Shortcomings of Medical Donations

Studies show that 80 percent of the medical equipment reaching developing nations' hospitals is donated but 70 percent of those donations don't work. Such shortcomings could explain why the world's medical communities' failed in their goals to deliver health care everywhere by the 21st century, said Robert Malkin, a Duke professor for the practice of biomedical engineering who also directs a voluntary program called Engineering World Health.

Malkin analyzed why nearly 3,000 pieces of such technology failed to work correctly during a Nov. 7 talk at a Duke conference on Bioengineering Applications to Address Global Health. Some widely-touted reasons, such as a lack of spare parts or an inability to train local staff to use the equipment, appear to actually be off the mark, he said.

One of the biggest real problems is hospitals' inability to replace disposable items connected the technology in places where the per-patient outlays for such "consumables" cannot exceed 34 cents, he said. Spare parts may be less of an issue than access to the right tools, he added. And staffs that might appear confused in training may really need access to manuals in the right language.

Malkin's own Engineering World Health (EWH) project sends volunteer engineers to work alongside hospital administrators to evaluate equipment needs. Those needs are then met with donated equipment.

After that, engineering and science students from Duke and other universities visit those hospitals after undergoing language and technical training in Costa Rica or Tanzania. Once on location, the students work on equipment repair and installation. And the voluntary engineers also make followup visits to make sure everything is working properly.

Between 2003 and 2007 EWH has put 1,623 pieces of equipment --- $3 milllion worth -- into service, Malkin said.