By developing-world standards, most Americans, even the average Joe with his blue collar and bagged lunch, live in luxury. Everything is at our fingertips. Even when ailing, it’s a short drive to see a doctor in a clean, cool room in complete privacy — right down to the paper gowns.
It’s easy to forget that everyday lives are much different elsewhere. People in Haiti, for instance, must travel miles on foot or by motorcycle — if they’re lucky — to seek medical care. And when they arrive, instead of finding comfortable rooms, they are treated under tarps and banana trees, in 100-degree heat and in public.
What’s worst is that, though these people live in poverty, they don’t live in ignorance. They know how things are in other parts of the world from television— clean, air-conditioned and with running water. They’re aware of what they don’t have and how medical care is supposed to be.
The challenges to providing health care in remote areas are myriad, but the lack of reliable power is one of the biggest challenges. Michael Wawrzeweski wanted to solve that problem — and he turned to experts in the solar industry for help.
Origins Of An Idea
As a certified physician’s assistant, Michael Wawrzewski knew the poor conditions in which people were medically treated through mission trips to places such as Haiti and Bolivia. Having started his own medical mission organization, Hospitals of Hope, he was also familiar with how challenging it is to provide help. He knew the unimaginable cost of running mission agencies or clinics in developing countries. He knew building hospitals could take months, finding qualified architects, obtaining building and medical supplies, getting clearances and going through customs could be equally cumbersome. And even after completion, he knew there would still be the cost of maintaining it. Even knowing all this, Wawrzewski was still determined to help.
“People struggle every day for clean water, access to medical care and electricity,” Wawrzewski says. “Many are children, and I know how important having good medical care for my children is to me. I know it’s important to parents over there, too.”
Wawrzewski’s first attempted to build a better medical clinic in 2005. His project manager Kyle Stevens helped put nuts and bolts to his idea to create an aluminum truck trailer that converted into a basic medical center. The model worked quite well during Hurricane Katrina disaster relief, but after the Haiti earthquake in 2010 Wawrzewski decided to revisit the idea to see how he could further improve it. The trailer was not ideal for traversing rough roads and was difficult to ship internationally to arrive on time. Instead, Wawrzewski reached for repurposed shipping containers.
“A shipping container is much easier to move,” Wawrzewski says. “The infrastructure already exists to ship the clinic around the world, whether by truck, train, boat or airplane. It can be helicoptered into a natural disaster site.”
A Redesigned Clinic
The team designed a 40-ft Clinic In A Can with one room that can be customized into a variety of medical rooms, including an exam room. Wawrzewski and Stevens researched the best possible construction materials and use of space.
For example, the two found using wood was a bad idea because insects would eat it. Instead, steel studs and fiberglass-reinforced panels made the clinic sturdy and structurally sound.
Another major issue was insulation. The metal box could quickly become an oven in hot climates. They resolved the problem by using a spray-in polyurethane foam on all the walls and ceiling, and included air conditioning, which was a treat for the patients and a godsend for traveling doctors unaccustomed to such heat.
With the updates, the Clinic In A Can model proved successful. But Wawrzewski saw room for one more major improvement: the clinic’s power source. Power by diesel generators is expensive and hard to transport to remote sites, and obtaining fuel requires an organization to make arrangements for storage and delivery on a weekly or monthly basis. Wawrzewski hoped to change that.
“I wanted to reduce the impact of our emissions, as well as the expenses and headaches of our clients,” Wawrzewski says
The goal was to make the clinic a self-contained structure that could function on its own in remote areas that were without running water or electricity. Wawrzewski thought alternative energy, maybe solar, could do the trick but wasn’t convinced it could be done. So he turned to Farrel Williams, owner of Apex Solar, for help.
“Michael was skeptical solar could be installed on the clinic successfully,” Williams says. “I actually applaud him for going on blind faith that what I told him could actually work.”
Wawrzewski and Williams spent some time tossing numbers back and forth, determining if the clinic’s roof could host enough solar to meet its power demand. Finally, they came up with a solution that could work except for one issue: funding. The quote was more than Wawrzewski’s clients were willing to pay, so it was back to the drawing board.
“We cut the solar in half,” Williams says. “It was the only solution because the inverter and batteries couldn’t be reduced in size or cost.”
It was less solar than ideal, but still enough provide full power to the clinic. The team decided on 12, 220-W modules from Solar Power Industries in Pittsburgh. But the racking posed yet another challenge.
“Because the container will be shipped, there can’t be anything hanging off it,” Williams says. “The solar array also had to be able to be erected fairly quickly and easily by people who have never installed solar.”
Williams found PV Racking’s system to be a good match. It breaks down to fit into the shipping container and then easily reassembles and disassembles as the clinic moves around. Installation is also easy, as modules slide into channels rather than bolt down. Williams and Stevens also worked together to find ways to place all the equipment inside the container so nothing would move around during shipping.
The result was a cost-effective, affordable system that could generate its own power, resist extreme temperatures, reach the point of destination on time without falling apart and assemble easily by the average person. Clinic In A Can had reached success.
How It Helps
Williams and Wawrzewski say the system is doing better than expected. Running the clinic on diesel can cost more than $10,000 a year, while solar can pay for itself in two years. The solar installation can last for more than 20 years, while only replacing the battery every five to seven.
“We’re quite impressed with how the system is working for our clinics,” Wawrzewski says. “It’s obvious solar costs more upfront, but after a couple years the electricity is free, which saves thousands of dollars in fuel costs. Solar just ultimately makes sense.”
Daniel White, assistant director of Clinic In A Can, has been surprised by the wide interest in the clinic. From mission groups in the Sudan, to governments, militaries and mining companies, the clinic is helping bring health care to remote locations.
“It’s just like walking inside a doctor’s office in the United States,” White says. “With options for dental work, radiology or surgical facilities, you can customize the clinics however you like. The possibilities are pretty much endless.”
Dr. Rick Moberly works overseas with DOCS for Hope and has used the clinic to treat a variety of ailments: hypertension, gastritis, intestinal parasites, malaria, tuberculosis, cholera and even provide prenatal care.
“After the patients have been sitting outside in the heat waiting to see you, they appreciate the cool air as well as being able to have a sensitive exam done in a private room,” Moberly says. “It’s much better than having an exam on a bench in front of hundreds of people, which can be quite embarrassing.”
Josh Jakobitz, operations director for Heart to Heart Haiti, has also worked with the clinic, particularly for use in primary care family practice. This one’s been customized with a pharmacy and a consultation room. He says it’s most rewarding to see the children receive help.
“Parents come with their kids at 6 a.m., before the heat, and sit in triage to see a doctor,” Jakobitz says. “The parents and the community have really embraced having their own health care within motorcycle or walking distance.”
Even though the clinic’s design has come a long way from a trailer truck, Wawrzewski and his team are always looking for ways to make it better and as cost-effective as possible. But he thinks using solar will be the best way to reach the developing world and provide high-quality health care.
“Solar has allowed us to provide modern medical care to the most remote areas all around the world,” Wawrzewski says. “From clean delivery of babies, to dental care, to modern vaccination for illnesses and viruses that kill thousands of children each year, we have the capability to meet all these needs because of solar.” SPW
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