maintenance (add water, brush electrodes, check voltage). 7
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Haiti grid power – voltage variations 135 Max Volts 125 Volts 115 105 7/24/12 14:40 7/25/12 7:20 7/26/12 0:00 7/26/12 16:40 Date and time Max Volt L1 Max Volt L2 Min nom volt La Fossette, EDH – July 2012
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Haiti grid power – poor coverage over time 12 10 8 Max kW 6 4 2 0 We1:00:00 Th1:00:00 PMFr1:00:00 PMSa1:00:00 PM Su1:00:00 PM Mo1:00:00 Tu1:00:00 PM We1:00:00 PM PM PM Date and Time Max kW Fame Pereo: EDH 10-18 Aug 2011
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Effects of poor energy infrastructure: Decrease in High Cost Service • Reduced operating hrs; • Generator fuel costs unserved population • Damage to expensive • Reduced capacity for lab instruments tests • Data loss • Nighttime safety concerns • Medicine spoilage • Decline in morale of • Need to redo lab tests medical/lab staff • Decline in morale of technical staff 10
IHFI -- IHFI -- Haiti Haiti Improving Health Facility Infrastructure • Energy assessments; measurements Evaluation • Monitoring • Technicians • Hospital staff • Administrators • Battery/inverter Project Technology • Training Pilots (solar, LED) Approach • Remote monitoring • Standards • Management/planning Institution • Training 11
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure 1 – Energy needs assessments Assessment sites New installation sites A total of 30 health facility assessments have been completed or are under way. 12
Max_Amp 100 Energy Assessments: actual electrical load variation 10 20 30 40 50 60 70 80 90 0 We1:00:00 PM We5:40:00 PM We10:20:00 PM Th3:00:00 AM Th7:40:00 AM Th12:20:00 PM Th5:00:00 PM Th9:40:00 PM Fr2:20:00 AM Fr7:00:00 AM Fr11:40:00 AM Fr4:20:00 PM Fr9:00:00 PM Sa1:40:00 AM Sa6:20:00 AM Sa11:00:00 AM Sa3:40:00 PM Sa8:20:00 PM Su1:00:00 AM Fame Pereo_ED'H Phase 1,2 Su5:40:00 AM 10 Aug 2011-18 Aug 2011 Su10:20:00 AM Su3:00:00 PM Su7:40:00 PM Mo12:20:00 AM Mo5:00:00 AM Mo9:40:00 AM Mo2:20:00 PM Mo7:00:00 PM Mo11:40:00 PM Tu4:20:00 AM Tu9:00:00 AM Tu1:40:00 PM Tu6:20:00 PM Tu11:00:00 PM We3:40:00 AM We8:20:00 AM We1:00:00 PM We5:40:00 PM We10:20:00 PM Th3:00:00 AM Facility Infrastructure Improving Health IHFI IHFI -- Th7:40:00 AM -- Haiti Max. Amp Phase 2 Max. Amp Phase 1 Haiti 13
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure 2 - Technology Battery-Inverter LED lighting Electrical wiring systems retrofit improvements 14
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Battery-Inverter backup power systems Standard designs: --- OutBack inverters --- Rolls-Surrette batteries The inverter-charger: • Grid (or generator) power available Charges the batteries (AC to DC) • No grid or generator power Batteries provide power (DC to AC) Contact vs. No-Contact 15
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure IHFIinstalled 33 battery-inverter backup power systems in 8 departments 16
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure LED lighting retrofit demo Hôpital de la Communauté Haïtienne (HCH), Port-au-Prince 4-ft LED replacement tubes Existing lighting • • 180 T12 fluorescent lamps -- typical LED international standards • 24/7 lighting – if power available • 90 lumens/W – high efficacy • 44W per lamp – high consumption • 50% reduction in electricity use • 66 lumens/W – low efficacy • 2-year payback 17 Source: ASAMLED, 2012
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Electrical wiring improvement Hôpital Universitaire d’Etat d’Haiti (HUEH), Port-au-Prince Emergency room Installation of ceiling Before After lamps, outlets and fans 18
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure 3 - Institutions Partners Haitian Ministry of Public Health and Population (MSPP )’s Project Unit (UGP ) National Reference Laboratory (LNSP) CDC Institutional Activities Standard designs, ToR template Monitoring/communications database Supervision of local installation companies USAID environmental compliance US National Electrical Code compliance 19
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Guyana Health Facilities Intervention • Remote hospitals and clinics – Two standard PV systems designed based on assessment loads – 1kW and 1.25kW – Local installers bid for installation at 9 sites Results: 12 Installations completed by June 2013 Partners Guyana Energy Agency (GEA) Ministry of Health
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• Data collected from posts Pre and Post Vaccination records published by the 1000 Rates Ministry of Health. 800 • 1 to 3 year old population chosen for more constant 600 vaccination rates through the years 400 • Pre PV system the vaccines were administered the day they 200 were delivered. Post PV system the vaccines are administered 0 on demand. Baramita Arakaka Aishalton 2012 2013 2014 • PV system impact can not be measured trough vaccination rates data from ministry, as this depends on actual vaccine supply and not refrigeration
Guyana Health Facilities Lessons Learned • Load simplicity contributed to system longevity and lower maintenance levels • Load complexity is required for higher Energy-Health impact/ remote areas health staff retention • Partnering with an energy agency has been highly effective on system endurance • Facility maintenance staff in within the Ministry of Health has not been responsive • Health (vaccination) statistical data is affected by other factors that do not allow a fair measurement energy impact
IHFI -- IHFI -- Haiti Haiti Improving Health Facility Infrastructure 4 - Training program Train administrators on the importance of maintenance, budgeting Train Train installers hospital on NEC staff on and safe system practices operation Train technicians in charge of installations 25
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Training activities • 150 technicians, installers and administrators trained • 9 Technician training sessions (5 days) • 2 Hospital Administrator training sessions (1 day) • 1 Installer training session (2 days) • 20 on-site medical/lab staff training (1h)
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure IHFI Data Logging and Management Health Facility UGP / MSPP Trained technicians Data center staff closer to their equipment - Store data Administrators - Analyze data - Manage technicians Technicians - Budgeting - Maintain equipment - Submit data logs to - Log operating data Project future needs; data center staff Optimize available - Deliver data logs to infrastructure Administrators More responsibility for their energy infrastructure 27 IHFI Training
IHFI IHFI -- -- Haiti Haiti Improving Health Facility Infrastructure Knowledge Management • Monitoring • Evaluation • Reporting • Information dissemination • www.poweringhealth.org • Facebook page • YouTube videos – Training/information – Documentation 28
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