Are You Afraid of the Dark: The Need for Electricity-Independent Surgery

"A light where currently there is darkness -- the energy to lift people out of poverty -- that's what opportunity looks like..." - President Obama

Universal access to electricity may be on its way, but pregnant women have no time to wait. The global population is expanding by 1.3 percent per year while access to electricity has fallen behind at 1.2 percent. Moreover, countries with the least access are experiencing the fastest and most 'deadly' population growth; the 1.2 billion people living without electricity have the highest risk of maternal mortality.

As populations in the developing world continue to expand rapidly, and with surgery almost wholly dependent on electricity, the importance of electricity-independent surgical solutions for health has never been greater.

The African continent is at highest risk and therefore in particular need of such solutions. It contains seven of the ten fastest growing populations and the least electrification, a lethal combination for its citizens' health. Nigeria has the second lowest electricity supply in the world; less than 25% of the population has access to power . Nigeria is also expected to be the third most populous country in the world by 2050 with women going into labor more than 230 million times. At current maternal mortality we can extrapolate, 1.5 million women will die due to pregnancy related complications. Despite more than halving maternal mortality in a decade, Nigeria still accounts for 10% of the world's maternal deaths. Many of these deaths are preventable.

Surgery is a proven, cost-effective means of improving maternal outcomes and can cure 20 percent of the global disease burden. A caesarean section is a simple lifesaving measure, given proper infrastructure. Unfortunately, electricity is a limiting factor, a problem that two-thirds of the African continent is unlikely to overcome for a few decades.

Universal access to electricity by 2030 is an overly ambitious -- and unfortunately -- insufficient campaign. Success in sub-Saharan Africa alone requires investment of over 300 billion dollars and immense manpower. If we intend to reduce maternal mortality further, surgical dependency on electricity must dramatically decline.

Essential surgeries rely on electricity for three key components: adequate lighting, continuous administration of oxygen and anesthesia, and sterile instruments. Electricity-independent options exist for anesthesia delivery and basic lighting. The ability to sterilize medical equipment is the final piece of the puzzle necessary to provide safe, sustainable surgical care.

Infection rates skyrocket without sterile medical equipment, making it impossible to ensure safe surgical care. In the developing world, infection rates in health care settings are as high as 40 percent, compared to 5 to 10 percent in the developed world. Surgical Site Infections (SSI) are one of the most common of these. These rates threaten to increase further as the need for surgical care increases faster than electricity infrastructure is added.

Innovations in electricity-independent sterilization are poised to join anesthetic gas delivery and basic lighting in a push to meet the increasing surgical need. Together these technologies can facilitate affordable and effective surgical care for the third of the global population that lacks it. A campaign for electricity-independent surgery must be considered in conjunction with investments for energy infrastructure. For millions of women - and their newborn infants - it is not enough to hope for the lights to come on in 2030.

Lauren Hasek provided invaluable editorial assistance and research in preparing this post.