Saving girls from cervical cancer through solar energy solutions

Every year, the Ministry of Health estimates show that 5,236 women are diagnosed with cervical cancer and 3,211 die from the disease. A fate that befell Magdalene Kahindi who was diagnosed in late 2015.

“One day she stood up and blood started flowing down her legs. She was 50 years old at the time. A very healthy, active woman. The diagnosis was a big shock to us,” says Agnes Kahindi, her daughter.

Kenya has a population of 16.8 million women aged 15 years and older who are at risk of developing cervical cancer, the second most frequent cancer among women aged between 15 and 44 years, according to the Catalan Institute of Oncology and the International Agency for Research on Cancer HPV Information Centre.  

Despite the magnitude of the disease, only 16.4 per cent of all women within the reproductive age turn up for cervical cancer screening, according to the Ministry of Health.

To avert this risk and in line with government efforts to reach at least 800,000 girls aged 10 years with the HPV vaccine, three innovative nurses are providing a hard-to-reach rural adolescent population in Makueni County with the lifesaving vaccine.

“In 2019, a solar powered freezer was donated to Kamboo health facility in Kamboo village located 10 kilometres from the nearest electricity grid. I collect vaccines from Makindu Sub-county Hospital located 17 kilometres away,” says Francis Muli, nurse in-charge of Kamboo health centre.

Makindu sub-county is the central store for Kamboo health facility and other dispensaries in the area. Not only are there no utility vehicles to collect vaccines from Makindu sub-county, there is no public transport from Makindu to Kamboo and surrounding villages.

Muli and other health providers in the area have, at their own cost, purchased motorbikes to reach their respective service delivery points.Vaccines are generally stored in a fridge where temperatures range from +2 to +8 degrees Celsius and, require cold chain storage conditions, and good distribution practices throughout the supply chain to maintain their quality and potency.

“We transport them from the central store to the service delivery point using a vaccine cooler box which can hold up to 500 doses,” he expounds.

Two adjacent villages, Yindalani and Yiuma Mavui, located 28 kilometres from the central store at Makindu Sub-county Hospital and, at least 22 kilometres from the nearest electricity grid, are also relying on the solar powered freezer to deliver the lifesaving HPV vaccine to girls in the area.

“I collect HPV vaccines from the sub-county hospital and store them at Kamboo health facility two to three times a week. I then collect these vaccines from Kamboo health centre in a vaccine cooler box and visit schools in my area for outreach HPV vaccination,” explains Benson Musyoka, the nurse in-charge of Ndalani dispensary in Yindalani village.

HPV vaccine was introduced in Makueni in March 2021. Musyoka vaccinated 46 girls aged 10 years with the two doses of HPV vaccine in 2021 and another 17 girls have received their first HPV dose in 2022 and the second dose in November 2022.

He says there are 236 health facilities in Makueni County —  11 are sub-county and level 4 hospitals, 47 are health centres and level 3 hospitals and the majority, a staggering 178, are dispensaries and level 2 hospitals such as Ndalani dispensary and they are unlikely to have electricity.

“If all these dispensaries have access to a solar powered freezer, the golden opportunity that HPV vaccine presents to stop cervical cancer would be presented to all eligible girls,” Musyoka observes.

Antony Matali, the nurse in-charge of Usungu dispensary in Yiuma Mavui village, says without the solar powered freezer, “it would have been impossible for residents of these three villages and surrounding areas to receive the HPV vaccine due to a lack of cold chain capacity.”

Cervical cancer is caused by the human papillomavirus (HPV), which is the most common sexually transmitted infection.

About 9.1 per cent of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 63.1 per cent of invasive cervical cancers are attributed to HPVs 16 or 18, according to the  HPV Information Centre.

The lack of electricity especially in public health facilities in rural areas disrupts immunisation and vaccinations efforts and, in this case, HPV vaccination to stop the killer disease.

Government data shows that while residential energy access increased from 52 per cent to 70 per cent between 2016 and 2019, energy access at government-operated health facilities only grew by one per cent from 69 per cent to 70 per cent in the five-year period 2016 to 2021.

Makueni County is one of 23 Arid and Semi-Arid regions with great potential to exploit sustainable energy solutions to strengthen health facilities cold chain capacities.

Muli confirms that the low cost but high impact solar powered freezer was donated as a pilot to test the difference between a fridge and a freezer in vaccine storage and preservation for resource constrained facilities in remote rural areas.

The freezer, he says, is superior as temperatures can go to below zero degrees Celsius, which is ideal for more heat sensitive vaccines such as Polio, Measles and BCG. The freezer maintains temperatures of +8 degrees Celsius at the top and that temperatures drop as you move towards the bottom of the freezer.

Muli says the off-grid freezer is low cost for cash-strapped health facilities because it is connected directly to the solar panels. They do not use batteries.

“It is a very simple system and the solar panels are light sensitive. It does not have to be scotching hot for the solar panels to generate power. The solar panels work as needed even during the rainy season,” Muli explains.

“The freezer is very low maintenance. You only need to wipe the solar panels at least once a month because when they collect dust, their capacity to absorb heat or light is compromised,” he adds.

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