- UNICEF is looking for a contract officer and a contract specialist (vaccine analyst)
- ACF Spain (or ACH) is looking for logistics coordinators in Lebanon, the Palestine territories, and the Sahel region.
Logistics
An interesting article in the Ugandan newspaper The Daily Monitor, warning for a possible new polio outbreak. The most interesting part came almost at the end:
Dr Zaramba [the Director General of Health Services; MK] said the health ministry has enough vaccines to roll out an emergency vaccination exercise for children below five years later this month and in April. …
However, Dr Mbabazi [a risk analyst at the WHO country office; MK] said there are “serious health system and bureaucratic problems” that have led to the re-emergence of polio in the country that need to be fixed “real fast”. He cited bureaucratic delays that stopped the government from responding quickly to the WHO warning.
He said, “They are now talking about this upcoming emergency vaccination but as far as I know, there is no money for logistics to do it on a massive scale. Yet it is the best that can be done under the current circumstances.”
Let me reiterate this:
- Seven million Ugandans are at risk of contracting polio
- There are sufficient vaccines to vaccinate all of them
- But: there is no money to arrange the logistics of a vaccination campaign.
Yet another example of how ignoring health logistics will lead to disastrous consequences. When will we start to integrate logistics in our health planning?
(Photo: Polio immunisation in Jinja, Uganda. Courtesy of Richard Franco. Some rights reserved.
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A couple of weeks back I wrote about a possible upcoming food crisis, and what it could mean for aid logistics. This made me finally pick up HPN‘s latest Good Practice Review, Emergency food security interventions, by Daniel Maxwell et al, which has been waiting on my to-read stack for some weeks. My friends, I was shocked — shocked, I say! (Add appropriate TV preacher’s voice here.)
When we talk about large-scale aid logistics, WFP is the obvious role model: no other aid agency moves such large amounts of goods over such long distances. (Whether or not this is a good idea in the first place is debatable, and will be debated in a future posting — but what is clear that at this stage WFP is doing it). Now why would the World Food Programme, from all other UN and other aid agencies, be the one with the largest logistics capacity?
Very simple: because (and read this well, Messrs Maxwell et al): good logistics is essential for food aid! Food aid (perhaps with the exception of cash transfers) needs good logistics like medical aid needs medical infrastructure.
So why, you may well ask, why this sermon? Why all this bold font? What, my dear Michael, is the cause of your outrage? Well, believe it or not, but Maxwell et al managed to write a 147-page guide on emergency food aid… including a half-page on logistics. That is right, they spend about 0.3% of their (otherwise admirable) review on it. Now does that seem right to you?
(Photo: EU food aid, courtesy of Rock Cohen. Some rights reserved.)
.jpg "Transport of artillery early 17th century (Jean Théodore de Bry, 1614)")
(This is the first article about the fundamentals of logistics in health and aid. A number of the issues that I outline here will come back in future postings.)
The health of a supply line is often measured by the ‘five rights’:
- Are the right goods (including in the right quality[1]) being delivered?
- Are they delivered in the right quantity?
- Are they delivered to the right location?
- Are they delivered at the right time?
- Are they delivered at the right price?
Of course, these same five rights are important in health and aid logistics as well, but the emphasis will often be different from ‘normal’, commercial logistics settings.
Starting with health logistics, it will be clear that the first four rights will get much more emphasis than in a commercial setting. E.g., a supermarket chain can decide not to sell lettuce for a day if the lost profit margin would be less than the extra cost of getting it to its stores; ethically, a hospital cannot easily weigh the lives and health of its patients against the costs — and in any case such a trade-off would make an interesting PR exercise. In other words: the constraints in medical health are mainly in the first four rights, and are much more rigid than in most (but not all) commercial settings. However, in resource-constrained settings (like in most developing countries), a lack of efficiency can mean that we have less resources to purchase life-saving supplies: health logistics in developing countries is a constant balancing act, where each error in either direction can mean loss of life or increased suffering.
In emergency aid, this holds true to an even greater extent: ‘the right quantity’ often will be massive, ‘the right quality’ is often not easy to determine in the hectic environment of an aid operation (hence often large amounts of supplies arrive that are in the end not used), and ‘the right location’ more often than not is extremely difficult to access due to shattered infrastructure, natural obstructions, or security issues, and will often be far away from the origin of the goods. This does not leave much space to experiment with ‘cheap’ alternatives. However, that does not mean that we should ignore efficiency: if gains can be made without endangering the effectiveness of our aid, why not use them? This will be the subject of a future posting — for now, let me just make the observation that I feel that we sometimes too easily allow ourselves to forget efficiency in our struggle for aid effectiveness.
In developmental aid[2], we are much more able to emphasise the cost side of logistics. Yes, our target areas still are often to access, and yes, the scale still often is massive, but we now can plan and forecast more easily (allowing to determine the right goods, the right quantity, and the right time more accurately), and hence we can plan our procurement and transport activities much further in advance. This implies that we can also procure much closer to our target areas, which by itself will already help decreasing cost. Most excuses for inefficient logistics that we see in emergency aid do not exist in development aid, and hence inefficient supply lines are a lot less acceptable.
Footnotes
[1] Especially in medical logistics, sometimes a sixth ‘right’ is added: are the goods delivered in the right condition. However, this is arguably included in the first right: e.g. expired drugs will definitely not have the required quality.
[2] Yes, I am aware that this is an artificial distinction and that there is a continuum from emergency to developmental aid. However, please humour me and allow me to use this divide for our analysis.
Continue Reading 4 comments }Aid and aid work, Logistics, Public health
- MSF Belgium is looking for a coordinator of logistics operations.
- The IRC is looking for a Senior Logistics Coordinator for the DRC
- IMC is looking for a Roving Senior Logistics Officer for Uganda
- Medair is looking for logistics coordinators in Sudan and Uganda
- GOAL is looking for a Logistics Advisor Emergency Response and for Logistics Coordinators for North and South Sudan (what’s up with the ‘logisitics’, guys? don’t want people to find the vacancies?)
Continue Reading 0 comments }Aid and aid work, Logistics, Public health
Demonicious is a source of often hilarious (but at times simply irritating) visual humour. Two weeks back they posted a series of pictures under the title Wonders of Logistics. Recommended for a smile and an occasional snort. A selection:
Update (November 14, 2009): Apparently Demonicious has disappeared from the web, and their funny photos with them. Too bad.
Updated update (November 21, 2009): And now they’re back again, with a new design. I guess they were just out for maintenance for a while.
{Talking about health logistics, we tend to concentrate on heath systems logistics, i.e. the logistics of the health system. What we ignore is the logistics of daily life and its impact on health.
To give one example: obesity is linked to the way our communities are designed and how long we spend in our cars each day. More dramatic examples include how distance from a source of clean drinking water impact on water use, or how transport and in-house storage of that same drinking water can make all the difference between clean or contaminated water.
An even more direct link between smallest-scale logistics and health are the risks that many women and girls in developing countries (especially in refugee settings) run when collecting firewood. Here it is not even the logistics that impact on the product (firewood) and hence on health, but the logistic activity (collection) itself that endangers people’s life and health (although there is also an indirect link: the use of firewood as fuel causes air pollution).
UNHCR and the Women’s Refugee Commission recently started the Get Beyond Firewood initiative, which is trying to find safe alternatives for firewood. This is a good example of how improvement of the smallest-scale logistics can improve life and health of people in developing countries.
Continue Reading 0 comments }Aid and aid work, Logistics, Public health
“Logistics, if it was easy it would be called taxes.”
– Retired Army Lieutenant General Russel Honore, reported by Eric Holdeman at The Disaster Zone.
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Logistics can impact quite severely on public health. If we do our work well, health professionals and patients get their supplies and lives are saved. If we goof up, those same lives might be lost. But sometimes, things become much, much worse.
A faulty logistics management system at the Peanut Corporation of America was partly to blame for a recall that ended with the corporation recently filing for bankruptcy protection. But in the mean time, 19,000 people had become ill , of which nine died, due to infection of certain products with salmonella.
Good logistics can be a lifesaver in the most literal sense of the word; but bad logistics can just as literally be a killer.
[Picture by joannapoe. Some rights reserved.]
{An aid convoy set off yesterday from London to Gaza, organised by a number of private donors and organisers. By itself this is nothing new: trucks and small convoys with private aid have been going on for quite some time already, mainly to Eastern Europe. However, there is one difference here: the Viva Gaza convoy comprised about 100 vehicles, amongst which a number of ambulances loaded with medical supplies.
This is more than a quantitative difference: with this convoy, privately organised aid suddenly has reached a scale that puts it in the same league as many established international aid organisations. Up to now, private aid was always limited by the lack of logistics capacity: a more or less hard limit of about ten vehicles, about fifty staff, and about 10 metric tonnes of goods seemed to prevent private aid from ever achieving the scale of professionally organised aid. This convoy smashes that limit with panache.
Not so long ago, ‘citizen journalism’ was seen as a fringe activity that could never threaten the position of the printed press. Just a couple of years later, is was suddenly perceived as the biggest danger to the newspaper industry in decades. These days, most of us would see it as an interesting and useful complement to newspapers and magazines, with both comparative strengths and weaknesses. Could we now see the start of a similar ‘citizen aid’ movement?
Of course the organisers are running into a number of logistical issues; e.g. having a number of participants arrested within a day on suspicion of terrorist activities is not auspicious. However, I still think this convoy might some day be seen as the start of a new era for the aid industry, in which big international and national aid organisations work side by side with citizen aid — and will be more stringently be held to new standards that will develop from successes in private aid activities. The only restraint for that to happen, large-scale logistics, seems to have been overcome.
Update (10 March 2009): the convoy has arrived in Gaza. Click here for an update.
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