How a thermometer saves lives

Wednesday October 25, 2006

Georgina Kenyon

When a group of Australian hospital workers devised a plan to take medical equipment to hospitals in Asia during their holidays, they did not realise that it was the beginning of a life-long aid project; nor that it would become a global effort.

In 1995 Peter Brophy, a clinical services policy and planning manager at a group of hospitals in Sydney, Australia was looking for a cheap way of having a holiday. He had become interested in Laos and Cambodia in Southeast Asia, not far from Australia, which at the time were still relatively unknown to most tourists.

The romance of unknown countries combined with a sense of adventure got him thinking about how he could travel, while using the skills of his job to fund the holiday. Helping people along the way would, he anticipated, help him achieve a level of personal satisfaction too.

Brophy?s full-time hospital job partly involved understanding the logistics of buying medical goods for hospitals in Australia as well as the safe disposal of out-of-date or surplus goods. As with most medical equipment, whether a thermometer or a part of a syringe, materials such as plastics have use-by dates. Before the materials degrade, however, there is a window during which the materials are still suitable for use ? even if in certain countries they?re not supposed to be.

This process of discarding medical goods, which were still good for use, from Australian hospitals was to become the basis of a new Australian and British government-backed charity project.

?I realised that hospitals can direct surplus medical products, including those which have passed their expiry date, to meet the needs of hospitals in neighbouring countries. It?s a worthwhile alternative to sending potentially valuable products to waste disposal,? says Brophy.

Following an initial self-funded trip during his annual leave to review the medical equipment needs of hospitals in Laos, Cambodia and Vietnam at the end of 1995, Brophy started to make funding applications. These he directed to the United Kingdom?s Department for International Development (DFID), the Australian government?s overseas aid program (AusAID) and Rotary International to pay for shipping costs of the equipment to Asia.

During the hospital review he was struck by the discrepancy between a lack of even the most basic equipment such as thermometers and how the doctors and nurses in so many of the hospitals were well-trained and informed on the latest treatments available for the patients. The doctors and nurses were also well aware of how scarce their resources were and how often they were forced to give less than adequate treatment to their patients.

Brophy was particularly affected by the malaria and leprosy patients he saw. The dramatic effect of leprosy remained vivid in Brophy?s memory. Cerebral malaria, he learned, in particular, was a great problem in some of the clinics and hospitals in rural and jungle areas.

Doctors were used to seeing many cases of malaria in children that had progressed to cerebral malaria because families could not afford to come to the hospital for treatment, especially during harvest time.

Back in Sydney, following several unsuccessful applications for funding, Brophy finally succeeded in securing a grant. And while working full time, he set about finding more volunteers and people interested in his project, in the corridors of Sydney?s hospitals.

Not all Brophy?s co-workers or supervisors supported the scheme; some were openly hostile, but several people from hospitals around Australia were interested and Brophy and his growing new team began to plan where to send the equipment.

?As a result of what I had seen in Cambodia and Laos, among the first recipients of the medical equipment was a leprosy village in northern Laos where one-third of the 240 inhabitants had contracted leprosy,? he explains.

Because of the stigma of the disease, leprosy patients were often ostracised from their village, and sufferers lived together in what local people termed ?leprosy villages?.

?The leprosy village we chose to receive equipment first was located a considerable distance from the nearest hospital, and the residents did not have ready access to even the most basic treatment facilities, including dressings and medication,? says Brophy.

The first container of medical equipment was then filled with disposable products collected from Australian hospitals and medical suppliers. It included surgical instruments, stainless steel bowls and kidney dishes, needles, syringes, sutures, catheters, breathing masks and gloves. There were also larger items such as operating tables, midwifery delivery beds, suction pumps and microscopes.

?Products that were past their expiry date were inspected to ensure the basic integrity of the packaging was undamaged before being sent,? Brophy explains. The first container, as well as every subsequent 20ft container sent, was worth around AUD70,000 (£280,000).

The process of transporting goods to Asia, however, was definitely not straightforward. Once the grant applications had been finalised and the slow process of waiting for funding had been cleared, the group had to start thinking about how to physically transport the goods from the ports of Asia up to the mountain village hospitals. In Laos, for example, in 1999, the dirt road from the capital, Vientiane, to the northern town of Luang Prabang was known to be highly prone to mud slides. Trucks driven by local drivers had to be organised in the capital, while Brophy?s team travelled up to the northern towns by plane or boat. Coordination, the team was to discover, was an arduous process and needed a lot of patience as plans often had to be changed. The team also found that in spite of forward planning, delays always occurred.

Some equipment, such as metal operating tables, also proved difficult for people to carry and did not always reach the intended destination.

The project did, however, prove a success despite several setbacks and it is now 10 years since it began. It is now called Global Medical Support and supplies equipment additionally to Africa and the Pacific, largely due to the commitment of several people from Rotary in Australia and private donors.

Following several charity jobs and the continual coordination of the project, Brophy is now planning to support the setting up of an eye hospital with a group of doctors in Indonesia, while continuing to work with the medical project.

?The combined effort of everyone allowed people?s lives to be saved and the health of many people living in remote areas to be improved,? says Brophy. ?The little we are able to achieve in collecting and distributing medical assistance does have a very real and immediate impact on the lives of people, as the local hospitals are better equipped and resourced to address the ever growing demand for health services,? he concludes.

Contacts

Rotary International
www.rotary.org

AUSAID
www.ausaid.gov.au

DFID
www.dfid.gov.uk

or get in touch with Peter Brophy himself at

 

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