Choosing between local and international suppliers
If you are purchasing equipment, you will need to decide whether to buy the equipment from a local supplier, or from an international seller.
There are benefits and disadvantages to buying from local suppliers
Benefits include ease of transportation: because the equipment is already in-country, the shipping costs will likely be much less, and you will not have to worry about importing the equipment or clearing customs. Additionally, if the vendor is local to the hospital, this can make it easier for maintenance staff to source spare parts. Finally, buying locally allows you to support the local economy, which adds an additional benefit to the donation.
However, some equipment may not be available locally or even in-country, and your choice of brand is likely to be much more limited. Counter-intuitively, some medical equipment is much more expensive when bought in a low-income country than in a higher-income setting, so it may be cheaper to buy abroad and import the equipment. Additionally, many developing countries do not have an agency that regulates companies which sell medical devices - and therefore it is easy for vendors to sell poor-quality or counterfeit equipment.
Compared to buying from local vendors, buying medical equipment from an international seller comes with its own set of benefits and challenges.
On the plus side, if you are buying from a ‘big-name’ manufacturer that is regulated in e.g. Europe or the USA, you can probably be confident about the quality of the equipment. Additionally, the range of options in terms of brands, and prices, is likely to be much greater than available in the local country.
Of course, the right approach will vary depending on what you are planning to donate, and where you are donating to. However, the key additional challenge with buying internationally is to consider: how will you get the equipment to the hospital you are donating to - including getting it through customs? This is also an issue if you are donating second-hand refurbished equipment. There may be significant costs associated with clearing the shipment through customs, and you will need to budget for this.
Who to ask for advice about importing medical equipment
Diplomatic channels can be a good source of advice and help: for example the High Commission or Embassy of your home country in the country you are donating to. Depending on the shipment, it is possible that they could recommend a suitable local agent, or include small items in their own regular shipments.
Always check national policies on importing and donating medical equipment. It would be sensible to approach the Ministry of Health in the recipient country to ask whether there are any country-specific regulations on importing medical equipment.
For example, Rwanda previously had a law stating that no second hand equipment could be brought into the country. This meant that refurbished equipment would not clear customs and would be sent back to its origin (at a cost to the sender). This appears to have changed as new guidelines on medical equipment donation published in 2017 simply state that equipment must have at least 70% of it’s life span remaining, as well as setting out other essential criteria that all donations must meet.
What factors would influence you to buy equipment locally instead of internationally? If you are planning a donation, which do you think will be more suitable for your project?
Want to know more?
If you are planning a large donation, you can find more information and advice about clearing customs in Chapter 5 of the THET ‘Making it Work’ Leaflet.
Additionally, the Rwandan guidelines on medical equipment donations to the country include a useful list of essential criteria that would be good practice for any donation.
You can find links to both documents below.
© St George’s, University of London