Posted by Duncan Maru, MD, PHD
Electricity is one of those basic public goods — like public schools and hospitals and safe water supplies — whose expansion tells a fundamental story about where a society is going, the power of its citizenry, the priorities of its leaders. The distribution of these public goods gives a snapshot on social equity. When my father was born in 1936 in the hills of Pennsylvania outside of Pittsburgh, fewer than 10% of all rural homes in the United States, compared with nearly 90% of urban ones, had access to electricity. That same year, the Rural Electric Administration (REA) was set up as part of the New Deal. Over the next two decades, nearly all of rural America would have electric power. While the successes tell a story of a wave of social justice and empowerment particularly of rural farmers, the gaps of this program also paint a picture of American society. When my wife and I did some clinical work on a Navajo Reservation in Gallup New Mexico a few years back, over seventy years after the REA, we visited several communities still lacking in electricity.
Rural Achham – where Nyaya works – is in a similar situation to where rural America was at the time of my father’s birth: over 92% of homes lack electricity. Nyaya Health constantly faces this reality, whether we’re treating diabetes (which requires refrigeration of insulin), powering our laboratory, or sanitizing our clinical equipment, the hospital and our patients rely on electricity that often simply is not there. The wires don’t run to the majority of our patients’ homes, and even when they do reach, the electricity is often unreliable. In times of peak demand and limited supply, “load shedding” takes place, where entire communities are scheduled to be without power for certain hours of the day. As such, electricity is often only available for four to eight hours per day. To work with this challenging system, we have a battery- and generator-based backup system in place at the hospital, and we are deploying solar power shortly.
A streetview of the tenuous electricity infrastructure in one of the more developed areas near the hospital, in Sanfebagar
It is thus with great excitement that the local electric authority has recently installed a new transformer in Bayalpata, providing triple phase electricity to our hospital. Nyaya Health supporters had been advocating for this system for well over a year. The typical single phase system sends a single alternating current through a wire to power electrical devices. Triple phase systems deliver three alternating currents together, making for a more stable signal. They deliver power more regularly and more efficiently, and allow for devices that require electric motors, such as certain laboratory and operating room equipment. It is now the onus of the Nyaya Health team to make optimal use of this new system, and to continue to advocate for expanded electricity services within the communities in which we work. Expanded access to electricity will be one measure of the social change we are working to achieve.
