ANNUAL ACTIVITY REPORT

MARCO, Board of Trustees,
May 16, 1998, Dayton, OH

(The following are excerpts from the Director's report on MediShare International to the MARCO Board of Directors, at its 1998 annual meeting in Dayton, Ohio. See story on St. Lukes Hospital below. )

Note: The Bush Hospital Foundation is MediShare's European Division. Its report can be found by clicking: Bush Hospital Foundation

"If you want happiness for an hour, take a nap. If you want happiness for a day, go fishing. If you want happiness for a year, inherit a fortune. If you want happiness for a lifetime, help somebody." - - - - - Chinese Proverb

Three days ago, on Tuesday this week, May 12, 1998, the program now known as MediShare International (MSI) began its tenth year. It evolved out of a Sunday morning, first time contact via amateur, or 'ham', radio ­ a three-way conversation with Mr. Ken Kirk-Bayley, GJ0KKB, on the Island of Jersey in the English Channel, Mr. Kirby Palmer, 9X5KP, in Rwanda, East Africa and Dr. Robert Smithwick, W6JZU, now W6CS, in California. Kirby told his new friends that he was on the staff of a little 'jungle' hospital in Rwanda, the Mugenero Hospital. He explained that the hospital's only sterilizer had failed a few days before and he could not find any materials with which to repair it on site and he suggested that perhaps the two of us might be able to help him find a new or usable gasket or a replacement sterilizer. Only a few hours later, with a sense of urgency Ken talked via radio with a Chicago area 'ham' who, miraculously, even though the company that manufactrured the sterilizer had long ago gone out of business, found a new replacement gasket at his local hospital, flew it immediately to Africa and in three weeks the unit was back in service. In another few days, we found a surplus table-top sterilizer and it, too, was dispatched to the little Mugenero Hospital. This was followed in short order with the donation and installation of a complete X-ray unit and an Ultrasound machine, all donated by contacts of MARCO members.

Growth of this new concept, now known as MediShare, though hardly spectacular, was continuous, and was supported enthusiastically by the MARCO board and members. Shortly thereafter, and building on the initial success of the Mugenero Hospital projects, then MARCO President Dr. Ed Ludin, K2UK, proposed to the Board the development of a program and the creation of a special fund to support it. At that time it consisted primarily of expenses associated with the acceptance, shipping, repair, refurbishing, and placing of medical-dental-hospital equipment donations into pre-qualified institutions. Sadly, Ed Ludin passed away suddenly, and this board at its next meeting, voted to designate this new fund the Ludin Memorial Fund. This remains the financial support of MediShare International-USA. Through succeeding years, a number of non-profit agencies and groups experienced in providing the elements of the program that MediShare and Bush Hospital Foundation are not equipped to manage, agreed to "partner" with MSI to provide these services. (See 'Part A' and 'Part B' of MediShare.)

Concurrent with the creation of MediShare International in America, and by a series of incredible coincidences, Mr. Ken Kirk-Bayley, in Europe, founded the Bush Hospital Foundation.

Acceptance of such equipment and its processing and placement remains the main-stay of the program - or did, until about six months ago. Experience in those earlier years demonstrated that many donors elected to absorb much of the expense involved in equipment processing, therefore the Ludin Fund was not being utilized to a heavy extent and modest reserves accumulated, once the start-up costs of the program were paid.

As we continued to work with our partners and their capabilities, it became clear and surprising to the MSI Committee that funds donated, even in modest amounts, can be leveraged to the point where $1 invested up front, can produce as much as $10 to $20 of equipment and/or supplies as measured against current wholesale prices, delivered to worthy recipients. The exact amount of this leverage factor of any one project depends on the mix of supplies versus equipment, new equipment versus older donated equipment, cost to the partner agency for repair and refurbishing, and the like.

To illustrate, currently in the two recent and major projects, the St. Luke's Hospital project in Kenya, and the Zolochiv Regional Hospital project in Ukraine, we experienced 'leverage' amounting to 12 - 14 x as described above (more detail later).

Equipment is still accepted on a case by case basis, but the use of even modest remaining funds to acquire supplies and equipment donated to partner agencies is much more cost effective. MediShare 'partners' are experienced in the refurbishing and conversion of donated equipment, as needed, and make it available to qualified recipients. Thus, for modest outlay of funds we can assist profoundly some truly urgent medical and hospital projects in countries of great and unlimited need.

Currently, and with the links and information provided in this web site, potential donors of medical equipment, instruments, and supplies are urged to work directly with our Partner Agencies, With information provided by the donor describing the material, the agency will inform them if the proffered medical materiel can be repaired, refurbished and placed, and is thereby acceptable. Just go to the web sites listed under 'Part A Partners' or call using the information provided.

EQUIPMENT OFFERED in 1997-1998

This is only a partial listing of some of the important donations to the MediShare program during the past twelve months: GE X-ray machine, portable X-ray machine, cephalometer X-ray, argon laser equipment, several ultrasound machines and Coulter Counters, a BioDynamic Unimeter, two hematology counters, Corning Electrophoresis Unit, Bechman Glucose Analyzer, Bechman RE2A Na/K Analyzer, Bechman pH meter, several defibrillators, urflowmeter, urethroprofilometer, gas cystometer, sphincter electromyograph, EKG-200, centrifuges, a number of dental units and chairs, dental X-ray machines, etc.

Not all equipment offered can be accepted for a variety of reasons. If equipment has long passed its expected useful life and thereby excessively vulnerable to breakdown, (as shown by records and experience), if spare parts are not available, if the manufacturer is no longer in business or no longer supports it, if repair costs as compared with the cost of new or newer equipment is high - these are all reasons equipment must be carefully screened in advance and accepted on a case by case, piece by piece basis. Even with these precautions, some equipment that has been accepted, was unsuitable or irreparable when examined by a certified medical equipment technician.

A following incident is another example of problems that may interfere with the orderly processing of equipment:

An argon laser was offered by an ophthalmologist. As judged from the description provided, the equipment was in 'good' condition. In fact we were excited about the prospect of receiving it, as we determined that the hospital in Ukraine, for which a shipment was then being prepared, has an ophthalmologist on staff who was eager to get it. However, the donor insisted on a letter of acceptance from MSI and Direct Relief in advance of delivery and inspection, listing the equipment and his own estimated value which was $15,000. It was explained that MSI could not, nor could DRI provide such a letter in advance as requested, but that a letter of acceptance would be provided after the equipment is accepted, inspected and delivered. Additionally, as a non-profit agency we could not provide the donor a figure representing the cost/value of any donated equipment. This information is up to the donor himself/herself to secure. As a non-profit agency it would be improper for us to get into that position. This is a long-standing procedure customarily followed by all such agencies. In this example, the donor would not accept these conditions, therefore the equipment was not accepted.

MAJOR PROJECTS - 1997-98

In addition to the normal flow of donated equipment through the system there have been two major projects undertaken this past year, and continuing as we meet. One is under the initiative and direction of MediShare (EU), the Bush Hospital Foundation, the other is under the direction of MediShare (USA). Both of these projects are described in more detail in links provided on the Home Page.

ST. LUKE's HOSPITAL, KALOLENI, KENYA

This project (to equip a new OB/Surgical wing) will not be described in detail here as it has been well covered in the MARCO Newsletter. It was accepted by Bush Hospital Foundation, MediShare, and Direct Relief International for support only after completion of a comprehensive questionnaire and an on-site visit by MARCO member Dr. Mike Marks (Medical Director, Bush Hospital Foundation) in the Fall of 1997. It was shipped from the West Coast in December, 1997.

E-mail messages received the first of this week from both Ken Kirk-Bayley - in France - and Ms. Kathy Poma of Direct Relief International, of Santa Barbara, CA, stated that "The shipment has arrived at Mombasa and is awaiting clearance on the usual paperwork. Also, a delay may affect the final delivery as extensive floods in the area have taken out many of the roads on the route to St. Luke's. The telephone has been out for weeks. It may well be that the "goodies" have arrived but the hospital is having difficulty in communicating the news to us."

This shipment was evaluated by the standard formula used by government and private agencies which is based on current wholesale catalogue prices. It consisted of nearly two tons of mostly new equipment, and factory-fresh supplies. The value of the shipment is $87,436.42 and the actual cost to MSI-BHF was $6886.00 - a leveraged 'markup' of 12x.

ZOLOCHIV REGIONAL HOSPITAL, KHARKIV OBLAST, UKRAINE

(MARCO member Dr. Alex Gavva, UR4LL, Medical Director)

MediShare -USA's major project was to supply some urgently needed hospital supplies, equipment, pharmaceuticals and instruments to this hospital in North Ukraine. Alex' hospital underwent a similar scrutiny to St. Luke's before the MSI Committee voted to proceed.

A shipment consisted of carefully selected items on a list provided by Dr. Gavva. It left the West Coast for Ukraine, on March 27, 1998, and is scheduled to arrive in Ukraine, via Helsinki, on Friday, May 15. In a recent E-mail Alex told the committee that immigration authorities with whom he has been working, had just informed him that our shipment was the FIRST such humanitarian aid received in that area by the Ukraine Government from the United States. A second E-mail received last week, informed us that the authorities have given final approval for it to be listed as 'humanitarian aid' (not often granted) and therefore is exempt from government import duties.

All expense related to the shipping was paid entirely from a Federal Grant to DRI from U.S.A.I.D.

This shipment is valued at $54,982.00. The actual cost to MSI-US was $3860.00 - a leveraged 'markup' of 14x. It was supported by the Ludin Memorial Fund.

PITCAIRN ISLAND:

I received an e-mail about six weeks ago from Ms. Jennifer Gagne, on the staff of the ARRL (American Radio Relay League). She passed on to me two e-mail messages from 'hams' in separate southern states, messages which berated the ARRL for not 'helping Pitcairn Island to procure urgently needed medical supplies'. The League is not an organization with capability or responsibility to provide humanitarian aid, therefore the requests were passed on to MSI.

I talked only a few minutes ago directly with Betty Christian, VR6YL, on 15 meters - our second recent contact (her husband Tom Christian, VR6TC, is the direct descendent and great, great, grandson of Fletcher Christian, the leader of the Mutiny on the Bounty). Betty told me that she personally talked to the nurse (the island's only medical provider) in the island clinic, who assured her that the clinic had NO need, certainly no "urgent" need, for medical or hospital supplies. Pitcairn Island is a British Protectorate, and the Crown long ago assigned the New Zealand Government, the nearest large British land mass, the responsibility for providing all needed clothes, food, and consumables including medical supplies. The supply ship from New Zealand visits the Island on a scheduled basis every four months.

MEDICAL EQUIPMENT REPAIR PROGRAM:

About two years ago, MediShare supported via a cash donation through International Aid/REAP (a Part A Partner) in Michigan, the establishment of a program to train indigenous people in selected countries, to service and repair the more common electric and electronic medical equipment on site. This obviates the extraordinary expense and necessity of taking failed equipment out of service for months as is required if it has to be returned to the factory for service. Further it teaches useful job skills to qualified young people. Mr. Billy Teninty - whom you met at last year's annual meeting in San Francisco - recently announced that a new program has just started in Ghana and another similar program is already under way in Nairobi, Kenya.

QST STORY - MORE :

As a result of Tom McShane's story on MediShare in Feb. 1997, QST, I have received inquiries from other agencies and groups who in various ways are assisting Third World hospitals. These groups include C.U.R.E., Tecno International, a Cuban group in Miami, and inquiries from individuals or groups in several countries - as Micronesia, Canada, China, Cuba, Russia, Australia, Mexico.

Note:
QST, the monthly magazine of the American Radio Relay League (ARRL), published a multi-page story on MediShare International, in the Feb. 1997,QST issue. The author was Mr. Tom McShane, Amateur Radio NW6P. It traces the history of MediShare in some detail and can be accessed by clicking on: QST This has been a truly remarkable experience for me, capped in one way by the recognition of the ARRL's (American Radio Relay League's) "International Humanitarian Award for 1996". This award was also simultaneously given to Mr. Ken Kirk-Bayley, the founder of our European Partner, the Bush Hospital Foundation. However, the genuine satisfaction has come from knowing that this modest program, participated in by literally scores of you fellow ham-members of MARCO, many other 'hams', and hundreds of interested people, has been able to assist some of the most needy, most deserving, and yes, some of the most appreciative people on this earth.

There have been sad times, and wonderfully happy times.

A turbocharged diesel Land Rover - prior to its conversion to a mobile clinic by BHF- MediShare International. It is now in use in Rwanda, Kenya and Zaire.

I am profoundly saddened to learn of the continuing genocide in the first country MediShare assisted, little Rwanda in East Africa. Many of the small professional staff in that little Mugenero hospital with whom we worked, albeit remotely, have been murdered. But I am gladdened to learn that two Land Rovers which MediShare International-BHF acquired and converted for use as ambulance­mobile clinics still serve in the refugee camps. I am gladdened to learn that a little one-room clinic founded by Bush Hospital Foundation - MSI in Kajire, Kenya about six years ago, now consists of several small buildings, with a permanent medical staff of two, sometimes three nurses and a physician who visits regularly. Then I was exultant when I received on behalf of MARCO the following brief e-mail from Dr. Alex Gavva (Medical Director of the Zolochiv Regional Hospital in Ukraine) not long ago relating to the current shipment he recently received:

I very much hope that the program can continue, even expand. Most conditions for doing this are present assuming this dedicated committee can continue its management and be augmented with interested and committed new volunteers. I will be available to assist a new Chairperson in any transition.

And finally, my profound thanks to the ever dependable MediShare Committee members. Currently they are: Drs. Eldon Snow, WA7RPR, "Bud" Clarke, KE2DT (just retired), Bob Currier, WB5D, Warren Brown, KD4GUA, Bruce Small, KM2L, Jeff Martin, KI0FT, Mark Fink, WA3QWA and our Bush Hospital Foundation members, Mr. Ken Kirk-Bayley, GJ0KKB (now F5VDB), and Dr. Mike Marks (no call yet).

And my great thanks go also to those past committee members and MARCO officers who must not be ignored. So at the profound risk of omitting important names and calls, let me list those I can remember: Then President, Ed Ludin, K2UK (SK), "Bud" Talbott, KC2ZA (SK), Dick Shoupe, W8QP (SK), Alfred Greenwald, WA3CBA, Ed Briner, WA3TVG, Bill Sprague, WA6CRN, Robin Staebler, NN3L, Polycarp Gadegbeku, WB4LPC.

Robert C. Smithwick, D.D.S. Director
Amateur Radio: W6JZU, now W6CS

May 12, 1998