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    July 31

    Andrea & Al - Bike Trip to Quebec

    Vvvrrrrooooommmm... Check out my sister and her boyfriend on their trip to Quebec this past weekend (click on the  "Jennifer's Pictures" link).  I had no idea that she was a Harley girl at heart!
    July 28

    The Constant Gardener

    I rented a bunch of DVDs (like I do in batches periodically) and picked up "The Constant Gardener".  I knew that it was about pharmaceutical companies and their use of African people to test out new drugs, but what I didn't realise was that it was set partially in Nairobi.  There were scenes from Kibera the oldest and one of the largest slums.  I'm  not even sure how good or bad the movie really is/was because I was so overcome with memories.  The smells, the sounds, the poverty... I was so much younger the last time I saw that.  Here I am worrying about UN per diems and hotel rates.  Hmmm. 
    July 27

    Official "Leader"

    So now I am the official leader of this workshop in Kenya.  It is pretty insane, because of the short timeline, but things are finally coming together.  We even have another instructor from South Africa who will be joining us.  I am going to make my first attempt at a "SharePoint" website later today, because the emails and files going back and forth are becoming unmanageable.  My Inbox keeps screaming at me that it is full - I suppose it is actually my IT department who is doing the screaming.  We also have hotels in Mombasa now (woohoo) and promising arrangements are being made on the Kenyan side for the workshop.  I was panicking a few days ago, but feel better now that I have seen some progress.  Now I just have to finish two projects here at ECRI and my own presentations for the workshop!  I can't believe that I leave a WEEK from TOMORROW.  Can't wait to see Sheila... how long has it been??? Three years?
    July 25

    New backpack & carryon

    Oooo!  I am getting geared up for Kenya with a new backpack... My old one was deteriorating, but had definitely served me well for over 12 years (yikes!) and travelled to Nunavut, India, South Korea, Kenya, Saskatchewan, my post Masters bus trip from SK to BC and Ohio via Chicago - he he, the Philippines, Boston, Ghana, London (UK), Spain, Northwest Territories, Jamaica, and numerous conferences to London (ON), Halifax, Quebec City, Minneapolis, Tampa and DC.  The poor thing needs to be laid to rest but now I have a funky new one with wheels AND a detachable daypack - woohoo fancy stuff!  All I have to do now is stay within the 23 kg limit for checked bags.  Ya - I know - I am crazy for getting excited about luggage! 
    July 23

    Sandy Hook

    Murphy's Law would have the sun come out just as Kerry and I were leaving Sandy Hook.  We did brave the beach through rain and thunderstorms and lots of clouds with my dollar store umbrella and Target quality beach chairs (with decadent footrests I might add) and a blanket and a couple of rain jackets and snacks and lots to read... yes, I came prepared.  Neither of us were particularly high energy, but we still got to have a good visit and enjoy the ocean a bit.  The $13 beach chairs ended up being impossible to collapse again into their carrier bags, but what can you expect from Target??? Although it might appear so from the picture (yes, I cut off some hair), we did not go to Gunnison Beach and bare all to the sun and sand - he he - well, there wasn't much sun anyway!  I didn't get very many pictures either with all the rain and it is not really fair to get the first look at my new haircut after rain and wind and sand.  I'll have to take some nicer ones.  Kerry and I spent several bouts of rain in the car, cruising the creepy old fort - um - was it Fort Hancock?  The weirdest thing was driving along passing beach after beach and then all of a sudden there is a missile - yep - just so you would know that you are entering US Army territory!  Our first night we had good seafood at a swanky restaurant by the water then yesterday we had jambalaya from "Orleans" restaurant in town (just HAD to check it out since Kerry is from Louisiana).  The beaches were lovely, but I actually think I like the Island Beach State Park one better... the sand didn't sing at Sandy Hook ... and it seemed like EVERYONE was a smoker.  It was gross and definitely took some of the enjoyment of the beach away.  I think I read somewhere that there is a smoke-free beach in NJ, so I'll have to try that one out sometime.  Now, I am going to try to get lots of sleep to face the crazy week ahead (presentations galore to prepare for Kenya plus all my "real" work - he he). 
    July 19

    Martin's Helicopter Ride Pics

    Check out "Jennifer's Pictures" (click on "Albums" at top right) to see photos of Yellowknife and surrounding area (Cameron Falls, etc.) from a helicopter.  Lucky Martin!

    Don't let the most useful part of your donation be the container!

    That was the final line in my presentation at AAMI last month.  Afterwards, I was approached by several people who have worked overseas and heard some of their stories of inappropriate donations to developing countries.  Here is a picture of a donation to Uganda where most of the equipment was not salvageable, but the container was put to good use!  Thanks to Jan Randa the head of Clinical Engineering at Haukeland University Hospital in Bergen, Norway who sent it to me.  Here's the text of my presentation and the photos that I included (can't upload powerpoint yet to Spaces - if anyone knows how to do that, please let me know).
     
    Stop All ‘Box and Ship’ Donations of Medical Equipment to Developing Countries

    Jennifer McGill, M.Eng., CCE(US)

    Senior Project Engineer, ECRI

    jmcgill@ecri.org

    610-825-6000

    ‘Box and Ship’

    When new or used medical equipment is sent to a developing country in a box, crate or container without consideration for the resources needed to install and/or keep the equipment working for its entire lifespan…

    Getting Equipment to its Destination

    • Meet local standards/regulations
    • Import taxes and/or "fees"
    • Local transportation - challenging & expensive
    • Need a "courier"?

    Getting it Working

    • Appropriate technology?
    • Manuals? In local language?
    • All parts included?
    • All peripherals included?
    • Installation – Does anyone know how?
    • Utilities
    • Grounding? 110/220V? Need UPS?
    • Water? Ventilation? Space? Shielding?
    • Training for users and service staff

    Indonesia – beds 110V/60Hz (see picture)

    Indonesia - No padding for tube – No controller (see picture)

    Keeping it Working

    • Cost & availability of consumables
    • Cost & availability of service
    • Availability of technical & clinical support
    • Maintenance procedures & local training
    • Tools and test equipment
    • Spare parts, cables, connectors - even bulbs, fuses, etc.
    • Protection from environment – monsoon, power spikes, black/brown-outs, heat, humidity, insects, reptiles and rodents.

    Ethiopia - Unresponsive service for 1 year for mammography machine (see picture)

    Indonesia – No reagents for clinical lab analyzer (see picture)

    More Information

    WHO "Guidelines for healthcare equipment donations" (

    http://www.who.int/hac/techguidance/pht/1_equipment%20donationbuletin82WHO.pdf)

    Ismael Cordero (ORBIS)

    Antonio Hernandez (PAHO)

    Andrei Issakov or Peter Heimann (WHO)

    Tom Judd (Kaiser Permanente)

    Jim Loeffler (International Aid)

    Frank Painter (ACCE - ACEW)

    Thanks to Billy Teninty (International Aid) and Jennifer Jackson (Brigham & Women’s Hospital) for providing some pictures.

    MAKE SMART DONATIONS
    Don’t let the most useful part of your donation be the container!

    July 16

    What's going on in Kenya these days?

    Here are some factoids about Kenya and its health system...
     
    • Inequality and poverty are rampant.  For example, the Western Province has 68% of the population living below the poverty line and possibly even higher rates in the Northeastern Province.*  Compare that to the 2003 US census data where 12.5% of the population was below the poverty line (24.4% for African Americans) and 14% in Canada in 2000.  Note: "Poverty line" definitions do vary from country to country.
    • The national prevalence of malaria in people over 5 years of age is 30%.*
    • WHO estimates the overall prevalence of HIV in Kenyan adults to be 14%, however certain areas can have much higher rates.  HIV prevalence of 35% was reported in Suba in 2002.  In 2000 in Kisumu, the prevalence was reported as 35% where 23% were women age 15-19 compared to 3.5 % among men of the same age.
    • 35% of the Kenyan population has access to essential drugs.*
    • Kenya had a national average of 19 hospital beds per 100,000 people in 2003.*  Compare that to 280 community hospital beds (represents 85% of hospital beds and does not include tertiary care or specialty beds) per 100,000 people during the same time period in the United States.**
    • The number of physicians per 100,000 people in 2003 was 15 in Kenya* and 287 in the US**.
     
    *From the Kenyan National Health Sector Strategic Plan II (see link above).
     
    **From the Kaiser Family Foundation (http://www.kff.org/)
    July 15

    Kenya Advanced Health Technology Management Symposium (Nairobi Aug 8) & Workshop (Mombasa Aug 9-12)

    The Kenyan workshop on health technology management almost fell through yesterday, but somehow we managed to obtain booked flights yet they are not fully approved by the World Health Organisation so the situation is still a bit precarious with only three weeks left before the trip.  It will be a heck of a lot of work to pull together five days of good teaching materials (basically by next Friday to get all the copies made in time), but we have a great team:
     
    Matt Baretich - Leader extraordinaire and clinical engineering consultant specializing in performance improvement strategies for healthcare facilities... http://www.baretich.com/
     
    George Johnston - Been in biomedical and clinical engineering since 1958. Most recently consultanted for Medical Service Corporation International on the Three Regions Project in Tanzania, Africa and the Global Assistance for Med Equipment (GAME) program in Kosovo.
     
    World Health Organisation (sponsor of the workshop)
    Andrei Issakov & Peter Heimann - Peter is the developer of the "Essential Healthcare Technology Package of software to help developing countries plan and manage their health systems.
    July 10

    Sheila and Olivia - Nairobi, Kenya

    Ohhhh... I can't wait to see my super-duper friend Sheila and her recently adopted Kenyan daughter, Olivia!  Just hoping that the World Health Organisation gets their act together in time for us instructors to buy our plane tickets.  Here's an article on the Ethiopia workshop that my former Partners co-worker (Jennifer Jackson) from Boston participated in... scroll down to page 3.
     

    Agin Caygeons win Dragon Boat Race!

    My Dad participated in the Dragon Flies Festival in Port Perry, Ontario to raise money for breast cancer support programs in the area.  His team - the Agin' Caygeons - won their race in the "Mixed Seniors" division.  The average age in their boat was 65 and no one had ever paddled a Dragon Boat before they started practicing a couple of weeks ago!  Pretty cool... here's a picture of their boat getting ready to start the last race and then the nail-biting, super-close finish. 
     

    Stardust (not Starlight)

    I danced so much that my feet have wicked blisters - ugh!  It was fun though.  After getting lost (as usual) I did find the Stardust Ballroom in NJ on Saturday and danced oh about 4 hours or so.  Yesterday, Jackie and I spent some time at the "Fiesta" at Penn's Landing, which had great food and live music and LOTS of people.  We then tried Rock Lobster again and there was no thunderstorm, so things started on time.  That meant that we got a good two hours of dancing in before 11PM!  The floor is yucky - too sticky - and probably contributed to my worsening blisters, but it sure was fun.  I think it will be jazz shoes for a while though:)
     
    Stardust Ballroom
     
    Penn's Landing FIESTA
     
    Rock Lobster
     
    July 03

    Rock Lobster - Rocked by Thunder, Lightening, Driving Rain and HAIL

    Yesterday I spent all day shopping for home office furniture at Ikea and then attempted to assemble it (no blood, but a lot of sweat and haven't even finished one piece yet).  A fellow ECRI co-worker (Jackie) wanted to check out the Salsa night at a restaurant called Rock Lobster.  It is right on the river almost under the Ben Franklin Bridge with a big tent over the dining area.  We decided to carpool down and got there nice and early (to avoid the cover charge of course!).  Within about half an hour a really dark cloud started to approach - rapidly.  Then there was thunder and lightening and soon it started to POUR rain.  Suddenly the restaurant staff yelled to move under the bar area which had a real roof. So we all ran over there and got drenched by the rain between the tent and the bar-hut-thing.  A few minutes later I saw marble-sized hail coming down!  It was all very dramatic and exciting.  I wish I had had my camera, but I don't take it dancing.  Once the music got started, it was fun to dance near the water... it reminded me of the Salsa cruises in Boston (except that you can leave whenever you want - he he).
     
    Weather damage report:
    0710 PM     TSTM WND GST     PHILA                   40.00N 75.15W
    07/02/2006  61 MPH GUST AND LIMBS DOWN WITH DIME SIZE HAIL

    July 02

    Island Beach State Park, NJ

    OK, so now I understand why everyone goes to "the shore"!  AND thanks to human nature... all the crowds are packed in right near the parking and facilities.  I swear that I only walked five minutes down the beach and had a lovely peaceful spot.  Only a few people settled near me later in the day.  Going early in the morning (I left here at 7am) is definitely the way to go, because the roads were not busy at all.  I actually made it in about 20 min less than Mapquest said it would take... and I was just keeping up with the flow on the PA turnpike!  I'm just waiting to get my first speeding ticket, but people truly drive at least 80 mph in 65 mph zones and still pass me.  NJ is another entity and it looks like speed limits are actually enforced, so I drove just about 70 mph.  Anyway, I spent a lovely, relaxing day on a huge white sand beach with the ocean waves for company.  No pictures though - I didn't want to leave my camera on the beach while walking... maybe next time.