EmPowering Healthcare Resilience

The Waterloo Institute for Sustainable Energy is a multidisciplinary research group at the University of Waterloo, tackling complex energy issues at the intersection of engineering, environment, science, and health. Our mission is to apply this research to generate innovative solutions and policies that will create long-term change and sustainability in energy systems. We recognize that global collaboration is crucial in achieving this goal, which is why in 2015 we created the Affordable Energy for Humanity initiative, a global consortium composed of over 150 members from institutions in 32 countries. With our partners, we work on sustainable energy research and on-the-ground initiatives, focusing on energy access in the global south. Our work ranges from electric vehicle research, to the energy-health nexus, to the implementation of off-grid renewable energy systems, and beyond. Through these efforts, we are working towards our vision of achieving clean energy that is accessible and affordable for all.

Up to 70% of health facilities in the global south lack a reliable source of electricity, a basic necessity for lighting, forcing medical personnel to deliver children, perform surgery, and treat emergent disease (i.e. COVID-19) under a dim kerosene or cellphone light. We will introduce a local clean energy resource that is low cost, easily transportable and a reliable solar-based power system (the “solar suitcase”) to 30 health clinics in refugee camps and peri-urban slum areas in northern Uganda. These modular emergency power kits serve as lighting and cellphone charging systems that help medical professionals conduct crucial medical care. This project will build resilience in vulnerable healthcare facilities by improving critical healthcare infrastructure - allowing health facilities to increase hours of operation, quality of care, and practitioner safety. We will elevate humanity by empowering healthcare resilience for the most vulnerable, while promoting action on climate change.

Lack of access to energy feeds a vicious cycle of poverty. Accelerated deployment of clean distributed energy solutions to reach the billion+ with no access is our ambition. 

Access to clean energy is a powerful catalyst for sustainable development, with impacts on health, education, water and sanitation, poverty alleviation, gender equality and more. Access to clean cooking fuels would reduce the 4 million deaths per year that occur due to indoor air pollution from polluting stoves and solid fuels.[1] Access to household electricity can provide income-generating opportunities, particularly for women. Access to lighting and networks are tools that can support children’s education. Most acutely, access to electricity in health clinics can support safer and more reliable healthcare practices to power equipment and reduce mortality, maintain vaccine cold-chains, and provide clean water. The world is a long way from providing the full extent of electricity needed to support health clinics in the Global South, but in this project we propose to begin bridging the healthcare infrastructure deficit by providing the most basic form of personal protective equipment - light. We will also reduce the burden on healthcare systems by providing clean cooking solutions to local community members.

[1] https://www.who.int/news-room/fact-sheets/detail/household-air-pollution-and-health

Our approach to tackling the healthcare energy crisis in Uganda is twofold: we will equip 30 health clinics in Ugandan refugee camps and peri-urban slum areas with solar lighting and cellphone charging systems, and we will provide biochar briquettes and clean cookstoves to local households as a clean cooking solution. 

The modular and transportable solar suitcases eliminate the need for expensive and unreliable diesel generators for electricity. The suitcases are well-suited to remote and off-grid communities that currently have no access to any form of electricity. We will provide healthcare facilities with training on these solar suitcases in order to ensure maximum benefit for medical workers and patients. 

This project will also provide locally sourced, clean-burning biochar briquettes to use as a clean cooking solution in 1000 households served by the clinics who receive a solar suitcase. These briquettes are created from waste agricultural products from local farmers, and will be used in tandem with clean-burning and safe top-lit up-draft stoves.

Following the installation and training period, we will collect data (GPS-tracked) for several months as the suitcases are used, and will develop analysis on the data to inform future initiatives to improve access in difficult to reach geographic terrains.

Uganda has the largest refugee population in Africa, with over 1.3 million, 204,541 of whom live in the Adjumani district. We have identified eight refugee settlements in the Adjumani district with greatest demand for energy access (villages Agojo and Maajii c1 to c7) that are our target population. Within these 8 settlements, we will choose 30 health clinics that maximize the number of people positively impacted by energy access, with particular focus on places that will serve women and children. The health clinics will be chosen in conjunction with the local government and the UNHCR, both existing partners of our work. We hope to improve healthcare resilience for over 25,000 people in this district.

The Adjumani district in Uganda is our target area because of the established critical need for improved healthcare and existing community relationships with our ‘on-the-ground’ partner Mandulis Energy. Mandulis Energy currently operates several off-grid energy access facilities in northern Uganda and is developing 15 additional sites including in Adjumani district. Community engagement is at the center of our energy access projects. We use a process called Social Value Mapping to ensure all community voices are heard and included in the decision-making process.

Our project elevates populations which have been made especially vulnerable due to a lack of access to stable energy. Without electricity and lighting equipment, health clinics cannot provide even the most basic services, such as storing medication, sterilizing equipment, and operating after sunset. This adds to the existing struggle of those who have been displaced, and makes them more susceptible to complications from diseases including malaria, diarrhea, and malnutrition. We aim to improve conditions for these groups who have been left behind, by improving conditions in healthcare facilities and households through the provision of lighting kits and clean cooking solutions.

The global need for innovative clean energy solutions for remote, off-grid, and/or underserved communities in the Global South is well established, and was built into the creation of WISE in 2008. In 2015, Dr. Jatin Nathwani of WISE and Dr. Joachim Knebel of the Karlsruhe Institute of Technology in Germany acted on the need for greater collaboration and innovation in energy access, and created the Affordable Energy for Humanity (AE4H) initiative. AE4H is a consortium of over 150 energy access practitioners from 32 countries. Members meet at biannual Innovation Labs to build ideas and work together on projects. 

Through several past projects with AE4H partners in East Africa, the lack of healthcare infrastructure has emerged as a prevalent development issue. Through our work in refugee settlements, we see the burden of diesel generators and other fossil-based energy sources on agencies such as the UNHCR and refugee camps. When the COVID-19 pandemic arose, we knew that our efforts to build resilience in healthcare through energy access was where we could leverage sustainable development best. We have used solar suitcases and sustainable biochar in past projects with great success, and we believe we can create a great impact again through this project.

At WISE we believe that SDG 7, access to clean and affordable energy, is at the centre of sustainable development. The provision of energy access that is clean, safe, reliable, affordable, and accurately meets community needs is a powerful catalyst for promoting health, alleviating poverty, providing clean water, reducing gender inequality, climate action, responsible consumption, and more. WISE’s executive director, Dr. Jatin Nathwani, grew up in Uganda and has witnessed first hand the transformational power of energy access.

The ongoing COVID-19 pandemic highlights the need for increased resilience and infrastructure in health clinics in the Global South. While the direct impacts of COVID-19 have been relatively low in Uganda so far, there may be future infectious diseases and health crises that have a larger impact. 

We are passionate about clean energy access as it is a low-cost, sustainable, and effective method of building healthcare resilience and healthy populations. Innovative clean energy solutions also provide a basis for a larger scale clean energy transition that is required in order to mitigate global climate change. Equitable healthcare, sustainable development, climate action - these are what motivates us, and what we hope to promote through Elevate.

WISE, Mandulis Energy, and the AE4H initiative have demonstrated success in numerous projects throughout the past ten years. WISE’s project successes include the creation of the HITCH Learning Platform (https://tryhitch.com/), the development of two offgrid solar installations in Canada and Uganda to generate crucial data for improving energy access (https://ae4h.org/projects/ohres), the compilation of an IEEE special issue on sustainable energy access for all, and ongoing projects in East Africa to provide sustainable and affordable access to energy.

Mandulis Energy has years of experience and a demonstrated large impact on energy access in East Africa. Mandulis’ Earth Energy project is Africa’s largest grid-tied biomass gasification power plant. This 20MW plant is in northern Uganda and is backed by KfW, the African Development Bank and Power Africa. Mandulis’ REPARLE project, in partnership with ACTED and USAID Power Africa, is developing 8MW of rural microgrids to provide energy access to farmers in Uganda. Through their array of projects, Mandulis is developing an additional 15 sites (500 kW-2MW capacity) poised to serve refugee settlements (6 high priority locations in Adjumani district) and Lamwo, Kiryandongo, Ramwanja, Kyaka, Kyangwali, BidiBidi. (https://www.mandulisenergy.com/)

Our AE4H academic partners (Oxford, KIT, Berkeley, ASU, IASS) bring the ‘state-of-the-art’ smart systems designs, field trials and pilot studies for remote monitoring and control and the social science capacity for building community empowerment.

WISE and Mandulis Energy have demonstrated efficiency and adaptability in responding to the COVID-19 pandemic. We were able to quickly conduct analyses regarding new community needs that arose because of the pandemic, and adapted our existing projects to meet these needs. WISE and Mandulis Energy’s existing projects in Uganda were expanded to include the provision of electric ambulances, due to a predicted increase in emergency healthcare services and cold storage. We pivoted our existing biochar production projects to the production of products to mitigate the spread of COVID-19, by providing local distilleries with the clean and efficient-burning biochar briquettes to power the production of hand sanitizers and PPE. Despite lockdowns, travel restrictions, the rapidly shifting funding environment, and the spread of COVID-19, WISE and Mandulis Energy have been able to overcome barriers to maintain a high quality of service for target communities. We have made a marked shift towards using energy access as a tool for improving healthcare, as it is our goal to continuously adapt to the most pressing global energy needs.

WISE has a history of bringing together international participants to collaborate and catalyze change in energy access. In 2016, we hosted the OpenAccess Energy summit, which resulted in the OpenAccess Energy Blueprint for achieving universal energy access. (https://ae4h.org/open_access). For the past 4 years, WISE has also been hosting ‘Innovation Labs’, which bring together entrepreneurs and researchers from organizations around the world, all focused on the common goal of achieving universal energy access (https://ae4h.org/projects/innovation_lab_current). At our most recent Innovation Lab, we hosted more than 50 participants for a 3-day event that included themed workshops and group challenges. WISE also leads an internship program, which sends undergraduate students to countries in sub-Saharan Africa to work with our non-profit partners on energy projects. WISE has hired more than 25 interns, who have made significant and lasting contributions at 12 of our partner organizations. Another recent accomplishment is the IEEE September 2019 Special Issue on Electricity for All, edited by Jatin Nathwani – WISE’s executive director. (https://wise.uwaterloo.ca/download/documents/wise-admin/strategic-plans/ieee_proceedings/final/proceedings_of_the_ieee_special_issue_sep_2019_volume_107_number_9_electricity_for_all_issues_challenges_and_solutions_for_energy_disadvantaged_communitiespdf;v1?attachment=0)

WISE’s leadership, through these and other instances, has brought together a global community of energy access practitioners, and is making a global shift in the goal for sustainable and affordable energy for all.

The Waterloo Institute for Sustainable Energy (WISE) is a research institute of the University of Waterloo, Canada. In 2015, WISE created the Affordable Energy for Humanity (AE4H) initiative. AE4H is a global consortium composed of over 150 members from 50 institutions in 32 countries - the majority in the Global South where issues of energy access are most prevalent. Members come from academia, civil society, private energy enterprises, government, nonprofit organizations, and more. WISE works with AE4H partners to design and implement clean energy systems to provide access to energy to remote and/or marginalized communities in the Global South.

Partnerships: Our organization has deep partnerships with over 50 energy access institutions in 32 countries, including universities, social enterprises, non-profits, and grassroots organizations. Energy access is a multifaceted issue that requires many types of expertise to solve. Through these partnerships, we can provide a holistic solution to energy poverty in refugee settlements, with a commitment to develop scalable solutions for the international community.

Inclusion: Our approach to energy poverty does not focus solely on technology but integrates community requirements and perceptions of value. Communities are not simply end-users, but partners empowered to become change agents. We use the Social Value Mapping method to conduct meaningful engagement with partner communities and ensure all voices are heard. We recognize that women are a powerful catalyst for development and place focus on the empowerment of women and girls.

Research: WISE and our partners are at the forefront of energy access research, on both the technical and social sciences. We have collectively tested numerous aspects of energy poverty solutions, have identified successful solutions and are ready to scale. Our subject matter expertise and iterative approach to finding energy poverty solutions make WISE truly unique and well-suited to coordinate the deployment of energy access solutions.

Access to energy in and of itself is an output, not an outcome. Through the provision of energy, we hope to catalyze positive outcomes in health, education, equality, poverty alleviation, and climate action.

Activities through this project are:

-        Provision of clean energy services to health clinics

-        Provision of clean cooking tools to community members

-        Provision of microbusiness training to women in the communities

-        Community engagement and education

-        Training of local community members to operate and maintain energy services

The related outputs are:

-        30 health clinics providing care to thousands of refugees and low-income residents in Uganda obtain access to low levels of reliable power

-        Health clinics are able to increase hours of operation

-        Community members are educated on clean electricity and clean cooking

-        Women in local communities are educated on operating microbusinesses

The related outcomes are:

-        Increased quality of healthcare leading to increased life expectancy and reduced mortality

-        Increased ability of health clinics to adapt to future health crises

-        Reduction in illnesses and mortality due to indoor air pollution, from provision of clean cooking supplies

-        Reduced burden on local health clinics to treat respiratory illnesses, due to provision of clean cooking supplies

-        Sustainable poverty alleviation through the creation of income-generating opportunities and increased time to pursue them

-        Increase in gender equality through the provision of services to women

-        Increased skills and education of community members through engagement activities and skills training

-        Increased local environmental protection and sustainability as dependency on firewood and fossil fuels reduces

-        Scaling of climate action through the success of clean and decentralized energy systems

The links between energy access and healthcare, equality, and poverty alleviation are substantiated by a wealth of research. For examples, please see below.

-        "Lasting Impact: Sustainable Off-grid Solar Delivery Models to Power Health and Education" –SE4ALL

-        “Access to Modern Energy Services for Health Facilities in Resource-Constrained Settings” -WHO

-        “Energy Consumption and Health Outcomes in Africa” –World Bank and WHO

-        “Use of Biochar-Producing Gasifier Cookstove in Rural Households” –Kinyua et. al.

We currently serve approximately 10,000 people through our work to provide access to clean and affordable energy. In one year, we hope to grow our impact and provide energy access to 25,000 people in refugee settlements and peri-urban slum areas, and in five years, to 100,000.

The first phase of our project will last one year and include distribution, training, and monitoring programs. The ‘solar suitcases’ will be distributed to 30 healthcare clinics in Ugandan refugee camps and peri-urban slums. We will also provide biochar briquettes and clean cookstoves to 1,000 households in the communities served by these clinics. To ensure adequate support is given and the communities can leverage the full potential of these supplies, will lead integration of solar suitcases into clinics and biochar into households. Our team will conduct training of medical personnel and household members. Once integration and training have been completed, we will continue to run regular check-ins with clinics and households, and conduct data collection which will be used for later analysis and research. 

In the next five years, our goal is to scale access to clean and affordable energy to over 100,000 refugees and marginalized people in East Africa. We will do this through research on the optimization and allocation of scarce physical assets for maximizing value of service delivery, and by continuing innovative public-private partnerships that deliver efficient and crucial clean energy access.

WISE currently works with over 50 global organizations to promote access to energy. Here a few of the organizations with whom we work more closely.

Mandulis Energy: a prominent renewable energy enterprise in East Africa, our on-the-ground partner for energy access projects in Uganda.

Trama TecnoAmbiental: a Spanish international engineering and consulting firm, has been a project developer (300+ projects over 30 years) and EPC with local partners providing rural electrification solutions worldwide.

Karlsruhe Institute for Technology, Oxford University, University of California Berkeley, Arizona State University, IASS Potsdam: These universities are at the cutting edge of developing energy access technology and processes for community integration. We work with these academic partners to develop research, designs, and engagement practices for our energy access projects.

Other relevant partnerships include: the MIT Energy Initiative, the UNHCR, Deutche Gesellschaft fur International Zusammenarbeit (GIZ), USAID, Africa Minigrid Developers Association, and Kenya Power.

Since its inception, WISE has acquired over $25 million USD in research grants across diverse energy disciplines in support of energy research. In the last year, WISE has begun Ugandan energy access projects with $1.4 million USD in grant funding from the United Kingdom’s Department for International Development, and $185,000 USD in grant funding from Humanitarian Grand Challenge, in partnership with several Affordable Energy for Humanity members.

Our budget for the proposed solar and biochar project is as follows:

Purpose

Cost (USD)

30 solar suitcases at $2250 each (including shipping)

$67,500

Biochar briquettes for 1000 households, 1 year supply

$50,000

Top-lit up-draft (TLUD) clean-burning stove x1000

$20,000

Microenterprise training for women (to sustain biochar market after initial provision)

$25,000

1 full-time local project manager and community liaison

$45,000

2 local internship students

$15,000

Consultation and community engagement activities

$10,000

Maintenance costs of energy technologies

$15,000

Travel & subsistence

$20,000

Contingency

$25,000

Total Requested 

$292,500

The main barriers we face in our work are the declining amount of development funding and finding funding organizations who understand and appreciate our approach to community-centric design and engagement. Partnerships with governments, communities, and local organizations, designing innovative technology, and maintaining a strong vision are our strengths, but we must find funders who believe in our vision in order to scale our projects to meet global energy access needs.

The Elevate Prize offered by MIT is unique because it places a focus on marginalized communities, it understands the principles of systemic and transformational change, and it is willing to invest in people with big ideas. We find these ambitions to be aligned with the work of WISE, and we look forward to the opportunity to scale development impact for some of the world’s most vulnerable through this project.