A shipment of medical equipment that arrived in Monrovia, Liberia, from Miami on Jan. 12 will enable 25 government hospitals to receive infection-control training. Critically, the shipment will help facilities that were partially or fully closed due to the ongoing Ebola crisis to recommence regular operations.
Many resources in the Ebola-response effort have appropriately focused on Ebola treatment; this flight launches an important new step in the response by providing training and supplies for health workers to safely resume vital services.
The delivery was organized by the Academic Consortium Combatting Ebola in Liberia (ACCEL), a network of academic centers with technical expertise in emergency medicine and logistics systems. Consortium leadership combines extensive experience in supporting both the Liberian health system and emergency-response operations, a unique mix that enables it to respond rapidly to the humanitarian crisis in Liberia.
“Our team of medical and supply-chain experts with years of fieldwork experience quickly assessed both the health care and logistics capacities in Liberia and planned a rapid response to support service providers on the ground,” says Jarrod Goentzel, founder and director of the MIT Humanitarian Response Lab, a member of ACCEL. The lab is part of the MIT Center for Transportation & Logistics.
The other members of the consortium are the University of Massachusetts Medical School, which leads the current initiative; Boston Children’s Hospital; Avenir Analytics; and the Icahn School of Medicine at Mount Sinai. A $7.5 million grant from the Paul G. Allen Family Foundation funds this effort, which is part of the broader #TackleEbola initiative.
Combined with procurement of locally available commodities, the 63-metric-ton air shipment of personal protective equipment (PPE) and sanitation supplies — valued at some $1.8 million — will meet two critical needs in Liberia’s constrained health care system.
First, hospital personnel will be able to train with proper protective supplies, which is critical, since safety protocols incorporate unique equipment designs. Traditional health care facilities in Liberia treat a wide range of patients, from pregnant women to malaria victims. Lack of training on infection protection and control (IPC) has severely disrupted hospital operations. Now staff can receive the training they need to perform in this stressful environment while protecting themselves against Ebola.
Second, the supplies will provide a three-month stock of IPC equipment for the hospitals. This is a vital resource in a situation where supply of critical items, such as protective coveralls, has been constrained and demand for the right equipment fluctuates wildly.
The consortium has developed a supply chain that is specially designed to support the relief operation, and flexes with changing conditions. Here are some of the supply chain's main features:
- Items in this shipment were sourced in the United States, and the logistics team led by Goentzel worked with a commercial distributor to access manufacturing capacity for products such as Ebola suits that are relatively scarce. Some manufacturers have increased their output as demand has soared.
- A major challenge is procuring equipment in large quantities so that the items are standardized. This is important since variations in the specifications — suits that come with or without hoods, for instance — make it much more difficult to effectively train medical staff in Liberia.
- Airlink, the NGO that provided the air transportation, collaborated with the ACCEL logistics team to secure cargo space. Most of the space was taken up by the ACCEL shipment, but spare capacity was made available to other humanitarian organizations. Airlink has received a grant from the Paul G. Allen Family Foundation to establish an air bridge to West Africa.
- Distributing the goods to hospitals that are scattered across Liberia is another logistics challenge; ACCEL is working with the United Nations Logistics Cluster in Liberia to facilitate distribution. The Logistics Cluster hub in Monrovia received the shipment and offers handling space to create the kits for each hospital. This facility feeds forward logistics bases throughout the country and provides transportation capacity where there are gaps.
- ACCEL is sourcing products locally where possible: Using local companies supports the Liberian economy, reduces costs, and streamlines the supply chain. Manufacturers of chlorine and storage containers have already been identified
The planning capabilities of the combined medical and logistics team provide a foundation for all response activities. It is essential to have a clear supply plan that is updated in response to shifting demands. For example, the initial plan in late November was revised as the forward team arrived in Monrovia, and subsequently corrected again as the number of hospitals covered increased based on new assessments of the situation on the ground.
Importantly, the consortium is working to ensure that the supply chain for critical supplies will continue to operate as long as it is needed.
“A critical part of the project is making sure that the systems we put in place are aligned with those developed and used by the Liberian Ministry of Health and Social Welfare, so the PPE supply chain can be sustained for the country’s hospital system,” Goentzel says.