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Common assumptions about and pitfalls of equipment donations

Common assumptions and potential pitfalls- adapted from the THET leaflet 'Managing the lifecycle of medical equipment'
Image of two men standing by a window and sink looking down at something with some apparatus behind them, soap at the window seal and a bottle of water.
© St George’s, University of London

Don’t be caught out by these common assumptions

When working in an unfamiliar setting, there may be many unexpected pitfalls that can threaten the success of your donation.

Before proceeding with your donation, think through the entire lifecycle of the equipment step-by-step and check that any essential conditions are actually in place.

Below are some common mistaken assumptions – always check that this is in fact the case.

Planning and procurement phase:

  • There is a comprehensive and accurate inventory of all hospital equipment.
  • Users know how to use the equipment OR there are resources/systems in place to provide systematic training of all necessary staff.
  • “Household name” or “well known brand” companies operate in the same manner in an emerging economy as they do in the UK.
  • You can trust the market to deliver equipment of good quality and safety.
  • A long-term budget is in place for equipment purchases.

Set up phase:

  • Systems are in place for effective, reliable, timely and safe transport from the port to the hospital.
  • The company will honour warranties.
  • Facilities exist and are appropriate e.g. space to store the equipment, doors big enough for equipment entry, floors strong enough, water and power supplies available.
  • The equipment will be delivered and installed by the supplier.

Use and maintenance phase:

  • A safe and stable electrical supply and clean running water is always available.
  • Medical gases are always available.
  • Non-clinical facilities e.g. sterilisation facilities, laundry departments, are (a) available and (b) function well.
  • Spare parts and consumables are available for reasonable prices within a reasonable timescale, and will continue to be available throughout the lifetime of the equipment.
  • Qualified and trained technicians are present locally, have access to use manuals and and will be able to maintain the equipment.
  • A budget is in place for equipment maintenance.

Decommissioning and disposal phase:

  • There are clear regulations on waste disposal, that take account of the environment.
  • Decommissioning regulations exist e.g. erasing of patient data and decontamination – and technicians know how to do this.

Case study: unexpected difficulty in accessing spare parts

For example, in 2012, Guy’s and St Thomas’ NHS Foundation Trust, Arthur Davidson Children’s Hospital and Ndola Central Hospital in Zambia set up a partnership focusing on improvement of biomedical services in those two hospitals.

A key challenge they encountered was how to get a supply of spare parts. The Zambian government had procurement regulations that did not allow public hospitals to order parts from outside the country (for example online).

The few Zambian medical equipment suppliers present in the country tripled or quadrupled prices and the lack of competition and market control allowed them to maintain this position.

To get around this, the partnership approached a local hardware store to order parts online, on behalf of the public hospitals.

This is just one example of an unexpected challenge – and a creative solution.

Talking point:

From your own experiences, can you think of any other assumptions that are not covered above? Please share any suggestions in the discussion section below.

© St George’s, University of London
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Medical Equipment Donations to Low Resource Settings

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