From Massachusetts to Haiti

How the world’s largest solar hospital came to be

You may be surprised to hear that the world’s largest solar-powered hospital is in the small and extremely poor Caribbean nation of Haiti. Elisa Wood looks at how this ground-breaking project came about.

The 19,000 m2 Mirebalais hospital is powered by a 250 kW solar array CREDIT: Partners in Health Haiti

Hugh McLaughlin was no stranger to Haiti. He had volunteered periodically at orphanages in the Caribbean country for more than a decade. So he knew the nation’s need ” Haiti is the poorest country in the western Hemisphere.

Still, as he stood in a ’14-acre rice paddy’ (5.7 ha) in Haiti’s Central Plateau three years ago, he was taken aback as he realised what was being asked of his Massachusetts electrical contracting firm. Sullivan & McLaughlin was to help transform the barren site into a state-of-the-art, 205,000 square foot (19,000 m2) hospital powered by solar ” and would do so mostly with volunteers.

Partners in Health, a Boston-based international aid organisation leading the project, intended Hàƒ´pital Universitaire de Mirebalais to be the biggest hospital in the Caribbean, a facility large enough to make real inroads toward serving a population left desperate following the 2010 earthquake that killed 220,000 people.

‘They were just breaking ground, and the magnitude of it grabbed me,’ he says. ‘They had no labour and were very concerned about costs. We had to build something from nothing.’

When he returned to the US from the exploratory trip, McLaughlin consulted with his two partners at Sullivan & McLaughlin (SullyMac), John McLaughlin and W. John Rudicus. The company employs 500 people and is based in Boston, where the largest employer is the healthcare industry. SullyMac had won many contracts to do electrical work in hospitals over the years. So the company’s three principals decided it was important to give back to the healthcare community. They agreed to assemble a team of volunteer electricians to work on the Mirebalais hospital.

SullyMac sought volunteers from within its own company, as well as the local Boston chapter of the International Brotherhood of Electrical Workers, a trade union. In all, about 100 volunteer electricians went to Haiti whenever they could over two years. Some were retired; others took time off from their jobs to help out. McLaughlin, however, singles out Fletcher Fuentes as the point person sent by SullyMac. Fuentes is a young former US Marine and an electrical journeyman who spent 18 months on the project. He and others helped train about a dozen Haitians to do the electrical work, so that the hospital could ease its reliance on foreign workers as time went on. The project’s intent was to foster Haitian self-sufficiency.

Fuentes said in an account of the project published by IBEW that he used his Spanish Creole to communicate with the trainees. (Most Haitians speak Haitian Creole.) The job was not easy; materials were not readily available, as they would be in the US. ‘There isn’t a supply house down the street, so most of the material is either carried down by volunteers on the plane or shipped in containers that take six to eight weeks to get to Mirebalais and clear customs,’ Fuentes was quoted as saying.

Accustomed to scarce resources, the Haitian trainees proved resourceful, McLaughlin says. ‘The Haitians had a great work ethic. They don’t have anything, so they figure out how to do with nothing. They were very clever.’

Solar beyond borders

SullyMac brought to Haiti not only its understanding of hospital electrical engineering, but also a proficiency in solar design and installation. Since SullyMac is located in a state with one of the fastest growing solar energy markets in the US, the company has a good deal of practice installing solar.

Massachusetts ranked third in the US for new electrical capacity from solar in a 2013 annual listing by the Solar Energy Industries Association and GTM Research. Solar growth has been dramatic in the state, which had less than 4 MW of solar in 2008 and now has more than 450 MW, already far exceeding its initial goal of 250 MW by 2017. Governor Deval Patrick continues to push a pro-solar agenda, which includes a solar renewable energy credit, or SREC, programme that requires utilities and retail suppliers to use solar in meeting a certain percentage of their electricity sales. As a result, the number of installations keeps climbing, and Patrick has set a new state goal of 1600 MW by 2020.

Massachusetts’ solar success spilled over into Haiti, with SullyMac drawing upon its expertise gained at home, where it has installed 20″25 MW of solar panels, most of it for Massachusetts institutions.

But Massachusetts and Haiti clearly present a tale of two solar markets. In Massachusetts, distributed solar is a clean alternative to an already highly sophisticated and reliable grid. The state has a population of 6.6 million served by ample grid power, about 13,150 MW. In contrast, most of Haiti’s 9.9 million people are lucky to get the crumbs of the nation’s meagre 130 MW of installed generation.

Distributed solar serves as an alternative to a barely functional grid in Haiti. The area where the hospital is located, about 30 miles (48 km) north of Port-au-Prince, loses power an average of three hours each day, according to Partners In Health. Three quarters of Haitians get their energy from burning wood and charcoal. Electrification is coming very slowly to the nation. By the standards of advanced economies, Haiti’s energy aspirations for the future are extraordinarily humble. The Ministry of Public Works, Transport and Communication seeks to achieve 12 hours per day of electrical service nationwide by 2032, under its long-term national development plan.

Given the weakness of the grid and the expected demand of the hospital, the engineers decided to add more panels than originally planned when they were about a quarter of the way through the project, McLaughlin says.

‘That’s when we changed all of the engineering and design. There was an enormous amount of work that went into that,’ he adds. A hydroelectric dam about 10 miles (16 km) away feeds power to the area, ‘but it is inconsistent at best. Even the voltage spikes and drops are all over the place. Having anything that ties to their grid is almost impossible to manage,’ McLaughlin says.

In Massachusetts, the electrical firm has focused on bringing efficiencies to solar installations. It applied those strategies in Haiti as it installed the 250 kW array, made up of 1800 panels located on a 200,000 square foot (19,000 m2) roof.

‘The engineering of it can be complicated, but the construction is not. We are always looking for efficiencies ” we have a prefab shop here. Once you get the system down, it is a lot of repetition. Once you hit go, it flies,’ he says.

In about two years the volunteers completed what is now the largest solar array-powered hospital in the world, a 300-bed, US$25 million project. German company Solon supplied the solar panels and the inverters came from Massachusetts-based Solectria. The facility includes a battery system to store solar energy and is able to sell any excess to the grid.

To properly orient the panels, the team relied on sun charts provided by the University of Oregon. Haiti’s intense sunshine proved to be both a benefit and a drawback, according to Partners In Health.

The intense heat threatened to reduce the operational efficiency of the solar panels, so the project engineers opted to float the panels about a foot (30.5 cm) above the roof. They coated the roof with white paint to lower the temperature. The hospital also includes various energy efficiency measures, such as natural ventilation and sensor-based lighting, to reduce demand on the system.

The solar array is expected to save the hospital around $379,000 per year Credit: Partners in Health Haiti

Partners in Health expects the solar array to save the hospital about $379,000 annually in electricity costs. Haiti’s grid power is expensive, about 35 US cents/kWh, making solar often a more economic choice. For a business to connect to the grid in Haiti, the cost is about 3800% of per capita income and takes about 60 days, according to the World Bank’s International Finance Corporation.

Bill and Bill visit

When it opened in March 2013, the hospital stood as the largest construction project completed since the 2010 earthquake, according to Partners In Health. The organisation had originally planned to build a small community hospital, but scaled up the project following the earthquake at the request of Haiti’s Ministry of Health.

By October, Mirebalais had accepted its first doctors-in-training, 14 Haitians who began medical residencies under the tutelage of both foreign and domestic physicians. The teaching component of the hospital is crucial because the poor health conditions in Haiti are linked closely with a physician shortage. Haiti has 25 physicians for every 100,000 citizens. By comparison, the US has 280 doctors for every 100,000 citizens, according to Partners In Health.

In its first nine months, Mirebalais served 42,000 patients, about 60% from the three surrounding regions and the remainder from throughout Haiti. The hospital now serves as many as 700 people per day and expansion plans are underway.

‘It continues to grow. We need to go down and do more solar, it has expanded so much,’ McLaughlin says. ‘I went down last September. I wanted to see Mirebalais completed. So we stopped by. It was amazing; there were hundreds and hundreds of people in the hospital. It was fully operational.’

The facility also is proving to be an economic booster for the Central Plateau. With an annual operating budget of about $16.2 million, the hospital pushes about $1.82 into the economy for every $1 spent, according to Partners In Health. It has created about 800 jobs, not just in health care but in support services for the hospital. For example, it creates a market for local farmers, who might otherwise have to rely on Port-au-Prince for sale of their wares.

The project has attracted attention worldwide, as well as celebrity visits. Former US president Bill Clinton visited during construction, and more recently Microsoft founder Bill Gates blogged in March that he and his family toured the hospital during school vacation.

He wrote: ‘I was blown away. The hospital opened last summer and was built using money donated after the 2010 earthquake. They spared no expense to make it a first-class facility. There’s a machine for performing CAT scans. There’s a sophisticated system for keeping medical records. The staff can send digital images to Harvard and get input from specialists there. They have modern incubators for premature infants. The hospital gets electricity from an enormous solar array (plus a diesel generator at night).’

For SullyMac’s McLaughlin, it’s on to the next project. He is now working with others on a smaller, 20,000 square foot (1858 m2), 30-bed hospital, called Saint Boniface. Here too, they plan to install solar and are currently seeking funding. Again, an electrician volunteer corps will do the work, an approach that McLaughlin says has proved highly effective.

‘I’ve had dozens of emails and phone calls and notes to say, ‘When is the next project? We want to go again,’ he says. ‘The idea of a volunteer corps, from a tradesperson perspective, worked out phenomenally well. It got the price tag way down. It [Mirebalais hospital] wouldn’t have happened without the volunteer corps. They wouldn’t have been able to fund it.’

Again, Massachusetts can offer expertise gained in its solar ramp-up. Like other US states, Massachusetts often becomes embroiled in debates over the costs of its ambitious solar programme. Discussion centres on whether benefits outweigh the expense to local utility ratepayers. Not discussed ” but clear from the Mirebalais story ” is how far-reaching those benefits can be, reaching well beyond the state’s borders to the most energy-poor parts of the world.

And McLaughlin is quick to point out that the experience working on the Mirebalais hospital did good for the electrician-volunteers as well.

‘Everybody personally and professionally came back different ” they really did,’ He says. ‘A lot of these guys didn’t have passports. It was their first time outside the country. When they came back it was never, “The Haitians do it the wrong way”. It was all respect, appreciation and getting a better grasp of how blessed we are here.’

Elisa Wood is a journalist focusing on the energy sector.

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