A look at some of the main medical equipment issues in

HaitiIsmael Cordero, Clinical Engineer

Consultant for ORBIS International

Haiti Eye Care SymposiumMay 18-20, 2012

Port au Prince, Haiti

3 Categories of Equipment Problems

1. Donations

2. Maintenance and repair services

3. Procurement

Donations- Proportion of medical equipment in Haiti that is donated…

A Lot!

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)

The Iceberg Principle

Donations- Why are they usually less-than-ideal?

Poor -or no- communication between donor and recipient!

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

Donations- Changing the Dynamics

donor ↘

recipient

Donations- Changing the Dynamics

donor ↔ recipient

Donations- Changing the Terminology

donor ↔ recipientsolicitor

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 should reject inappropriate donations-

donation policy• Signed MoUs between donors and solicitors

WHO guidelines for

medical device donations

- Adapt to Haiti’s reality and needs

- Develop and distribute by SHO/CNCP

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

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

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

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

WHO guidelines for

medical device procurement

- Adapt to Haiti’s reality and needs

- Develop and distribute by SHO/CNCP

Maintenance- problems• Many different brands and models of

equipment- no standardization• Many devices are obsolete• No budgets for repairs and spare parts

Thank You!

ismaelcordero@me.com