Increasing Medical Technology Use in Zanzibar, Tanzania

Jayson Marwaha Han Sheng Chia

Natalie RingElizabeth Kinnard

Zanzibar is made up of 2 is lands

1 Mill ion People

Just a 48 -Year Life Expectancy

Only 1 Tertiary Hospital

8 Secondary Hospitals

PROBLEM 1

All Hospitals Lack Life Saving Equipment

1 . Zanz ibar rece ives cos t l y equ ipment , pa t i en t s benefi t2 . US fac i l i t i e s rece i ve t ax -wr i t e off s ,

3 . Excess mach ines avo id id l ing / l and fi l l ,

win-win-win solution

SOLUTION 1

US facilities have excess equipment due to big budgetsExcess is sold/scrapped/idles

MED International collects excess

Delivers it to Zanzibar

But wa i t…

70% o f equ ipment dona ted to the deve l op ing wor ld

i s wasted1

Why?

Donated equ ipment i s 1. poorly matched t o needs o f r ec ip i en t

2. Barriers to Utilization l i k e no eng ineer s / spare par t s / r eagen ts p reven t con t i nuous

use

PROBLEM 2

1Malkin 2007

Good Match ing :T h e p a i r i n g o f d o n a t e d e q u i p m e n t t o t h e n e e d s

a n d c a p a c i t i e s o f r e c i p i e n t s

Barr ier E l iminat ion :T h e d e s i g n o f s u p p o r t s y s t e m s s u c h a s t e c h n i c i a n t r a i n i n g a n d a c c e s s t o s p a r e p a r t s n e c e s s a r y f o r

t h e c o n t i n u o u s o p e r a t i o n o f e q u i p m e n t

SOLUTION 2

MED International will incorporate 1. Good Matching and 2.Barrier Elimination

into our Donation Strategy

Donation Strategywith Good Matching + Barrier Elimination

SUPPLY DELIVERY UTILIZATION

We coordinate 3 primary functions

Domestic Shippers

International ShippersSuppliers

Suppliers donate the equipment, local transport firms deliver it to port,Tanzanian government ships it to Zanzibar

BarrierElimination

Good Matching

To increase utilization, MED International employs good matching and works with partners to eliminate barriers on the ground

Barrier Elimination Specifics

Zanzibar Hospital

Lack of US made Spare Parts

EquipmentBreakdown

No Trained Staff

Undefined Barrier*Barrier to

Utilization

Partners & Solution Providers

MED International

+Manufacture

rs

Trained Maintenanc

e Unit

Practitioner training facilities

TBD Solution

*More barriers, and priority of barriers to be determined during summer assessment in Zanzibar

Other Organizations in this Space

They focus $ on Horizontal Integration– Expanding the supply of equipment to many countries without good matching or barrier elimination leading to 70% under utilization

Rwanda BoliviaNigeria VietnamEquipment Equipment

Equipment Equipment

We focus $ on Vertical Integration

Zanzibar

Technician Training

Access toSpare Parts

Access to Reagents

Equipment

One location+ More services = Higher Utilization

Vertical Integration is Challenging

Government of ZanzibarPartner, Recipient

Ivo de Carneri FoundationAdvisor

Cadwalader, Wickersham & Taft, LLC Legal Representative

Brown UniversitySponsor, Advisor

NUS School of Public HealthAdvisor

Equipment Donors*

African Engineering Schools and Reagent Suppliers**

*Company name confidential for indemnity** Relationship TBC

But a growing network of partners & advisors situates us well

Partners in Zanzibar

“Chake Chake Hospital has a parasitology lab, the room is there, but it is empty.”

- Yahyah Al-Sawafy , Resident Representative Ivo de Carneri Foundation

“I am the only biomedical engineer…Spare parts and training upgrade. Both are important for us.”

- Marine Mathna, Biomedical Engineer Mnazi Moja Hospital

“I am pleased and satisfied with the discussions we had and I look forward to

working with you very closely to implement what we have agreed upon.”

- Amb. Seif A. Iddi, 2nd Vice-President of Zanzibar

Co-Director Jayson Marwahameets 2nd VP Seif A. Iddi

Timeline

Aug 2011Oct

Jan-Mar 2012MarApr

MED International incorporatesJayson Marwaha meets Zanzibar GovernmentMED liases with Zanzibar contacts, receives hospital needs listForms new board of directors, expands operations teamSends 1st Shipment for MOH Chemistry Laboratory to Baltimore port

Milestones

Next Steps

AprApr-Jun

Jun-Aug

Aug- Dec

Jan-May 2013

Preparation for 2nd ShipmentDesign summer 10-week study in ZanzibarLiaise with engineering contactsExecute 2nd shipment10-week study in Zanzibar to evaluate barriers to utilization Negotiations with MOH, training schools, engineers, suppliers in ZanzibarCompile dataExpand number of donor suppliers Expand funding baseTwo more shipmentsTraining of 2 biomedical technicians from Zanzibar

Potential Funding Model

In the near future, we aim to adopt a resale model

For every 10 pieces of equipment that suppliers donate, we will

sell 1 on the second hand US market and donate 9 to Zanzibar

*Ratio TBD

All funds will be channeled back into the organization to cover

operations cost, reducing dependency on grants

We have been working with our lawyers and will meet with suppliers in

June to structure this

Why Zanzibar? Why Now?

Zanzibar’s Ministry of Health is rolling out its Essential Health Care Package (EHCP) and we are an official partner

The EHCP is a health care revamp of all its public health facilities

Government motivation for better health care is highNeeds are great

MED International is positioned to capitalize on this. With your help, we will be able to bring and support vital

medical equipment to the people of Zanzibar

And they need support