Making light work: solar’s potential to lift rural Indians out of poverty

Imagine this. You’re living in a remote rural hamlet in the forested hills of Mysore, in the southern Indian state of Karnataka. You’re miles from the nearest doctor, a day’s journey by foot and bus to the nearest hospital. And there’s no mains electricity. If you suddenly fall ill and need urgent medical help, what are your chances?

A few years ago, they’d be slim. Today, though, you make your way a couple of hundred metres down the track to a minor miracle: a small, gleaming white building topped with solar panels. Inside, a specially trained health worker checks you out, runs a few tests, takes your blood pressure, even does an ECG, maybe gives you some lifesaving treatment or medicine. Then she connects you to a doctor in a distant hospital, who’s right there on the screen, giving you the sort of specialist consultation that would normally be far out of reach.

It sounds like one of those rosy scenarios beloved of futurists, but this isn’t speculative fiction. The Climate Smart Health Clinic, as the sign over the door declares, is here and now, in the village of Basavanagiri Hadi.

It’s part of an ambitious programme that is using a combination of solar power and mobile connectivity to revolutionise the prospects for healthcare across swathes of rural India. It springs from the Selco Foundation, “the charitable arm of Selco India, the country’s leading solar company specialising in small-scale, decentralised systems.”

With the backing of the Ikea Foundation, the scheme is designed to provide reliable, clean and affordable electricity to 25,000 of the country’s state-run primary health care (PHC) centres, as well as to explore entirely new ways of delivering health services – like the ‘tele-clinic’ in this Mysore village.

The solar panels on its roof, along with inverter and battery packs, generate enough electricity to power lights, monitor screen and camera, fans, vaccine cooler, medical kit such as digital stethoscopes, and, of course, the vital mobile connection to the distant hospitals.

In the past I had to travel a long way to see a doctor. It took all day and it cost a fair bit, too. Now I just walk up to the clinic. It’s so much easier

On the day I visited, a young woman from the village, Bhanumathi, was being shown the ropes by health facilitator Sunil Kumar, in preparation for taking over running the clinic. He talked her through how to take blood pressure and pulse rates, and she practised on me. (After checking the results on the screen, she reassured me that my readouts were quite normal – “for an older gentleman”. Cheers …).

Having local people at the helm helps build trust, explained Dr Zeenath Roothi, project manager for monitoring and evaluation at Selco Foundation. “When it’s something so new and unusual as this, people feel reassured to see a familiar face”. And down the track in the hamlet, there’s no doubting its popularity.

“In the past I had to travel a long way to see a doctor. It took all day and it cost a fair bit, too”, said villager Chikkamani Kullaiah. “Now I just walk up to the clinic. It’s so much easier.” Being able to get tests done there and then eases worry, too, added her neighbour, Chikkamani Shivarudra. “I never knew I had anaemia until I was tested at the clinic. Now I can monitor my own haemoglobin levels.”

“We have drop-in clinics on different days”, explained Kumar. “So, Monday is general health, Thursday is paediatric, and so on.” And as he ran through all the services on offer, the contrast between this and the typical ‘patient experience’ in the so-called developed world became more apparent. Never mind remote rural India, I thought, we could use this in crowded urban England.

Tele-clinics like this are just at a pilot stage, but there are already 10 up and running. Meanwhile, the rollout of solar to existing PHCs is well on the way, with nearly 6,000 completed. The vast majority already have a grid connection, but it’s often far from reliable – and that can be fatal, explained Selco Foundation’s associate director, Rachita Misra. “If you suddenly lose electricity just as a woman’s giving birth – and a lot of deliveries happen at night – that can be disastrous.”

Operations, too, can go badly wrong if there’s a sudden power cut. Some PHCs have a diesel generator as backup, but these aren’t always reliable, either: they can’t be depended on to kick in and keep a smooth flow of power just when it’s needed. By contrast, solar panels can keep backup batteries charged and ready to fill the gap – as I heard repeatedly from doctors and nurses at a number of PHCs scattered through south-west Karnataka.

Never mind remote rural India, I thought, we could use this in crowded urban England

At Mulluru health centre, manager Dr Brinda has around 12,000 villagers in her care. “We used to have power cuts all the time”, she told me. “Often at night when we needed it most”. It played havoc with their stock of vaccines, which have to be kept at just the right temperature in the clinic’s refrigerator. “Someone would have to jump on a motorbike and race to take the vaccines to safety” [in the nearest site with power]. And sometimes they’d be too late.

Now the vaccines stay cool, as do the medics. Selco designers have even come up with a solar-powered backpack which keeps vaccines cool long enough for a health worker to take them out on motorbike or bus to surrounding homes and villages. And they’ve also developed a solar-charged backpack containing monitoring equipment to help mobile maternity care specialists check up on women with potentially high-risk pregnancies. Early interventions like these can save lives, Dr Roothi explained.

Then there’s the health and wellbeing of the staff themselves: a well-lit health centre is a much more comforting place for the (usually female) nurse on duty overnight.

Illuminating livelihoods

But solar in remote areas such as this doesn’t help with health, it puts more money into people’s pockets too – and does so on a commercial basis. Just how it achieves this became clear travelling through the hills above the coastal city of Udupi in the company of Guruprakash Shetty, Selco’s deputy general manager. As the car winds its way up roads bordered by a mix of forest and farms, he ticks off the sort of artisans who’ve had their lives transformed by the reliable electricity that solar provides: “Potters, tailors, dairy farmers with milking machines, millers, blacksmiths, juice sellers, garages, barbers ….”.

With its presence betrayed by the telltale panels on roofs or in yards, it was easy to stop by the roadside and chat to some of these ‘solar entrepreneurs’. Take blacksmith Shrinivas Archaya, who produces everything from pickaxe heads to surprisingly intricate dental instruments in his village forge. He showed me how his punchy solar-powered fan – itself developed specially for forges by Selco engineers – has helped him get just the right amount of heat he needs for the work.

“I have current [mains electricity]”, he explained, but adds that it’s always going down. “When that happens, I was just sitting idle. Now with the solar I can work from 10 until night.” As a result, his income has gone up substantially – more than enough to meet the repayments on the loan he took out to buy the system.

Sitting in her tailor’s workshop outside her home, Mrs Vijay was finishing work on a bright blue blouse when we came by. The solar-powered sewing machine she bought in 2022 is a small miracle, she said, explaining how, without electricity, she had to use a foot treadle. “Now I can make two or three blouses in a sitting, compared to just one before. So I earn the same amount of money in much less time. And now I have more time for myself. And for the house”, she adds, quickly.

Even for people who are connected to the – often unreliable – mains grid, solar makes economic sense, explained Shetty. “The smaller systems pay for themselves in less than a year”, in terms of savings on electricity bills. Bigger ones – powerful enough to run power tools, or kitchen equipment like food mixers and fridges, for example, can take up to five years to cover their costs in terms of bill savings, but enable the user to earn more income, which helps offset the price.

Harish Hande, who founded Selco more than 20 years ago, told me it’s a myth that the poor of India can’t afford solar, pointing to the fact that the company’s sold more than half a million systems, many to rural villages. “Solar makes sense in three circumstances: when there’s no grid, so it’s the only electricity available; when the grid is unreliable [still the case over much of rural India]; and when the grid is super reliable – but more expensive than solar” – the price of which has fallen tenfold over the last 30 years.

Back in Basavanagiri Hadi, in addition to the tele-health centre, the local women’s self-help group (SHG) is reaping some of the benefits. Its houses all have their own solar connections, and there are solar streetlights too, with the cost shared between the villagers and the Selco Foundation. Like many rural settlements, it has a mains electricity supply – in theory.

But as SHG member Chikkamani Shivarudra told me, as we chatted with her neighbours outside her house, “there were always lots of power cuts; hardly any power at all during the rains, and often none at night, which meant elephants would come through the village”. (Sounds romantic, but in practice that’s not only scary, but means trampled vegetable gardens, plundered millet stores and broken fences.)

Now, thanks to solar, there’s power 24/7 for everything from mobile chargers to radios to lights – vital for children to study after school. Some of the women have set up sewing businesses. Shivarudra’s bought a camera and printer: a useful combination in a country renowned for its government forms and photo ID. “The chance to earn our own money has made life a lot better”, she says.

As we get ready to leave, her mother comes by, keen to share her excitement at how the village “is now all lit up at night”. In the past, she says, “we would be nervous walking out after dark, because there might be a tiger, and we wouldn’t be able to see it.” Now, she says, they can keep a look out, and if they see a tiger, “we can run away”. Away out of the darkness, into the light.

Main image: Basavanagiri Haadi Tele Health Centre, tribal village health workers Bhanumathi and Sunil Kumar outside. All photography: Martin Wright