Aid and aid work

The importance of contingency planning

by Michael Keizer on April 29, 2009

Slightly over a week ago, I was trying to write an article for this blog about how health issues could impact logistics. I just could not make it work: the main health impact on logistics would be from a pandemic, and although that seemed pretty realistic to me, I also felt that my readers would probably not see it as realistic enough to spare it a second thought. That was a real issue for me, because the main reason why I wanted to write the post was to get people thinking about logistics contingency planning for a pandemic.

Of course, I am now kicking myself for not have written what would have been a fairly prophetic post – and perhaps have influenced one or two people to take some action.

So my apologies for being late – let’s just say that this is a mistake I will not make very soon again.

The impact

Let’s just assume for the moment that swine flu will go pandemic. What effects will this have on our supply chains?

The most obvious one is that it will put severe demands on it. We will need to have massive amounts of medical goods at the right spot, at the right moment. How to deal with this issue merits a separate post, which you can find here.

Perhaps more insidious is the fact that every supply line depends on people – and in case of a flu pandemic, many of those people will be incapacitated (by illness or death), or be subject to isolation or quarantine. This will mean a severe blow for many of our supply chains: without truck drivers, store managers, clerks, and purchasers, our supply lines will soon break down.

Furthermore, quarantine measures might also mean that transport will be infinitely more difficult: if we can’t have trucks or planes come into the country where we work, goods will not come in either.

How to deal with it

So how to deal with this? At this stage, preparation would include four steps.

The most important issue, which needs immediate action, is to prioritise our logistics: which goods for which programmes are most needed. I would suggest to divide them into three to five groups, ranging from “immediately indispensable” to “doesn’t matter if it’s a couple of months late”. Note that we are not talking about articles here, but about article/programme groups: article 1 for programme X might be in a different group than the same article for programme Y. This needs to be done now: you do not want to have these discussions while you are in the middle of a crisis.

A second issue that needs to be dealt with concurrently with the prioritisation, is a sensitivity analysis of our supply chains: which parts our supply chains will be most vulnerable to disruption? It could be very helpful to develop a couple (not too many) scenarios and see how they impact our supply chains. When doing this, don’t forget that our supply chains extend beyond our own organisation: include the possibility that e.g. your main supplier will be severely impacted, or that your main transporter will be knocked out. Also look outside the logistics departments, e.g. by taking into account that your programme staff might be so severely overburdened that they will no longer be able to make forecasts or report regularly.

Based on the prioritisation and the sensitivity analysis, prepare contingency plans that deal with the various scenarios in such a way that (as far as possible) goods from the highest priority groups will be where they are needed, when they are needed. These contingency plans could include e.g. stockpiling (explicitly taking the risk of increased expiries), already hiring extra staff, and many other possible actions. What it exactly will entail for your organisation will depend on many factors, and there is definitely no one-size-fits-all solution. It will be important here to think laterally and come up with creative solutions: this is an extraordinary situation, and will need extraordinary solutions.

The fourth and last step is resourcing and communication: make sure that you have the (financial) resources to implement your contingency plans – which will mean that you will need to ‘sell’ your plans now to senior management of your organisation – and communicate the plans to all people involved, which would include practically everyone within your organisation, and quite a number of people outside it.

I can hardly stress enough that these steps need to be taken now: if and when the crisis arrives, it will be too late. You might counter that nothing ever goes according to plan, and that the crisis that will really happen is unlikely to be the one you planned for; that might be true, but having these plans and resources at the ready will give you an enormously increased resiliency that will enable you to cope much better than otherwise. To quote general Dwight D. Eisenhower: “plans are nothing; planning is everything”.

A call for action

Go now to the person(s) responsible for logistics planning in your organisation, and ask them whether they have prepared contingency plans for a severe pandemic impacting on your supply chain. And don’t let them get away with generalities; things are much too serious for that. And if you yourself are responsible: did you do your homework? Finally: please come back here and let us know what you did: at this stage, we should all learn from each other.

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Overhead, HQ, and the global financial crisis

by Michael Keizer on April 25, 2009

Ritratto di Frà Luca Pacioli (1495). Luca Pacioli (1445 - 1517) is the central figure in this painting exhibited in the Museo e Gallerie di Capodimonte in Napoli (Italy). The painter is unknown, although some people are convinced the painter is Jacopo de#39; Barbari (1440-1515).

How much should we spend on non-project costs, a.k.a. ‘overhead’ or ‘HQ’? Ten percent? Twenty? More? Or less? Please think about this for a couple of minutes before you read on, and define for yourself what would be a reasonable percentage in the organisation that you work for.

So now I am going to tell you that whatever percentage you came up with is wrong.

Nasty, huh?

My point here is that we should really stop thinking in percentages. Sure, it sounds nice that we can tell people that we spend only 15% on ‘overhead’, but it is totally meaningless.

First of all, we have these people called accountants, who are very good at defining ‘accounting principles’ in whatever way is needed to present the best picture.[1] When we say that we spend 15% on overhead, we actually say, “15% of our expenditure is attributed to overhead, but that could be any odd (or even) number under different accounting and presentation principles”.

Furthermore, defining how much we want spend on organisation (shall we just stop using those disparaging words ‘overhead’ and ‘HQ’?) in terms of total expenditure, or even as an absolute number, really is utter nonsense. No self-respecting company would say at the start of the fiscal year, “let’s spend so-and-so much on our corporate organisation – doesn’t matter on what, you can just spend this amount”[2]. Instead, they look at what support and control activities are needed from corporate, and then make first an activity budget, and subsequently base a financial budget on that. Similarly, we should define what level and manner of support and control we need from our central departments, and then try to cost it. In the end, the only thing that matters here is how the people we try to aid get most bang for the buck – and if that is more by spending it on support, because that will increase our efficiency in the field by so much, than that is where we need to spend it.

Over at humanitarian.info, Paul Currion makes the very astute observation that the current global financial crisis might actually help us to look at these issues in a more rational way. In short, he contends that the resulting squeeze on our budgets might force us to look more at efficiency, and do that in a less mechanical and more rational way than just at expenditure in the field versus at HQ. He might be right – I definitely hope so.

(Image: Ritratto di Frà Luca Pacioli (1495). Luca Pacioli (1445 – 1517) was, amongst many other things, the inventor of double-entry bookkeeping, a system we still use today. He was also the first to realise that profit and loss were no absolutes but depended on how you accounted for them.)

Footnote

 

[1] I have been an accountant and an auditor. Believe me, I know.

[2] Show me a company that does, and I show you a bankrupt in the making.

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The power of the pipeline

by Michael Keizer on April 24, 2009

Trans-Alaska Oil Pipeline by rickzWhen preparing a new order, you take into account goods that are still in transit (a.k.a. the pipeline), right? Right, so we need not discuss things further.

Or do we?

In practice, there are a number of issues that surround the pipeline that complicate things and ensure that in reality, we often incorporate incorrect pipeline figures in our calculations.

  • Time. When do you expect the goods to arrive? Tomorrow? Next week? In a year? And that date, does it relate to arrival in your transit port, a country away? Or at the airport next door? And how long will clearing and onward transport to your projects take? In the end, the main issue is when the goods will arrive where they are needed, in your programme; all other considerations are important only for the purpose of determining that date. However, in the settings where we work, they are often difficult to predict. An example: some years ago, I was involved in importing a large consignment for an African ministry of health. We felt that we had done our planning quite well, taking normal transit and clearing times into account and adding a buffer based on the normal spread. What we did not know, however, was that the ministry of agriculture had ordered a massive consignment of fertiliser – and when I say “massive”, I mean tens of bulk shiploads, all arriving at more or less the same time. This consignment arrived at the same time as our containers, congesting the port of entry to a point where we could not land the containers for several days, and then struggled for several weeks to find onwards transport capacity. I learned from this the value of growing and maintaining an extensive information network in whichever location you find yourself. If I had talked with some people in the main transport companies, I would soon enough have heard that their capacity was fully booked out.
  • Confirmation. You know you ordered 20 boxes of paravenozole, delivery at your warehouse due next week, but did you actually get a confirmation from your supplier? Too often we do not insist on binding timelines, with obvious results; and if we do, we do not enforce them well enough. This is improving, though: I have seen various solutions to this problem. The one I like best is to have ‘order managers’: dedicated staff who take over the management of the order once it has been placed, ensuring that confirmations are received and regularly following up status with the supplier.
  • Matching.You know that there are 20 boxes of paravenozole in the next plane to arrive, but… for which project are they? And to cover which order? The supplier of course uses a different system of identifying orders than you do, let alone of article coding. So how can you match this? Obviously, the key here is keeping your paperwork in order, ensuring a clear trail from project order ID, to your order ID, to the suppliers order ID. In reality, this is slightly more complicated than it sounds because we often need to split up orders, and might have on-the-run changes. And of course, we are not talking of one consignment with one type of goods for one project on one order… However, none of this is insurmountable. The most important thing here is discipline: the discipline to document continuously what we do, why we do it, and what are the results – in such a way that we can easily find things back. It does not really matter whether we have an old-fashioned paper-based system or a state-of-the-art ERP system: the principles of documenting and cross-referencing remain the same.
  • Units. A small last issue, but one that does trip us up sometimes: did we order twenty boxes of paravenozole, each of 100 doses, 2000 doses in total? Or twenty overboxes, each containing 50 boxes, 100,000 doses in total? Make sure that you document, double-check, and feedback to your projects and your supplier in case you have any doubt.

Taking into account your pipeline figures is your an essential part of order management; and although it may take a lot of work, most of it should be routine activities that can be done at a clerical level. Your pipeline is your connection to your future deliveries, and can give you an invaluable idea of that future for a very small investment.

(Image by rickz.)

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What to bring on a logistics deployment

by Michael Keizer on April 22, 2009

The ever-interesting Chris Blattman published a list of things to bring for field work. A very useful list, I should add, and some of the suggestions in the comments are very worthwhile too. Just don’t try to bring everything that’s in there.

So what specifics would I add for a logistics deployment?

  • A clicker (one of those thumb model counters). Will help you immensely during verification activities.
  • Cling wrap. Has more uses than I can easily mention here, but for starters: repairing leaky containers, repairing car windows… actually, combined with some duct tape, it can repair almost anything — even, in an extreme situation, some bodily harm (but get to a doctor ASAP).
  • So the next one, obviously, is duct tape. More uses than you or I can even imagine.

  • Sticky labels, A6 size (4 on an A4 page), printable. Again, more uses than you would expect.
  • Permanent markers. You will always see that you need them when there are none around.
  • An el-cheapo digital camera, preferably one that can make rudimentary videos. Worth its weight in gold for training purposes.
  • The electronic version of the ordering catalogue of whichever organisation you are working for. Your organisation is too small to have a catalogue?[1] Get one from a bigger organisation with similar activities (so in the medical area the MSF catalogues, for education UNICEF, for water and sanitation OXFAM, etcetera). This will help you immensely when ordering yourself or when getting people to be more specific on their orders.
  • Your organisation’s logistics, admin, and financial procedures in electronic form, including the standard forms used.

So what do you take with you when you go to the field?

Footnote

[1] Actually, your organisation is not too small. If it is big enough to have more than one programme, it is big enough to have a (rudimentary) catalogue.

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Latest job opportunities (22 April 2009)

by Michael Keizer on April 22, 2009

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Latest job opportunities (20 April 2009)

by Michael Keizer on April 21, 2009

  • The Organization for Security and Co-operation in Europe (OSCE) is looking for a procurement officer for Macedonia.
  • HelpAge International is looking for a logistics manager for Darfur (Sudan).
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Research wanted! A call for papers

by Michael Keizer on April 18, 2009

No sooner had I finished my post calling calling for more evidence on what works (and what doesn’t) in health/aid logistics, than an email message arrived from the HUMLOG institute, alerting me to an excellent opportunity to do so. The Supply Chain Forum, a professional journal on logistics, supply chain and operations management, will publish a special issue on humanitarian supply chains. Please see their call for papers for more information.

Now get those keyboards clicking!

(Image by Nic McPhee.)
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Pirates!

by Michael Keizer on April 16, 2009

Things are getting slighty ridiculous.

I have posted twice now on piracy. That is honestly about as much attention as I would like to give them on this blog. Yes, they are a serious threat to aid logistics, and yes, they specialise in spectacular actions that are fine to generate breathless comment — but they are definitely not the most important issue in aid work, or even aid logistics.

Yet the last couple of weeks they have suddenly entered  the consciousness of the public; suddenly everybody and their various aunts and uncles are scrambling to get on board and get their part of the booty. [Okay, enough pirate-related imagery, already. I will stop now.]

Just have a look at this graph from Google Trends:

Have a close look at the bottom part of the graph, which traces how often news articles refer to pirates, and note the sharp increase over the last month or so (the spikes in the top graph are related to losses of the baseball team). It now has come to the point where TV shows will follow pirates and the actions against them.

So what caused this spike? Only one thing: for the first time, pirates hijacked a ship under the US flag. Now what does that say about the media — and about us?

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How to get things done: more on the logistics of logistics

by Michael Keizer on April 16, 2009

In my previous post on why logistics seems to be so prone to “herding cats” problem (thanks, Laura Walker Hudson!), I suggested five  reasons:

  • The complexities of logistics are “deep” complexities, and are not readily apparent.
  • Daily logistics experiences are not always applicable to large-scale logistics.
  • Our evidence base is sketchy, which has a ‘halo’ effect on all logistics activities.
  • There are hardly any aid logisticians with a recognised advanced degree in the field.
  • Aid logisticians are not the biggest fans of systems or administration themselves.

So what to do about his?

1. Work on the evidence

This is easier said than done. However, we will need something more than our gut feelings and personal experience to be able convince our colleagues. Other areas in aid routinely publish about lessons learned — why don’t we do so in logistics?

  • If you have seen (or developed) a particularly successful technique or method, or seen a received one wreak havoc in a particular setting, don’t keep it to yourself: write an article for an appropriate journal.
  • Think how you can incorporate research in your daily practice and do so. Most aid organisations, and defintely most health organisations are open to facilitate research as long as it does not inconvenience their programs too much. Health and humanitarian disciplines routinely do research within programmes, but logistics rarely does.

2. Explain, explain, explain — and learn

Too often, we do not explain why we want to do certain things a certain way: why is it necessary to fill in that request form, why can’t we just go to the pharmacy and take what is needed, why do we need to make consumption forecasts? Be didactic; and be proactive about — don’t wait for your colleagues to ask, because they will only do so when their irritation level is already high. And if you feel that you cannot explain, rethink — perhaps we are on the wrong track.

This holds true the tactical planning level as well: why do you elect to go for six-monthly order cycles and not three-monthly ones? Why do you select these suppliers and not those? Why do you procure your drugs in Europe and not locally? Include in your explanations why logistical solutions that work at the level of one patient, one time, will not work at the level of a large-scale intervention.

Make sure that everybody understands (or at least has a chance to understand) what you are doing and why, and you will see that it will suddenly is much easier to implement your systems. You will also get much better feedback — and who knows, that feedback might lead you to reconsider your plans and improve them beyond recognition.

3. Get a recognised qualification

Get that master’s degree in aid or health logistics, and see how much more recognition you suddenly get (and how much deeper your understanding of what you do will be).

I am working on my second master’s degree now (in public health, specialising in health logistics for develing countries), but my first one was only sidewise related to aid/health logistics. Already I notice that people take more account of what I am saying, just because they feel that I somehow ‘earned’ that by studying the field. Utter nonsense, of course, but it is how the game plays — and you’d better play along if you want to have the impact you know you can.

Working on my MPH has also given me an opportunity to better integrate my knowledge. It haven’t yet learnt much that was completely new to me, but I am now better able to put things in their context, and to see links between seemingly disparate pieces of knowledge that I did not see before. It also enables me argue more convincingly (not necessarily better, but definitely more convincingly) because it has given me better knowledge of the language of health and health professionals. And finally, it has enabled me to expand my network in global health, which means that I know who to call next time I have a problem that I don’t have a good solution for, or when I think that I need specialist input for.

Get that qualification — it’s worth it.

4. Don’t undercut yourself

When the unexpected happens, don’t throw your logistics systems overboard and get into emergency mode. First think how you can accommodate the issue within your existing systems. By giving the right example, you can show the importance of those systems and that they are not just impediments to getting our work done.

Don’t change systems without in-depth understanding. Many logistics managers in aid, especially in emergency aid, have very clear ideas about how things should be run and do not hesitate to change things in the first couple of weeks (or sometimes even days) after they have arrived. However, your predecessor probably was not a fool either, and would have had reasons to implement the systems the way they did — based on what they knew after having worked for some time in that particular setting. Don’t change systems before you have been in the programme at least six weeks to two months — and for developmental programmes even longer. Changing things too fast, too soon, will only serve to undercut yourself and future logisticians.

And finally: follow the systems yourself. Nothing will undercut your authority as quickly as a ‘do what I say, not as I do’ attitude.

(Image by Todd Lappin)

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The logistics of logistics, or: why logistics solutions never work here

by Michael Keizer on April 10, 2009

Vaccination; 041028-N-9864S-021 Yokosuka, Japan (Oct. 28, 2004) - Hospital Corpsman 3rd Class Tiffany Long of San Diego, Calif., administers the influenza vaccination to a crew member aboard USS Kitty Hawk (CV 63). Currently in port, Kitty Hawk demonstrates power projection and sea control as the U.S. Navy's only forward-deployed aircraft carrier, operating from Yokosuka, Japan. U.S. Navy photo by Photographer's Mate Airman Joseph R Schmitt (RELEASED)

“That would never work here.”

I have had to listen to this reply more times than I can easily remember. It will usually come up when I propose to put procedures into place instead of continous ad-hoc decisions, standardisation instead of reinventing the wheel time after time, or proven solutions from other places in a new setting. There is a little devil in all of us that tells us that we are unique, that what works there will never work here, that every little decision we take needs our 100% attention.

Reality is different, and we only need to look at our daily lives to see everyday proof. Do you agonise daily which to put on first, your socks or your shoes? Do you feel that, in your case, it really is a good idea to keep on breathing while you swallow your soft drink? Do you try to walk through closed doors, just to see if that might lead to better results? Or will you today drive to work in reverse, just to see whether that will work better? Of course you don’t; you are aware of best practice from a lifetime of experience and from the example set by peers (classmates, siblings, friends…) and authority figures (parents, teachers, driving instructors…), and you do not go about testing those practices every day again.

Perhaps more pertinently, most of us would really not appreciate if our doctor or dentist would start experimenting with new procedures or home-made drugs when we go to our next appointment (at least, not while there are other, proven possibilities to use first). We really don’t want our electrician to try out a revolutionary new insulation method he recently thought up. Yet when it comes to aid logistics, suddenly there is no such thing as received wisdom, because “every situation is different.”

What causes this behaviour? Why do we behave so differently when it comes to aid logistics?

I think there are a number of issues here:

  • Everybody is a logistician. Or at least, everybody thinks they are. “Just get the bloody stuff here when we need it, can’t be that hard cannit?” Unlike medicine, dentistry, or electrical engineering, the complexities of logistics are much further beneath the surface — so it is not as clear to the average aid worker that logistics management sometimes requires a bit more than just common sense.
  • Unlike many other areas, our daily logistics experiences are not scalable. Logistics routinely deals with complexities of scale: techniques that can be used at small scales will break down at the large scale. Vaccinating one patient is not much different from vaccinating 10,000: draw up, check, swab, inject, discard — and then times 10,000. However, the logistics of a 10,000 person vaccination campaign is many times more complex than those for a one-patient ‘campaign’. A vaccination nurse would have experience organising the logistics for a one-patient (or perhaps 10- or 100-patient) vaccination, but not a 10,000-patient campaign; and consequently would not realise how much more complex the issues become. I will write more about complexities of scale in an other post.
  • The evidence base for much of aid logistics’ best practices is comparatively sketchy. Unlike e.g. medicine, we do not have a history of formal trials; most of our evidence is based on case descriptions and anecdotal evidence. There is a small base of formal trials in logistics in corporate settings, but there results can only be applied very tentatively to aid work. As a result, those techniques that do have a base in evidence are usually not accepted as authoritative by aid workers because they are applied to logistics. No doctor would deny the usefulness of treatment protocols; the advantages of protocols (or procedures, or algorithms, or whatever you would like to call them) have been amply demonstrated, but apply this to logistics and people will loudly complain about imposed bureaucracy.
  • There are no recognised degrees for aid logisticians. Doctors need to pass medical exams. Electricians need to sit for their tests. Drivers need to pass a driver’s test before they get their licence (well, in most developed countries anyway). We expect a degree in public health from a public-health specialist. But aid logisticians come in all kinds and shapes, some with more logistics knowledge and skills than others. There are now a couple of specialised aid logistics master’s degrees, but as they are very new there are hardly any graduates in the field yet. The results are double-edged: on the one hand, not all aid logisticians have the knowledge to recognise the importance and usefulness of standard logistics operational solutions and methods; and on the other hand logisticians do not get recognition as specialists in their own right, and hence their authority is not recognised or accepted.
  • Aid logisticians tend to be an unruly, desk-hating lot. We come from all walks of life, but especially amongst field aid loggies there is an over-representation of people with backgrounds that pre-dispose them against accepting anything remotely smelling of authority, or of desk work[1]; and that includes things like procedures, administration, standardisation, etcetera. In this sense we are our own worst enemies, and tend to sabotage our own systems.

So what can we do to improve on this? How can we change this behaviour from logisticians and other aid workers alike? More in my next post, after Easter.

(Images by the US Navy and Martin Deutsch.)

Footnote

[1] Or as one colleague once told me, with obvious pride: “We are the last adventurers — and the rest of them are just pale bureaucrats.”

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