The Stuff Dreams are Made of

A bit of background:

Since about 1998, I have been involved with my Rotary club and district in donating a treasure trove of used medical equipment from US blood centers to blood banks in countries with far more needs than money.  The projects each began with our hearts happy and full of joy with the belief that the process will be relatively quick and easy to do.  We had a devoted team of Rotarians and friends willing to do the physical and mental labor to get the equipment well on its way to new homes. Many projects followed with Rotarians from around the world. We learned much.

I want to give an idea of some of the issues that need thorough research before final commitments are made; I’m not trying this to scare you away from a noble humanitarian mission – just help you make sure that the mission can be accomplished.

Don’t reinvent the wheel.  Rotary has lots of resources, like our Rotarian Action Groups that will give you guidance.

Remember that each project takes a team.  Rotarians are delighted to help, especially giving advice.  Make your team members responsible for getting answers that relate to their field of experience.  Ask the guy who sends heavy tools around the world about shipping, the lady who runs the NGO to help qualify recipients, the banker how to move funds.  Rotarians are also very good at making introductions, locally or around the world.  I wish I could tell you that all the projects I have been associated with went perfectly.  But that would violate the 4-Way Test.

The slightly out-of-date medical and laboratory equipment that is replaced in affluent nations may be the stuff that dreams are made of for those in the developing world. Rotary projects that facilitate the repositioning of equipment can give tremendous value for a relatively small expenditure of cash. 

But trans-national donations have far more complexities than an in-country purchase. Seemingly insignificant issues can clobber a great project if not properly addressed in the planning process.  

Finding the right recipient may be as easy as working with a local Non-Governmental Organization that redeploys medical equipment.  Start there if you can.

IS IT THE TRUTH?

Success will be defined by improved health care in the recipient hands.  No matter how well-meaning the gift, humanitarian causes are served only by its appropriate, cost-effective, reliable and safe function. 

The most critical consideration is finding a recipient whose needs and workflow match the capability of the equipment; one who has the resources to install, maintain, repair that particular model device and feed it the particular kind of supplies that it demands.  Some devices are pretty generic and can be used in a wide variety of circumstances; others require a specific brand of supplies and chain of processes which may or may not be licensed and available in a given country.

Here’s a hypothetical example – one with lots of things to think about that come from a composite of experiences…

A blood center buys a new state-of-the-art automated centrifuge for $45,000 and offers the 10 year old predecessor (which cost $30,000 new) for donation to a developing country. Sure, the used unit doesn’t have all wiz-bang features of the new one, but different areas have different needs, and this unit is in good condition with lots of life left.  The manufacturer states that parts and supplies will be available for at least five more years.

If there isn’t five years life left in the device, stop right here.  There is no long term need served by giving technology that has a very short service life; the recipients will become defendant upon it only to fight frustration and disappointment when it fails or supplies become unavailable.

Only the technical authorities at a given blood center can determine if any particular donation would work with their processes and if all the elements of support can be obtained.  They will need the specific technical manuals for the device before they can ascertain that it will meet their needs – and that they can meet its needs.

The technical staff will also have to determine if there is appropriate space, electrical and possibly water utilities, heating/air conditioning/ ventilation.  Management must be willing and able to purchase needed supplies and perhaps, train or add staff with specific skills.

IS IT FAIR TO ALL CONCERNED?

If it isn’t going to be cost effective for the recipient, don’t push it.  Never, never, never accept that statement “I know we can use it because we need everything and we can work around any problems.”

It is a double tragedy when expectant recipients cannot use a newly received gift – one that other worthy people in a different area could have used.

Back to our example

Now a centrifuge is a machine a lot like a big washing machine in size and shape, thought it may weight about 800 pounds, perhaps 1,000 pounds when packed.  A prospective recipient needs an extremely stable floor that can bear this weight; and of course, a way to get the device into place.  (You aren’t going to pop this up on your shoulder and carry it up three narrow flights of stairs, friend.)

Electrical equipment must be set up for proper voltage, frequency, and phase. Also this may require a big surge of electrical current upon startup – you can’t get away with a string of extension cords.  You need an electrician’s or engineer’s advice. It is appropriate to require a formal statement from the potential recipient organization that they can meet the requirements stated in the equipment’s specifications.  If you don’t know, don’t assume!  So, a qualified recipient blood center learns of the potential donation, does a thorough technical review, needs and, wants the stuff – what happens next?

 WILL IT BUILD GOODWILL AND BETTER FRIENDSHIPS?

Perhaps the local Rotarians - on either end - will help facilitate the transfer.  This kind of project can become the basis of wonderful relationships as Rotarians work together.

Please note that mechanisms for funding through the Rotary Foundation are changing drastically July 1, 2013; districts and clubs are establishing new policies and procedures.   

The inevitable words “How much?” will be soon heard.  So we need to look to the key elements of expense. 

Import fees, tariffs, duties, special duties, extra special duties, permits, inspections – these could be trivial or they can eat you alive.  You need a professional import/export broker with country specific knowledge about medical and laboratory devices.   Do not assume that duties will be waived unless you have the specific document in your hand; even then, look out for “special duties”, tariffs and fees.

While the new unit just bought cost $45,000 be very, very careful brandishing this figure in the context of the donation. While the donated unit originally cost $30,000, it is worth some fraction of its original cost, let’s assume that this unit may sell used in the donor’s country for $8,000.  That is probably the value that should be shown on all export / import documents.  Many great projects have hit tremendous obstacles when the wrong numbers were used and various duties and fees were leveled on the original cost (or current replacement cost for new technology.) In other words: do not inflate the value of equipment to make the project look more important.

Make sure there are no applicable export regulations between the donor and recipient nations or medical equipment licensing laws prohibiting the export, import, and full use.  In some cases, especially when computer equipment is involved, the donor nation may require an export license to allow specific technology to be shipped to certain nations.  Under some condition you may find that a particular item is protected from importation by patent or copyright laws. These are battles you cannot win.

This is why you need a real, honest-to-goodness, professional, certified import broker on your team from the very beginning – before anything with a cost or description is ever seen by any government office!

Packing stuff up seems like it should be easy, but…  Prior to packing, laboratory equipment must be properly decommissioned.  Maintenance cycles and all repairs must be performed. Fluids must be drained, equipment properly cleaned, loose parts and spares catalogued and secured, manuals provided, supplies assembled and packaged.

Someone may have to pay for repairs or buy spare parts and supplies.  Don’t assume that the recipient has the resources – or that they can make missing parts.  A few hundred dollars may be an easy gift for a Rotary Club in the donor’s area- it may be an almost impossible hurdle in the recipient’s area. 

Properly packaging a centrifuge demands that central rotor be removed and carefully packed so that it isn’t damaged.  The chassis of the unit needs to be internally secured. If the unit is going to be shipped by sea, it must be placed in a vacuum bag prior to crating to protect from the damage of the salt air.  Crating must have wooden skids or a pallet so that it can be safely used with a fork life. Packaging could cost $$1,500 -2,000.

Fail to decommission, repair, pack and crate properly and you may as well be shipping scrap metal. The whole effort can be a waste if the equipment is abandoned for lack of money, supplies and technical support.

Moving a properly crated unit a few thousand miles might cost $2,000.  Maybe you can find a donor to help; there are groups that consolidate humanitarian shipments as “space-available” with commercial freight; these may take a few months longer – and that vacuum bag protection against sea air is essential.

Customs, tariffs, import, and brokerage fees must be paid immediately when your shipment arrives in the destination country or penalties build up fast.  Demurrage (compensation paid when there is a delay in loading or unloading a carrier causing a delay in the carrier's departure) can be levied when delays occur.  So make sure that the arrival is well-planned, funds are immediately available, and inland shipping is contracted, and facilities are ready for delivery.

The facility must have the right space, wiring, environmental systems before the unit can be installed.  Floors must be checked for structural strength and leveled before heavy machines can be put in place.  A forklift may need to be rented to get the unit off the truck.

Persons with appropriate skills – and perhaps certifications – will be needed to assemble, calibrate, and test the device.  The specific supplies needed for the system, including critical spare parts, must be on hand.  Technical manuals may need translation.

The blood center’s technical staff will need to formally certify that the equipment is working properly, train their team.  This may necessitate a bit of travel for a key person to attend training.

WILL IT BE BENEFICIAL TO ALL CONCERNED?

Everything takes longer than anticipated.  It is really hard to predict how long each phase of a humanitarian donation will take; please keep these issues in mind as you plan:

• How much serviceable life remains in the item?  How long will parts and supplies be available?
• When will the donated items become available?  What if this is delayed?
• How long will it take to get technical confirmation that the recipient really needs, can use, and can obtain all the needed supplies, parts, and ancillary equipment?
• Where will they be stored while awaiting clearance for shipment?  What if this stretches to months?
• How long will export / import procedures take? What if these procedures take much longer than anticipated?
• How long to raise all the funds?
• When will the recipient really be ready to accept the gift?
• Where can the gift be stored if the facility is not ready? Is it secure?
• How long before the gift it can be put to use?

These projects almost always take longer than one would expect and usually will Rotary  span years.

One of our greatest challenges within Rotary is our annual change of responsibilities. Make sure that you have commitments that will endure as leadership in our Rotary Clubs changes.

Do the research.  Don’t be afraid to ask difficult or embarrassing questions.  Don’t ship until every detail has been resolved in a satisfactory manner and every piece of the picture has come into focus. Prior planning can avoid delays, disappointments, frustrations and potential project failure.

 Then sit back and remember

The mission of Rotary International is to provide service to others, promote integrity, and advance world understanding, goodwill, and peace through its fellowship of business, professional, and community leaders.

It will feel good. – And your team will be ready for the next adventure in Service above Self.