Today is Wednesday, 3 August. Every Wednesday we have the Ostomy and cancer pain relieve Clinic.
It is a special day because we received Waldschrat's shipment of Ostomy products few days ago, and we hand them to the patients today. It was a good help to those who receive them, thanks to Waldschrat.
Four patients with Ostomy received complete set of Rings and Pouches supply for one month. In addition to some accessories as sterile cleaning swaps and soothing ointments.
Another two patients received Rings only plus the accessories.
We took some pictures to the patients while receiving the supplies. The pictures still in the Camera, I will post them as soon as it will be available to me (the Camera is not mine).
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I have an answer, but it's not a good one.
I was able to track down a high level aid organization person (who I will not name). He said that no one was touching pharmaceutical shipments because Kimadia was the final authority on distrubtion of drugs. It's illegal to import any pharmeceuticals without approving it through Kimadia. Kimadia will not accept drugs from any European countries, and probably not America either. They take approx 6 months to verify "drug quality." When the CPA was in charge, they were able to expedite some pharmaceuticals, but since they left, nothing has gone through. While they were there, they caught a bunch of extremely corrupt officals who they fired, and replaced. The agency became corrupt again, and is due for another replacemen of staff in 4 months, also probably corrupt.
The only way to route drugs is to make contact directly with the Ministry of Health, then they will refer you to your contact at Kimadia, who will establish paperwork to allow you to import (subject to inspections). That's the only legal way to do it.
Illegally, many doctors have been flying out of the country and stuffing their briefcases full of drugs and bringing them home. If they are caught, the drugs will be confiscated at minimum. The other solution that works is to illegally drop ship to an airport, or seaport, or other transport and hope it doesn't get searched on the way. You would not be able to ship drugs from america this way, as it would be illegal and you would probably go to jail.
You could ship from another middle eastern country (probably Jordan or Turkey), although, as an American, there is some issue about the legality of purchasing drugs in a foreign country and shipping them to another foreign country.
Referigerated shipping will cost at least $5000, with no guarantees that your shipper will not get killed in route, or will steal the drugs himself, and sell them on the street.
The least risky option is to air ship it to an airport in Iraq and have a trusted individual there pick it up at the airport to deliver it directly to the hospital. Again, this is illegal.
The individual I spoke to said that Iraq is the worst country they have ever worked in, in terms of corruption. They've always been able to use the resources of a trusted aid organization to handle and disseminate shipments, but that option has been definitely closed to them in Iraq. The recommendation to me was to concentrate on other ways to help the hospital.
In terms of forward progress on this issue, the first step has to be concentrating our efforts on the reform of Kimadia, and making the drug procurement and distrubution process a transparent one. As anyone wo has worked in bureacracy in America knows, this is a tall order.
However, the stark truth is that people are dying. People who would have lived with medicine (not just here, but in any hospital) are now going to die.
So it's a battle worth fighting.
It is possible that we can find a way to ship drugs through military channels, but they are required to get the okay from the Ministry of Health and Kimadia. So it is unlikely that this will change the outcome much.
Truthteller,
I am so, so sorry. I definitely understand now why you feel so helpless. I am feeling helpless myself. But the first roadblock in our way is people. People are just people. We just have to find a way to reform the system, that's all. (Ha! Ha!) It won't change unless we work to make it change. Now.... how to do that?
Any thoughts from anyone here?
"Any thoughts from anyone here?"
Elect someone you can trust to work from within the government to effect change. This, of course, would be something TT would have to try.
In the meantime try and ship through military channels and get them to ride herd on the MOH. They may still have some pull.
This person said they are in charge of more than 15 million worth of aid shipments and have high level contacts in our government and Iraq's, and they view the importation of pharmeceuticals in Iraq to be impossible.
our army would be required to get clearance from the MOH before accepting or distributing drugs.
Still... we can slog ahead. We have to get a contact at the MOH as the first order of business. That person will have to give us the appropriate paperwork to import drugs.
However... I worry about bringing too much attention to Truthteller's hospital. There are bad people in Kimadia and the MOH. Do I want them to be paying attention to Truthteller?
Non-drug shipments, in any case, are not subject to this inspection, so we can continue to direct ship those.
I contacted the head of drug procurment at the Iraq Ministry of Health. Again, I am concerned for the safety of truthteller and his hospital, so all I said was that I was interested in donating pharmaceuticals to a hospital in Iraq, and wanted to direct ship to the hospital. We'll see how long it takes to get a reply.
I agree that you should take all steps to protect TT, his Identity, and the Blogs integrity. What good would it do if we send all the Drugs in the world but someone takes TT away?
I hope folks will now consider chipping in on this project. It seems to be possible to get stuff to Mosul. The first shipment went via FedEx and shipping was pretty high, $147 for an 8-pound package. The advantage of FedEx is usually that it is very fast, but apparently that does not apply when stuff is shipped to Iraq. FedEx can move a package from San Francisco to New York in 24 hours but it took them about 3 weeks to deliver to Mosul!
I plan to try further shipments of ostomy supplies via air mail parcel post using the regular post office shipping. The shipping charges on the first shipment via FedEx were quite high, $147 for a package weighing 8 pounds. According to the post office, shipping charges via air parcel post would be roughly $50 for a package the same size. Regular parcel post would be less, but slower. FedEx has a very good understanding of customs formalities, so customs problems which did not impede the first shipment might complicate shipments via parcel post. Only testing these alternate methods of shipment will prove whether they are safe and useful. FedEx definitely works, even if it is expensive.
Chemotherapy drugs are a more difficult problem, but I think I have found a solution for that - again, it remains to be tested. I gave my credit card info today to a company which will try shipping some chemo drugs to Mosul via FedEx. Part of the order will originate in the US and part will be shipped from Europe (probably Germany) because prices were better there. The main hurdles will be getting the stuff there in Iraq's summer heat without serious deterioration and bypassing the Kimadia monopoly. The drugs that ened it will be shipped in insulated containers packed with ice and FedEx has provided preliminary assurances that it will refrigerate them while they are at "stopping points" in Dubai and Baghdad. The ostomy supplies spent a week in Dubai and a week in Baghdad, apparently waiting for a plane or truck at each location.
I have been totally unable to get any response to my emails to Kimadia. I have no phone number for any person in their organization. My contact in Mosul indicates that he is in communication with Kimadia's Mosul office. I think it is best to let the doctors in Mosul negotiate with Kimadia - referring to the hospital or even to Mosul in a communication to Kimadia could have dangerous consequences if they are corrupt and defensive, and if they are not then the best people to explain Mosul's needs are the doctors of Mosul. I am told that in the years before the first Gulf war the hospitals of Iraq were well-served by Kimadia. I hope Kimadia will again become a praiseworthy servant to the people of Iraq in the future. At this time it seems that Kimadia is unable to properly serve Iraq and unable or unwilling to communicate with those who would like to help.
Thank you, Truth Teller, for the report of my small gift's arrival in Mosul. I know it is tiny in proportion to Mosul's needs. We can only hope that the story of it will encourage others to contribute likewise.
For those who would like to contribute ostomy care supplies themselves, I remind all that this first shipment was arranged through ostomycaresupply.com and my contact there was Cynthia Hacherl. In the US she can be reached toll free at (866)207-5909. The online ordering system at ostomycaresupply.com won't work properly for shipments to Iraq so you will need to phone Cynthia to make the arrangements.
An alternative is to contact Friends Of Ostomates Worldwide (USA), an organization which I believe needs some help with shipping costs for ostomy supplies they have collected and want to send to Mosul.
I wish to remind truth teller that I selected the supplies I sent using the best judgement I could apply but I am largely ignorant of the intricacies of how these products are used and which sorts are best suited to Mosul's patients. I believe thare are different requirements for post-surgical care, for instance. Any feedback on the appropriateness of what was sent and what is needed in the future will be helpful.
I should mention that while the package of ostomy supplies which left for Mosul weighed 8 pounds the stuff I ordered only weighed about 3 pounds. I was initially confused by this but Cynthia Hacherl informed me that they used more supplies as PACKING MATERIAL, stuffing in useful items until the box was full and would not rattle!!!
I have seen the pictures that were taken and given them to FOW-USA as evidence that the ostomy supplies that were recieved were properly delivered. I recommend that the pictures of the recipients NOT be published on the internet in order to preserve their privacy and security. Pictures of the carton and it's contents might be interesting to the public and would not compromise the privacy of the patients.
Contacted the FOW people to see if I could donate. Here's their contact info if any of the rest of you would like to help: info@fowusa.org
Thanks again Walschrat.
Truth Teller, I am a nurse in Canada and would like to help with some of the supply issues. What sort of ostomy supplies are needed, ie,sizes,etc. Do you need bandage supplies at all. I am a visiting nurse and carry all kinds of supplies. I'm not sure if intravenous needles could be shipped but I'm sure you would need those too. I was thinking I could contact some of the ostomy suppliers and perhaps they would be willing to donate.
A shipment of procarbazine (100 capsules) reached the hospital in Mosul on August 21 via FedEx and part of the shipment was immediately transferred to a patient with urgent need. This shipment was pretty exciting - ordered in California, arranged in Minnesota by the pharmacy, actually shipped by a German source who offered a bargain price (more bang for the buck!), it arrived in Baghdad with a typo in the address which had to be corrected on the fly over the telephone and then hit roadblocks north of Baghdad twice and got turned back before finally making it through to Mosul. One heck of a bank shot, but it worked and the stuff reached the hospital!
I am worried about Truth Teller. Neither he nor his family has posted in quite a while now!
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