Solar energy transforms Uganda’s off-grid healthcare amidst Covid19 pandemic

Fredrick Mugira , September 30, 2021

  • Half of Ugandans live in areas served by the national hydroelectric power grid.
  • Hydropower is the dominant energy source in the country and several other countries in sub-Saharan Africa.
  • Sales of off-grid solar-powered refrigerators, vital in providing health services such as keeping vaccines cold, also remain low in Uganda.
  • Government visions that by 2040 every Ugandan should have access to power. And about 30 percent of this is expected to come from solar.

In addition to struggling with the second Covid19 wave challenges, like most urban dwellers in Uganda who rushed to villages at the start of lockdowns, Gloria Mucyunguzi had another crisis to contend with in the village: erratic power. 

Remote from the grid, every time the sun sets, Mucyunguzi’s marital village of Mburamaizi in Bihanga, Buhweju district gets shrouded in darkness. But she badly needed a healthcare facility with access to electricity to have her child immunized. 

Health facilities need electricity to power essential medical devices, refrigerate medicines, lights, and safely deliver babies in the operating rooms, among other purposes. For example, most vaccines are refrigerated at 35 and 46 degrees Fahrenheit to remain safe for use. 

“With suspended public transport, I could not take my child back to Mbarara city for immunization,” narrates Mucyunguzi. Her only option was to carry her child on the back and walk to any health center. But Nsika health center four — the health facility on the power grid nearest to her village, is situated about 16 kilometers. To reach it, Mucyunguzi would have to climb over ten hills. But to her disbelief, she climbed only one hill and found a health facility — Bihanga health center III, powered by solar energy, that offered the services she needed. 

“We offer such services because of solar power,” narrates Osbert Ntumwa, the assistant in charge of Bihanga Health Center III that is off the power grid in Bihanga, Buhweju district.

Solar panels the maternity wing of Bihanga Health Center III, in Buhweju district

Bihanga Health Center III is one of the health centers in Uganda that benefited from free solar systems, installation, and maintenance under the third phase of the energy for rural transformation project (ERT Project III). 

The energy for rural transformation project’s first phase started about 15 years ago with the West Nile region. Its third phase started about five years ago and has installed free solar systems at 329 public health centers in 24 districts, including Buhweju. Under this project, a health center three gets a solar system of about 980 watts; health center fours receive 1500 watt systems while health center twos get suitable solar packages according to the health services they are offering and staff houses needing power.

The initiative is funded by the government of Uganda and the World Bank at a tune of 28.6 billion Uganda shillings. It targets improving the delivery of health services in rural health centers through increased access to modern energy and ICT services.

“We have now started new installations to cover 177 health centers in 42 districts,” narrates engineer Robert Nuwagaba, the project manager.

“Our concentration is on lighting for both medical buildings and staff houses; vaccine refrigeration for health centers two, three, and four; blood refrigeration is only done at health center four,” reveals Nuwagaba. 

He says solar energy also powers medical equipment such as microscopes, ultrasound scanners, and other low energy consumption equipment in these health centers. 

Towards climate-smart health care

With half of Ugandans living in areas served by the national hydroelectric power grid, hydropower remains the dominant energy source in the country and several other countries in sub-Saharan Africa. Fortunately, solar radiations are abundant in this world region, although governments haven’t utilized them maximally, especially in the health sector. 

While Uganda, Kenya, and Tanzania all saw a dip in off-grid solar lighting sales at the beginning of the pandemic, Kenya’s sales have doubled in the past three years to be more than three times the sales of Uganda and Tanzania combined, according to the most recent Global Off-Grid Solar Market Report produced by GOGLA, the global association for the off-grid solar energy industry. Conversely, Uganda and Tanzania’s sales have not increased significantly.

Sales of off-grid solar-powered refrigerators, vital in providing health services such as keeping vaccines cold, also remain low in Uganda. From 794 refrigerators sold from January to June 2020, there were only 306 sold from July to December, according to the GOGLA report.

By using solar, health facilities mitigate climate change through the adoption of low-carbon energy sources. Such climate-smart health care does not only benefit the climate but also people’s health. 

Clean and sustainable energy use in the health sector minimizes air pollution, which surrounds health units that use diesel generators, according to Jeconeous Musingiwre, an environmental scientist and the southwestern region manager for the national environment watchdog- NEMA. It also “cuts costs that health centers would have incurred running on hydroelectric power,” Musingwire further notes. 

Compared with hydroelectric power — one of the widely used cleaner energy in the country, Musingwire says solar energy “is accessible, and at the same time its tariff rates are not exorbitant for people and institutions.” And also, hydropower has a challenge of low flow of waterways. For example, mini hydroelectric power plants at small rivers in Uganda, such as river Mpanga in Kamwenge —one of Buhweju’s neighboring districts, generate almost nothing in the dry spells due to the low water level that fails to turn turbines.

Sustainable energy for rural communities’ transformation

Under the ERT Project III, “12 public health centers” in Buhweju district received free solar systems according to Pius Manigaruhanga, the Assistant District Health Officer Buhweju, raising the district’s electricity coverage to “40 percent,” according to Melex Musinguzi, the district’s works committee chairperson.  Now residents of this hard-to-reach district are assured of better health services, according to Olive Koyekyenga, the woman MP of Buhweju district. “Women can now deliver babies under adequate solar light in health centers, unlike in the past when they would deliver under candlelight,” contends Koyekyenga. 

With solar-powered refrigerators, Bihanga health center III, like other health center threes in the district, works as a Covid19 vaccination center. 

Francis Mwijukye, the MP Buhweju constituency, describes this as a landmark, saying, “it has saved hundreds of people from traveling long distances to get a vaccination, some of who would have given up because of long distances.” 

Women and Children receiving drugs through a window at Bihanga health center III in Buhweju district.

Lack of access to affordable and reliable electricity deprives millions of rural people of quality healthcare in developing countries. The situation is worse across rural Africa, where electricity coverage stands at only 25 percent

For Uganda, Nuwagaba believes that in the next five years, all public health centers in the country will be having solar power. 

Government visions that by 2040 every Ugandan should have access to power. And about 30 percent of this is expected to come from solar.

Due to regular load-shedding, the project also installs solar equipment at some public health centers on power grid but in far-to-reach areas, emphasizing maternity wards and theaters. 

“Even if the grid is there, what about when the grid is not there,” wonders Nuwagaba. He acknowledges increasing donors’ support to this initiative citing funding from the UN development agency – UNDP that is enabling installation of 15,000 kilowatt solar systems at some health center fours countrywide. Such a system “runs all the equipment at a health center four, and we even have a surplus,” according to Nuwagaba. 

Wafula Wilson, the assistant commissioner in the energy ministry, says they have also taken to installing solar water heating systems at health centers fours off the power grid to enable women in labor to bathe in warm water needed to facilitate normal birth and bathe newly born babies. “We installed about 400 solar water heaters across the country, but also we have recently installed eight systems,” notes Wafula.

Succeeding amidst challenges  

Some of the solar systems at health facilities that were the first to benefit under this project in districts like Moyo, Madi, Gulu, and Amur, among others, have reduced their functionalities to 50-60 percent.  

Now a facility that is supposed to have solar power a whole night may have it for only six or five hours, and this is because batteries have reached their lifespan, according to Nuwagaba. 

He says they have requested close to nine billion shillings from the finance ministry to functionalize solar systems at over 980 health centers countrywide. 

“But also we had a five-year contract for maintenance of these solar systems. But, unfortunately, when the five years elapsed, they were left unattended too,” narrates Nuwagaba. He says it is now the headquarters or the regional workshop that attend to them, which is “overwhelming.” To overcome this challenge, the project wants to have increased years of maintenance on new contracts from five to 10 or 15.  And also, the project is investing in remote monitoring of these systems to detect early and solve technical challenges in outlying areas where these systems are installed. 

But Wafula says beneficiary health centers need to take the lead in finding solutions to challenges their solar systems face. “Health centers need to save money they have been spending on generators and electricity and use it to maintain their solar systems,” notes Wafula. 

Solar panels at Bihanga Health Center III, in Buhweju district

Covid19 impact on solar energy use 

“We lost a full year,” narrates Nuwagaba, further disclosing that “a health center which was supposed to receive solar power in 2020 June, is most likely to receive solar in 2023 January.” 

But also the pandemic has forced some companies dealing in solar systems to get out of business, according to Nuwagaba, noting that, “we are likely to see an increase in the prices of the equipment, but also it (pandemic) has delayed us.”

From July-December 2020, solar lighting sales started to recover from the initial drop after the pandemic began but were still 31 percent less than in the last half of 2019, according to GOGLA. 

According to Andrew Ssentongo, a renewable energy expert and MD general renewable solutions limited, the Covid19 pandemic led to a loss in revenue of solar equipment dealers and less solar electricity consumption in the country as anticipated.

He tips the sector to adapt by shifting their attention from the areas greatly affected by the pandemic citing tourism and leisure, to those less affected such as the health sector. 

This story was covered as part of the Clean Energy Wire (CLEW) fellowship. Data visualizations by Annika McGinnis.

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