headline picture of project

Solar-powered Hospital Handover





How to design and implement an energy exit strategy for the handover of a hospital project to the community.


Tanganyika province, Democratic Republic of Congo


  • Solar photovoltaic (PV) panels
  • Solar chargers and inverters
  • Batteries
  • Solar direct-drive vaccine fridge (with solar PV panels)
  • Wiring, cables
  • Mounting solution
  • Area for the installation (roof, field, etc)
  • 2014 Handover Toolkit for general MSF guidelines on project handover


  • Energy referent
  • Flying electrician
  • Mission electrician
  • Assistant technical logistician/electrician
  • MoH Hospital Director

Part 1: The off-grid location

Shamwana is an extremely off-grid location, with very little transport access, particularly during the rainy season. Before the handover, the energy supply system relied completely on shipments of 1,000 litres of diesel a month, which could not have worked after MSF left. The timeframe for MSF’s handover was very tight, with only four months from project closure decision to the handover date.

Part 2: Working with our local partner

In April, we began to develop ideas for energy solutions. I spoke to the Ministry of Health staff and discussed the most vital equipment required for the hospital to continue serving the community. The hospital director, Dr Daddy, was eager to help establish an alternative energy source and helped us set realistic targets for a new energy system. He foresaw a 10 per cent decrease in hospital operations after handover, once the facility became fee-paying and MSF transport services stopped running.

Setting realistic targets for current and future energy demands is critical to develop a good solution! Plan carefully to avoid underestimating future needs.

Dr Daddy and I agreed that an oxygen concentrator and a refrigerator for vaccine cold storage, which could be run continuously, and lighting, for the nights, would be essential for the hospital to continue operating. The hospital was already used a solar direct drive electric water pump.

Analysing requirements

Part 3: Converting our plan into kWh and costs

I contacted my former colleagues at the RISE research institute in Sweden, since I had not previously designed a solar-powered system. They helped me work out that the peak power requirements would be approximately 4 kWh, with an energy storage requirement of 13 kWh for the nights. This would not include system autonomy for an entire day without any sunshine (albeit rare in Shamwana), since we proposed leaving a small hospital generator and a minimal stock of diesel fuel as backup.

Using the available cost figures for solar-powered equipment, I estimated the total cost would be below €10,000, not including the solar-powered cold storage refrigerator.

Getting buy in

Part 4: Pitching the plan

I proposed the plan to the mission’s project coordinator and logistics coordinator, who were both enthusiastic about it. They put me in touch with the energy referent and field electricity advisor in HQ who had recently finished designing a similar project in DRC and were also enthusiastic about my proposals for Shamwana.

Part 5: Developing the design

We worked throughout May to design the system in detail. This included determining the number of batteries and solar panels the hospital would need.

We decided to build two separate systems, one for the oxygen concentrator (a Devilbiss 5 LPM concentrator), which would require almost two-thirds of the system’s capacity, and one for lights and some other minor electrical equipment. The reason for separating the systems was to secure the availability of power for medical oxygen around the clock. The autonomous solar-powered vaccine fridge would be installed with a separate solar power system.

Part 6: Procurement and up-cycling

Luckily, we had some equipment (primarily batteries) in the project that could be reused. We also managed to get some of the solar panels at a very low cost from an earlier batch donated to MSF by the manufacturer. The total cost for the equipment was limited to just over €10,000, including the solar fridge (at €7,000). If we had bought new batteries (which it later turned out we should have) and had payed full price for all solar panels, the total cost would have been roughly €15,000.

Part 7: Woodwork for platform

While waiting for the equipment from HQ, I designed an installation platform for the panels, which we could build out of the locally available and very durable hardwood. This ensure we were ready to quickly install the panels when the last pieces of equipment arrived, only two weeks before the handover. With a slightly longer timeframe, a pre-made standard aluminium mounting system would have been preferred and would have saved significant effort compared to building a local version from scratch.

In the northern hemisphere, the general rule for solar panel placement is, solar panels should face true south (and in the southern, true north).
It’s important to pick the right spot for the solar panels. Is the area big enough? Will it get uninterrupted sunlight? Even partial shading of a solar array can affect energy production.

Part 8: Rewiring for the new layout

It took two weeks for our fantastic assistant tech-log and electrician, Jean-Murck, and mission electrician, Pablo, to rewire the hospital’s electricity system into the new limited electrical layout. After consulting with staff, we decided to connect roughly a third of the hospital’s lights to the solar-powered system. As well as the 12 large solar panels and 12 batteries required to run the oxygen concentrator, an additional four panels and four batteries were installed to power the rest of the equipment. The rest of the electrical installations were kept in place and connected to the generator, in case of a larger emergency in the area that would require the hospital to operate at full capacity again.

Part 9: Testing and verifying the system

In August, MSF’s flying electricity adviser arrived to help us with the final set-up and to verify the installations on the pre-determined handover date. We then had two weeks to test and verify the system before we left the project and the region at the end of the month. We conducted these tests while fully connected and operational with the solar power system and did not need to start the generator again.

Part 10: Servicing Guidance

With the new solar-powered system up and running, our focus shifted to training the local staff on how to operate and maintain it. We prepared a PowerPoint training, which doubled as a manual what parts to check regularly and what to do in case of a break-down.

When setting up a new system, training the team to maintain and use it properly is important; service life of batteries will reduce if they are overused.

Part 11: After the handover

By the time we left Shamwana, we were confident that the system was serviceable, but there was of course a worry that something could go wrong in the future, when there would be no skilled electricians or spare parts, and no mobile phone network for communication. This worry was further strengthened when OCA also decided to close the projects in the region.

Three months after the handover, just before the project’s closure, we paid one last visit to Shamwana and found the system to be working well.

Epilogue: the batteries!

In summer 2017, we received a message that the smaller solar-power system (for the lights) had started cutting out during the night. In September, I therefore raised money privately to buy new batteries and, in October, went from Sweden to Shamwana to install them. This was a highly rewarding expedition, since I otherwise found the hospital in very good order. By cutting down the lights to an absolute minimum, Dr Daddy had also managed to preserve some energy. But this highlighted why we should have ordered an entirely new set of batteries. The life-span of a battery is necessarily limited, and replacements are a significant cost for a rural hospital with minimal income. I returned again in summer 2019 to replace the other batteries, alongside a Congolese electrical engineer that I have got to know in Lubumbashi. The hospital is there and is running well, and I believe every MSF project should have solar power as at least a part of its standard energy system. But for future solar-power systems I’ve learned to design-in longer-lasting batteries.

Unless you have a connection to the national grid, you will need to store the electricity produced by solar panels in batteries. It is important to choose the correct battery technology and scale the battery bank and solar energy production to the demand.

“With the solar power system, the very difficult task of continuing to provide quality healthcare to this vulnerable region was made possible.” Dr Daddy Ebwas Mupanda, Shamwana hospital director

Do you think your project would benefit from a similar approach? To get started:

  • List the medical equipment that is essential to be operated day and night.
  • What is the current energy requirement in kWh? What will be the energy requirements in the future?
  • Start the discussion with your team.

Implementing this design requires review and coordination with HQ. Note that, at the time of going to print, OCA (Jason Van Dyke, Energy Referent) has validated the contents of this feature. If you have any technical questions, please get in touch with your Energy Referent.