6. Donations in Emergency Situations

6.1 Donations in Emergency Situations – General

6.2 Donations in Emergency Situations – Consumables

6.3 Donations in Emergency Situations – Medical Equipment

6.4 Donations in Emergency Situations – Pharmaceuticals


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6.1 Donations in Emergency Situations – General

6.1.1 General – Emergency Needs Assessment
    Donations should only be made based on an expressed need, at the request of the in-country partner and after a thorough needs assessment confirms that the donation is also appropriate for the setting.
      In addition to the general and specific product  donations standards, the following factors should be considered when determining whether or not to donate during a disaster.
      6.1.1.1 Whether the local population is participating in any assessments and product requests. 6.1.1.2 Whether outside aid is being accepted and has been requested. 6.1.1.3 Whether other organizations are responding and when possible determine if multiple requests have been made for the same product by more than one organization. 6.1.1.4 Whether there is an expedited plan in place for vetting new partners. 6.1.1.5 The organization should evaluate unusually large requests to avoid sending excess product that might create a disposal issue for the recipient. 6.1.1.6 Verify customs clearance procedures to determine if they have bee waived, modified or forbid emergency medical donations.

      Guidance:  It is extremely difficult during an emergency situation or humanitarian crisis to get accurate information or conduct a needs assessment.  Assessments are best handled by in-country experts or in-country recipient partner staff so that questions are answered within the event operating environment.  Most aid organizations, including MSROs, are better positioned to respond to a crisis during the recovery phase when the needs can be more accurately determined.  Conference call briefings provided by international humanitarian aid organizations is one way to attain accurate situation assessments, identify collaboration partners and determine if and when to respond.
      Resources – 6.1 Appropriate Donation Practices in Emergency Situations
      Drug Donations in Post Disaster Situation (PDF) Resource: Case Study This resource is a case study on a post disaster situation in East Timor, El Salvador and India. It contains a situation analysis that applies guidelines from the Interagency Guidelines for Drug Donations. It was published in 2002.
      Source: Health, Nutrition and Population, The World Bank. Available at: http://apps.who.int/medicinedocs/en/m/abstract/Js17063e/. Accessed on 9/3/13.
      Drug Donations in Emergency Situations, The Sri Lankan Post-Tsunami Experience Resource Type: Case Study This resource, published by Tufts University – Journal of Humanitarian Assistance, in 2007 is a case study of the post-tsunami experience in Sri Lanka. Sections includes, Direct Costs of Unsolicited Donations, Types of Improper Donations, Indirect Costs of Unsolicited Donations, among others.
      Source: Tufts University – The Journal of Humanitarian Assistance. Available at: http://sites.tufts.edu/jha/archives/54. Accessed on 9/3/13.
      Handbook for RCs and HCs on Emergency Preparedness and Response Resource Type: Handbook This resource contains information on adequate response capacity, humanitarian coordination, needs assessment and, multi-agency response.
      Source: Inter-Agency Standing Committee, Handbook for RCs and HCs on Emergency Preparedness and Response. Available at: www.humanitarianinfo.org/iasc/downloaddoc.aspx?docID=5568&type=any. Accessed at: 9/17/13.
      Checklist for Effective Disaster Response: Insights for Wise Humanitarian Action Resource Type: Checklist This checklist was created to help aid organizations determine what an appropriate response is during a disaster situation.
      Source: Grantmakers in the Arts: Supporting a Creative America. Checklist for Effective Disaster Response: Insights for Wise Humanitarian Action. Available at: http://www.giarts.org/sites/default/files/checklist-for-effective-disaster-response.pdf. Accessed on: 9/20/13.

      Top 6.1.2 General – Short Dated Products
        During a disaster product donations should be held to the same quality standards as in non-disaster situations.  Products must be used prior to the expiry date.
        6.1.2.1 MSROs should document requests for short dated product including who is requesting the product, why it is requested, how it will be transported and used prior to the expiration date. 

        Guidance: There are times that short dated products or products not approved in recipient country are donated during a crisis and can be used safely.  This is because the products are often airlifted and used immediately or within a very short period of time.   For example medical teams hand carried products and larger airlifts arrive in days as opposed to the months long ocean freight process. However, short dated or other donations exceptions should never be made without being specifically requested by those responding to the disaster and after confirming their capacity to use the products safely.  Once approved products should be processed and packaged in the same manner as non-emergency shipments and sent by the most expeditious means available.
        Resources – 6.2 Quality Standards in Disaster Donations
        PQMD Principles and Standards Resource Type: Reference This resource includes a set of medical product donation guidelines that are helpful in identifying quality measures in emergency situations. The PQMD Principles and Standards serve to inform and guide medical donation practices while allowing for the flexibility needed to operate in diverse operating environments around the world. See Standard 5.6.
        Source: Partnership for Quality Medical Donations – PQMD Principles and Standards for Medical Product Donations. Available at: http://www.pqmd.org/index.php?option=com_content&view=article&catid=26:what-we-do&id=44:pqmd-principals-and-standards. Accessed on 9/5/13.
        WHO Guidelines for Medicine Donations (PDF)  Resource Type: Reference This WHO resource provides a set of recommended guidelines for general medicine donation with specific areas focused on donations in emergency situations.
        Source: World Health Organization. Available at: http://whqlibdoc.who.int/publications/2011/9789241501989_eng.pdf. Accessed on 9/5/2013.

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        6.2 Donations in Emergency Situations – Consumables

        6.2.1 Consumables – Emergency Needs Assessment
          Emergency consumable product donations should only be made based on an expressed need, at the request of the in-country partner and after a thorough needs assessment confirms that the donation is also appropriate for the event. In addition to the general and specific product donations standards, the following factors should be considered when determining whether or not to donate during a disaster.
          6.2.1.1 Approved products should be processed and packaged in the same manner as non-emergency shipments. 6.2.1.2 Approved shipments should be sent by the most expeditious means available.

          Guidance: Proper packaging is especially important in an emergency operating environment where it can be difficult to protect the products from heat, water and other environmental challenges.
          Resources – 6.2.1 Verification of Need
          Disaster Emergency Needs Assessment: Disaster Preparedness Training Programme Resource Type: Research Study This resource, provided by the International Federation of the Red Cross and Red Crescent Societies includes resources on disaster needs assessment, disaster needs assessment reporting, emergency response based on emergency assessments, and assessment tools including checklists, gap identification charts, and questionnaires.
          Source: International Federation of Red Cross and Red Crescent Societies. Disaster Emergency Needs Assessment: Disaster Preparedness Training Programme. Available at: http://www.parkdatabase.org/files/documents/2000_Disaster-Emergency-Needs-Assessment_Disaster-Preparedness-Training-Programme_IFRC.pdf. Accessed on: 9/17/13.
          WHO Technical Guidelines – Emergency Management Essentials Report Type: Website This resource contains links to helpful information on emergency situation needs assessment and effective response mobilization. Resources includes, myths and realities, natural disaster profiles, standards health kit descriptions, and several other
          Source: World Health Organization, Humanitarian Health Action. Available at: http://www.who.int/hac/techguidance/ems/en/. Accessed on 9/17/13.

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          6.3 Donations in Emergency Situations – Medical Equipment

            6.3.1 Medical Equipment – Emergency Needs Assessment 
              Emergency medical equipment donations should only be made based on an expressed need, at the request of the in-country partner and after a thorough needs assessment confirms that the donation is also appropriate for the event. In addition to the general and specific product donations standards, the following factors should be considered when determining whether or not to donate during a disaster.
              6.3.1.1 Approved products should be processed and packaged in the same manner as non-emergency shipments. 6.3.1.2 Approved shipments should be sent by the most expeditious means available.

              Guidance: As a general rule medical equipment should not be donated in emergency situations, unless it is established that the equipment will be used after the disaster.  Items should not be donated that have not been specifically requested and medical equipment should not be donated if the recipient has not demonstrated that they have the needed capacity and training to handle the item correctly.  The exception to this is any equipment listed in the guide published by the United Nations entitled Emergency Relief Items: Compendium of Generic Specifications, Volume 2.
              Resources – 6.3.1 Proper Medical Equipment Donation During a Disaster
              Emergency Relief Items: Compendium of Basic Specifications Vol. 2 Resource Type: Report This document was created by the World Health Organization in 1999. It outlines basic specifications on emergency relief items. It includes information on catheters, tubes, drains, dressings, injectable and medical supplies, linens, medical equipment, sterilization, surgical equipment, x-ray material, laboratory equipment, sutures and surgical needles, anesthesia, contraceptives, and selected essential drugs during a disaster.The World Health Organization. Emergency Relief items; Compendium of Basic Specifications 1999.
              Source: The World Health Organization. Emergency Relief items; Compendium of Basic Specifications 1999. Available at: https://www.ungm.org/Publications/Documents/erc_vol2.pdf. Accessed on: 9/17/13.
              Medical Supplies Donated to Disaster Areas Often Unsuitable Resource Type: Article This article was published by World Watch Institute and discusses the problems with most medical equipment donations made during a disaster. This is an excellent resource for anyone wishing to learn more about why medical equipment should not be donated in disaster situations.
              Source: World Watch Institute. Medical Supplies Donated to Disaster Areas Often Unsuitable. 2013. Available at: http://www.worldwatch.org/node/4593. Accessed on: 9/17/13.
              Medical Equipment Donations in Haiti: Flaws in the Donation Process Resource Type: Research Paper This research paper details the findings of a study conducted by Project HOPE after the 2010 earthquake in Haiti. The study found that only 28% of the donated medical equipment was working properly. The study also outlines the reasons why donated medical equipment is frequently unsuitable in post disaster settings.
              Source: Dzwonczyk R, Riha C. Medical equipment donation in Haiti: flaws in the donation process. Rev Panam Salud Publica vol. 31 n.4 Washington Apr. 2012. Available at: http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892012000400012. Accessed on: 9/17/13.

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              6.4 Donations in Emergency Situations – Pharmaceuticals

              6.4.1 Pharmaceuticals – Emergency Needs Assessment During a disaster pharmaceutical product donations should be held to the same quality standards as in non-disaster situations.  Products must be used prior to the expiry date. In addition to the general and specific product donations standards, the following factors should be considered when determining whether or not to donate during a disaster.
              6.4.1.1 MSROs should document requests for short dated pharmaceutical products including who is requesting the product, why it is requested, how it will be transported and used prior to the expiration date. 

              Guidance: Having established processes in place in the recipient country will speed needs assessment and logistic operations during an emergency.  If the organization can’t do the assessment in country or work with a existing trusted partner, then pharmaceutical donations should not be made.
              Resources – 6.4.1 Pharmaceutical Logistics in Emergency Situations
              PQMD Principles and Guidelines Resource Type: Guidelines This resource provides general guidelines for medical product donations, specifically pharmaceuticals. It includes details and guidelines on expeditious transportation
              Source: Partnership for Quality Medical Donations. Available at: http://www.pqmd.org/index.php?option=com_content&view=article&catid=26:what-we-do&id=44:pqmd-principals-and-standards. Accessed on: 9/17/13.
              Mission Possible – Customs Clearance Resource Type: Video This resource provides an informative video on the customs clearance process and ways to safely expedite the process.
              Source: Partnership for Quality Medical Donations. Available at: http://www.pqmd.org/index.php?option=com_content&view=article&catid=26:what-we-do&id=48:mission-possible#customs. Accessed on 9/17/13.
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