Medical use of oxygen is over 100 years old. Oxygen therapy is used in the treatment of a wide array of diseases ranging from pneumonia to sepsis and severe malaria. The need for oxygen is especially acute among children. It is reported that hypoxemia affects over 13% of children with pneumonia over 10% of children with malaria. Additionally, one in five neonates requires oxygen to survive their early days. Pneumonia, caused by various underlying conditions, is the leading cause of death among children globally, claiming the lives of 1.4 million children under the age of 5 annually. While oxygen therapy and other low technology interventions can significantly reduce this number, such treatment is often not available in South Asia and sub-Saharan Africa, where the need is maximum. Lack of resources, remoteness of locations, and interruptions in power supply often make conventional oxygen supply methods unviable in such locations. The consequences can often be shocking. In August 2017, 64 children died in a hospital in north India due to lack of oxygen while their horrified parents stood watching. The disruption in that case was caused primarily due to lack of financial resources. This problem is severe in developing countries, with nearly half of these deaths concentrated in sub-Saharan Africa.

Clearly, providing affordable and reliable oxygen supply to these countries can save lives and significantly lower child mortality globally. A recent viable solution involves using solar power to address this need for oxygen supply.

When solar technology meets oxygen generation

Conventionally, standalone oxygen delivery systems use electricity to separate oxygen from air. This, however, is difficult in remote locations without grid access. The other alternative commonly available is to establish a supply chain of compressed oxygen cylinders. However, this can be cost intensive and unreliable, especially in low resource, remote locations. Dr. Michael Hawkes, an assistant professor in the University of Alberta’s Division of Pediatric Infectious Diseases is no stranger to the consequences of lack of oxygen supply. He talks about his experience in a hospital in Uganda to the science daily as

In the hospital you often didn’t have access to oxygen cylinders. So, the power goes out and you’re out of luck. We had children that died in front of our eyes.

His experience motivated Dr. Hawkes to develop a solar-powered oxygen generator. Basically, instead of depending on conventional energy sources, the solar-powered oxygen (SPO2) generator utilises free solar energy. Given that solar energy is readily available in most locations in South Asia and sub-Saharan Africa, it can easily be deployed as a standalone system in even remote locations. Funded by the Grand Challenges Canada grant, the first systems of this kind were deployed in Uganda. The pilot study included 28 children with pneumonia at hospitals in a city (Jinja) and a relatively remote location (Kambuga) in Uganda. 25 PV panels installed on hospital rooftops in both locations, generating enough electricity to treat two children at a time. The 7.5kWh panels in these systems supplied a 300 W oxygen concentrator effectively 24/7. The battery banks ensured uninterrupted operation during the night. The study showed that these systems were viable in both locations, allowing 22 of the 28 children to survive.

The next step of this project was to subject the SPO2 systems to a large randomised trial. This was achieved by comparing the supply from SPO2 system to conventional cylinder oxygen supply. With a sample of 130 patients (all below the age of 13), the study concluded that SPO2 systems were as effective as standard cylinder oxygen supply chains. It is possible that in remote, resource-constrained environments, the SPO2 systems are more suitable, as the oxygen cylinder supply chains may not be reliable.

The way forward

The local medical community reacted positively to the SPO2 intervention. In fact, though the study concluded in 2015, it is reported that the systems are still in use as of 2016. Empirically, though the initial investment needed for these systems are high, once deployed they require little maintenance. The technology involved is not complex, and local resource persons can be trained to maintain these. The system is also independent of the grid, making it an ideal solution for remote locations. Finally, the technology involved is clean and environment-friendly, and does not have a notable carbon footprint or any other harmful particulate emissions. Naturally, there is much interest in adapting and spreading this technology to various locations. The Bill and Melinda Gates Foundation, along with other organisations, is in the process of introducing these systems to Papua New Guinea and Nigeria. It is hoped that with this larger, more diverse study, the conditions necessary for making the SPO2 systems economically feasible in the most challenging locations can be identified. The research team now hopes to spread and deploy these systems across developing countries and remote locations. The Ministry of Health in Uganda, along with funding agencies, has a massive, countrywide scale-up of SPO2 systems in the pipeline.

“If we could expand it, could you imagine how many children would have access to life-saving oxygen therapy?” Hawkes wonders. “The challenges are different in these areas of the world, and the innovations need to be different as well.”

Solar interventions and health security