Surgery Lit By a Cell Phone? This Solar Lantern Saves Lives During Childbirth

We were in Malawi for three days when I asked a hospital midwife to tell me the word for pregnancy in Chichewa, the local language. “Pakati,” she told me. “What does that translate to?” I asked. “Between life and death.”

I looked at her soberly, taking in the significance of what she had just told me. In Malawi, as in so many parts of the developing world, pregnancy is indeed fraught with peril. In 2010, the WHO reported the Maternal Mortality Ratio for Malawi was 470. That means that for every 100,000 live births, about 470 women will lose their lives. And my Malawi colleagues on this trip suggested the risk in rural areas is significantly higher. In fact, a young woman in Malawi faces a 1 in 36 lifetime risk of dying from pregnancy-related complications.

When I was a practicing obstetrician in California, a big part of my job was to provide preventive care, identify and treat pregnancy complications as they arose, and ensure a joyful outcome for mother and baby. My pregnant patients had a lot of questions—about natural childbirth, the use of pain medication, the chances of needing a c/section, and so on—but never about the odds of survival. We all assumed that childbirth was an event to be celebrated, rather than one to be feared.

In Malawi, a healthy outcome is far from certain. For a rural woman, access to a decent health center is a significant challenge, often necessitating hours of travel by foot. Women in Malawi are encouraged to have at least four prenatal visits, compared to a minimum of eight visits for routine care in the United States. But at best, prenatal care identifies only a fraction of the complications that can occur in childbirth. The greatest threats to life: hemorrhage (excessive bleeding); obstructed labor (inability of the baby to fit through the birth canal); eclampsia (high blood pressure leading to convulsions); and sepsis (disseminated infection)—usually manifest close to the time of delivery. These conditions may not be preventable, but they are certainly treatable with proper medical and/or surgical care. They need not result in death. But appropriate treatment does require skilled clinicians capable of providing immediate emergency care.

The global Safe Motherhood movement now recognizes that emergency obstetric care—critical care that addresses the major complications of pregnancy—is an essential part of the package of health services that must be provided to every pregnant woman. In Malawi, community health workers and village leaders are called upon to encourage pregnant women to deliver in a health center. The law now forbids home births. This means that women must be able to reach functional health centers: facilities stocked with clean equipment, medical supplies, trained health providers, and something that is often overlooked—light.

We've designed the WE Care Solar Suitcase to help address this problem. The Solar Suitcase is an economical, easy-to-use portable power unit that provides health workers with highly efficient medical lighting and power for mobile communication, computers and medical devices. It was originally designed to support timely and efficient emergency obstetric care, but can be used in a range of medical and humanitarian settings.

On this trip to Malawi, we travel for hours to reach each clinic. As our four-wheel drive carefully maneuvers muddy dirt roads with deep trenches of water, I ask myself if I would choose to make the trip by foot if I were in labor. Would I be willing to leave the security of my home to arrive at a clinic shrouded in darkness? In Malawi, clinics lacking electricity expect women to bring their own candles and matches as part of their birthing kit. For a woman living in poverty, even the price of a candle can be a deterrent to obtaining skilled care.

So many women make a calculated risk. They stay home. They make the same choice their mothers made, and try and deliver by traditional means. They take their chances. And, in places like Malawi, where skilled health care is far and clinics are often in darkness, many of them are unable to obtain the care they need when problems arise. And pregnancy tragically does become a period of time “between life and death.”

I visited one health center in the middle of the night. Without my flashlight, I would not have been able to see my hand in front of my face. I look at the midwife in this health center with awe, imagining the courage it must take to come to work each night. I think about the thousands of babies I have delivered in the United States, and wonder how I could have functioned without the entire hospital infrastructure in place.

On this evening, the midwife shows me the only light available. She pulls her cell phone out of her pocket and shines a dim blue light in my direction. The battery is low, she explains. She shows me how she carefully sets the phone on a counter and points it in the direction of the delivery table six feet away. I can barely see the table. “How do you repair a laceration with this light?” “I don’t,” she apologizes, “I must wait for morning.”

I pull out the bright yellow suitcase that is the reason for my visit. When I open it and turn on the lights, the room becomes visible again. And now Fanny has a wide smile on her face. She immediately realizes that she will no longer rely on cell phones or candles at night. That her cell phone can always be charged. That the fetal Doppler we include with the Solar Suitcase will make it easier for her to hear the fetal heart beat. “By the grace of God, you have come,” she tells me.

Image courtesy of We Care Solar


When former Pittsburgh Steelers' center Mike Webster committed suicide in 2002, his death began to raise awareness of the brain damage experienced by NFL football players. A 2017 study found that 99% of deceased NFL players had a degenerative brain disease known as CTE (chronic traumatic encephalopathy). Only one out of 111 former football players had no sign of CTE. It turns out, some of the risks of traumatic brain injury experienced by heavily padded adults playing at a professional level also exist for kids with developing brains playing at a recreational level. The dangers might not be as intense as what the adults go through, but it can have some major life-long consequences.

A new PSA put out by the Concussion Legacy Foundation raises awareness of the dangers of tackle football on developing brains, comparing it to smoking. "Tackle football is like smoking. The younger I start, the longer I am exposed to danger. You wouldn't let me smoke. When should I start tackling?" a child's voice can be heard saying in the PSA as a mother lights up a cigarette for her young son.

Keep Reading Show less
via Gage Skidmore / Flickr

On Tuesday morning, President Trump tweeted about some favorable economic numbers, claiming that annual household income is up, unemployment is low, and housing prices are high.

Now, just imagine how much better those numbers would be if the country wasn't mired in an economy-killing trade war with China, bleeding out trillion-dollar-a-year debts, and didn't suffer from chaotic leadership in the Oval Office?

At the end of tweet, came an odd sentence, "Impeach the Pres."

Keep Reading Show less

October is domestic violence awareness month and when most people think of domestic violence, they imagine mostly female victims. However, abuse of men happens as well – in both heterosexual and homosexual relationships. But some are taking it upon themselves to change all that.

Keep Reading Show less

At this point most reasonable people agree that climate change is a serious problem. And while a lot of good people are working on solutions, and we're all chipping in by using fewer plastic bags, it's also helpful to understand where the leading causes of the issue stem from. The list of 20 leading emitters of carbon dioxide by The Guardian newspaper does just that.

Keep Reading Show less
The Planet
via International Labour Organization / Flickr and Michael Moore / Facebook

Before the release of "The Joker" there was a glut of stories in the media about the film's potential to incite violence.

The FBI issued a warning, saying the film may inspire violence from a group known as the Clowncels, a subgroup of the involuntarily celibate or Incel community.

Incels an online subculture who believe they are unable to attract a sexual partner. The American nonprofit Southern Poverty Law Center describes them as "part of the online male supremacist ecosystem" that is included in its list of hate groups.

Keep Reading Show less