PIH-EMR

The PIH informatics team’s blog

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Power to the Clinics

Posted by pihemr on April 3, 2008

It’s something most people take for granted when they talk of implementing an EMR system anywhere, even in a developing country. We know to ask questions about Internet bandwidth, or how frequent blackouts might be, are there staff members with enough computer skills to operate the systems, etc. But in general, we take it for granted that there will be some kind of power. The rural mountains of Lesotho, however, don’t afford us the luxury of making this assumption. The tiny Sesotho villages operate much as they did when this mountain kingdom was formed in the 1800’s. Thatch-roofed rondavels dot the mountainsides with rows of maize filling in every spot of arable land and sheep grazing on the land above that. Fire and the traditional Basotho Blanket are the only measures for keeping warm in the harsh winters and transportation is primarily on horseback, although the occasional truck does wind its way through the mountains to provide stocks of lamp kerosene, Coca-Cola and Hansa beer to the rural shops. While the power grid has made its way to the primary townships in the mountains, the “last-mile” still remains far out of reach for all of the rural villages where PIH operates. The lack of a market in the impoverished villages have made the likelihood of the grid extending into these areas any time soon low at best. Generators, with relatively low initial costs seem like a good alternative, but factor in rising fuel costs and the sheer difficulty of hauling liters of petrol up to the sites and this option too becomes infeasible. The villages do enjoy plenty of year-round sunshine however, so when the Solar Electric Light Fund (SELF) was approached by PIH to bring solar power to the clinics it seemed like a perfect solution.

After months of planning, procuring and the shipping of two containers from the other side of the world had been completed, we were ready to begin the installation of the equipment at our sites. Our team was comprised of our leader Walt Ratterman, a solar expert from SELF, three local electricians and a couple of IT guys. The first task was to unpack and sort the shipping containers full of equipment into piles for each of the four sites. From there we loaded the equipment onto 4 ton trucks for the slow and arduous journeys to the sites. The equipment included solar panels, 140lb. batteries, racks, mounting poles and a whole host of electrical equipment. Two of the trucks completed their journeys without incident, while the other two got stuck at river crossings that required their offloading and reloading onto boats or smaller 4×4 pickups for the rest of the journey. With the equipment onsite and the team in place we began assembling the various components that after a few days of work, resulted in the lights being flipped on for the first time in these villages. The idea of these rural villages skipping entire generations of electrical production and jumping right to an eco-friendly and sustainable solution is heartening indeed. Patients can now be attended to at night, doctors have the facility for crucial laboratory equipment and our laptops running OpenMRS now have a place to plug into. Soon Internet will follow and these clinics will take a leap forward into the 21st century with all the advantages that modern communication, telemedicine and electronic record keeping have to offer.

-Jeremy

 

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