Logistics includes everything that is non-medical and non-policy-related about a project. At Jude-Anne, a 70-bed hospital, this is a big, big job. Walls and beds, water and electricity, laundry and sterilization, cleaning--and maternity is messy business--and waste disposal. The guards, the orderlies, the cooks, the drivers: all logistics. (Then there's the logistical stuff related to the office: finance, procurement, communications...)
Last weekend, we had a generator problem. I noticed on Thursday, when I tried to wash my hands. No water in the tap. Found one of our Haitian logs, and said, there's no water in the lab.
He said, I know, there's no water anywhere. We're trying to fix the generator.
I replied, Please do! I can't have a hospital with no running water.
The water problem resolved within minutes. But two days later, our generator showed worse problems.
I know nothing about generators. (That's why they don't let doctors do logistics!) I can't tell you the diagnosis of our generator. Sick, is all. Gravely so.
We have a back-up generator, which is very small. Just barely enough to run the lab and the OR, temporarily. I've been told that generators need to be switched off regularly, or they overheat.
The logistics guys were madly rewiring the circuits to the hospital. I ran around madly turning off lights and fans and unplugging cell phone chargers. And explained and apologized to the staff: it's a bit dark, and it's very hot, but we have to prioritize the lab and the OR. God help us if we lose a fridgeful of blood for transfusion. Or the lights in the OR.
The hospital staff continue to amaze me. No one really complained. Lately, we're doing double the usual number of deliveries, way beyond normal capacity for this hospital, and a subject for another blog entry. That night, they were delivering by the light of emergency lamps, the kind used on construction sites. It was baking hot. The midwives shrugged and kept working. Babies wait for no one.
Logistics rented another generator, not quite big enough, but it was what was available late on a Friday afternoon. It came on a truck with a crane. I had no idea they were so big.
But not quite big enough, as I said. Two Haitian logisticians split the weekend, because everything needed switching over every four hours. One did the days, the other did the nights. We agreed that ironing the gowns and sterile fields for the OR was unnecessary luxury. As long as they are clean, dry, and sterile, who cares if they have wrinkles' Apparently the iron takes a sizeable electrical load. The dryer was more important.
We made it through the weekend, though the delivery room spent some minutes in absolute darkness. Now we have a new, even bigger, generator, that also came on a truck with a crane.
Yes, logistics. Amazing.