On a research trip in Nigeria, Dr. Laura Stachel watched as physicians performed an emergency cesarean section.
What happened next stunned her.
"The lights went out," Stachel recalled, "and I said, 'How are they going to finish?' "
She was even more surprised by the nonchalant response.
"You didn't even see people reacting because it was something they were so used to," she said.
Fortunately, Stachel had a flashlight with her, and the doctors were able to use it to complete the surgery. But during that two-week trip in 2008, she witnessed countless other times when the lives of mothers and babies were at risk simply because of a lack of reliable electricity. Pregnant women would arrive at the hospital with severe complications, but without adequate light to treat them, procedures had to be compromised or delayed until daylight. Some women were even turned away.
"I realized that my skills as an obstetrician-gynecologist were utterly useless (without) something as basic as light and electricity," Stachel said.
Stachel said midwives in Nigeria use all kinds of makeshift lighting when they deliver babies: kerosene lanterns, candles, even cellphones.
"That's not adequate light for maternity care," she said. "If somebody is hemorrhaging, if a baby needs resuscitation, you need to have directed light."
Nigeria is one of the 10 most dangerous countries in the world for a woman to give birth. In 2010, an estimated 40,000 Nigerian women died in childbirth -- 14 percent of all such deaths worldwide, according to the World Health Organization and the United Nations.
Meanwhile, the neonatal mortality rate is also one of the worst in the world. Each year, about 4 percent of babies in Nigeria die before reaching 28 days old; for comparison, the United States rate is only a fraction of this at 0.4 percent.
Stachel said that in her two weeks in Nigeria, she saw more complications than she had in her entire career in the United States.
"Once I witnessed the things that I saw," she said, "I had to let people know, and I had do something about it."
With the help of Hal Aronson, her husband and a solar energy educator, Stachel worked to find a solution. He drew up designs for a solar electric system to provide a free source of power to the state hospital in northern Nigeria where Stachel had conducted her research.
While they raised funds for the project, Stachel returned to Nigeria with a small kit to help show what the system would be able to do: It had a couple of solar panels inside, some lights and walkie-talkies to improve communication.
The kit was only meant for demonstration purposes -- a miniature model of the larger system. But the surgical technicians saw it as something else.
"They said: "This is incredible. You have to leave this with us. ... This could help us save lives right now,' " Stachel said.
She did just that, and news of the kit soon spread to other clinics. So each time Stachel would return to Africa, she came with one or two new "solar suitcases" assembled by her husband.
Today, the solar suitcase includes two solar panels that are mounted on a clinic's roof and connected to high-quality LED lights. Once fully charged, it can provide light for up to 20 hours. The kit also contains headlamps, a fetal Doppler to monitor a baby's heart rate and a cellphone charging unit.
Over time, the solar suitcase has become simpler in design.
"We got to something that was really rugged, simple to use, portable and that we knew would really work in harsh environments," Stachel said.
It also spread to other countries after Stachel and Aronson started a nonprofit, We Care Solar. Since 2009, the kits have been helping health care workers save lives not only in Nigeria but in facilities throughout Africa, Asia and Central America.
For Stachel, the solar suitcase is only part of a bigger mission to improve maternal health care and lower mortality rates in developing countries.
According to the World Health Organization, about 800 women die every day from preventable causes related to pregnancy and childbirth. And 99 percent of all maternal deaths occur in developing countries.
"I really want a world where women can deliver safely and with dignity, and women don't have to fear an event that we consider a joy in this country. To see birth associated with death and fear is an outrage," Stachel said. "Before I went to Africa, I knew women were dying at high rates. I just didn't know they were run-of-the-mill things we can take care of."