You may remember our report last winter on the development of a Haiti hospital predicted to become the world’s largest solar hospital. The Hôpital Universitaire de Mirebalais opened last March. So far, it’s living up to — even exceeding — all the predictions.
Solar might seem to some of you a poor choice for powering hospitals — but it isn’t
Why choose solar to keep a hospital running? Considering the often cited issue of “intermittency,” proposing a solar hospital seems counterintuitive. The electrical systems that support the activities of doctors, staff, patients, and visitors are more critical in hospitals than in almost all other major facilities. Interruptions of hours, minutes, and sometimes even seconds can mean the difference between life and death.
“Sporadic electricity impairs the operation of surgical wards, delivery wards, essential hospital equipment, and hospital communications. This compromises the ability of health workers to provide safe, appropriate, and timely medical care. Labor and delivery nurses cannot quickly notify on-call physicians of emergencies. Midwives and physicians are forced to make treatment decisions without the benefit of necessary diagnostic tests. Obstetric procedures and emergency surgeries are conducted under grossly suboptimal conditions and can have tragic consequences,” says a wecaresolar report.
Healthcare centers also consume lots of energy. They operate around the clock. They need very sophisticated HVAC systems to control temperature and air flow. As well as the machines that sustain operating rooms and patient beds, these buildings use huge amounts of energy-intensive equipment for sterilization, refrigeration, labs, computerization, cleaning, laundry, and food service. An EIA Commercial Building Energy Consumption Survey in the US showed that although large hospitals (> 200,000 square feet) account for less than 1% of all commercial buildings and 2% of commercial floor space, they consume 4.3% of total energy delivered to the commercial sector.
In fact, that’s exactly the point — their heavy electricity consumption actually makes hospitals good candidates for solar power. The savings attained are proportionally greater than in other types of commercial buildings. Additionally, the energy consumption in hospitals is more constant and predictable than elsewhere. Using solar can result in substantial energy savings, especially during daytime hours when demand for power is highest. Finally, the sustainability and self-sufficiency provided by effective solar can positively affect the bottom line in a big way.
Aren’t the cards stacked against a country like Haiti?
Haiti is one of the 20 poorest nations in the world, and the least self-sufficient in the western hemisphere. It has the lowest levels of access to safe water and sanitation. GDP per capita (2011) is only $1,235. In a population of 10 million, only 20% of Haitians have any electricity, and 80% live below the poverty line. Widespread health problems include off-the-charts maternal mortality (from obstructive labor, eclampsia, obstetric hemorrhage, and sepsis — 60% of births take place at home) and the largest outbreak of cholera in recent history, which occurred after the devastating 2010 earthquake near the capital of Port-au-Prince. The quake inflicted $7.8 billion in damages on top of an already precarious situation, creating widespread homelessness and spawning off-grid shanty towns in devastated areas.
Haiti’s energy assets are few, and dwindling. All but 2% of the land has been deforested in a scramble for wood and charcoal for domestic uses. Unsustainable diesel, mainly imported from Venezuela, provides more than 60% of the nation’s electricity. Electricity costs six and a half times times as much in Haiti as it does in the state of Maine. And Haitians measure power intermittency not in terms of seconds or minutes, but in hours. Random outages average three hours a day.
How did Haiti acquire a large state-of-the-art medical and academic facility?
Both the cost and the intermittency of existing power in Haiti precluded any modern healthcare capability. Yet the warm island nation now has a state-of-the art research and teaching hospital equipped with the latest diagnostic and communications technology.
The Haitian government sought outside help to create a facility that would overcome overwhelming odds and meet many of the country’s needs. Partners in Health, a 25-year-old Boston-based nonprofit founded to bring modern medical science to those most in need around the world, expressed an interest.
PIH had experience equipping 40 hospitals, most recently solar-energy systems for clinics in other areas of Haiti as well as Rwanda, Malawi, and Lesotho. The organization teamed with the existing medical and government authorities, the Red Cross, the GE Foundation, HP, Artists for Haiti, and several others to conceptualize and implement the Hôpital Universitaire de Mirebalais.
The rationale for the new Haiti hospital was threefold. First, it would offer primary care to 185,000 people in Mirebalais and two neighboring communities, Saut d’Eau and Savanette. Second, it would serve a much wider area with secondary and tertiary care needs, providing a center for specialist procedures. Third, with this nucleus of experts as a teaching base, it would provide a new level of high-quality, in-country education for resident physicians, nurses, and other health personnel.
The Haiti hospital planners envisioned a 200,000-square-foot campus with 300 beds and over 600 outpatients at a time, at least double the capacity of a typical American hospital. By contrast, the Lacolline Hospital, built in a neighboring province in 2008, had one-quarter the space and only 55 beds.
To avoid the high price and unreliability of grid power in Haiti, designers constructed a surprisingly uncomplicated array of solar photovoltaic panels on the building’s roof. They used over 1,800 standard-efficiency (14% conversion rate) polycrystalline silicon panels from the German company Solon. Each panel can generate up to 280 watts, thus providing a total 500 kW of peak DC power.
Massachusetts-based Solectria Renewables manufactured the 95 kW inverters, of which there are five, providing over 400 kW AC. The University of Oregon devised a sun chart that allowed project engineers to orient the array for maximum efficiency. Engineers from Sullivan & McLaughlin Companies traveled to Haiti and trained a group of local electricians in installing and using the system. Two have become regular employees. Jim Ansara, the hospital’s director of design and construction, notes: “This is an incredibly simple system to maintain…. All we need to do is rinse the panels quarterly with water.”
Construction provided about 800 new job opportunities for Haitians and proceeded with only a couple of glitches. The unstable electrical grid and old system of backup generators didn’t mesh well with the new apparatus at first. Also, the roof was so hot at times that the panels lost efficiency, so the engineers painted the roof white to lower its surface temperature, suspended the panels about a foot above the roof to maximize air flow, and anchored them with concrete blocks.
The end result has proven over nearly a year now to provide more than 100% of the hospital’s daily needs. The power surplus allows administrators to sell daytime overage back to the grid and function on grid energy at night, with diesel generators for backup. Mirebalais is on track to cut about $379,000 in annual operating costs. In other respects, too, the hospital is eco-friendly, well designed, and prepped for hurricane-force winds. Designboom calls this “a testament to the ability of the built form to create a sustainable system for survival.”
If you want real-time details, the hospital’s Solectria Renewables–sponsored website gives 24/7 reads (refreshed every 15 minutes) on the site, local weather information, the environmental footprint, and other project details. Today’s generation (and it was cloudy): 1,340.3 kWh. The lifetime total thus far is 485 MWh of energy generated and a total reduction of 291 tons of carbon dioxide emissions equivalent.
The medical education function of the hospital officially started this fall. Studies have indicated that the facility is addressing much of the unmet need for fever treatment and women’s health, and that Mirebalais is partnering well with the other hospitals in the region, even boosting visits to nearby Lacolline. With only a $2.2 million initial investment, the solar power system will pay for itself in just under six years, far less than its design life.
Thanks to a relatively small investment in solar technology, the poorest country in the Western Hemisphere now owns a state-of-the art research and teaching hospital equipped with 21st-century diagnostic and communications technology.
The Hôpital Universitaire de Mirebalais fulfills a second important goal of Partners in Health: it serves as “an antidote to despair among those most in need.” Such decentralized solutions “offer people in off-grid regions access to electric power, a fundamental requirement for economic and social development.”
The Haiti hospital also confirms the wisdom of recent solar hospital investments in other nations like India, Nepal, Saudi Arabia, Gaza, Turkey, Malawi, and Congo; American progress with Veterans Administration facilities; and existing and planned US hospitals in Florida, Nevada, and California. Areas previously thought seasonally challenged, such as the UK, New Jersey, and Virginia, have also now begun to expand the range of sun charging for healthcare facilities.
And solar energy will clearly help determine Haiti’s future. In fact, with the help of the Clinton Foundation — and leading solar technology manufacturers SMA, Unirac, Trina, and Sunora Energy — NRG Energy Inc. just installed another solar array and battery storage system at Hôpital Bernard Mevs, Port-au-Prince, the only trauma, critical care, and rehabilitation facility in the Caribbean nation. It is ultimately expected to enhance life-saving services and equipment there. More to come.
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