You can have the best, most effective doctors and nurses in the world. You can also have high-quality medical supplies, medicines, and equipment available. But without a skilled, efficient, and strategic global logistics team, life-saving healthcare cannot happen.
The critical role of global logistics in humanitarian work cannot be understated. A potent example is the incident of the cargo ship, the Ever Given, becoming lodged in the Suez Canal in the Spring of 2021, blocking the critical shipping route and holding up an estimated $9.6 billion of trade per day. The impact of global logistics doesn’t just have an economic cost, but when you’re carrying desperately-needed medical supplies, there can be a human cost as well.
From catastrophic holdups like this to even a small supply-chain hiccup, the Medical Teams International global logistics team overcomes diverse and compounding challenges every day to ensure that our direct healthcare services can continue to operate. So that shelves stay stocked with medicines. So that emergency nutrition reaches communities before more lives are lost. So that we can operate safely, ethically, and efficiently.
I sat down with Jonathan Spence, Medical Teams’ Director of Logistics and Procurement, to better understand the incredible work his team does and the many ways that our logistics staff operates heroically, if silently, as the forceful undercurrent of Medical Teams’ work.
What exactly does our Global Logistics department do?
Jonny: I like to describe Logistics as the “how” when we think about delivering health outcomes. It’s what enables us to actually provide life-saving medical care. It’s more than just getting the medicines, bandages, and equipment into the hands of those providing the care—you need a purchase order to buy something, then a plane to transport it, then someone to handle the import and customs process, then someone to get it from the point of entry to the clinic, and so on. There are so many steps that need to happen before the actual care can reach the beneficiary.
I also like to think of our department like the hub and spokes on a wheel—logistics is very much like the central hub with many spokes fanning out that represent different processes: purchasing, transport, asset management and maintenance, warehousing, training, navigating legal and economic regulations, and so on. All of those elements together provide the stability that allows the wheel (the healthcare we provide) to keep going forward.
Our Global Logistics team is divided into two categories: International Logistics and Medical Health Products (MHP)
The International Logistics Team plays a critical role in ensuring the smooth flow of goods and services across Medical Teams International’s global operations. Our primary responsibilities include:
- 💊Procurement: Sourcing medical supplies, vehicles, and essential goods in the most efficient and cost-effective way possible
- 📋Inventory Management: Tracking stock levels, managing storage, and preventing shortages
- 🚚 Fleet & Asset Management: Maintaining vehicles and equipment for efficient use and longevity
- 🚨Contingency Planning: Rapid deployment of buffer stocks and supplies distribution for outbreak responses
- 📦Customs & Shipping: Managing import/export processes, securing permits, and ensuring regulatory compliance
…and much more!
The Medical Health Products (MHP) Team ensures that donated medical supplies reach the people who need them most. With four full-time staff and over 150 weekly volunteers (equivalent to 12 full-time positions!) MHP operates primarily from our Distribution Center (DC) in our Tigard office.
The MHP Team supports our country offices and partner organizations to ship donated medical supplies worldwide. Additionally, MHP supports 30+ nonprofit organizations in the Pacific Northwest, providing essential over-the-counter medicines, hygiene products, and medical supplies to those who need them most.
What are some of the different types of logistical challenges you encounter?
Jonny: There are many! Some of the most significant ones are geographical. For instance, in some of the places we need to get supplies to, there are no roads. So, our options there are to:
– Find a 4×4 or off-road-capable vehicle and drive cross-country
– Use a helicopter or plane to fly the supplies in
– Use pack animals like camels or donkeys (we recently delivered a shipment of measles vaccines via camel in Ethiopia!) 🐪🐪🐪
There are weather-related challenges, such as counties that experience a rainy season. Excess rain can make existing roads too muddy or completely flooded, forcing transport vehicles to find alternative routes, which can delay the arrival of critical items like medicines.
There are country-specific challenges, like in Sudan, for example. Due to the flaring conflicts and warring factions, you need permission from the government to travel ANYWHERE. Even though we are a humanitarian organization carrying life-saving goods, we need permission in advance for the entire delivery route, from the port of entry all the way to the shipment’s final destination.
Sometimes there are personnel challenges created by the complex environments we work in. For example, people who work in-country to receive goods and transport them are often working with less technology and capacity and are given fewer opportunities for professional development. When you have temporary, hourly staff with little training in how to handle high-dollar-value medical shipments handling a shipment valued at $200K, there is a great temptation to steal or sell the contents for personal gain. We require all of our vendors and contractors to sign a Supplier Code of Conduct, but often people working in this context face challenging ethical dilemmas.
Finally, there are challenges with the quality control of the goods we procure. For example, nearly 20% of the pharmaceuticals in Africa are counterfeit or compromised, so any medicines that we procure locally run the risk of not being able to be used once they get to the clinic. We try and source medicines from Europe or places where they can ensure a higher quality of health products, but sometimes, for time-sensitive situations, it’s quicker to get products from within the country. So much of logistics is a balancing act we do to determine how to get the best quality products to the people who need them as quickly as possible.
Can you walk us through the journey of a box of medicine, for example, as it travels from where it started to its destination?
Jonny: Yes—for the sake of this hypothetical example, let’s follow a box of dengue vaccines. With the surge of dengue cases happening right now in Sudan, this is a very relevant example. The dengue vaccine must be kept at a temperature of 2°C-8°C (36°F-46°F) or else it will no longer be effective.
1️⃣ The first step would be the procure the vaccine from a high-quality source, typically somewhere in Europe.
2️⃣ Then it is packed in a temperature-controlled container or box and stored until shipping arrangements are confirmed.
3️⃣ Our team then begins communicating with the receiving country, Sudan, about where to send the shipment and we begin the required customs paperwork. Once the shipment is cleared to arrive, it is sent on its way. The current timeline for the paperwork and approvals to get supplies into Sudan is up to 4 months.
4️⃣ The container of vaccines arrives in Sudan and goes through a customs intake process so that it can be cleared to be transported to somewhere else in the country.
5️⃣ Contracted Sudanese staff receive the goods and prepare to load them into a truck for transport to the refugee camp clinic—BUT WAIT—no refrigerated trucks are available. It’s 107°F outside, so they must wait 3 days for the next available truck.
6️⃣ While in transport, the staff noticed that there have been two temperature spikes on the container’s sensors—staff has to contact the Program Team en route and ask if the vaccines are still ok to use. Thankfully they are, and they proceed with delivery.
7️⃣ Delivery staff can’t get to the clinic via the main road because of flooding, so they have to find another way around on a makeshift road.
8️⃣ Finally, the vaccines arrive at the camp clinic, but the electricity is out due to a mortar that exploded nearby and destroyed a power line. Staff must arrange for backup equipment to keep the vaccines cold on-site, like solar panels or generators.
9️⃣ Finally, the vaccines are distributed to refugee families in the camp’s clinic!
How does your personal faith tie into your work with logistics?
Jonny: For logistics to be effective, you need to understand the “bigger picture” of what’s going on. You have to have a sense of that one box of supplies, that one vehicle, in the grand scheme of the operation you are supporting in order to strategize how best to handle that particular asset.
Similarly, with one’s faith, you need to stay connected to God’s larger plan and your role in the larger community of faith. That’s what helps you stay grounded and feeling like part of something greater than yourself.
Part of my personality has always been wanting to understand the “why” and the “how” of things. In the case of my role at Medical Teams, the “why” is our mission and outcomes, and the “how” is the processes we use to achieve that mission and those outcomes. Both of these elements are the core of logistics, so it’s really a great fit for me!
I truly feel that God has called me to use my talents to help bring health and wholeness to a hurting world—to fulfill the mission of Medical Teams. Isaiah 61 comes to mind—”They will rebuild the ancient ruins/and restore the places long devastated;/they will renew the ruined cities/that have been devastated for generations.” This idea of holy restoration is something that is central to our mission, and something that strategic, efficient, and human-centered logistics can help bring about for the communities we serve.
To hear Jonny talk more about how he lives out his faith through his role at Medical Teams, you can watch his candid conversation with Executive Chaplain Joe DiCarlo HERE!
To read more about the places where we work, you can CLICK HERE!
If you are local to the Portland area and feel inspired to become part of our logistics team as a volunteer, you can learn more about opportunities HERE!