Aid and aid work

Humourless links for January 3, 2010

by Michael Keizer on January 3, 2010

Big h/t to the humlognews newsletter.

{

Continue Reading 0 comments }Aid and aid work, Logistics, Public health

The challenge of reverse logistics in global health

by Michael Keizer on January 2, 2010

The Valley of the Drums, a toxic waste dump in northern Bullitt County, Kentucky. This site was one of the reasons the the U.S. Superfund law was enacted.

Have you ever thought about the reverse logistics in your supply chains? Very likely if you are involved in medical logistics, but probably not in those terms: reverse logistics is not something that comes up on a daily basis in discussions in our field.

Reverse logistics is basically what happens when goods need to flow back in the supply chain. The most obvious example is of course when expired drugs need to be sent back for proper disposal, but reverse logistics might actually be more common than you think: disposal of materials and equipment, recalls, returns of overstocks so they can be used somewhere else in the organisation: these are all examples of reverse logistics.

Yet we hardly ever put systems into place that deal with our reverse logistics; possibly because it is seen as an exception instead of the regular occurrence that it actually is in many organisations. The results are predictable: losses and negative side-effects are common. Some examples:

  • Financial losses Most organisations would have tight controls on expensive goods as they travel through the ‘normal’ supply chain. However, I have seen many instances in which these controls were absent or much less stringent when dealing with reverse logistics. In one example, when trying to see what happened with a large generator (value: several tens of thousands of dollars) after it was sent back for repairs, I discovered that nobody had actually followed up after it was sent back and a replacement arrived, and in the end it was untraceable. This was a big and unnecessary loss for the organisation.
  • Negative health effects If expired drugs are taken from the reverse supply chain and used (possibly after having been sold on the local market), they can wreak havoc on the health of the people using them; some drugs become toxic after some time, but even those who do not will probably start losing efficacy and would be as bad as under-strength counterfeit drugs – and that is even apart from the effects of uncontrolled use of e.g. antibiotics on the development of resistant strains.
  • Environmental damage Drugs might be beneficial for us, but they are not always so for our environment. Many drugs are toxic for other animals and plants; and even when they are not, it is not always clear what would be the long-term effects on the environment of uncontrolled dumping of drugs. That alone should be enough to have tight controls on what happens with expired drugs and how they are disposed of. This is even more true of e.g. used engine oil and other toxic waste: do you know what happens after an oil change? Is the oil just burned, or even worse, buried, possibly poisoning ground water for years to come? Or is it properly disposed of in an incinerator that reaches temperatures that are high enough to prevent hazardous fumes to be formed?
  • Legal liability In many countries where we work, there are strict laws surrounding disposal of drugs (especially psychotropic drugs), and ‘losing’ drugs in the reverse supply chain can open us to legal liability. Similar issues arise around environmental damage.
  • Loss of reputation Although there is still not much press attention for aid and global health organisations’ records when it comes to the effects I mentioned above, I don’t think it will be too long before our actions in this area will be put under the microscope as well (as they should be). Do you really want your organisation to be the first of the black sheep that will be singled out for our atrocious reverse logistics practices?

It is clear that we need to start working on our reverse logistics. It should not be too hard: the basic principles and best practices that we use in ‘normal’, forward logistics, can be used in reverse logistics too. The only question is: do we start working on this now or will we wait until it is too late?

{

Continue Reading 15 comments }Aid and aid work, Featured, Logistics, Public health

Latest job opportunities (November 21, 2009)

by Michael Keizer on November 21, 2009

[Image: Job opportunities by Coffeechica]

{

Continue Reading 0 comments }Aid and aid work, Logistics

Latest job opportunities (November 19, 2009)

by Michael Keizer on November 19, 2009

[Image: Job opportunities by Coffeechica]

{

Continue Reading 0 comments }Aid and aid work, Logistics

Simplicity, participation, and some tall tales

by Michael Keizer on November 18, 2009

Usually, I find myself nodding enthusiastically when reading J.’s Tales from the Hood; his thoughtful mini-essays on humanitarian aid work (with, as he describes it, “occasional digressions toward rock music, motorcycles, and parenthood”) have from time to time even been known to make me belt out a loud “yeessss!!!”, accompanied by fist-pumping motions that look totally ridiculous on a bespectacled, bald, overweight forty-something.

But this time I found myself frowning, and actually disagreeing vehemently. In his latest article on “rules to live by”, he writes:

Don’t overdo “process.” Yessssssssssssss, process is important. But process is not the actual point of aid work. The point is product, output, outcomes, impacts, benefit to beneficiaries… [INSERT PREFERRED AID-WORLD BUZZWORD]. If your process doesn’t lead to one of those in fewer steps than you have fingers, then it is probably useless and should be fixed or abandoned immediately.

And then:

Don’t overdo “participation.” Sometimes less is more when it comes to group decisions and group-led processes. If you can make the decision, make it. If you must involve others: Involve the lowest number of people practical for operational decisions. Involve only technicians and/or those with direct managerial authority over the project in question on technical decisions.

Of course, of course J. is right that outcomes are more important than process – but I think he overstates his case when it comes to the simplicity of the process. By total coincidence, I posted a response yesterday on humanitarian.info in which I said, “… if your solution can be written on a postcard, it probably solves nothing”. This was the summation of a four-paragraph argument that silver bullets don’t exist, that we need to look at systems as a whole when searching for solutions to issues, and that consequently those solutions will hardly ever be simple. To put it another way: we don’t live in a Hollywood movie; our problems will not be resolved in two hours in a script that can be gleaned from a one-page summary.

It all comes back to what I wrote in my post about ICT versus systems: if you want progress, you will need to do much more than just introduce yet another tool or another procedure – you will need to tackle the system, and on the whole systems don’t respond too well to short, sharp shocks. And all this with the caveat that, yes, of course there will be complex issues that can be resolved in a simple manner – but not that many.

Similarly, although I agree totally that one shouldn’t ‘overdo’ participation, I think that J.’s rules of thumb (“If you can make the decision, make it. If you must involve others: Involve the lowest number of people practical for operational decisions. Involve only technicians and/or those with direct managerial authority over the project in question on technical decisions.”) are overly simplistic. Yes, of course I keep the final responsibility as the manager in charge, but I can use inclusive process[1] to:

  • build consensus, which will make my life much easier when finally implementing what needs to be implemented – and in many cases actually lead to an increase of effectiveness and efficiency, because the time spent on participation is outweighed by the time saved on implementation;
  • get feedback in an early stage that can make the difference between doing something stupid or doing something smart – and so improve our product/outcomes/impacts/benefit to beneficiaries/whatever. In other words: sometimes the street sweeper knows more about how to deal with autumn leaves than the dendrologist.

And now go and add Tales from the Hood to your feed reader – because J.’s writing shows that he doesn’t take his own advice on simplicity too seriously and really thinks about what he does; and that is a treat that is all too rare in the testosterone and adrenaline filled world of humanitarian aid.

[Images: simplicity by Gisela Giardino; Participation 12 pack by dharmabumx. Some rights reserved.

Back to post [1] Okay, so I have to admit that I have thrown that one in purely to be provocative. Can I have a bit of fun sometimes?

{

Continue Reading 2 comments }Aid and aid work

Latest job opportunities (November 13, 2009)

by Michael Keizer on November 15, 2009

{

Continue Reading 0 comments }Aid and aid work, Logistics

Humourless links for November 14, 2009

by Michael Keizer on November 14, 2009

{

Continue Reading 0 comments }Aid and aid work, Logistics, Public health

Latest job opportunities (November 10, 2009)

by Michael Keizer on November 10, 2009

{

Continue Reading 0 comments }Aid and aid work, Logistics

If you have followed this blog, you will know that I am very much in favour of more academic input into our logistics efforts. As you can imagine, I was tickled pink when I saw the ads for a new book about humanitarian logistics, written by respected INSEAD academics Rolando Tomasini and Luk Van Wassenhove.

Let me not mince words here: I am disappointed. Expectations are high when a prestigious university like INSEAD releases a book under its own impressum, but those expectations are not met – not even closely. The reason actually is made clear in the first paragraph of the book. The authors describe their experience in humanitarian logistics on which they base the book: case studies they did for WFP/UNJLC, the IFRC, and FUNDESUMA. In other words, they base a book about humanitarian logistics in general on limited experience with three organisations that are very unrepresentative of the sector as a whole. This has clear effects throughout the book: although they do make some valid observations (especially when they talk about partnering with the private sector, which is clearly their focus), much of what they describe is over-simplified, or even dead wrong.

All three of the organisations they worked with (especially the IFRC and FUNDESUMA) have a focus on disaster aid, which obviously skewed their view severely. It leads to occasionally ridiculous assertions; a good example is that, according to Tomasini and Van Wassenhove, in humanitarian supply chains “… time cycles are very short [and] new and unprecedented demands occur frequently …” (p. 8). Definitely true in some types of humanitarian response – specifically disaster response – but totally untrue of many other types. When the authors describe the characteristics of a humanitarian supply line (ch. 1), they very clearly have a specific type of humanitarian response in mind; a type of response that in reality makes up a minority of humanitarian work.

Chapter 5, which is devoted to information management (which people who know me will immediately recognise as one of my personal hobby horses), goes as far as basically describing the SUMA model (with a bit of info about UNJLC’s website thrown in for good measure) as the paradigm to follow, without recognising that it is totally inappropriate for a majority of humanitarian aid work. A bit of scrutiny of e.g. humanitarian.info would have been useful to inform this chapter.

The book comes into its own in chapter 7, about partnerships between humanitarian and corporate organisations. It is very obvious that this is what the authors are experts in, and it is the most useful and well-written chapter of the book. Sadly, that is not enough to justify its rather inflated price.

All in all, this is a missed chance. Gentlemen, I just know you can do better: get to it.

{

Continue Reading 7 comments }Aid and aid work, Logistics

Latest job opportunities (6 November 2009)

by Michael Keizer on November 6, 2009

[Image: Job opportunities by Coffeechica]

{

Continue Reading 0 comments }Aid and aid work, Logistics