Project Bo in action - A message from Dr Niall Conroy

Dear friends of Project Bo,

I wanted to update you on the impact that your support is having on some of the most vulnerable babies in the world.

As you may already know, newborn mortality rates in Sierra Leone are some of the highest in the world, with babies dying at alarmingly high rates throughout the country. Since I started working with newborns in the country in 2013, things have improved, but at a very slow rate. It is still tragically true in most of Sierra Leone that the death of a newborn isn’t an exceptional event.

Project Bo is helping to change that situation in Sierra Leone’s second-largest region. Because of your generosity, Bo Government Hospital has recently been the recipient of a large solar power system, which supplies 24-hour electricity to the neonatal unit.

Late last year I went to Bo, and one of the main purposes of my visit was to see for myself how this system was operating and the impact it was having. I can tell you first-hand that it is an amazing development! Before its arrival, babies died every single week in the neonatal ward due to power failures, which could last for days or even weeks at a time. In the developed world we take power for granted, but in Sierra Leone that is far from the case. Reliable electricity is vital in order to run oxygen machines and baby warmers, as well as to provide light for the nurses and doctors to provide effective care around the clock.

Before the arrival of the Project Bo solar power system, most of the babies who died did so because they didn’t have enough oxygen or because they were too small to maintain their own body heat. It wasn’t uncommon for nurses not to spot that a baby was deteriorating overnight, as they didn’t even have a lightbulb to watch their tiny patients. Finding babies dead in their cots at first light was a common and distressing experience for the staff in the unit.

The direct impact of the solar system is hard to measure at such an early stage, especially given the quality of medical records in the unit. However, a preliminary analysis shows that since its installation survival rates appear to be up by around 40% relative to the year before, perhaps saving as many as eight lives per month. In a unit where, during my initial period as the neonatal doctor, approximately 180 babies died each year, we could be witnessing a real game changer for newborn survival in the region.

I will continue to collect data on the impact of the system and I hope to publish one or more academic papers in due course. I am also analysing the interviews that I conducted with parents and healthcare workers during my visit, which will give further insights into the effect that a reliable electricity supply is having on this community. I will keep you all informed as data collection progresses.

I am also really looking forward to working with Michael Liebreich and the other Project Bo volunteers to share information about this project with stakeholders from the energy, development and medical worlds. It already looks like there are very significant lessons to be learned from the experience with Project Bo, and we need to make sure that other regions without electrical power or with intermittent supplies benefit too.

Project Bo and the solar panels are a real success story, but there is still a lot of work to do. The improvements in care at Bo Government Hospital’s neonatal unit have sparked a surge in attendances. Where previously people stayed away from the unit because it had a reputation for patchy care, parents now want their unwell babies to be admitted there, which is bringing a new set of problems.

There is now insufficient room for the mothers to sleep, as their accommodation has been overwhelmed by the volume of new arrivals. That means mothers are now sleeping outdoors on concrete, for up to three weeks, while their babies receive treatment. These women are willing to endure this kind of suffering for the good of their babies. But they have been robbed, attacked by dogs and many have fallen ill from malaria, as they are exposed to mosquitoes at night due to the lack of shelter. In some cases, the mothers become so ill and exhausted sleeping outdoors that they feel no alternative but to take their babies home early, before treatment is complete.

I am aware that there are still some funds being held as a contingency from the initial Project Bo fundraising, so I have been speaking to Michael and the others on the steering committee about possibly using them to target this issue. I am talking to the hospital leadership and as soon as we have a plan – perhaps a new dormitory – I will be putting forward a structured proposal.

Overall, my impression is that the solar system is a magnificent success. On previous visits, I witnessed many babies die each week in the unit. This time, during my three-week stay, incredibly there was only one death.

When I asked the head nurse if the electricity was saving lives she replied “yes, yes, yes. Less babies are dying now”. This is down to you and every single person who helped with Project Bo. There were no other options in Bo. Nobody else was waiting in the wings to help with this issue. The project Bo team and donors were the last hope for these babies and their families, and you delivered faster and with more generosity than I could have ever hoped for.

On behalf of the staff, families and the babies in Bo Government Hospital, thank you all so very, very much.


Niall Conroy