The impact of electricity failures threaten the ability for the development and delivery of surgical, anaesthesia, and overall healthcare in LMICs, as seen in Fig 1. The Lancet Commission on Global Surgery, the World Health Organization, and many others states that access to reliable electricity serves as a potent factor in global surgery. Without reliable access to electricity, many necessary components of a hospital, such as lights, anesthesia machines, and imaging equipment, become ineffective and unusable, especially in times of urgent medical needs. As an integral part of society, electricity serves as a vital component of health care policies. In low-income and middle-income countries (LMICвЂ™s), this global epidemic is especially poignant in health care delivery, or lack thereof. Over 1 billion people in the world lack access to electricity. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Д¬ompeting interests: No authors funded to do this specific research project due to the fact that funding agencies we approached do not fund this type of research connecting electricity and health care directly. Undergraduate research students received either Slatt Fellows research funds or ESDD work study research funds: Brady McLaughlin, Michael DiGaetano, Abigail Awodele, and Leslie Omeeboh. Mechtenberg summary salary as SEED Funding for her new ESDD research lab. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Дata Availability: All relevant data are within the paper and its Supporting information files.ДЇunding: University of Notre DameвЂ™s Center for Sustainable Energy has given ESDD Lab Seed Funding to do research in Sustainable Energy and International Development broadly. Received: FebruAccepted: JPublished: November 4, 2020Д¬opyright: В© 2020 Mechtenberg et al. (2020) Health care during electricity failure: The hidden costs. This is quantified into a fundamentally new energy healthcare system risk chart (EHS-Risk Chart) based on severity of event (probability of deaths) and likelihood of event (probability of electricity failure).Д¬itation: Mechtenberg A, McLaughlin B, DiGaetano M, Awodele A, Omeeboh L, Etwalu E, et al. The authors define hidden costs due to electricity failure as VSL/E ($/kWh) and compare this to traditional electricity costs (always defined in $/kWh units), including Levelized Cost of Electricity (LCOE also in $/kWh). Combining these methodologies, the cost from the Value of Statistical Lives lost divided by Energy shortage ($/kWh) is calculated for EHS type and region specifically. In the second methodology, additional patient risks were calculated according to time and duration of electricity failure and medical procedure impact type. In the first methodology through research literature and/or measurements, the authors obtained and analyzed a yearвЂ™s worth of hour-by-hour energy failures for four energy healthcare system (EHS) types in four regions (SolarPV in Iraq, Hydroelectric in Ghana, SolarPV+Wind in Bangladesh, and Grid+Diesel in Uganda). Two methodologies were created to quantify these hidden costs.

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