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Increasing Medical Technology Use in Zanzibar, Tanzania
Jayson Marwaha Han Sheng Chia
Natalie RingElizabeth Kinnard
Zanzibar is made up of 2 is lands
1 Mill ion People
Just a 48 -Year Life Expectancy
Only 1 Tertiary Hospital
8 Secondary Hospitals
PROBLEM 1
All Hospitals Lack Life Saving Equipment
1 . Zanz ibar rece ives cos t l y equ ipment , pa t i en t s benefi t2 . US fac i l i t i e s rece i ve t ax -wr i t e off s ,
3 . Excess mach ines avo id id l ing / l and fi l l ,
win-win-win solution
SOLUTION 1
US facilities have excess equipment due to big budgetsExcess is sold/scrapped/idles
MED International collects excess
Delivers it to Zanzibar
But wa i t…
70% o f equ ipment dona ted to the deve l op ing wor ld
i s wasted1
Why?
Donated equ ipment i s 1. poorly matched t o needs o f r ec ip i en t
2. Barriers to Utilization l i k e no eng ineer s / spare par t s / r eagen ts p reven t con t i nuous
use
PROBLEM 2
1Malkin 2007
Good Match ing :T h e p a i r i n g o f d o n a t e d e q u i p m e n t t o t h e n e e d s
a n d c a p a c i t i e s o f r e c i p i e n t s
Barr ier E l iminat ion :T h e d e s i g n o f s u p p o r t s y s t e m s s u c h a s t e c h n i c i a n t r a i n i n g a n d a c c e s s t o s p a r e p a r t s n e c e s s a r y f o r
t h e c o n t i n u o u s o p e r a t i o n o f e q u i p m e n t
SOLUTION 2
MED International will incorporate 1. Good Matching and 2.Barrier Elimination
into our Donation Strategy
Donation Strategywith Good Matching + Barrier Elimination
SUPPLY DELIVERY UTILIZATION
We coordinate 3 primary functions
Domestic Shippers
International ShippersSuppliers
Suppliers donate the equipment, local transport firms deliver it to port,Tanzanian government ships it to Zanzibar
BarrierElimination
Good Matching
To increase utilization, MED International employs good matching and works with partners to eliminate barriers on the ground
Barrier Elimination Specifics
Zanzibar Hospital
Lack of US made Spare Parts
EquipmentBreakdown
No Trained Staff
Undefined Barrier*Barrier to
Utilization
Partners & Solution Providers
MED International
+Manufacture
rs
Trained Maintenanc
e Unit
Practitioner training facilities
TBD Solution
*More barriers, and priority of barriers to be determined during summer assessment in Zanzibar
Other Organizations in this Space
They focus $ on Horizontal Integration– Expanding the supply of equipment to many countries without good matching or barrier elimination leading to 70% under utilization
Rwanda BoliviaNigeria VietnamEquipment Equipment
Equipment Equipment
We focus $ on Vertical Integration
Zanzibar
Technician Training
Access toSpare Parts
Access to Reagents
Equipment
One location+ More services = Higher Utilization
Vertical Integration is Challenging
Government of ZanzibarPartner, Recipient
Ivo de Carneri FoundationAdvisor
Cadwalader, Wickersham & Taft, LLC Legal Representative
Brown UniversitySponsor, Advisor
NUS School of Public HealthAdvisor
Equipment Donors*
African Engineering Schools and Reagent Suppliers**
*Company name confidential for indemnity** Relationship TBC
But a growing network of partners & advisors situates us well
Partners in Zanzibar
“Chake Chake Hospital has a parasitology lab, the room is there, but it is empty.”
- Yahyah Al-Sawafy , Resident Representative Ivo de Carneri Foundation
“I am the only biomedical engineer…Spare parts and training upgrade. Both are important for us.”
- Marine Mathna, Biomedical Engineer Mnazi Moja Hospital
“I am pleased and satisfied with the discussions we had and I look forward to
working with you very closely to implement what we have agreed upon.”
- Amb. Seif A. Iddi, 2nd Vice-President of Zanzibar
Co-Director Jayson Marwahameets 2nd VP Seif A. Iddi
Timeline
Aug 2011Oct
Jan-Mar 2012MarApr
MED International incorporatesJayson Marwaha meets Zanzibar GovernmentMED liases with Zanzibar contacts, receives hospital needs listForms new board of directors, expands operations teamSends 1st Shipment for MOH Chemistry Laboratory to Baltimore port
Milestones
Next Steps
AprApr-Jun
Jun-Aug
Aug- Dec
Jan-May 2013
Preparation for 2nd ShipmentDesign summer 10-week study in ZanzibarLiaise with engineering contactsExecute 2nd shipment10-week study in Zanzibar to evaluate barriers to utilization Negotiations with MOH, training schools, engineers, suppliers in ZanzibarCompile dataExpand number of donor suppliers Expand funding baseTwo more shipmentsTraining of 2 biomedical technicians from Zanzibar
Potential Funding Model
In the near future, we aim to adopt a resale model
For every 10 pieces of equipment that suppliers donate, we will
sell 1 on the second hand US market and donate 9 to Zanzibar
*Ratio TBD
All funds will be channeled back into the organization to cover
operations cost, reducing dependency on grants
We have been working with our lawyers and will meet with suppliers in
June to structure this
Why Zanzibar? Why Now?
Zanzibar’s Ministry of Health is rolling out its Essential Health Care Package (EHCP) and we are an official partner
The EHCP is a health care revamp of all its public health facilities
Government motivation for better health care is highNeeds are great
MED International is positioned to capitalize on this. With your help, we will be able to bring and support vital
medical equipment to the people of Zanzibar
And they need support