Power outages are not mere nuisances, they’re surgical emergencies. In one Tanzanian hospital, a scheduled adenotonsillectomy hit a snag when the generator failed, plunging the theatre into darkness mid-operation; “the most stressful 5 minutes” that felt like a lifetime to Dr. Amos Muzuka, an Anaesthesiologist from Mbeya Zonal Referral Hospital. He is not alone.
According to the World health Organization, globally, more than half of hospitals in lower-income nations report unreliable energy jeopardizing everything from medication cold chains to emergency surgery. Compact solar theatre units which were first developed by KidsOR in Dundee illustrate that big change can come in small packages. They power operating rooms for eight hours post-sunset and indefinitely during daylight, eliminating reliance on uncertain grids or costly diesel generators.
What began as a pilot in 4 Smile Train partner hospitals across four countries—DRC, Tanzania, Nigeria, Zimbabwe—quickly demonstrated its value: hospitals averaged 1,104 kg of CO₂ reduced in just one month, with projections reaching 13 tons annually per site. Investing in solar-powered surgical theatres isn’t just clinical, it’s ethical and environmental too. Each system is expected to save 1.5 tons of CO₂ yearly per theatre.
Real Impact in Africa
A survey titled “Solar Surgery System Feedback Survey” released in May 2025 was carried out on 21 hospitals in rural, urban, and periurban locations across Africa. It sought the experiences of hospitals that were using the solar operating rooms from its efficiency to ease of use. The real-world results are powerful. 68% of the respondents confirmed an uptick in surgical safety, while 93% reported fewer power-related interruptions. 92% of the feedback showed that the operating rooms aligned with greatly with their Environment, Social, & Governance (ESG) and sustainability goals.
Clinicians stress how transformative this has been: “We can still operate even when the electricity is off,” observed a respondent, “benefiting pediatric patients by avoiding prolonged fasting” said one respondent. “It has given us the confidence of no power interruptions and therefore no service delivery interruptions despite there being country-wide load shedding challenges throughout the period,” reported another.
More than setting up, maintenance is imperative
Setting up the solar theatres was not enough; there was the question of who would be responsible for maintenance and how they would go about it. As might be the case in many low-resource settings that receive new, high-quality. and often expensive equipment, poor maintenance, lack of spare parts, and technical expertise often render the costly equipment unusable and redundant, which further cripples the operational costs of the hospital.
The survey reported that while some hospitals maintained their solar panels every three months, the respondents agreed that it was easy to monitor the performance of their solar surgery system. On clarity and accuracy of the information provided by the solar monitoring system, 57% surveyed very accurate while 21% confirmed that the data was accurate. This data gives the hospital leadership a planning runway for their operations while maintaining the optimal use of the theatre.
As with every technological development, pitfalls such as the equipment emitting too much heat and a greater demand to scale the equipment to the entire hospital facility are expected.
Closing the Gap in Pediatric Surgery
These solar installations show that distributed, off-grid solutions can and should become a healthcare baseline in regions with unstable infrastructure.
This must become a norm, not a novelty. We need Government incentives encouraging solar installations in public hospitals, multilateral investment, from development banks to cross-national funding, and robust training, not just equipment delivery, but also local technicians must own and sustain the solutions.
KidsOR and Smile Train have already installed solar theatres in 61 African hospitals, with 77 projected by end-2025. The 5-year collaboration has contributed immensely to prioritizing and advocating for safe pediatric surgery, in a world where 1.7 billion children are in dire need of these much-needed services, according to the Lancet Commission. Decades later, the vision is that children’s surgery, especially uplifting those from low-resource settings, will be an exciting discussion in the corridors of advocacy and other development agencies.
A Call to Shine Brighter
These pioneering solar operating rooms light more than surgical fields, they illuminate a future where safe, green, context-appropriate healthcare is a right, not a luxury. Global health leaders, policymakers, and funders: this is the moment to double down. Carbon won’t save a child’s life, but reliable lighting and energized ventilators will.
As the world continues to heighten its interventions to climate change, we are seeing healthcare’s future: safe, sustainable, and grounded in local need. The sun is rising on a new era for African pediatric surgery. By embracing context-specific, solar-powered operating theatres, Smile Train and Kids Operating Room (KidsOR) are ushering in a quiet revolution, one that should serve as a model for healthcare resilience across the Global South.
By Mrs. Nkeiruka Obi – Vice-President and Regional Director for Africa at Smile Train and David Cunningham – Chief Executive Officer at Kids Operating Room (KidsOR).