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[[Category:Logistics]]
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[[Category:Aid and development workers]]

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Content[edit]

Lancing a boil? The Lancet on the aid industry
January 23rd, 2010Michael Keizer11 comments

Various scalpelsWhen a leading professional journal like The Lancet writes an editorial that is scathingly critical of aid organisations, people sit up and pay attention. And scathing it is: according to the article, large aid agencies are “[p]olluted by the internal power politics and the unsavoury characteristics seen in many big corporations”, and “… can be obsessed with raising money through their own appeal efforts”. They “… sometimes act according to their own best interests rather than in the interests of individuals whom they claim to help” because “… humanitarianism is no longer the ethos for many organisations within the aid industry”. The result: “… relief efforts in the field are sometimes competitive with little collaboration between agencies, including smaller, grass-roots charities that may have have better networks in affected counties and so are well placed to immediately implement emergency relief.”

Wow. That is quite something. The point of all this seems to be in these two sentences:

Given the ongoing crisis in Haiti, it may seem unpalatable to scrutinise and criticise the motives and activities of humanitarian organisations. But just like any other industry, the aid industry must be examined, not just financially as is current practice, but also in how it operates from headquarter level to field level.

Allow me to make five observations here. The first is that The Lancet does not offer any evidence to back up their claims. They might be right, they might be wrong – but without the evidence we will never know.

Secondly, I happen to think they make valid points, which are sadly invalidated by the way they are phrased as blanket statements. Organisations, including aid organisations, are not monoliths and exhibit widely divergent behaviour on different occasions. The same organisation that acts disgracefully on one occasion can be a beacon of selfless and ethical behaviour in another setting; sometimes even at the same time. Obviously this holds true even more when one makes this sort of pronouncements across a whole industry.

Thirdly, the article conflates all types of aid into one, prescribing humanitarianism as the overriding principle for all aid. The authors ignore that not all aid is humanitarian aid; e.g. bilateral reconstruction aid or nation-building aid has nothing to do with humanitarianism, unless one would stretch the concept to a point where it becomes meaningless. I am writing an article on typologies of aid (and let me tell you, it is not easy going) because this sort of conceptual confusion is actually quite common and leads to meaningless discussions.

Fourth, shorn of its rhetoric, The Lancet makes a valid point when they say that more scrutiny of the sector would be beneficial. The critiques that I have seen up to now are mostly (perhaps even almost exclusively) very superficial, and are for a large part either hagiographic on the one hand or bludgeoningly hypercritical on the other; and most of them are thin on evidence (more so when looking at emergency and humanitarian aid than development aid). It is high time for more critical scrutiny that is balanced and based on evidence, mainly because it could be a catalyst for huge improvements in our practices.

Fifth, I am disappointed by a lack of suggestions for improvement. It is easy to be critical, but then please tell us what and how we can improve – and in slightly more detail than that we need to ‘coordinate better’. I am not suggesting that should have been in the same article – after all, an editorial has its limits – but as it was published in a special issue on violent conflict and health, there would have been ample space for a more in-depth article in that same issue, spelling out how to get the sector to the next level. Sadly, the editors did not do so.

All in all, I think the editorial suggests rightly that more scrutiny is necessary – but that point is sadly overshadowed by the article’s conceptual fallacies, lack of evidence for its claims, and general emphasis on rhetoric over content.

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Categories:Aid and aid workTags:Aid, Aid organisations, Development, Emergency aid, Humanitarianism, Nation building, The Lancet
Complicating a numbers game: SAR, emergency preparedness, and how we should spend our resources
January 20th, 2010Michael Keizer18 comments

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Over at his blog Wanderlust, Tris Clements questions whether sending in SAR teams is the wisest way to spend our resources:

If, as is generally shown, SAR teams can only hit the ground after 48 hours, and are only saving a few dozen lives in any given reponse [sic], is this a worthwhile use of funding? Should the media continue to carry such high-profile stories and continue to justify this as the best way forward in an emergency? Had an additional 1,200 medical staff and equipment been flown in to Port-au-Prince instead, how many people could they have treated, how many life-threatening wound infections treated, how many shock-managing IV drips inserted, in the last three or four days? Thousands? Tens of thousands?

These are important and relevant questions. However, I think Tris leaves out an important part of the equation: why do we actually send out these SAR teams?

Part of it can be found in an intriguing comment in response to my blog post on the logistics of emergency response: commenter rob_s suggests to send local people involved in emergency preparedness in developing countries to disasters like Haiti earthquake, so they can learn from and experience firsthand the lessons learned.

This is exactly how many of the developed countries who have sent SAR teams think. It is not only altruism, or even a PR exercise, but also a valuable opportunity for these teams to train and learn, so they are better able to respond when something similar happens in their own countries. In that sense, one should add the lives saved by better preparedness in future disasters to the lives saved now; but it will be obvious that any estimate of how many lives we are talking about is no more than a guess, educated or otherwise.

Tris’ questions are still very relevant, and the answer is still likely to be that the resources spent on foreign SAR teams could be spent better elsewhere; but the arithmetic is a bit more complicated than he makes it out to be.

[Image: Fairfax County Urban Search and Rescue at Montana Hotel in Port-au-Prince, by Chuck Simmins. Some rights reserved.]

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Categories:Aid and aid work, Logistics, Public healthTags:Emergency aid, Emergency preparedness, Haiti
Logistics questions around the Haiti earthquake
January 16th, 2010Michael Keizer54 comments

Perhaps unsurprisingly (although it did surprise me, for reasons that I will explain later), I have received a lot of questions about the logistics of the Haiti response. Some of the most frequently asked questions, with a stab at some answers.

But first: although I am on standby for Haiti, I am not there, so everything that I say here specifically about the situation there is only second-hand, from what I hear from friends and colleagues and from what I read in the media.

And secondly: this is not a crash course in emergency logistics, nor will it be very helpful for the logisticians who are there or will be going there. If anything that you read here is new to you, you have no business of going to Haiti as a logistician (unless you will be supervised there by people who do know).

Why is logistics in Haiti so much more difficult than in other disasters?[edit]

It isn’t. Really, not at all.

Every sudden-onset disaster causes similar logistics problems. The 2004 tsunami, the earthquakes in China and Iran, even hurricane Katrina in the US: in all of these cases logistics was the main limiting factor for aid.

A painful truth that you will not hear spelled out very often: emergency aid in these circumstances is totally dependent on local preparation, and any aid that that will come from outside the area will be largely ineffective until the logistics has been cleared up – which is usually only after several days in the most favourable circumstances. This is why disaster preparedness is so important, and it is also a main reason why countries like Haiti, which don’t have much capacity for disaster preparedness in the first place, are always so badly hit when the (inevitable) disaster strikes. It is also why expectations of what aid will accomplish over the next couple of days should not be set very high (and why twits like this guy, or this nitwit, should seriously shut up until they know what they are talking about – and that I use these harsh terms here, which I have never done before, should say something).

So why do I hear so much more about logistics now than in previous disasters?[edit]

I think you are asking the wrong person (I am a logistics specialist and have no clue about media), but I have observed two parallel developments over the last couple of years that might have contributed:

  1. For the second time in the history of modern of humanitarian aid (the first time was in the early 1980s), aid organisations have been refocussing on logistics as a core competence for aid. Especially the 2004 tsunami was a rude shock for many established organisations, who had become complacent about their logistics capacities and had stopped investing in it – and as a result operated at (to put it in friendly terms) less than optimal levels of effectiveness. Since then, logistics capacity is again increasingly seen as asine qua non for effective aid, and emergency aid organisations are (again) talking about it as a key competency – also to the media.
  2. Also outside of the organisations themselves, people started to become interested in humanitarian logistics, and there has been much more coverage of it. Recently there have been a number of books on the subject released, universities have started taking an interest in it as a subject of serious research (and teaching), aid watchers have put the occasional spotlight on aid logistics, and bloggers have started writing about it (with even the occasional blog totally dedicated to the subject). All this has contributed to more attention in the press and the public at large to aid logistics, and I think we now see the first results in the huge attention for the logistics in Haiti.

In that case, what are the main logistics challenges in disasters like this?

Remember, logistics is all about the five rights: the right goods, in the right quantity, to the right place, at the right time, at the right price. One of the main issues here (and one that I have seen very little coverage of) is that in a chaotic situation like this we just don’t know what are the right goods, the right quantities, or even the right place. Needs assessment is incredibly difficult, especially in view of how difficult it is to access some areas.

“So”, I hear you say, “just send as much as possible of everything, and we’ll sort things out later”. That would be a very nice idea, if we weren’t already struggling with overburdened and disrupted infrastructure (more about that later); everything that we send that is not needed, means that we cannot send something that is needed. This is a precarious juggling act, and although logisticians have some tools to deal with it (e.g. the much-vaunted kit system, a development from the 1980s first aid logistics revolution – but one that is nearing the end of its shelf life, for reasons that I will explain at some other time), it is still the major forgotten logistics challenge.

Furthermore, unused goods can become a serious liability after the crisis; e.g. the Indonesian government had to spend untold millions of dollars on disposal of unwanted goods after the 2004 tsunami, causing a serious burden on the reconstruction.

A second issue that is under-reported, is the logistics of logistics: logistics is an immensely fuel-hungry venture (think cars, think trucks, think planes and helicopters, think generators), and getting the fuel where it is needed is not easy. In this sense, Haiti will probably be rather easier than most crises, due to the proximity of two of the largest oil producing countries in the world, and the largest navy fleet in the world; expect one or more of the US Navy’s Brobdingnagian supply ships to turn up soon with large fuel stores.

A third main issue is the wide-spread destruction of physical infrastructure. Port-au-Prince’s harbour at the moment is effectively useless, the airport (not one with a very high capacity in the first place) is damaged, and roads are destroyed and blocked. Large transport helicopters would be immensely helpful but are by far the most fuel-guzzling mode of transport (there we go again with the juggling act) and are not that easy to get there because of their limited operational range; e.g. an Mi-26 (carrying 20 tonnes) ranges only 800 kilometres, which can be extended to 1900 kilometres using additional fuel tanks – but that would seriously impact on its load carrying capacity.

In the fourth place, communications will be difficult. Over the last years, aid organisations have become more and more reliant on telephone communications, and these will be disrupted and overburdened. Many organisations have lost their expertise in radio communications (five years ago, I could program and set up a Q-mac, a backpack-sized mobile HF transceiver, in ten minutes flat, three minutes if it was pre-programmed; I now would need a manual and at least 30 minutes), and many of their staff have no clue about radio protocol – which sounds boring but is absolutely necessary to prevent total chaos on your radio channels. As a result, communication will be a real challenge.

Fifth is coordination. There will be such a host of different organisations on the ground that it will be difficult to ensure that we don’t duplicate efforts (well, duplicate as little as possible). Even more important is to avoid hindering each other, e.g. by using the available infrastructure inefficiently, causing congestion. This is one of the reasons why I would seriously suggest smaller organisations and individuals (especially those that have no previous experience in emergency response) to stay away and not even consider going there before the third stage response starts to set in (probably in about two weeks). For the people on the ground, this means going to coordination meetings. People who have worked with me know that I mostly consider these as a waste of time (I think using personal networks is almost always muchmore effective and efficient) – but the one main exception is during the first phases of an emergency response. So yes, even in situations like this, humanitarian logistics will involve long hours in airless rooms trying to come to agreements and exchanging information; sorry to prick your romantic bubble. Update January 17, 10 AM AEDST Apart from going to the coordination meetings, of course it is essential that aid logisticians use and contribute to the information on the log cluster web site.

And then there is the longer term to think of. Decisions taken now can have serious repercussions later, and this is something that every loggie worth their salt will continuously have in the back of their mind. The last thing you want to happen is saving a life now, but costing multiple lives later on in the response.

Apart from these six primary ones, there is a host of secondary issues that I will not bore you with, but that will cause my colleagues in the field more than one heartache.

Any good news?[edit]

Well, I already mentioned the proximity of Venezuela and the US. One other thing that will make my colleagues’ lives a bit easier is that, although the number of victims is staggering, the geographical spread of the disaster is relatively limited (compared to e.g. the South China, Pakistan, and Iran earthquakes), so once we can get them there and the fuel issue is solved, widespread use of helicopters actually is a realistic option. And finally, the neighbouring Dominican Republic has been spared the worst of the disaster and can be used as a staging ground for the response.

So what can I do?[edit]

For this stage of the response, not much. Donating money (not goods!) to a reputable aid organisation with expertise in emergency response and a pre-existing presence on the ground might help for the longer term, but in the short term the needs seem to be met. Keep on giving, but with an eye on the longer term.

Don’t go out there. You cannot help and will only be a burden to the people who can. The only exception is if you are a humanitarian or military logistician with experience in emergency response, in which case I would suggest that you contact the organisation with which you have worked before (other organisations will not have time to vet your credentials and will use their own roster of experienced people).

And finally: spread the word about these issues far and wide, so that people start giving for emergency preparedness and not only the response; including the building of capacity within the aid organisations, like expertise at HQ level. This is one of the reasons why aid organisations spend money on ‘overhead’, and why it is so silly to judge aid organisations by the percentage spent on overhead.

Finally, comment freely in the comments section, and don’t hesitate to ask questions.

Updates[edit]

January 18, 1 PM AEDST

  • WFP is contracting to get the fuel situation solved.
  • US forces have taken over traffic control of the Port-au-Prince airport, but ther are some questions about how they set priorities.
  • Security issues are now added to the list of logistics issues: there are reports of looting (especially at night) and the UN is recommending that aid convoys be secured by armed personnel, but there is some disagreement on how widespread and serious this actually is.

January 18, 4 PM AEDST

According to WFP, repairs to the south pier of Port-au-Prince’s harbour are underway. Informally, I have heard that some ships might be able to dock by Tuesday (local time); if that is true, that would be very good news!

January 19, 3 PM AEDST

  • The informal information I received about the opening of the harbour now seems to be confirmed officially.
  • Until the harbour opens, the airport remains one of the main bottlenecks. Conflicts about priorities are now fought out over Twitter, which I can only be very unhappy about: this is a triumph of the loudest voice instead of reason. Perhaps MSF’s flight should have gotten highest priority, but getting that about by flooding the USAF Twitter account is not the way to go — and I am afraid that this tactic will actually be detrimental to MSF’s interests and, more importantly, their patients’ interests in the long term.
  • In general, more and more aid does seem to get to the people who need it. This, again, follows more or less the normal pattern: as logistics bottlenecks are solved and needs are assessed, the ‘pipeline’ widens and lengthens and items are getting where they are needed.

January 19, 5 PM AEDST

WFP logistician and aid blogging guru Peter Casier, on his way to the Dominican Republic to head WFP’s logistics operations there, confirms that the fuel contract was obtained yesterday and that the first fuel truck already arrived in Port-au-Prince. This will take a lot of pressure from the logisticians there.

January 20, 11 AM AEDST

  • Director of communications for MSF-Canada, Avril Benoît, takes me to task on Twitter: she says that the concrete impact of the “Twitter agitation” is exaggerated and that Twitter is only a small part of MSF’s media advocacy. That might be so, but that does not negate that it was a poorly conceived idea that sets a precedent for future similar campaigns with even less reason. It will also not have made MSF any friends at the place where it matters: the people making the hour-to-hour decisions based on the priorities set — which put medical supplies only at fourth place, for reasons that one might disagree with but that are definitely not total nonsense.
  • As expected, the South pier of Port-au-Prince harbour can now receive geared ships and barges; however, the container terminal is still inoperative and remains so for the near future.
  • UNHAS has contracted a 12 mt plane that will start a cargo shuttle between Santo Domingo and Port-au-Prince.

January 20, 11 PM AEDST

  • WFP starts a cargo shuttle between Santo Domingo and various sites in Haiti.
  • Apparently coordination on the ground between aid agencies is fairly good compared to earlier large-scale disasters. However, this is a second-hand impression gleaned from a very limited number of people, so it could be totally incorrect.


???[edit]

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Categories:Aid and aid work, LogisticsTags:Aid logistics, Air transport, Earthquakes, Emergency aid, Haiti, Organisation
Latest job opportunities (January 11, 2010)
January 11th, 2010Michael KeizerNo comments


huamitarian logistics jobs[edit]

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Categories:Aid and aid work, LogisticsTags:Aid logistics, Congo (DRC), Côte d'Ivoire, Egypt, Haiti, Health logistics, Kenya, Malawi, Merlin, MSH,Ranting and raving, Rwanda, Senegal, Sudan, UNICEF
Humourless links for January 10, 2010
January 10th, 2010Michael KeizerNo comments


applying supply chain management principles to human resource management[edit]

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Categories:LogisticsTags:Chukudu, Congo (DRC), Human resources, Logistics of daily life
Three parties rolled in to one: third-party logistics for global health and aid
January 9th, 2010Michael KeizerNo comments


Five-party logistics?[edit]

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Five-party logistics?

I have written several times before about supply chain visibility, and where it will lead us. One of the main reasons why visibility will be such an important issue for the foreseeable future, is because third-party logistics(or 3PL) will become more and more important.

So, I hear you ask, what is this 3PL? And why would it become more important? And, last but not least, why would that imply that supply chain visibility would become more important? I will write about those last two questions in a next post; this post will concentrate on an explanation of 3PL and its advantages (and disadvantages).

To explain this, let’s have a look at a fairly common scenario. Let’s say that you are the logistics manager of an aid organisation that has a central warehouse in the capital, and a couple of projects around the country, and you need to send a shipment from the central warehouse to one of the projects. Basically, you have two choices:

  1. You use your own transport, sending a truck (owned or rented) with the shipment from your central warehouse to the project. As you are the ‘first party’ in the shipment, this is known as first-party logistics or 1PL.
  2. You contract a transport company to ship the goods to the project, based on a contract and a waybill. The transport company (or as loggies like to call them, the carrier) is also known as a ‘second party’, and hence this is an example of second-party logistics or 2PL.

Most likely you now have an idea where this is going, but let’s spell it out anyway. Instead of having your own warehouse and trucks, you could have an external provider organise all this for you. You only need to tell the provider that a shipment made up of so many of this item needs to go to that project, and they take care of the rest (at a price, of course). A provider who offers this sort of multiple, integrated services, is called a third party and (you guessed it) this is an example of 3PL. 3PL providers come in all kinds, some offering a wider array of services than others; some very familiar ones are international couriers and international postal services, and freight forwarders: all three offer to organise your shipment across a variety of carriers and often (but not always) include clearing services.

Needless to say that there is actually an animal called fourth-party logistics (or 4PL), but I will leave that one for another day.

The reason for 3PL to exist at all is threefold:

  1. 3PL providers are specialised in integration of links in the supply chain, and they can levy much more expertise in this field than any aid or global health organisation ever will be able to. They know the markets to the last digit, have extensive knowledge of and experience in integrated supply chains, and have seen the same issues crop up over a variety of organisations – and know of many techniques to overcome these issues.
  2. 3PL providers can leverage economies of scale through combined facilities and shipping at much larger scales than any but the biggest aid and global health organisations, potentially providing better efficiency.
  3. 3PL allows for easier up and down-scaling: as our needs change, we can just use more or less of the provider’s services, instead of having to deal with a restructuring of our organisation (including possibly painful measures like lay-offs, or, conversely, having to go through expedited hiring of new staff, with all kinds of risks attached).
Untitled by PACOM @ Flickr

3PL by the US and Indonesian armies on behalf of USAID.

Of course, there are good reasons why 3PL can be a very bad idea, too – or even impossible:

  1. Aid and global health work often takes place in places and markets in which 3PL providers have no or very little experience, which might mean that their general expertise does not add that much value.
  2. In some contexts in which we work, 3PL providers (and, indeed, 2 PL providers) do not operate because of security constraints.
  3. Specifically for humanitarian aid, it is important to adhere to standards of neutrality and impartiality; it can be difficult to verify that 3PL providers do so, and the added limitations could mean that they are not able to offer any increased efficiency (e.g., it implies some limitations regarding combined cargo).
  4. In case of disaster response, many 3PL providers would have difficulties dealing with the damaged and overburdened infrastructure, which aid organisations have much more expertise in.

Yet, taking all this into account, I still foresee that we will use more and more 3PL services. Stay tuned to read why.

[Images: Mailboxes by by Minesweeper @ Wikipedia (public domain); untitled photo by Pacom Webmaster (some rights reserved).]

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Categories:Aid and aid work, Logistics, Public healthTags:1PL, 2PL, 3PL, Aid logistics, Health logistics, Supply chain visibility
Humourless links for January 3, 2010
January 3rd, 2010Michael KeizerNo comments


logistics training[edit]

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Categories:Aid and aid work, Logistics, Public healthTags:Aid logistics, European Conference on Operational Research, Georgia Tech, Health logistics,Meetings/conferences/other discomforts, Scholarships, Zaragoza Logistics Centre
The challenge of reverse logistics in global health
January 2nd, 2010Michael Keizer2 comments

the challenge of reverse logistics[edit]

The Valley of the Drums, a toxic waste dump in northern Bullitt County, Kentucky. This site was one of the reasons the the U.S. Superfund law was enacted.

Have you ever thought about the reverse logistics in your supply chains? Very likely if you are involved in medical logistics, but probably not in those terms: reverse logistics is not something that comes up on a daily basis in discussions in our field.

Reverse logistics is basically what happens when goods need to flow back in the supply chain. The most obvious example is of course when expired drugs need to be sent back for proper disposal, but reverse logistics might actually be more common than you think: disposal of materials and equipment, recalls, returns of overstocks so they can be used somewhere else in the organisation: these are all examples of reverse logistics.

Yet we hardly ever put systems into place that deal with our reverse logistics; possibly because it is seen as an exception instead of the regular occurrence that it actually is in many organisations. The results are predictable: losses and negative side-effects are common. Some examples:

  • Financial losses Most organisations would have tight controls on expensive goods as they travel through the ‘normal’ supply chain. However, I have seen many instances in which these controls were absent or much less stringent when dealing with reverse logistics. In one example, when trying to see what happened with a large generator (value: several tens of thousands of dollars) after it was sent back for repairs, I discovered that nobody had actually followed up after it was sent back and a replacement arrived, and in the end it was untraceable. This was a big and unnecessary loss for the organisation.
  • Negative health effects If expired drugs are taken from the reverse supply chain and used (possibly after having been sold on the local market), they can wreak havoc on the health of the people using them; some drugs become toxic after some time, but even those who do not will probably start losing efficacy and would be as bad as under-strength counterfeit drugs – and that is even apart from the effects of uncontrolled use of e.g. antibiotics on the development of resistant strains.
  • Environmental damage Drugs might be beneficial for us, but they are not always so for our environment. Many drugs are toxic for other animals and plants; and even when they are not, it is not always clear what would be the long-term effects on the environment of uncontrolled dumping of drugs. That alone should be enough to have tight controls on what happens with expired drugs and how they are disposed of. This is even more true of e.g. used engine oil and other toxic waste: do you know what happens after an oil change? Is the oil just burned, or even worse, buried, possibly poisoning ground water for years to come? Or is it properly disposed of in an incinerator that reaches temperatures that are high enough to prevent hazardous fumes to be formed?
  • Legal liability In many countries where we work, there are strict laws surrounding disposal of drugs (especially psychotropic drugs), and ‘losing’ drugs in the reverse supply chain can open us to legal liability. Similar issues arise around environmental damage.
  • Loss of reputation Although there is still not much press attention for aid and global health organisations’ records when it comes to the effects I mentioned above, I don’t think it will be too long before our actions in this area will be put under the microscope as well (as they should be). Do you really want your organisation to be the first of the black sheep that will be singled out for our atrocious reverse logistics practices?

It is clear that we need to start working on our reverse logistics. It should not be too hard: the basic principles and best practices that we use in ‘normal’, forward logistics, can be used in reverse logistics too. The only question is: do we start working on this now or will we wait until it is too late?

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Categories:Aid and aid work, Logistics, Public healthTags:Aid logistics, environment, Expired drugs, Health logistics, law, Organisation, Procedures, reverse logistics
Latest job opportunities (November 21, 2009)
November 21st, 2009Michael KeizerNo comments

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Rollin’, rollin’, rollin’: herding river horses
November 20th, 2009Michael Keizer2 comments


water logistics[edit]

The day, water, sun, moon, night – I do not have to purchase these things with money.



- Plautus

Was Plautus ever wrong.

It seems that it has been quite a while since I have written about the logistics of daily life, so let’s have a look at the logistics of what must count as the most daily of our needs: water.

imageFirst a truism: water is heavy. Just try to haul around 90 litres of the stuff and you will totally agree with me. In fact, it is so heavy that carrying it can lead to severe health problems. E.g., a 2003 Lancet article describes how 30-40 percent of a rural Tibetan population suffered from chronic back pain (a severe condition in a predominantly non-mechanised agrarian society), before an intervention aimed at correct carrying techniques and the building of ‘back-happy tap-stands’ (no, I really didn’t make that up – see the picture to the right to get an idea what it looks like).

File:2660617414 afe9a80b70 m d.jpgIn the developed world, we use this really nifty invention for our water logistics: pipes, a technology that has served us well for more than 2000 years (although one shouldn’t underestimate the amount of lead poisoning it has caused over the years – there are theories that it even contributed to the downfall of the Roman empire, although they are unlikely to be correct). For the moment, though, it is unlikely that water infrastructure will come any time soon to the remote areas of least-developed countries: the average Tibetan or Ethiopian subsistence farmer will still need to haul their water from a backbreaking distance.

That is why the hippo roller is such a great idea: by transforming the container itself into a wide wheel-like contraption, 90 litres of water at a time can be dragged around with a lot less effort: those 90 kilograms of water suddenly seem to weigh a lot less, and of course it can be transported much more hygienically than in an open container. So is it all downhill work from here?

Of course not. Even the hippo roller has some drawbacks that need to be worked on. Probably the most important one is… well, you guessed it, it is logistics. To make this a winning proposition, hippo rollers really should be produced close to where they are used, instead of shipped halfway across the globe: one of the litmus tests for the appropriateness of technology is whether it is feasible to produce it locally. A second issue is penetration: up to now, around 30,000 of them have been distributed, which is (if you allow me a very lame pun) nothing but a drop of water in the ocean. Such small numbers mean that it we really don’t have enough experience yet to know whether it really is such a good idea as it seems to be. It also means that there is no hippo-roller-repair man in every village, which means that it is unclear what happens with damaged rollers; and as I haven’t been able to find any evaluations yet, I really don’t know how long the average roller holds up in real life, or how easy it is to repair when it does get damaged.

Still, it is a good example of how creative thinking about logistics can help us to come up with ideas that will help the majority world immensely – and of how important logistics is for the daily life of all of us.

[Images: tap stand from the article by Hoy, Toole, Morgan & Morgan; uphill Hippo rolling by Project H Design. Some or all rights reserved.]

Latest job opportunities (November 19, 2009)
November 19th, 2009Michael KeizerNo comments

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Simplicity, participation, and some tall tales
November 18th, 2009Michael Keizer2 comments

all problems can be solved in two hours[edit]

200pxUsually, I find myself nodding enthusiastically when reading J.’s Tales from the Hood; his thoughtful mini-essays on humanitarian aid work (with, as he describes it, “occasional digressions toward rock music, motorcycles, and parenthood”) have from time to time even been known to make me belt out a loud “yeessss!!!”, accompanied by fist-pumping motions that look totally ridiculous on a bespectacled, bald, overweight forty-something.

But this time I found myself frowning, and actually disagreeing vehemently. In his latest article on “rules to live by”, he writes:

'Don’t overdo “process.” 'Yessssssssssssss, process is important. But process is not the actual point of aid work. The point is product, output, outcomes, impacts, benefit to beneficiaries… [INSERT PREFERRED AID-WORLD BUZZWORD]. If your process doesn’t lead to one of those in fewer steps than you have fingers, then it is probably useless and should be fixed or abandoned immediately.

And then:

Don’t overdo “participation.” Sometimes less is more when it comes to group decisions and group-led processes. If you can make the decision, make it. If you must involve others: Involve the lowest number of people practical for operational decisions. Involve only technicians and/or those with direct managerial authority over the project in question on technical decisions.

Of course, of course J. is right that outcomes are more important than process – but I think he overstates his case when it comes to the simplicity of the process. By total coincidence, I posted a response yesterday on humanitarian.info in which I said, “… if your solution can be written on a postcard, it probably solves nothing”. This was the summation of a four-paragraph argument that silver bullets don’t exist, that we need to look at systems as a whole when searching for solutions to issues, and that consequently those solutions will hardly ever be simple. To put it another way: we don’t live in a Hollywood movie; our problems will not be resolved in two hours in a script that can be gleaned from a one-page summary.

It all comes back to what I wrote in my post about ICT versus systems: if you want progress, you will need to do much more than just introduce yet another tool or another procedure – you will need to tackle the system, and on the whole systems don’t respond too well to short, sharp shocks. And all this with the caveat that, yes, of course there will be complex issues thatcan be resolved in a simple manner – but not that many.

File:2890282371 ce4c3837d4 m d.jpgSimilarly, although I agree totally that one shouldn’t ‘overdo’ participation, I think that J.’s rules of thumb (“If you can make the decision, make it. If you must involve others: Involve the lowest number of people practical for operational decisions. Involve only technicians and/or those with direct managerial authority over the project in question on technical decisions.”) are overly simplistic. Yes, of course I keep the final responsibility as the manager in charge, but I can use inclusive process[1] to:

  • build consensus, which will make my life much easier when finally implementing what needs to be implemented – and in many cases actually lead to an increase of effectiveness and efficiency, because the time spent on participation is outweighed by the time saved on implementation;
  • get feedback in an early stage that can make the difference between doing something stupid or doing something smart – and so improve our product/outcomes/impacts/benefit to beneficiaries/whatever. In other words: sometimes the street sweeper knows more about how to deal with autumn leaves than the dendrologist.

And now go and add Tales from the Hood to your feed reader – because J.’s writing shows that he doesn’t take his own advice on simplicity too seriously and really thinks about what he does; and that is a treat that is all too rare in the testosterone and adrenaline filled world of humanitarian aid.

[Images: simplicity by Gisela Giardino; Participation 12 pack by dharmabumx. Some rights reserved.

Back to post [1] Okay, so I have to admit that I have thrown that one in purely to be provocative. Can I have a bit of fun sometimes?

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Latest job opportunities (November 13, 2009)
November 15th, 2009Michael KeizerNo comments
Humourless links for November 14, 2009
November 14th, 2009Michael KeizerNo comments

logistics training[edit]

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Kudos, buddy! Or: how logistics information management will help you do your job
November 12th, 2009Michael Keizer4 comments


collecting hard data: supply chain visibility[edit]

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My previous article about I-See technology was the first post on what looks to become a mini-series on logistics information management; it gave me some fresh ideas for new posts, and why not go with the flow when you’re on a roll?[1]

This one will be about logistics data and what to do with it. Hello, are you still there?

A couple of years back, I was asked to analyse and improve on a supply line for an international NGO in an East-African country.[2] My first obvious question was: how bad is it actually? They didn’t know: although everybody knew that hardly anything was delivered on time and that there were a lot of mistakes in order fulfilment, leading to frequent stock-outs and overstocks, nobody could really give me any hard data – it was all seat-of-the-pants. When I asked what caused the problems, and where in the supply line they occurred, I was told that that was why I was hired, and could I please get on with the job?

By the time I left, I was told that the supply line had never worked as well as it did, and that I had done a sterling job; but had I?

I think it is time to let the cat out of the bag on that one: in fact, the supply line hadn’t improved a bit – at least, after I started measuring things, my indicators remained fairly flat. In fact, they showed that the supply line really didn’t do that badly even before I arrived, taking into account the context.

What did change, though, was that I used the increased supply chain visibility to give useful feedback to field managers, both logistical and operational ones. For the first time, they would know when to expect their supplies, and would be informed at an early stage if things seemed to go off-track; which meant that they could plan for it and start taking contingency measures at an early stage. I also started to churn out regular one-page overviews of how the supply chain was actually doing, which showed nicely that we didn’t do too badly. Of course I presented this as a big improvement: nobody wants to be told that they were actually quite wrong.

Now this is a nice story, but how would this have helped me if, in fact, the supply chain had been the shambles people thought it was? Having increased visibility would at least have helped me to find out where exactly in the supply line the problems occurred, and perhaps even what caused them; it would also have enabled me to see whether my remedies worked, and to which extent – it would even allow me to try out various measures, and see which one (or which combination) worked best. And finally, it would possibly have helped me to argue my case when expensive or painful measures would have been necessary.

All this turned out to be moot, and I got kudos for what was a fairly easy job. Want those kudos too? Then start working on your supply chain visibility.

[Image: Kudos Buddy by Adam Fagen. Some rights reserved.]

Back to post [1] I just love mixing my metaphors. It’s like those chemistry experiments I did in school, with sometimes similarly interesting (or malodorous) effects. Back to post [2] Sorry, can’t be more specific than that.

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Do you see? Technology aiding supply lines – or not
November 11th, 2009Michael Keizer1 comment


a system is not a box of software[edit]

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Does your organisation currently have an IC technology project running that aims to improve the supply chain? Odds are that it has, or has had one in the recent past, or is planning one for the near future – that is, if your organisation is anything bigger than a couple of volunteers with a budget of a couple of hundreds of thousands of euros. And you should: continuous improvement of your supply chain is a necessity, and ICT is indispensable to do so.

Or rather, you shouldn’t.

Too often, ICT is implemented as a stand-alone solution for supply line problems. ICT is indispensable to support any but the most trivial of supply lines, but rarely is it a solution by itself for whatever are your supply chain woes.

Does this sound like a truism to you? In fact, it does to me – but I have seen several of these ICT-as-a-panacea projects in aid logistics, so I think it is fair to say that apparently not everybody agrees. Oh, of course management of these projects will pay lip service to the idea that processes, attitudes, knowledge and training, and many other aspects will need to improve too, but in reality you see that everything concentrates on the technological solution: processes are adjusted around the technology, staff are trained in using the technology, and so on. And there we go again, in a straight line towards the next round of ‘technological innovation’.

ICT can help us to build systems that help us get the right information, at the right time, to the right people, at the right price, to make the right decisions and take the right actions. (Sounds familiar? It should.)

But: the operative word here is ‘system’. No, I am not talking about computer systems – when I say system, I refer to (ahem) ’a coordinated whole of human, physical and organisational resources (including procedures and structure), striving for a common goal’. In other words: your logistical department is only just part of the organisation’s logistics system (striving for logistical effectiveness and efficiency), which in its turn is part of the system that is your organisation as a whole (striving to perform whatever is its stated mandate as effectively and efficiently as possible), which in its turn… you get the idea. What is not a system is the shiny new ERP software that your director of resources has just bought after a slick demonstration; it could be part of an effective and efficient system – or it could break it.

I said it before and I will say it again: information and communications technology are indispensable to run anything but the most trivial supply lines; but it is there to serve the goal of those supply lines, and not the other way around. Technology should be part of an integrated system with more or less clearly defined goals. The systems should not be built around the technology, because that will hardly ever lead to real integration; instead technology, procedures, and people should be seen as a indispensable parts of the whole system, giving us eyes to see what is coming – I-see technology instead of IC technology.

(Image: Airborne Caffeine Delivery System by Todd Lappin. Some rights reserved.)

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Latest job opportunities (November 10, 2009)
November 10th, 2009Michael KeizerNo comments


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Book review: ‘Humanitarian logistics’ by Tomasini and Van Wassenhove – a missed chance
November 9th, 2009Michael Keizer5 comments


a book on humanitarian logistics[edit]

333pxIf you have followed this blog, you will know that I am very much in favour of more academic input into our logistics efforts. As you can imagine, I was tickled pink when I saw the ads for a new book about humanitarian logistics, written by respected INSEAD academics Rolando Tomasini and Luk Van Wassenhove.

Let me not mince words here: I am disappointed. Expectations are high when a prestigious university like INSEAD releases a book under its own impressum, but those expectations are not met – not even closely. The reason actually is made clear in the first paragraph of the book. The authors describe their experience in humanitarian logistics on which they base the book: case studies they did for WFP/UNJLC, theIFRC, and FUNDESUMA. In other words, they base a book about humanitarian logistics in general on limited experience with three organisations that are very unrepresentative of the sector as a whole. This has clear effects throughout the book: although they do make some valid observations (especially when they talk about partnering with the private sector, which is clearly their focus), much of what they describe is over-simplified, or even dead wrong.

All three of the organisations they worked with (especially the IFRC and FUNDESUMA) have a focus on disaster aid, which obviously skewed their view severely. It leads to occasionally ridiculous assertions; a good example is that, according to Tomasini and Van Wassenhove, in humanitarian supply chains “… time cycles are very short [and] new and unprecedented demands occur frequently …” (p. 8). Definitely true in some types of humanitarian response – specifically disaster response – but totally untrue of many other types. When the authors describe the characteristics of a humanitarian supply line (ch. 1), they very clearly have a specific type of humanitarian response in mind; a type of response that in reality makes up a minority of humanitarian work.

Chapter 5, which is devoted to information management (which people who know me will immediately recognise as one of my personal hobby horses), goes as far as basically describing the SUMA model (with a bit of info about UNJLC’s website thrown in for good measure) as the paradigm to follow, without recognising that it is totally inappropriate for a majority of humanitarian aid work. A bit of scrutiny of e.g. humanitarian.info would have been useful to inform this chapter.

The book comes into its own in chapter 7, about partnerships between humanitarian and corporate organisations. It is very obvious that this is what the authors are experts in, and it is the most useful and well-written chapter of the book. Sadly, that is not enough to justify itsrather inflated price.

All in all, this is a missed chance. Gentlemen, I just know you can do better: get to it.

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Latest job opportunities (6 November 2009)
November 6th, 2009Michael KeizerNo comments


humanitarian jobs[edit]

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Not a fairy tale: when the five rights of logistics are not enough
November 5th, 2009Michael Keizer1 comment

a parable[edit]

File:Donkey 1 arp 750px.jpg

Warning: serious business in a very silly disguise ahead.

You will of course remember that logistics is all about the five rights: getting the right goods, in the right quantity, to the right location, at the right time, at the right price. (And if you don’t, you could read all about it in my March article on the five rights.)

But now imagine the following scenario (perhaps a bit too literally a scenario, but please humour me).

You are the logistics coordinator for a nutritional NGO in the Kingdom of Far Far Away. After a rather nasty little conflict about a swamp, large groups of displaced people have moved to the edges of the disputed area, where spontaneous IDP camps have appeared. As there is hardly any food available there, levels of malnutrition rise alarmingly (and there there have even been some unconfirmed cases of cannibalism amongst one of the tribes, the Jinjabredmen). Your NGO has decided to intervene and you are tasked with finding sufficient amounts of the local staple, faerivloss.

You have two possible sources for the faerivloss:

Humourless links for 4 November 2009
November 4th, 2009Michael KeizerNo comments


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Mountain goats, beer, and logistics: a game
November 3rd, 2009Michael Keizer1 comment


games that teach logistics[edit]

File:1578272618 5a45f23624 m d.jpgAt times, the best training you can give people is a game, and that is especially true of logistics.

There are quite a number of counter-intuitive issues in logistics. Probably the most famous one is the Forrester (or whiplash) effect: forward prediction of demand in separate links in the supply chain will often lead to increasing cycles of alternate over- and under-stocks that travel through the chain like the undulations in a cracking whip. In other words: in a situation in which you do not have sufficient information about what happens further down the chain (as is so often the case), trying to look into the future can actually damage reliability and efficiency. Or to put it even more succinctly: don’t try to be smart when your ignorant.

So looking ahead can be bad for you? How is that for being counter-intuitive?

I am not going to explain here why this happens. Instead, I am going to ask you to play a game with a couple of your mates. Each of you is responsible for a link in the production and distribution of beer (hmmmm… how about Mountain Goat?), within a couple of rules – the most important one being that you are not to talk with each other, but only communicate by purchase orders and invoices. Sounds almost like the real world, doesn’t it? I mean, how often do you sit around a table with all supply managers in the full supply chain to see what each of you expects to happen next month?

Setting up the game and organising a play takes a bit of organisation, but luckily there is anonline version, graciously run by the Swiss Federal Institute of Technology (who else?). So get a group of mates or colleagues online and play the game – and be astounded by the results. Please do so before reading on after the fold.

So, have you played the game? Then the results as they are explained here by prof. John Sterman should look familiar. Did you expect this to happen? Highly unlikely, unless you had some previous logistics training or have been confronted by the Forrester effect before, either in a game or in real life – or are a natural-born operations research genius, in which case I would love to work with you.

There are two things to notice here. One is that the Forrester effect is only one of a number of very counter-intuitive issues in supply line management; and people who think that you can work large-scale logistics without some understanding of the underlying dynamics and (gasp!) mathematics will find themselves running a supply chain that is either completely unreliable or highly ineffective – probably both. What’s even worse: they would probably not even notice it.

Now please note that I am not saying that we should only use logisticians with an advanced degree in logistics and operations research (although I think having more of these people would be a great thing, for various reasons); but I do maintain that you will need to do a lot of reading on the subject if you ever want to run any supply line that is even marginally larger than your local clinic in a manner that is both effective and efficient. Of course, if you don’t care that you cause regular stock-outs, or that you continuously need to destroy expired drugs that have been lying around in your warehouse for mountain goat’s… ermmm, donkey’s years, than you can forget about all that; but in that case, why are you reading this blog?

Interior cockpit of a twinjet flight simulatorThe second point to make is that, actually, it is not really necessary to know any of the underlying dynamics and (gasp!) mathematics. Am I contradicting myself here? Not really: you can gain some understanding of the two without having knowledge of it. Just having been confronted by e.g. the Forrester effect in a game is a powerful experience that you will not easily forget, even if you don’t know your regression from your integration; and it will easily teach you the importance of knowing at the start of the supply chain what is happening at its end. Few people who have played the beer game will forget the importance of demand communicationthroughout the chain, even if they have never heard of kanban or action triggers.

Prof. Sterman’s description of games like these as “flight simulators for management education” is a very good analogy; after all, most flight simulators these days live as games on home computers, even though they started as a safe and cheap way of training pilots. And remember, ‘safe and cheap’ here is ‘safe and cheap as opposed to crashing plane after plane until you get the hang of it’ – which, for some reason, is what we insist on doing in aid logistics.

Now please excuse me; I have a nice, cool glass of beer waiting for me. Mountain Goat, of course.

[Photo credits: Mountain Goat Beer Hightail Ale by Richard Giles; Interior cockpit of a twinjet flight simulator, courtesy of NASA.]

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Latest job opportunities (2 November 2009)
November 2nd, 2009Michael KeizerNo comments


logistics jobs[edit]

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A tale with a tail: why logistics should be integrated into your planning
November 1st, 2009Michael KeizerNo comments


a logistics disaster[edit]

Poster for vaccination against smallpox.Logistics is so often an afterthought.

All you programme managers, country directors, and other people managing aid programmes out there: how often do you integrate logistics planning into your planning from day 1 of your design phase? (And if any of you say: “always”, please let me know when you need an experienced logistics manager – I would just so love to work for you. Not that I would believe you, of course, unless you are a logistician by background yourself – and even then I would be sceptical.)

An old post by Diane Bennett on the Aid Watch blog tells a cautionary tale of what happens when you don’t integrate logistics into your planning. It is a seven-year history of how a lack of logistics planning caused thousands of deaths in remote South Sudan; not because the logistics weren’t thought of, but because they weren’t integrated into the programme from the start.

A medical NGO who wants to support a vaccination will have to take into account how to get the vaccines on the spot – and finding out much later that “… vaccines were available … at a regional distribution center, a $5000 air charter flight away” is too late. If UNICEF and WHO want to ensure vaccination on the spot, they will also need to ensure transportation to it, and possibly refrigeration there. All these should be planned from the start, because this tale clearly demonstrates how taking logistics on at a later stage will only lead to disaster.

But possibly the biggest issue here is that none of the three organisations involved really did their homework. Measles vaccines are fairly heat tolerant. If they would have been transported to the site in a cold box, and then used within a couple of days or even weeks (depending on the ambient temperature), no refrigeration at all would have been necessary. This technique, known as the ‘fast chain’, has been in use for some time and is endorsed by WHO; but apparently nobody managed include this in the planning.

The tale shows only one thing: include logistics and logisticians in your planning from the start, and you will sleep a lot better at night. And don’t we all want that?

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Aaaaand… he’s back
November 1st, 2009Michael KeizerNo comments



File:2167678122 98cdc52405 m d.jpgSo that was not cool. To put it mildly.

I write a post looking back on three months of A Humourless Lot, promising to post more regularly. And shortly after that I let things slide (please, let me use a euphemism now and then) to the point of non-existence.

So I apologise. There were reasons (aren’t there always?), but I should have at least posted something like an occasional update here.

I will try to better my life. And thank you if you haven’t totally deserted this blog and am still reading it – it means a lot to me.

[Photo credit: Jen Waller]

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Latest job opportunities (21 June 2009)
June 22nd, 2009Michael Keizer1 comment


logistics jobs[edit]

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H1N1: Logistics during a pandemic (3)
June 12th, 2009Jurgen Hulst2 comments


it's a pandemic. Now what?[edit]

So it’s a pandemic, now what? Let’s assume you’ve read through Michael’s post oncontingency planning and his follow-up ‘the logistics of swine flu aid’ and your organisation has updated their pandemic preparedness plans, or is in the process of doing so now. Did you think of everything?

meeting counterparts in protective suits

Meeting counterparts. Source: A.Cook

Let’s take another look at your;

  • Supply chain
  • Staff protection
  • Programme operations

Supply chain and border crossings

Contingency planning done at country level with UN PIC and governments suggests an increased role of national military and police in case of a pandemic outbreak when national services and infrastructure will be impacted.

A high level of staff absenteeism (30% or higher) will extend to your suppliers; make sure to include them in your plans. Will your logistics staff and your shipping agent and main transporter be able to handle customs clearance and possible extra measures for quarantine and maintaining security of supplies? Do they know how to handle cold chain & clearance procedures for medicines & vaccines, which may be needed during a pandemic?

Staff protection

You’ve considered protective equipment for your staff who will be in contact with influenza patients (either at work or at home) and may have purchased particulate face masks, gloves and hand washing gel, maybe even Tyvek protection suits if you’re with a medical organisation.

Did you consider training for protective measures? A pandemic logistics simulation trainingP2LX in Nov.2008, found that a major part of using protective equipment is learning how to assess the level of risk and deciding when to use it. And: You learn by doing it, not by reading about it. Secondly, the protection of this type of equipment is only effective when used properly.

Programme operations

You went through the four steps as recommended in this earlier post ; prioritise your logistics,sensitivity analysis, contingency planning and communication.

Your contingency planning answered the important question: How will your programme operations adapt to a national pandemic situation, with significantly less human resources and an increased strain on the supply chain?

Does your pandemic preparedness plan extend to your offices at field level? And does it include your local implementing partners? If not, perhaps now is the time to sit down with your partners at field level to discuss their role and activities.

Take note that staff protection will also affect them. How will they deal with it when your staff has all the protective gear and they don’t? Things could get ugly.

In case you are with a medical organisation, did you consider the additional requirements or shift of focus of your programme if you’re suddenly confronted with a surge in influenza patients and deteriorating local healthcare services?

Conclusion

Now that H1N1 has spread globally and a pandemic has been officially declared a possibility is that we will continue to see a gradual increase in cases, until a larger local outbreak happens in a particular region or perhaps your country.

To maintain the key activities of your programme in the field during an outbreak, the basic principle of the supply chain still applies: the chain is only as strong as its weakest link. Your programme operations will only continue successfully if you have looked beyond your own organisation and included suppliers and local implementing partners in your planning, communication and training. (Guestpost by Jurgen Hulst, @NFIguy)

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Latest job opportunities (2 June 2009)

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How to organise a distribution in six easy steps

244pxChasing’ Carly writes about how a distribution went rather wrong, under the title Crowd Control. So howshould you organise a distribution?

  1. Make sure that the recipients know in advance when and how the distribution will be organised. In Carly’s case, probably the right time to do so would have been when the coupons were handed out, the day before.
  2. Make sure that the goods are there when promised, and make sure you have enough. Nothing will incite a riot as handily as handing out goodies to the first half of the crowd and then tell the other half they will have to go back home empty-handed.
  3. Make sure your distribution area is well prepared. As Carly observes, nobody likes to stand in the sun (or rain, or driving wind) for long periods of time, so make sure there are shelters; use rope and posts to demarcate corridors for lines; prepare signs for the various queues; make sure that you have communication equipment (a.k.a. a megaphone or bullroarer); ensure water, sanitation, and where appropriate, food are available; etcetera, etcetera. If you start thinking about this on the day itself, you are definitely too late.
  4. Make sure that your registration system is prepared. I will write more about this at some time in the future (thank you, Rob Stephenson, for giving me some serious food for thought on the subject).
  5. Make sure that you have crowd control systems in place. Have ‘crowd controllers’ in situ several hours before the distribution starts. Ensure that they are clearly recognisable. Have authority figures from the community (elders, church leaders, whatever works in the context you are in) assist them by bolstering their clout and by defusing possible conflicts. Make sure that everybody knows what to do when things get really ugly (basically: run).
  6. Make sure that you have logistics back-up capacity. Have one or more people with some logistics experience at the ready who are not directly involved in the distribution itself, and who can jump in when logistics (for whatever reason) breaks down. Ensure that they have sufficient extra materials (rope, plastic sheeting, water, duct tape, spare megaphone, etcetera, etcetera) to be effective.

And a bonus step: don’t call in the cavalry unless lives are in danger. In most aid contexts, it is a sure-fire way to lose cooperation.

A little exercise for the reader: why is the title of Carly’s post incorrect? (I suspect it is on purpose – a more descriptive title would probably draw far fewer readers.)

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The job search: a rant

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The regular logistics job postings on A Humourless Lot always draw a predictable amount of steady attention. Obviously, none of them gets as much attention as, say, the post onpandemic contingency planning, but if you add them all up, they are responsible for a large chunk of traffic on the site. I think it is safe to say that there are quite a number of people out there looking for a (new) job in logistics for health and aid.

I think it is also clear that there are quite a number of organisations that are desperately short of qualified, experienced staff. So why on earth do they make it so difficult for people to find their vacancies?

Some of the worst practices I have seen over the last couple of months:

  • Posting vacancies late (less than a week before closing). In one case I even saw a vacancy being posted on ReliefWeb after the closing date[1] .
  • Posting incomplete vacancies: no submission details, no person to contact for further information, nothing about the further process, incomplete or missing requirements or even details of job content… the list is endless.
  • Spelling mistakes that make finding jobs a lot more difficult. One ‘interesting’ example was how Goal Ireland managed to consistently spell ‘logistics’ as ‘logisitics’ in the titles and descriptions of a whole slew of their vacancy postings – so if anybody had searched for ‘logistics’ vacancies on their site, they would never have found them.
  • Posting vacancies that are not really vacancies. We all know them: those job openings for which the ideal candidate is actually already selected, and are only posted for form’s (or internal regulations’) sake. Don’t do it: the word will go around, and your next opening will not get candidates from the people in the know, who will all have heard about your despicable behaviour, but from the poor newbies who haven’t heard – exactly the people who you want to apply for you high-level logistics management position, right?
  • Only posting on your own site. You think that everybody has the opportunity to go and make regular visits to every single site? Be smart: post your job openings on the main inter-agency sites.

So next time when you complain about the lack of qualified candidates for your logistics positions, just first look at your own job publication practices

Footnote[edit]

Back to post [1] That particular posting was later removed. A pity, I would have loved to name and shame.

  1. You can buy it in the capital for about 200,000 shrec/MT (about $800/MT). Transport by local truck (affectionately called ‘donkeys’ because of their usually greyish colour, their ability to where even stallions can’t, and their drivers’ propensity for Eddie Murphy impersonations) will cost you an additional 30,000 shrec/MT.
  2. You can get the faerivloss for free from the local sub-office of WFG (the World’s Fairy Godmother) who just received an enormous donation of the food from the Republic of Dizneeland (halfway across the globe). The donation is sitting in warehouses in the main harbour, but the government of Dizneeland offers to transport it for free to the IDP camps using a number of MH-53E Sea Dragon helicopters, stationed on a carrier just of the coast.

Not a difficult choice, isn’t it? Both options give you the right goods, in the right quantity, at the right location, at the right time; but the donation gives it to you for a price that is much righter than the locally bought goods. So you quickly fill in the WFG requisition forms and go off for a beer.

A couple of years later, you return to Far Far Away as part of your organisation’s emergency team. Although the IDP’s have all returned home after the resolution of the conflict and the accession of the new king (as the result of the unfortunate anuration of the old one), the region again is in the grip of a famine, and you quickly find out why: after the importation of massive amount of free faerivloss, the price on the local markets collapsed and the local farmers were forced of their land (and have moved to giant slums in the capital, where they joined the former donkey drivers, who now try to make a precarious living by driving taxis or, if they are lucky, work as drivers for the numerous NGOs that have made their base there). Most of the land lies fallow, and there will be no faerivloss harvested for the second year in a row. Complicating matters is that the local harbour is rendered largely unusable due to a number of very destructive hurricanes – probably the result of global warming.

Suddenly you get a sinking feeling in your stomach; similar to what you felt when, as a five-year-old, you pulled the tail of what you thought was the neighbour’s cat, but turned out to be some strange feline wearing boots and a rapier, speaking Spanish-accented English.

Of course, in reality our decisions will normally not have such dramatic consequences – but each of our decisions could have smaller but still noticeable negative consequences. When you import goods from overseas, you will have an impact on the local economy, and transport will have an impact on the global environment. And, of course, the fact that your NGO does not need to pay for the donated goods or their transport, does not mean that those costs have not been incurred.

Normally it is not up to us logisticians to make the decision whether we would forego a possible advantage for our organisation, based on wider-ranging considerations like climate change or economic consequences. However, it is up to us to make the people who do take these decisions aware of the possible consequences of our logistical choices, and ensure that they know that there is more than just the one option.

Coordinating logistics

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Editor’s note: As a first on this blog, I have asked Jurgen Hulst, a colleague for which I have tremendous respect, to write a guest post on coordination of logistics. Jurgen started in 2000 with humanitarian work in South America. Since then he has been doing various work always with a health logistics focus in several humanitarian emergencies worldwide. In 2005 he made the switch from an NGO to logistics work at a big UN agency. He is currently active in supply chain improvement and emergency logistics coordination, through the cluster approach. Jurgen can be found on Twitter as @NFIGuy.

The private sector acknowledged that creating partner networks to improve collaboration can improve supply chain efficiency and save millions. The United Nations, mindful that a collective effort could strengthen a humanitarian response in emergencies, in 1991established OCHA to improve coordination.

Easier said than done. Do you need to be coordinated?

Right, until 2005 it was business as usual, until an independent review identified long-standing gaps: weak partnerships and insufficient accountability.

As a result in 2005 the IASC, a “unique forum involving the key UN and non-UN humanitarian partners”, started the Humanitarian Reform, using the cluster approach as a new, improved, way of creating partnerships and improving collaboration.

What does this mean for logistics during a humanitarian emergency? It means that in recent new emergencies such as in Pakistan and Gaza and in ongoing humanitarian crises, a Logistics Cluster, supported by WFP, can provide a platform for local and international NGO’s, government and UN agencies to improve logistics collaboration; and consequently improve the overall humanitarian response.

If you are actively involved in logistics in a humanitarian crisis:

  1. Visit http://www.logcluster.org/ to find out if your country has a Logistics Cluster. If so, this site will be good source for up to date maps, road, air, sea transport and contact information. If not, it is still a useful resource for Logistics toolkits & links.
  2. Participate in the next local Logistics Cluster meeting, because you can meet colleagues and find solutions for customs issues, increased transport prices and shortages of warehouse space, to name a few frequent problems.
  3. Participate even if your organisation has well established operations, because your knowledge can help newcomers, while others agencies may offer supplies and serviceswhich you can use immediately.
  4. Turn to WFP as a ‘provider of last resort’ for logistics. This means that WFP, as the lead agency for Logistics, accepted the commitment to do their utmost to fill critical gaps in the logistics operations during a humanitarian response.

Logistics and supply chain management in the private sector evolved from doing it yourself, to outsourcing parts of it (third party logistics or 3PL), into using companies which provide integrated supply chain solutions (fourth party logistics or 4PL).

Similar to 4PL the Logistics Cluster provides a unique opportunity for the humanitarian community to share assets and competencies, in order to reach integrated solutions. However, contrary to 4PL, a Logistics Cluster or lead agency does not attempt to run logistics operations on behalf of your organisation.

Does it work, or is it just another talk shop? I invite commenters to provide their own experiences.

(Image: UN JLC recruitment poster by Nigelito @ flickr)

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Supply chain risk management

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A lot has been written about how to deal with logistics disasters, or how to avoid specific types of mishaps. Much less attention is given to the process of managing those risks.

Risk management for the supply chain is not really different from generic risk management. Like all risk management processes, you start by making an inventory of possible risks, based on your environment, the programmes that you try to support, possible future scenarios, etcetera. This inventory includes the nature of the risk, its likelihood of occurrence, as well as its possible and likely impact. The result should be an overview of the possible extent of risk for each of the risks that you list. Some examples:

  • If a meteorite would hit your main logistics hub, you would be in dire straits indeed. However, the likelihood of this happening is vanishingly small. As a result, the extent of your risk is still very low.
  • If one of your 15 drivers would fall ill, it would probably not pose much of a problem; however, the likelihood of this happening in any given year approaches certainty. Still, because of its low impact, the extent of the risk would be low.
  • Having your one and only purchaser fall seriously ill would not be a big problem in a well set up system, in which everything is well documented. The likelihood of this happening is also quite small, so the extent of the risk here is very low.
  • However, if documentation is sketchy and most of the knowledge about markets and suppliers is locked up inside the head of your purchaser, the impact of this happening would be a lot bigger. Suddenly, the extent of your risk is now medium or possibly even high.

This last example points to the importance of the risk environment when performing your risk analysis. (It also points towards a possible way of dealing with it, about which more later.)

The next step is to design a strategy to deal with the risks. All risk strategies can be divided into four basic categories: avoid, reduce, transfer, and retain. In our example, this would mean:

  • Avoid: an avoidance strategy could take the form of not doing any local purchasing, or perhaps withdrawing from the programme. This illustrates that avoidance strategies are rarely feasible in the environments in which we work, but nevertheless they should be considered.
  • Reduce: ways in which we could reduce the extent of the risk include hiring a second purchaser (reducing the likelihood of being marooned without a purchaser) or ensuring good systematic registration and documentation (reducing the impact of the purchaser falling ill).
  • Transfer: we could outsource our purchasing to an external company, using service level agreements to ensure that they deliver what we we need, when we need it. This is not a very likely scenario for most of us, but it is something that we often do with e.g. air transport: we transfer the (very real) risks linked to these operations to e.g. a charter company.
  • Retain: we could decided that the extent of the risk is so small (e.g. because we hardly do any local purchasing anyway), that we take no action and leave things as they are. In other words: grit your teeth and suck it up.

A risk management plan basically consists of the risk analysis, with the appropriate strategy for each of these risks. Risk management plans for multinationals often comprise whole volumes (or, more and more often, many Gigabytes of documentation, code, and data), but for most field operations there is no need to go to that length: two to five pages would normally be enough. On an organisational level, it will obviously depend on how big your organisation is as well as its nature: the risk management plan for a two-project, one-country educational organisation will probably be not much more than the one-page result of a day’s hard work, but WFP’s risk management plan will more likely resemble that of a big multinational company.

However, whatever the size or nature of your organisation: you cannot afford to go without some form of risk management; organisations that think they can tend to be unpleasantly surprised at some stage.

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Three months on: looking back

File:363716200 13928a8246 d.jpgA Humourless Lot is now slightly over three months old: my first post (on Somali pirates) was published on February 6th. Time to have a first look back.

Judging from the number of unique visitors and page views, by far the most popular posting is my review of logistics contingency planning and pandemics, posted on April 29. This is perhaps not surprising as it played directly into the news cycle on pandemic swine flu (and equally unsurprisingly but perhaps disappointingly, it has received very few visits after attention in the press wandered elsewhere).

What is more surprising (and encouraging) is that second place is taken by my review of Harvard professor Michel Anteby’s antics around (business) ethics. Ethics is an important issue in any profession, but in view of the plentiful opportunities for fraud , it is even more so in logistics than in many other fields.

This agrees more or less with how I feel about the postings on this blog: these two articles are definitely not bad. However, if you would ask me to name my favourite posts, it would probably be the one on overhead and how to deal with it in a more rational way than we do now, and the mini-series on the logistics of logistics. These posts get surprisingly little attention, something I would definitely like to see changed.

When I started this blog, I gave myself three months to see where it would take me and to decide whether to continue after that – a decision that I wanted to base on whether or not it would add to productive discussions on logistics for health and aid. That three-month period has passed, so it is time for an evaluation.

I think that I have succeeded in contributing to some necessary debates. I have received some positive feedback, but more importantly, I have seen some conversations that I have been able to trace to articles that I posted here. Still, I am not yet where I would like to be. For one, I had expected more discussion on the blog itself (especially around controversial issues like applied ethics or air ship transport); instead I have been engaged in some interesting and invigorating dialogues by email – something I was very happy with by itself, but which by its nature does not contribute to public discourse. I was also a bit surprised by the mismatch between my target group (mainly logisticians and logistics managers) and the people who actually actively participate in the discussions: I get more response from aid and (global) health generalists and from programme managers than from logistics specialists. But perhaps I should not be surprised.

One unexpected advantage: I have discovered that I really enjoy writing, something that is new to me. Most of my writing up to now has been in the form of technical papers and policy documents, something which does not inspire unending daily joy. I have now found out that writing for a wider audience is a much more interesting and joyful experience (and it seems to help making my technical writing a bit less dry too).

So all in all, the experience has been a very positive one, and I feel that the (not negligible) amount of time I invest in researching and writing for this blog is more than outweighed by the effect it has, as well as the fun I have doing so. In other words: I will definitely go on doing this.

The question now is: how can I further improve? One issue that has been pointed out to me is that postings are a bit irregular: sometimes weeks go by between posts. This is definitely something that I can improve on, so my public commitment here is that I will write at least four posts every week.

I would appreciate any further pointers: how can I improve this blog? Any subjects that should really be covered and aren’t yet? How can I stimulate more discussion? And how can I get more logisticians to join? Please let me know.

(Image: Rear View Mirror by Robert Fornal.)

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Go and be enlightened![1]

File:340122951 9ac05fe97f m d.jpgI am going to do something that I will not do too often: I am going to tell you to read a post about health supply chains on another blog, and not add anything to it. Over at the global health blog at change.org, Bryn Mawr student Mara Gordon just wrote an absolutely fabulouspost on Coca-Cola and public health, explaining how it is around the corner from anywhere and what we can learn from that in public health. She is not the first to make the comparison, but it definitely is one of the most tasteful and refreshing ones I have read: good till the last drop.

(Image: Coca-Cola in Morocco by ciukes @ Flickr)

Footnote[edit]

[1] If you like a little puzzle: how many Coca-Cola slogans have I used in this posting? No prize, but an honourable mention for the first to post the right answer. But only after you have read Gordon’s post.

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My little sideline

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A Humourless Lot clearly is a blog on logistics for health and aid, and even though I very occasionally make small excursions, I try to keep it tightly focussed on that subject. However, even though I am professionally specialised in it, my interests in (global) health range much wider than ‘just’ logistics – interests that I have not been able to really express here.

So you can imagine how chuffed I was when Alanna Shaikh, the ‘guide’ for one of the most widely read and accessible blogs on global health, asked me to become a regular guest blogger. I have started last Monday with a series on global health and human rights, and will post on a weekly schedule. I am not yet exactly sure where my posts will take me, but I am sure it will be an interesting ride.

So if you are interested in my interests outside of logistics, have a look at the global health blog at change.org – or go there anyway, as it is definitely one of the best blogs on the subject you can find.

(Image courtesy of Daneel Ariantho.)

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The plane truth: aid transport and (illicit) arms trade

A skirmish with smugglers from Finland at the Russian border, 1853, by Vasily Hudyakov (1826–1871).

If a paper entitled Air Transport and Destabilizing Commodity Flows gets widespread attention in the press, it is time for logisticians to sit up and pay attention. A policy paper from the Stockholm International Peace Research Institute (SIPRI) with that bone-dry title was recently released, and made quite a splash. The reason: it made an explicit link between aid work and the smuggling of small arms and light weapons. So was Beyond Borders an accurate depiction of reality after all?

Luckily, things are a bit more tenuous than that. The authors (Hugh Griffiths and Mark Bromley) performed a survey of “Security Council Sanctions Committee and other arms trafficking-related reports”; based on this survey, they conclude that “… at least 90 per cent of intercontinental air cargo carriers named in UN Security Council and other arms trafficking-related reports have also supplied UN agency, EU and NATO member state government departments, NGO and private contractors in Africa, Europe and the Middle East” (p. 24). This is then translated into headlines like “Africa aid shipped in planes ‘used for weapons’”. As so often, catching the reader’s eye seems to be more important than truth.

Looking at the report itself, I have one major critique to start: much of its argument is based on the authors’ survey that I mentioned above, but methodology and full outcomes are not presented anywhere – only those results that the authors want to present are brought forward. This makes it effectively impossible to verify or challenge their conclusions. They would have done themselves and us all a favour by giving (e.g. in an appendix) a rigorous presentation of their methods and all results, not just the ones they feel are interesting for us.

Update (14 May): Andrew Hughey points out that the database of air cargo carriers that was used by the authors is published online (thanks, Andrew!). However, still missing is an explanation of exactly which are those “other arms trafficking-related reports” are, as well as how they identified which of these carriers were supplied by UN/EU/NATO/NGOs/private contractors.

Having said this, Griffiths and Bromley make a number of interesting points. The one that relates most directly to logistics for health and aid, is that too often we support arms trade (legal trade, but perhaps more importantly, also illegal trade) by using air transport contractors for aid operations that are known to be involved in this (illegal) trade. I don’t know whether we do; absent this presentation of their research methods and outcomes we will just have to take their word for it. However, I do know that we hardly ever take this into account when contracting air transport. In fact, personally I have to admit that I have literally nevermade the effort to find out whether a transport contractor was involved in illegal arms trading; I don’t know how typical my experience is, but I suspect that it is definitely not totally atypical (other aid logisticians: please feel free to comment – anonymous comments more than welcome!). MSF’s Gerald Massis made the particularly lame comment, “It’s like you hire a taxi. After your trip you don’t know what they do afterwards.” That one had me cringe; I would wish Massis had done his homework before he said that.

A more cogent argument is that, by their very nature, many contexts are mainly or exclusively serviced by contractors who are involved in more-or-less damaging or illicit trade: I don’t expect KLM or Lufthansa to start flying on El Geneina any time soon, and the transport companies who do are the ones that would usually be more open to risky but profitable deals like arms transports. Our choices are sometimes extremely limited, a reality that seems to be difficult to translate into a news headline.

However, I am afraid that we cannot deny that, too often, we do not put sufficient effort in selection and filtering of transport companies. I for one will be a bit more circumspect about this in the future, and I hope that the SIPRI report will have other aid logisticians start thinking seriously about this issue as well.

(Image: A skirmish with smugglers from Finland at the Russian border, 1853, by Vasily Hudyakov (1826–1871).)

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On ya bike![1]

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In some ways, this post wants you to consider the opposite of my previous post (on the use of airships in aid logistics). Don’t ever let it be said that I am not a fence-sitter.

Airships are great at integrating what was a multimodal[2] (part of a) supply chain into a monomodal one: instead of using various transport means, they could in many cases deliver from origin to destination in one go where before we would have to use several transport means.

However, the use airships for aid is still some time away, and even when it finally arrives there will still be destinations that will be very hard for airships to reach. The most apparent of these are dense urban settings: a large airship, although it needs less landing space than a wide-body plane, still needs considerably more space than e.g. a helicopter. As a large part of aid work takes place in these dense urban settings, we will need to look at other solutions for the last mile. This is all the more true for health logistics: as populations urbanise, more and more of the health effort will need to be concentrated in the cities and towns – and in most developing and middle-income countries these are very densely built up.

The easy solution is of course the tried and true combination of truck and car. However, for various reasons this is actually not appropriate in many settings:

  • Cars and trucks are relatively expensive means of transport: not so much in purchase cost (although those are not negligible), but especially in running costs and maintenance.
  • Maintenance might not always be possible: especially in developing countries it is at times difficult to find the necessary spare parts or the skills to maintain cars[3].
  • Trucks and cars add significantly to air pollution, which is already a problem in many cities in developing and (especially) middle-income countries.
  • In the most densely built-up areas, even cars can be impossible to manoeuvre.

So what solutions can we look at?

By far the oldest one is the use of raw manpower: human porters that carry goods wherever they are needed. Obviously, they can get anywhere where people can go, and where labour is cheap this is often the most economical way of transport. However, unless managed very well, porting can be punishing for the people involved, and lead to serious long-term health problems.

File:110400199 1781b8da46 m.jpgA much better solution is the lowly bike[4]. Like porters, it can get almost anywhere where there are people; if not by riding it, then at least by pushing. It can bear much larger loads (more about that later) but with negligible stress on the body of the biker. And finally, bikes can be repaired by almost any technician worth their salt[5].

New developments in bike design mean that they can be used for much heavier and bulkier loads. A good example is the Big Boda load-carrying bicycle, a design from Worldbike. Bikes like this can successfully compete with cars and trucks in many settings, and should be considered seriously when designing logistics systems for health or aid.

(Images by Kees van Mansom and Worldbike.)

Footnotes[edit]

[1] If you wonder what I am talking about: have a look at this list of Australian English vocabulary.

[2] Multi-modal transport in this sense refers to transport using more than one means, e.g. train and truck, or ship-train-truck, etcetera. Strictly speaking, the term is reserved for when we have only a single transport contract, but I will use it in a slightly looser sense here.

[3] This is becoming a serious issue as cars are ‘computerised’ and more and more models cannot be maintained without expensive diagnostic machinery and specialised skills and knowledge.

[4] Yes, I am originally Dutch. Why do you ask?

[5] Obviously, I am not talking about your Bernard Hinault Special.

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Air logistics: are we on the same Page?

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Wouldn’t it be great if we could transport our goods from one place to another using just one transport means from place of dispatch until the spot where we deliver aid (thus eliminating time and capital intensive loading and unloading activities), staying high above conflicting parties until we have reached the very place where we want to land (thus avoiding highway robbers, pirates, lacking infrastructure, and roadblocks), at relatively high speeds (130 – 160 km/hour), with excellent fuel efficiency (thus dramatically decreasing transport costs) – and all this without having to invest in very expensive infrastructural works?

Well, the technology is there. What we need now is someone to invest in it.

After the dramatic holocaust of the Graf von Hindenburg, airships were off the map for anything remotely interesting. This lasted for quite a while, but the early 1990s saw a resurgence in development efforts for airships. Most of these were unsuccessful and ended infinancial problems. However, there are some successful examples as well, e.g. de Zeppelin NT. What is still missing is a large, long-range airship: the ones used now are much smaller than their pre-WWII cousins, and have a much shorter range.

The problem is that the market for the sort of airship that would be useful for aid work is very limited: only activities that normally have high numbers of transit points, have issues with roads leading to their destinations, and have relatively high cargo and passenger number requirements, would be able to sustain these much larger and farther-ranging airships – and that leaves very little but the humanitarian aid effort and the military (and yes, there has been some interest from various military powers in airship development).

So the question is: would we be able to support the development of an airship model suitable for aid work? Or have someone do it for us, e.g. a big donor? It will be clear that supporting the development of a big airship will be impossible for almost any aid agency (with the possible exception of one or two UN agencies) – but would there be a case here for a consortium of aid organisations and/or donors to put money in it?

A number of initiatives have sprung up that seem to answer this in the affirmative; but none have been very successful, possibly partly because support from aid organisations and donors has been totally absent. The potential advantages of using airships for aid work are immense; but nothing will happen without that support.

It is about time we start being less conservative about aid logistics and look at possible revolutions instead of only looking at incremental evolution. And perhaps, in some years, this will not be the only Zeppelin involved in aid:

(Image courtesy J. Rohrer)

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The public/private mix in health logistics

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Some time back I went on a tangent to rant about the wisdom (or rather, the lack thereof) ofconcentrating on the public sector for health, to the detriment of the private sector. The word “logistics” was conspicuously absent in that post, a lacuna that I am going to repair in this one.

I guess that it will be clear how important the public sector is for health logistics in developing countries. But how about the public sector? What could be its role?

Combine the words “logistics” and “private sector” in one sentence, and obviously third party logistics (or 3PL) will jump immediately to mind (or it should, if you have all been paying attention and read my post on visibility and transparency). However, there are very few logistics companies (or, for that matter, health ministries or health NGOs) in developing countries who would be able to implement the necessary visibility; so I am afraid 3PL lies rather further in the future than one might wish.

An existing example of more or less successful inclusion of the private sector in the health system, are the private retail pharmacies you can find almost everywhere in developing and middle-income countries. In many of those countries, it would be (almost) impossible to get the necessary medical supplies to the patients without this private initiative.

However, it is not all sunshine and laughter. For example:

  • There are serious questions about the quality of the supplied medications by private retail pharmacies in developing countries. Not only can this be extremely harmful for the patients themselves, but it can also contribute to the further spread of resistant strains of viruses, bacteria, and parasites.
  • Likewise, the quality of advice given by private pharmacists is not always the best. Research shows that not only is this advice not always up to par due to a lack of knowledge, but there is the obvious problem that the pharmacist wants to sell items on which he can make a (larger) profit; and so they would be clearly tempted to advice e.g. anti-diarrheals instead of ORS.
  • Private pharmacies will go where there is profit to make. This means that sparsely populated areas or especially poor populations are more likely not be served by any pharmacy.
  • Likewise, private pharmacies will not give away their goods to their poorest customers either. This would mean that the poorest parts of a population that is served exclusively by private pharmacies might not be able to access the necessary medicines.

None of these issues are insurmountable; e.g., quality of supplies and advice can be increased by better supervision and training, incentives can be given to pharmacies to establish themselves in sparsely populated areas, and a voucher system can be instituted to safeguard the needs of the poorest. However, all this costs money too, and in the end it might actually be more effective to have a public (government-owned or sponsored) pharmacy than a public one. This is not something that can be decided on a system-wide level; more likely, the most effective and efficient solution is a mix of private and public pharmacies, supplemented with adequate supervision, training, and financial incentives. Finding the right mix is not an easy task, and probably finding this right mix will include a number of painful mistakes. Don’t forget that the most successful systems in developed countries are the result of many years (and sometimes centuries) of ‘tinkering’.

However, one thing is clear: an all-public system of pharmacies is as likely to be ineffective of hugely inefficient as an all-private system. Dogmatics will not help us at all, and that is as true for pharmacies as for many other issues in health logistics.

(Image courtesy of Getty Images through daylife).

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Logistics of swine flu aid

Deborah Cannon/AMERICAN-STATESMAN 03/27/06 Michael Leavitt, Secretary of U.S. Department of Health and Human Services talks with an audience at the Hyatt Regency in Austin, Texas on Monday, March 27, 2006. The state held an all-day summit on pandemic flu preparedness efforts.I have had to rewrite this post three times today as new developments rolled in (not the least of which is of course that we are now officially in a pandemic), and as I found more pertinent information

The swine flu pandemic will obviously have a severe impact on our supply chains; however, it will also impact on the demand placed on these supply chains. These demands will come from two sides: the obvious external demand related to the programmed response to the pandemic, but also the less obvious internal demand caused by efforts to protect (and treat) our own staff.

Both will put an increased strain on a supply chain that will already be more vulnerable. Normally, I would have said that this would require forethought and planning, but it seems we are a bit too late for forethought – so let’s stick to planning.

Note that I will write here as if we all work in medical organisations; of course, many of us work in other types of aid work, but as demands in medical aid will be most intense, this presents a ‘worst case’, and although not all of the aspects debated here will be relevant to other organisations, many will.

Much of what I wrote in my post on contingency planning for the supply chain, is applicable to this issue as well. The four-step approach (prioritisation, sensitivity analysis, preparation of plans, resourcing and communication) is valid as well. However, there some things to keep in mind.

One issue that will hit every organisation, will be logistics (including procurement) of goods related to the protection of our staff. It will be necessary to sit down now with whoever in your organisation is in charge of OSH and work out what you will need. Think of protective clothing, microfiltrating face masks, and (depending on whether your staff will be in direct/prolonged contact with influenza patients) many other items. A specific issue is the availability of antivirals. If these are needed in any more than very modest amounts, and you do not have them stockpiled yet, it will be highly unlikely that you will be able to procure them now.

A second step is to look at your organisations programmes, and how they will adapt to the pandemic. Is it likely that your organisation will be involved in the treatment of patients? If so, you will need to start planning for that now: get your programme people to give you an idea of where things might go – again, developing a couple of likely scenarios – see what would be demanded from logistics in these scenarios, and how you can address those demands. I cannot stress enough that now is the time to pipe up if your conclusion would be that logistics cannot address the demands in one or more of the scenarios: both top management and your programme departments should know. Conversely, it would also be a good idea what would be your best guess of what you can do.

In case of a pandemic, your biggest headache (next to keeping your supply chain from collapsing) will probably be procurement: demand for the same limited amount of resources will increase tremendously (share prices for manufacturers of antivirals are already soaring), and you will be just one of the very many customers. So start talking now with your suppliers and see what can still be done. You might already be too late, but you will definitely be too late if you wait much longer.

As with the protection of your supply chain, using a methodical approach to the increased demand caused by the pandemic is essential, and the same four-step approach can be used successfully. However, in the end it is again not so much how you plan, or what you plan, butthat you plan which will make all the difference. Don’t be caught on the hop.

(Image by Ryan Schultz. Some rights reserved.)

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The importance of contingency planning
April 29th, 2009Michael Keizer2 comments

Slightly over a week ago, I was trying to write an article for this blog about how health issues could impact logistics. I just could not make it work: the main health impact on logistics would be from a pandemic, and although that seemed pretty realistic to me, I also felt that my readers would probably not see it as realistic enough to spare it a second thought. That was a real issue for me, because the main reason why I wanted to write the post was to get people thinking about logistics contingency planning for a pandemic.

Of course, I am now kicking myself for not have written what would have been a fairly prophetic post – and perhaps have influenced one or two people to take some action.

So my apologies for being late – let’s just say that this is a mistake I will not make very soon again.

The impact[edit]

Let’s just assume for the moment that swine flu will go pandemic. What effects will this have on our supply chains?

The most obvious one is that it will put severe demands on it. We will need to have massive amounts of medical goods at the right spot, at the right moment. How to deal with this issue merits a separate post, which you can find here.

Perhaps more insidious is the fact that every supply line depends on people – and in case of a flu pandemic, many of those people will be incapacitated (by illness or death), or be subject to isolation or quarantine. This will mean a severe blow for many of our supply chains: without truck drivers, store managers, clerks, and purchasers, our supply lines will soon break down.

Furthermore, quarantine measures might also mean that transport will be infinitely more difficult: if we can’t have trucks or planes come into the country where we work, goods will not come in either.

How to deal with it[edit]

So how to deal with this? At this stage, preparation would include four steps.

The most important issue, which needs immediate action, is to prioritise our logistics: which goods for which programmes are most needed. I would suggest to divide them into three to five groups, ranging from “immediately indispensable” to “doesn’t matter if it’s a couple of months late”. Note that we are not talking about articles here, but about article/programme groups: article 1 for programme X might be in a different group than the same article for programme Y. This needs to be done now: you do not want to have these discussions while you are in the middle of a crisis.

A second issue that needs to be dealt with concurrently with the prioritisation, is a sensitivity analysis of our supply chains: which parts our supply chains will be most vulnerable to disruption? It could be very helpful to develop a couple (not too many) scenarios and see how they impact our supply chains. When doing this, don’t forget that our supply chains extend beyond our own organisation: include the possibility that e.g. your main supplier will be severely impacted, or that your main transporter will be knocked out. Also look outside the logistics departments, e.g. by taking into account that your programme staff might be so severely overburdened that they will no longer be able to make forecasts or report regularly.

Based on the prioritisation and the sensitivity analysis, prepare contingency plans that deal with the various scenarios in such a way that (as far as possible) goods from the highest priority groups will be where they are needed, when they are needed. These contingency plans could include e.g. stockpiling (explicitly taking the risk of increased expiries), already hiring extra staff, and many other possible actions. What it exactly will entail for your organisation will depend on many factors, and there is definitely no one-size-fits-all solution. It will be important here to think laterally and come up with creative solutions: this is an extraordinary situation, and will need extraordinary solutions.

The fourth and last step is 'resourcing and communication': make sure that you have the (financial) resources to implement your contingency plans – which will mean that you will need to ‘sell’ your plans now to senior management of your organisation – and communicate the plans to all people involved, which would include practically everyone within your organisation, and quite a number of people outside it.

I can hardly stress enough that these steps need to be taken now: if and when the crisis arrives, it will be too late. You might counter that nothing ever goes according to plan, and that the crisis that will really happen is unlikely to be the one you planned for; that might be true, but having these plans and resources at the ready will give you an enormously increased resiliency that will enable you to cope much better than otherwise. To quote general Dwight D. Eisenhower: “plans are nothing; planning is everything”.

A call for action[edit]

Go now to the person(s) responsible for logistics planning in your organisation, and ask them whether they have prepared contingency plans for a severe pandemic impacting on your supply chain. And don’t let them get away with generalities; things are much too serious for that. And if you yourself are responsible: did you do your homework? Finally: please come back here and let us know what you did: at this stage, we should all learn from each other.

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Overhead, HQ, and the global financial crisis
April 25th, 2009Michael Keizer2 comments

Ritratto di Frà Luca Pacioli (1495). Luca Pacioli (1445 - 1517) is the central figure in this painting exhibited in the Museo e Gallerie di Capodimonte in Napoli (Italy). The painter is unknown, although some people are convinced the painter is Jacopo de#39; Barbari (1440-1515).

How much should we spend on non-project costs, a.k.a. ‘overhead’ or ‘HQ’? Ten percent? Twenty? More? Or less? Please think about this for a couple of minutes before you read on, and define for yourself what would be a reasonable percentage in the organisation that you work for.

So now I am going to tell you that whatever percentage you came up with is wrong.

Nasty, huh?

My point here is that we should really stop thinking in percentages. Sure, it sounds nice that we can tell people that we spend only 15% on ‘overhead’, but it is totally meaningless.

First of all, we have these people called accountants, who are very good at defining ‘accounting principles’ in whatever way is needed to present the best picture.[1] When we say that we spend 15% on overhead, we actually say, “15% of our expenditure is attributed to overhead, but that could be any odd (or even) number under different accounting and presentation principles”.

Furthermore, defining how much we want spend on organisation (shall we just stop using those disparaging words ‘overhead’ and ‘HQ’?) in terms of total expenditure, or even as an absolute number, really is utter nonsense. No self-respecting company would say at the start of the fiscal year, “let’s spend so-and-so much on our corporate organisation – doesn’t matter on what, you can just spend this amount”[2]. Instead, they look at what support and control activities are needed from corporate, and then make first an activity budget, and subsequently base a financial budget on that. Similarly, we should define what level and manner of support and control we need from our central departments, and then try to cost it. In the end, the only thing that matters here is how the people we try to aid get most bang for the buck – and if that is more by spending it on support, because that will increase our efficiency in the field by so much, than that is where we need to spend it.

Over at humanitarian.info, Paul Currion makes the very astute observation that the currentglobal financial crisis might actually help us to look at these issues in a more rational way. In short, he contends that the resulting squeeze on our budgets might force us to look more at efficiency, and do that in a less mechanical and more rational way than just at expenditure in the field versus at HQ. He might be right – I definitely hope so.

(Image: Ritratto di Frà Luca Pacioli (1495). Luca Pacioli (1445 – 1517) was, amongst many other things, the inventor of double-entry bookkeeping, a system we still use today. He was also the first to realise that profit and loss were no absolutes but depended on how you accounted for them.)

Footnote[edit]

[1] I have been an accountant and an auditor. Believe me, I know.

[2] Show me a company that does, and I show you a bankrupt in the making.

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The power of the pipeline
April 24th, 2009Michael KeizerNo comments

Trans-Alaska Oil Pipeline by rickzWhen preparing a new order, you take into account goods that are still in transit (a.k.a. the pipeline), right? Right, so we need not discuss things further.

Or do we?

In practice, there are a number of issues that surround the pipeline that complicate things and ensure that in reality, we often incorporate incorrect pipeline figures in our calculations.

  • Time. When do you expect the goods to arrive? Tomorrow? Next week? In a year? And that date, does it relate to arrival in your transit port, a country away? Or at the airport next door? And how long will clearing and onward transport to your projects take? In the end, the main issue is when the goods will arrive where they are needed, in your programme; all other considerations are important only for the purpose of determining that date. However, in the settings where we work, they are often difficult to predict. An example: some years ago, I was involved in importing a large consignment for an African ministry of health. We felt that we had done our planning quite well, taking normal transit and clearing times into account and adding a buffer based on the normal spread. What we did not know, however, was that the ministry of agriculture had ordered a massive consignment of fertiliser – and when I say “massive”, I mean tens of bulk shiploads, all arriving at more or less the same time. This consignment arrived at the same time as our containers, congesting the port of entry to a point where we could not land the containers for several days, and then struggled for several weeks to find onwards transport capacity. I learned from this the value of growing and maintaining an extensive information network in whichever location you find yourself. If I had talked with some people in the main transport companies, I would soon enough have heard that their capacity was fully booked out.
  • Confirmation. You know you ordered 20 boxes of paravenozole, delivery at your warehouse due next week, but did you actually get a confirmation from your supplier? Too often we do not insist on binding timelines, with obvious results; and if we do, we do not enforce them well enough. This is improving, though: I have seen various solutions to this problem. The one I like best is to have ‘order managers’: dedicated staff who take over the management of the order once it has been placed, ensuring that confirmations are received and regularly following up status with the supplier.
  • Matching.You know that there are 20 boxes of paravenozole in the next plane to arrive, but… for which project are they? And to cover which order? The supplier of course uses a different system of identifying orders than you do, let alone of article coding. So how can you match this? Obviously, the key here is keeping your paperwork in order, ensuring a clear trail from project order ID, to your order ID, to the suppliers order ID. In reality, this is slightly more complicated than it sounds because we often need to split up orders, and might have on-the-run changes. And of course, we are not talking of one consignment with one type of goods for one project on one order… However, none of this is insurmountable. The most important thing here is discipline: the discipline to document continuously what we do, why we do it, and what are the results – in such a way that we can easily find things back. It does not really matter whether we have an old-fashioned paper-based system or a state-of-the-art ERP system: the principles of documenting and cross-referencing remain the same.
  • Units. A small last issue, but one that does trip us up sometimes: did we order twenty boxes of paravenozole, each of 100 doses, 2000 doses in total? Or twenty overboxes, each containing 50 boxes, 100,000 doses in total? Make sure that you document, double-check, and feedback to your projects and your supplier in case you have any doubt.

Taking into account your pipeline figures is your an essential part of order management; and although it may take a lot of work, most of it should be routine activities that can be done at a clerical level. Your pipeline is your connection to your future deliveries, and can give you an invaluable idea of that future for a very small investment.

(Image by rickz.)

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What to bring on a logistics deployment
April 22nd, 2009Michael KeizerNo comments

The ever-interesting Chris Blattman published a list of things to bring for field work. A very useful list, I should add, and some of the suggestions in the comments are very worthwhile too. Just don’t try to bring everything that’s in there.

So what specifics would I add for a logistics deployment?

  • A clicker (one of those thumb model counters). Will help you immensely during verification activities.
  • Cling wrap. Has more uses than I can easily mention here, but for starters: repairing leaky containers, repairing car windows… actually, combined with some duct tape, it can repair almost anything — even, in an extreme situation, some bodily harm (but get to a doctor ASAP).
  • So the next one, obviously, is duct tape. More uses than you or I can even imagine.
  • Sticky labels, A6 size (4 on an A4 page), printable. Again, more uses than you would expect.
  • Permanent markers. You will always see that you need them when there are none around.
  • An el-cheapo digital camera, preferably one that can make rudimentary videos. Worth its weight in gold for training purposes.
  • The electronic version of the ordering catalogue of whichever organisation you are working for. Your organisation is too small to have a catalogue?[1] Get one from a bigger organisation with similar activities (so in the medical area the MSF catalogues, for education UNICEF, for water and sanitation OXFAM, etcetera). This will help you immensely when ordering yourself or when getting people to be more specific on their orders.
  • Your organisation’s logistics, admin, and financial procedures in electronic form, including the standard forms used.

So what do you take with you when you go to the field?

Footnote[edit]

[1] Actually, your organisation is not too small. If it is big enough to have more than one programme, it is big enough to have a (rudimentary) catalogue.

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Latest job opportunities (22 April 2009)
April 22nd, 2009Michael KeizerNo comments