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Assistance: Would you like to donate funds to buy, transport, and set-up a second fridge?

The need

Remote areas pose the greatest challenges to providing preventive health-care. The population is sparsely scattered over the valleys and hill tops, and often the only communication is by word of mouth. Medicines also cannot be transported easily because they need to be kept cold or they lose their effectivness. This constraint severely limits the ability of health clinics to cover a large surrounding area.

Vaccines are the most cost effective health-care intervention, yet while these are considered basic in western societies, they are still largely unavailable in poorer nations. In Northern India the authorities claimed a vaccine coverage of 80-85% of the population, yet were still experiencing polio outbreaks. Testing of the locals showed that the coverage was actualy less than 25% of population.

A small grass roots organization such as KSP has the potential to provide a workable model of vaccine delivery at the periphery of a health-care system that could be implemented on a larger scale. The goal of KSP is to gradually install and test the effectiveness of a network of solar and wind-powered vaccine refrigerators in remote strategic locations, as defined by the District Health Officer in Taplejung.

Vaccine Refrigerator #1 - Lungthung Health Post

The installation of the first fridge to a remote village in north-eastern Nepal shows just how much effort is required in a charity program. The first vaccine fridge was purchased in February 1999, and tested in California for a month before being air-freighted to Nepal. Cherie Bremer-Kamp, Rob Rowlands, and two other KSP volunteers flew to Kathmandu in April, with solar panels, a wind generator, and other items. The fridge was then taken by truck to the District Headquarters town of Taplejung, at the end of a very long and dusty 48-hour drive from Kathmandu.

The fridge was then carried by hand, in its packing crate, for three days to the Lungthung Health Post. Despite weighing over 200 lbs, three Sherpa porters carried the fridge, each taking 10 minute stints, while the others steadied the load or measured bridge clearances. Their work was outstanding, and the fridge was unpacked, undamaged, outside the health post at Lungthung at the end an an exhausting nine-day trip.

Anticipation of the fridge's arrivial had been high. The Health Post worker, Mr Tek Bahadur Rai, had allocated a space in his already crowded four-room health post. First, a table had to be constructed to hold the fridge for eye-level access to the vaccine. Then solar panels and the wind-turbine were installed on the roof, using slotted angle iron and through-bolts to construct a frame. Village labor and local materials, were donated for this portion of the project. Finally, the two "Solar Deep Cycle" batteries were filled with acid. To everyone's amazement, by the end of the second day there was ice in the freezer!  For more information, see Technical Report on Installation of Vaccine Storage Refrigerator at Lungthung Health Post, East Nepal

Outcomes

Since the installation of the fridge, it has worked flawlessly. Mothers have been able to bring their babies to the health-care post to recieve vaccines on a reliable basis. The ability to store vaccines in a remote location has eased the strain of delivery at the extreme of the health care system in rural Nepal. The wind generator provides sufficient power to keep the fridge cold during the winter months when the solar panels are less effective.

Apart from checking the battery acid level monthly and topping up with rainwater when necessary, no maintenance should be required for at least two years. The batteries and wind generator last 10 years, and the solar cells last 30. It is unlikely the structure of the health post will survive this long!

Six More Fridges

Due to the success of the first fridge in Lungtung, KSP was asked by the District Health Officer to install six further solar powered fridges in other remote locations in the Taplejung district. A proposal was succesfully made to Agilent Technologies to fund the project, and the fridges were installed in November and December 2000. The fridges were installed in health posts at lower altitudes and are powered by solar panels alone. A evaluation visit in March 2001 showed that all fridges are working well, and that vaccines are already in place.

Would you like to provide some funds toward the purchase and installation of the second vaccine refrigerator, or would you like to volunteer your skills or time to help with this project?

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