A look at some of the main medical equipment issues in Haiti

1. A look at some of the main medical equipment issues in Haiti Ismael Cordero, Clinical Engineer Consultant for ORBIS International Haiti Eye Care Symposium May 18-20, 2012 Port au Prince, Haiti

2. 3 Categories of Equipment Problems • Donations • Maintenance and repair services • Procurement

3. Donations- Proportion of medical equipment in Haiti that is donated… A Lot!

4. Donations-Problems • Not designed for the environment • Obsolete • Not compatible with local clinical practices • Broken, not fully functional, or missing accessories • Requires expensive or impossible to find consumables & accessories • No operation manuals (or in the wrong language) • No service manuals • No repair parts • Not repairable in country • Too many different types of models (no standardization)

5. The Iceberg Principle

6. Donations-Why are they usually less-than-ideal? Poor -or no- communication between donor and recipient!

7. Donations-Poor Communication • donors lack awareness of the local realities of the intended recipients • donors and recipients often do not communicate as equal partners in the pursuit of a common goal • recipients have difficulty articulating to the donor how best they can be helped • the recipient’s circumstances may lead them to believe that anything is better than nothing

8. Donations- Changing the Dynamics donor ↘ recipient

9. Donations- Changing the Dynamics donor↔ recipient

10. Donations- Changing the Terminology donor↔ solicitor recipient

11. Donations- Some things that can be done • Standard equipment lists of models prepared by solicitors • Priority equipment needs lists prepared by solicitors • Checklists for donors • Checklists for solicitors • Solicitors shouldreject inappropriate donations- donation policy • Signed MoUs between donors and solicitors

13. WHO guidelines for medical device donations • Adapt to Haiti’s reality and needs • Develop and distribute by SHO/CNCP

14. Maintenance- problems • Very few technicians available to repair medical equipment • Very few hospitals with biomedical equipment technicians on staff • The technicians that are available have not received specialized medical device training • Technical schools not offering diplomas for medical equipment maintenance • Spare parts not available locally

15. Maintenance- possible solution • Create a small independent equipment maintenance service available to all eye care providers • Train two or three technicians on common eye care equipment • Provide specialized factory training for sophisticated devices • Equip with tools, manuals, physical space • Charge nominal fee for services • Endorsed and monitored by SHO/CNCP

16. Procurement- problems • Procurement not possible within Haiti • Shipment and Customs barriers • Procurement performed overseas by each doctor individually • No standardization on models • No discounts for bulk purchasing • No strong relationships with vendors

17. Procurement- possible solution • Procurement performed by equipment maintenance service for a small fee • Eye care providers to agree on standard preferred models • Buy several of the same devices instead of one at a time • Share expensive sophisticated devices

18. WHO guidelines for medical device procurement • Adapt to Haiti’s reality and needs • Develop and distribute by SHO/CNCP

19. Maintenance- problems • Many different brands and models of equipment- no standardization • Many devices are obsolete • No budgets for repairs and spare parts

20. Thank You! ismaelcordero@me.com