1. Challenges
1.1. Transportation
1.1.1. Sending goods from PGH to these places over seas
1.1.1.1. Cheapest by boat
1.1.1.1.1. 3-months from PGH to Zimbabwea
1.1.1.1.2. Usually don't have well developed infrastructure
1.1.1.1.3. Bad roads
1.1.2. Poor/bumpy roads
1.1.3. Rainy season
1.1.4. Cost of transportation is high
1.1.4.1. Size/Weight
1.1.4.1.1. Assembled in country
1.1.4.1.2. Things that can ship/pack well
1.1.4.2. Biggest part of budget is shipping
1.2. Maintenance
1.2.1. Item arrives safely but has been shaking/on boat for 3 months
1.2.1.1. Needs initial maintenance
1.2.2. Brain Drain
1.2.2.1. Doctors/Nurses leave to go towards higher salaries
1.2.3. Usually the guy who's fixing the truck/motorcycle when it breaks down
1.2.4. Availability of parts
1.2.4.1. Fuses - took 2 weeks to get there and shut down the entire hospital
1.2.4.2. If it needs parts/replacements not easy to find
1.2.4.3. Gloves are highest demanded item
1.2.4.3.1. Washing single use gloves
1.3. Access
1.3.1. Electricity
1.3.1.1. Voltage
1.3.1.1.1. 220/240v
1.3.1.1.2. 110v
1.3.1.1.3. Som have both
1.3.1.2. All hospitals experience 6/8/12 hours of blackouts
1.3.1.2.1. Some only have generators
1.3.1.2.2. Don't have regular electricty
1.3.1.3. Aim towards non-electrical items
1.3.2. Layout of Hospital
1.3.2.1. Most were started as mission/private hospitals
1.3.2.1.1. Small outposts that grew
1.3.2.1.2. Lots of small buildings where you have to go in and outside
1.3.3. Central O2, Suction, Electricity
1.3.3.1. Typically not wired with central O2 or Suction
1.3.3.1.1. Usually have to go refill big tank
1.4. Challenge of good Intentions of Donors
1.4.1. Working with hospitals to make sure we're not duplicating efforts
1.4.2. Making sure it's through a group that can
2. Pittsburgh
2.1. Education Program
2.1.1. 2nd in books to US govt
2.2. Medical Devices
2.2.1. Make sure we don't end up in bad articles like you read
2.3. 15-16 employees in it's office with 2 warehouses
3. Medical Equipment
3.1. In US
3.1.1. Safe/Controlled Environment
3.1.2. Most are designed like this
3.2. Abroad
3.2.1. Not as clean
3.2.2. More like a closet with dirt/dust/animals
3.3. Understand where it's going
3.3.1. Mostly donated equipment
3.3.2. Purchasing critical medical devices
3.3.2.1. Surgical Tables
3.3.2.2. Birthing Tables
3.3.2.3. Suction Machines
4. Designing Devices
4.1. Locally sourced materials
4.1.1. Beds with brackets but use bamboo to hold the loads
4.1.2. Things that can be built on site in a simple manner