Summary of initiative
Take My Hands is a social enterprise that sources usable medical equipment and resources from New Zealand health providers and sends them to overseas hospitals and health centres in need. In 2021 Counties Manukau Health partnered with Take My Hands to source items (donated and purchased) and deliver them via container to Kiribati and Vanuatu. Funding from the NZ Ministry of Foreign Affairs and Trade (MFAT) via the NZ Medical Treatment Scheme (NZMTS),was used to purchase some of the requested items and to cover freight costs. In-country logistic and associated costs are always met by the partner governments.
The NZMTS includes a focus on providing skilled health personnel to undertake specialist consultation and treatment work, and also training and mentoring of the local health workforce in specific partner countries. Travel restrictions due to the COVID-19 pandemic meant that health specialists could not go in country. While many signed up with remote training and mentoring, but there were cost savings available due to no travel.
The national referral hospitals in Kiribati and Vanuatu lack the necessary medical equipment and resources for reliable quality service delivery and for the training of clinical and allied health professionals. MFAT agreed to the use of cost savings from the lack of Pacific in-country travel to be used for needed equipment and resources, especially where there was a link to the already-agreed consultation and treatment and capacity building priorities.
Health problem: The lack of fit-for-purpose equipment and supplies impacts the reliable delivery of a range of health services and also means that staff may not have the knowledge or experience to provide the required health care. Staff need to train with the correct equipment and also have fully-operational equipment and supplies (including consumables) to perform the required procedures and interventions. Funding constraints and/or lack of skills mean that medical equipment is not available, replaced, repaired or used to capacity.
The strategy (rationale for intervention)
Our strategy had 2 prongs:
- To ensure that there was fit-for-purpose equipment available for health professionals to do their jobs and to expand the range of specialist health services being offered. This is especially important at a time when national health budgets were under considerable pressure due to responding to the pandemic.
- To ensure that the equipment and resources would support the upskilling of health professionals in-country. This also served as a morale-booster as well as being very practical in terms of improving the ability of health care professional to provide quality care.
Results and impact
The Take My Hands ‘call-outs’ for donations based on very specific lists of pre-approved items and compliance with partner country ‘donations policies’ meant that each of the two filled-to-capacity containers that left Auckland in June had medical equipment and supplies that were sorely needed. The response to the ‘call-outs’ was tremendous and was supplemented by some specific purchases, including of consumables until supply chains can be established. In additional Counties Manukau Health was able to donate some over-supplies of quality used items, again all agreed with the Kiribati and Vanuatu Ministries of Health before being packed.
Connectivity constraints is the main challenge, but this can be overcome if allow sufficient time. Calls may need to be reschedule and in-country staff allowed enough time to check information. In terms of good management and use of the assets, the involvement of the head of the relevant Biomedical dept is key – this person will ensure that requested items are compatible, there is the ability to install and maintain it and that it is loading into any asset management system (with assigned responsible personnel, department and listed maintenance and ongoing consumables).
Adopted a country-led approach will lead to the best results. This might include the flexibility to purchase the container so that it can remain on-site and provide storage until items of distributed or commissioned. Do not rush – allow sufficient time for every step of the journey, and respect what the local health officials say.
Prioritising medical equipment and other items that are linked to consultation and training work means that the equipment has a high chance of being put to good use and looked after.
The model adopted whereby local Ministries of Health are fully engaged with prioritising their requests, responding to offers, proactively engaging in planning and executing the roll-out of equipment and supplies upon arrival and distribution made it exciting to be part of. Any replication needs to ensure that the time is taken to use an approach that has good local ownership.