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05/07/2013

Donating fancy medical equipment to the developing world? Think first

Donating medical equipment to poor countries -- it sounds like a great idea but in reality, the altruistic gesture could wind up doing more harm than good.

Scientific American recently reported on a study looking at seven hospitals in Haiti, which collectively received 115 pieces of medical equipment following the devastating 2010 earthquake. Their findings were pretty discouraging:

- Only 28 per cent of the equipment was still working and being used

- Another 28 per cent was sitting idle due to technical reasons

- 30 per cent was no longer working but could be repaired

- 14 per cent was no longer working and impossible to repair

Even worse, some of the donated items were never even used -- incubators for premature babies, for example, required an electrical voltage that was too high for Haiti.

This is not the first study to scrutinize the benefits of donated medical equipment. This one analyzed hospital equipment in 16 countries between 1986 and 2010 and found that an average of 38.3 per cent was no longer in service. Scientific American also points to a WHO report that estimates only between 10 and 30 per cent of medical equipment is being used in countries where up to 80 per cent of equipment is donated by foreigners.

In August, The Lancet published a study reporting that as much as 40 per cent of health-care equipment in low-income countries is out of service; this compared to rich countries, where only 1 per cent of medical equipment is out of commission.

The Lancet paper points out that most medical equipment used in wealthy countries has been designed for, well, wealthy countries -- they assume hospitals will have access to technical expertise, spare parts to repair the machines, health workers that can operate the equipment and reliable electricity.

So how can foreign countries donate to low-income countries without cluttering their supply rooms with useless state-of-the-art equipment? The Lancet study suggests investing in "process innovations" (solutions for improving healthcare delivery that are appropriate to the country) and developing "frugal technologies" -- like, perhaps, this low-tech $5 toolkit that one Toronto doctor is using to save newborn lives in rural Pakistan.

And making an intelligent donation can require a lot more effort than you might think, as this WHO report shows. In 2000, a group of wealthy North American philanthropists actually travelled to a teaching hospital in Gambia to ask them what they needed. The hospital requested and received more than 20 oxygen concentrators -- but the first ones they used stopped functioning after just 30 minutes and local technicians were unable to fix them. The donors even sent a technical assistant to Gambia to help -- but ultimately, the oxygen concentrators wound up in storage within a matter of weeks.

Jennifer Yang is the Star’s global health reporter. She previously worked as a general assignment reporter and won a NNA in 2011 for her explanatory piece on the Chilean mining disaster. Follow her on Twitter: @jyangstar

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