From Whose Perspective?

Never did get the internet issues worked out, and thanks to Rachel for posting what I could get to her. Now with great service 30000 feet over Florida, go figure.

 I've accumulated several, and over the next few days, look forward to sharing them with you

Five hundred years ago, it was common belief that the Earth was the center of the Universe, and all other heavenly bodies revolved around us. Although this was subsequently disproved, we are often reminded of our own tendencies toward egocentricism. And this can become painfully obvious when working in a different culture.


The supply chain challenges here at Sacre Coeur stem from multiple sources, not the least of which is the generosity of individuals and organizations around the world. We were inundated with supplies and donations after the quake, and continue to receive tremendous help from CRUDEM and its network of supporters. In recognition of the need for inventory control, we partnered with Humanitarian Software and BarControl Systems to computerize and inventory our pharmacy and medical consumables. This is a daunting tasks with 1800 SKUs(with multiple subcategories), and 12,000 cartons of inventory. The pharmacy presents additional challenges, as medications, delivered in bulk, are eventually dispensed to individual patients. Bar Code stickers are printed as materials arrive, and there are specific MDC codes on US manufactured drugs that identify dose, form, strength, and quantity.

As supplies arrive, they are bar coded and HSC employees are to scan the item and where it is placed. When a requisition from the hospital comes, the amount dispensed is scanned and subtracted from the inventory. Moving supplies from one location to another should be easily monitored. A running total of supplies on hand, and rate of utilization, will provide a guide to anticipate needs, reduce duplication and prevent shortages.

If it were only that easy…

I spent yesterday in our pharmacy warehouse, which as you may recall, was created by welding shipping containers together. It is well organized, (air conditioned), and has full wireless network access. Since it is the only source of narcotics and other medications for the hospital, you’d think we could monitor utilization, but the reports just didn’t make sense. As I was counting used vials to get a proxy for utilization, I noticed some had bar codes and other didn’t. Remember I said that the US NDC codes served to classify the bar codes? Foreign manufactured meds (probably 50% of our stock) don’t.

Now these were not drugs unavailable in the US. Many were common antibiotics, like Augmentin, with identical strength and form. But they weren’t counted since they couldn’t be labeled. Working with Will Bardos from the bar coding side, we solved that one last night by cross referencing to the codable equivalent, not worrying about specific manufacturer or trade name, rather assuring that the dosage and form were identical.


Challenge 2 was the scanner. They were intuitive to use, but as Will asked a staff member to show us how they dispensed an item, they struggled. As I looked at the scanner, I realized the instructions were in English. Although this system has been employed in other parts of the world, English was more prevalent. The administrators using the system in Milot were bilingual, but other members of the team were not. The egocentric response would be, “If they want a job, they need to learn English.” The pragmatic and practical response is, “This is a major change in how they do business; let’s make it as easy as possible.” We are currently working on translating the instructions into Creole.

For those of you following this blog over the years, these incidents may not seem as dramatic as the stories after the quake. But there is a common theme – as human beings we all have the tendency to deal with our own needs first and view the world from our perspective. The successful among us see multiple other points of view and can adapt their response. We did that in the crisis atmosphere after the quake, and will strive to maintain that attitude.

When I was a Boy Scout, I remember a Native American saying. “Never judge a man until you walk a mile in his moccasins.” Thought that was a little hokey then, finally starting to get it now.

Bonswa!