Can Digital Health Go Off-Grid And Still Save Lives?

The Medical Futurist
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What would you do without your smartphone or laptop for a week? Some cannot even imagine putting them down for a second, without thinking much about the vulnerability of our entire digital existence.

What if a hurricane destroys the electric grid? What if power supplies get cut off by unstoppable rain? What about a future dystopic scenario with our traditional energy sources depleted due to overconsumption? And what if we just look at less fortunate parts of the world where stable electricity service is a rare treasure? We collected some examples of how medicine could become more independent of the traditional electricity system – through the power of the Sun. Keep your heads up, sustainability in healthcare is coming!

Addicted to electricity

The basis for all healthcare technology is electricity. Well, the very foundation of every other technology as well. In the developed world, we are addicted to electricity on the level of the individual and the entire society. We cannot imagine a day without smartphones, laptops, or TV screens anymore. As our homes become wired up more and more with every passing day, we might soon add smart refrigerators, smart mirrors, or intelligent heating systems to the list, too. However, our bigger systems, such as healthcare, transportation, industrial production or education are also powered by ‘artificial lightning’. Moreover, in the last couple of years, our lives became as heavily reliant on energy sources, most of all electricity, as never before. According to statistics, energy use in the U.S. is doubling every 20 years. Google alone uses enough energy to continuously power 200,000 homes. The amount of energy it requires to conduct 100 searches on the site is the equivalent of a standard light bulb burning for 28 minutes.

The situation is surely no different in healthcare either. The bedrock of any health system is electricity, and the significance of the science and practical application of how to generate electric power becomes even more important in the era of digital health. The U.K. Department of Health named electricity as the ‘most vital of all infrastructure services’ because ‘without it, most other services will not function’.

That’s certainly one of the weakest points of any digital health system. How could we keep up the level of health service without electricity in extreme events? What if power supplies get cut off by hurricanes and other adverse weather-related events? What about a future dystopic scenario with our traditional energy sources depleted due to overconsumption?

How do you care for patients after dark?

Although we should definitely look more into backup options for apocalyptic scenarios, we do not really have to stretch the boundaries of our imagination this far. Many countries in the developing have to face the ‘lack of electricity’ trouble on a daily basis. For example, in Tanzania, only 7 percent of the population has access to the electric grid. In Kenya, power outages could last 4.5 hours at a time on average. Looking at healthcare, a recent study of 11 major sub-Saharan African countries found that roughly 1 in 4 health facilities had no access to electricity, and only about one-third of hospitals had reliable electricity access.

The consequences of the lack of electricity in healthcare settings are grim. When you don’t have a reliable lighting system, you basically cannot operate on patients, cannot deliver babies or even diagnose the most basic conditions after sunset. Moreover, power outages lead to interruptions in the use of essential medical and diagnostic devices; blackouts cause disruption in the communication lines; medical supplies, blood, vaccination cannot be kept under safe conditions; and medical facilities cannot operate X-rays, ultrasounds, or incubators. How could disruptive solutions help in these situations? Could sustainable energy sources mean viable alternatives? Can we imagine healthcare without the traditional electricity grid and operating on solar, wind, or geothermal power?

Solar energy powered smartphones for health workers in Zanzibar

Let’s start with the Swiss army knife of our digital times, the smartphone. If we only consider the healthcare applications of our current ‘silver bullet’, we are already talking about a possible ECG device, symptom checker, medication manager, otoscope, or vision checker. All these applications would be indispensable in the developing world where resources are scarce – if we could somehow solve the charging issue. The smartphone is only valuable as long as it’s not dead.

Let’s take solar power. While it also has its limitations, mainly that solar panels have a rather low conversion rate and its usability is rather seasonal, the alternative energy source could prove to be a life-saver in some parts of the world. Especially, in developing countries where mobile penetration started to sour in the last decade – but you still need electricity to power those phones.

That’s exactly the issue that the Little Sun social business wants to solve in Tanzania. As many healthcare community workers lack electricity in their homes or when they have to deal with patients, they started to empower them with the portable Little Sun Chargers – phone chargers working with solar energy – to make sure their most important medical tool, their smartphone, never dies.

Thank the sun for better hearing

Botswana-based Deaftronics attempts to tackle the lack of medical specialists by using the Sun. It has manufactured the first solar-powered hearing aid unit, Solar Ear. This technology is game-changing in a country where there are only 12 audiologists and five audiology centers for a population of over two million.

Each Solar Ear unit includes a digital hearing aid, a solar battery charger, and four rechargeable batteries. The batteries can also be used in 80% of hearing aids currently present in the market. This invention reduces the amount of visits patients are typically required to make to care centers in Africa, Brazil, China, India, and Singapore, which also assists in saving time and money.

Solarclave for more sterile devices

In rural settings where healthcare facilities sometimes take up only a tent, a doctor, and a nurse, sterilization can pose a real challenge. Especially, since it not only means putting scissors, tweezers, scalpels and other medical instruments under boiling water. Instead, they must be autoclaved using high-pressure steam at 121 degrees or higher for 15 to 20 minutes.

Students from MIT designed a so-called Solarclave in July 2011 and tested its working in Nicaragua. The innovative solution has a series of mirrors reflecting sunlight, concentrating rays of light onto a closed bucket which acts as a “pressure cooker”. The heat generated inside is well over the required minimum for sterilization; any instruments placed inside the vessel will be sterile and ready for use. Their design can work in off-grid clinics, it’s cheap, relatively simple to repair. Another group of engineers led by Oara Neumann and Naomi Halas of Rice University developed the idea into the first functioning prototype that passed standard FDA-level sterilization tests two years later.

The sunshine can cool it down

Not only sterilization but also storing blood samples, vaccines, and other medical supplies constitutes a major challenge in rural settings since refrigeration needs to be constant while these far-away medical facilities often have blackouts and power outages for hours or days.

Even in the developed world, vaccine refrigerators sometimes drop below the freezing point and damage the drugs. Studies show that about 13% of vaccines in developed countries, and nearly twice that in developing countries, are exposed to freezing temperatures. To solve those problems in one stroke, the UK-based company, Sure Chill, has developed a solar-powered refrigerator with a freeze-proof mechanism. The WHO approved the solution, which the enterprise already brought to more than 40 countries.

Solar suitcases for doctors on the go

Dr. Laura Stachel, an obstetrician and gynecologist at the University of California and her husband, Hal Aronson, a solar power specialist, designed a “solar suitcase”, a portable kit originally containing a small photovoltaic (PV) solar panel, battery charger, and outlets for energy-efficient LED (light-emitting diode) lights, and brought it to a hospital in Nigeria.

As they realized that there’s a strong need for it, they established We Care Solar, a nongovernmental organization. More than 600 solar suitcases, now factory-made, have been deployed in more than 25 countries of sub-Saharan Africa as well as Haiti, Nepal, and the Philippines.

Pacemakers connected to the sun

Although experiments have produced the introduction of a solar toothbrush without the need to use toothpaste as well as a solar blood pressure monitor, a truly fascinating, futuristic, and extremely useful innovation in the area was presented by Swiss researchers two years ago. They showed that postage-stamp size panels implanted under the skin could theoretically generate enough electricity to run pacemakers and similar devices that now require bulky batteries.

The Swiss team claims the study is the first to generate real-life data on how typical human movement patterns could gather enough light-derived power for medical instruments such as pacemakers. Previous studies had simulated how such devices could work beneath flaps of pig skin (which has similar optical properties as human skin), showing a few minutes of direct sunlight exposure was enough to charge a pacemaker for a whole day. Imagine that in the future, we might be able to wear solar-powered digital tattoos and send tiny nanobots into our bloodstream to collect information and send it to the doctor – all through tiny solar panel technology and other amazing nanotechnological innovations.

These are just a couple of renewable energy initiatives for the health sector in the developing world, but individual examples are small compared to the enormous energy needs in rural areas around the world, especially Africa, South America and the Caribbean, and their untapped solar resource potential. Thus, we hope that these solutions will multiply exponentially in the coming years to enable access to care even in the most vulnerable settings – without electricity.

Can Digital Health Go Off-Grid And Still Save Lives?