pharmacy establishment in maiduguri,...

1 Action Against Hunger USA Case Study: Establishing a Pharmacy

ACTION AGAINST HUNGER CASE STUDY:

PHARMACY ESTABLISHMENT IN

MAIDUGURI, NIGERIA

By Iryna Lukyanova, Warehouse Manager

At the beginning of my mission in Maiduguri, Nigeria, one of my objectives and one of the

most important projects was to set up and organize the pharmacy.

I was very excited to start the project but had a very limited time. I joined the base in

Maiduguri on June 13th, 2017 and on 7th of August 2017 the medicines arrived. I

immediately started to search for the location where we will set up our pharmacy. The

Logistics Manager and I visited one premise which was offered by the Ministry of Health

free of charge until December which was:

- far away from the office (40 minutes’ drive)

- with no facilities (washing room, for example)

- With no equipment (shelves, A/Cs, appropriate generator)

- With no ceiling and unpainted

Of course, it was a cheap choice, but the experience shows that the cheap choices usually

do not work. After careful consideration, we concluded that:

Initial condition of Ministry of Health Warehouse

If the pharmacy building is far away it will make it very difficult to:

✓ control the temperature during the weekends;

✓ communicate between the program staff and pharmacy supervisor.

The program staff must travel further to get their supplies and usually

they do not have the time as medicines must be distributed starting

early in the morning.


The best place to establish the pharmacy, which I have noticed from

my previous experience establishing the pharmacy in South Sudan,

is within the office compound or guest house. Or, if you do not

have this opportunity, try to find the premise next to your office or

guests house.

Abraham Lincoln said: “Give me six hours to chop down a tree and I

will spend the first four hours sharpening the axe”. We did not have

these four hours to sharpen our axes and began our preparation

immediately.

Luckily, we had a quite large warehouse - 129.81 square meters - within our

office compound and, after calculating the volume of the supplies with our

Logistics Coordinator, it was clear that this space would be enough to

accommodate the shipment (2 trucks, 20 tons) and even leave space for an

additional shipment.

So, after getting the approval and support from our Field Coordinator, we literally started from

scratch. Our identified premise contained many items in a disorganized way, but we cleaned

it and all the items were moved to the new warehouse off-site that we had secured.

Some “scary” photos of the beginning are below, but as you know, to begin something is

always scary:

“The best place to establish

a pharmacy… is within the

office compound or guest

house. Or…try to find a

location next to your office

or guest house.”

Always calculate

your expected

volume before

selecting a space.


Progress after moving, cleaning, and installing the ceiling.

After moving the items for 2 days, we finished and washed the warehouse

with Dettol, water and soap.

Let me also point out that although the items were still in the warehouse,

we managed to install a ceiling. Previously, there was no ceiling, only

zinc. We also reinforced the doors to assure the heat will not influence

on the temperature inside the pharmacy.

Then step 2 began: connection of the generator and painting.

We also got lucky with the generator as we had the old one at the guest house, which we

moved to the office. This old generator worked as our temporary solution while we were

waiting for the bigger generator to reach our base which will support 4 A/Cs (2 at the

daytime, 2 at night). So, the working hours of the generator was decided to

be as follows:

- during the office hours – our office generator will support 2

A/Cs (daytime);

- during the night - our old generator from the guest house will

support 1 A/C

Painting the new pharmacy space was the easiest part as I got the support

from the Field Coordinator and the owner of our office building and everything was done

within one weekend.

Let me add an important fact:

Reinforced doors

and double

sealing help

regulate internal

temperatures

Understand and

establish your

cooling needs

before purchasing

equipment.

The pharmacy must be painted with a light colored, enamel paint inside and outside

(2 or 3 layers, depending on the weather condition of each country) to minimize the

attraction of the sunlight and ensure pharmacy will look clean and tidy.

Always clean

and sanitize

a new space

as your first

step


Ceiling Outside Doors Wall

Strong metallic shelves

After finding the appropriate shelves online I showed the presmises to three suppliers and received quotes from each before ordering

14 shelves

Standing A/Cs

Four powerful units were ordered after considering the heat and our cooling needs

Metallic Ladder

One ladder was ordered to allow staff

access to the upper shelves

While doing the renovation and reinforcement works we did not forget to order the

necessary equipment for the pharmacy:

Panasonic,

Model CS-

C18MFH 240-

220 L


Oluwamayowa Adeoye and Iryna Lukyanova after offloading

The day the shipment of medicine arrived, Monday, 7th of August 2017, we were fully

prepared to accept the shipment together with Oluwamayowa Adeoye, our Pharmacy

Supervisor, whose first day at work commenced with assisting me in coordinating and

managing the offloading of the medicines.

And here we are together: tired, but happy with the result of our team work. As Hellen Keller

famously said, "Alone we can do so little, together we can do so much."… even to offload

two 20 ton trucks within 1 day!

The next day after offloading we:

✓ Organized the drug stock in accordance to:

o Alphabetic order;

o Pharmacological purposes;

✓ Created aisles between the walls and pallets for easy access to

the drugs;

✓ Placed the Bin Cards and prepared the Stock Cards in

accordance to AAH regulations.

o We are using the simplified Bin Card as it

eliminates the double work of writing the balance

on the Bin Card and Stock Card. Plus, we are

writing the budget code on the top of each bin card.

✓ We created the report of what was received and sent to Abuja

to settle the payment with the supplier;

✓ We created a separate Stock Follow Up for the pharmacy which Mayowa

(Pharmacist) will update after each dispatch of the drugs to the programs.

✓ We created folders to store and organize SROs/Delivery Notes and Stock Cards

Note: There is no space

provided on the stock

card for the budget code,

however it is

recommended to have it

in case the same product

falls under two different

grants


We also brought the table, chair and shelf where our Pharmacy Supervisor

keeps: o Stock cards;

o Folders with SROs and delivery notes, stock cards;

o Temperature and humidity card

o Stationaries;

o Some pallets for the future shipments

Next, we installed the simple temperature control device to control the temperature

and humidity inside the pharmacy. We use the temperature and humidity card

from the KitLog and take the data every day in the morning, daytime and evening.

Finally, we established a cleaning schedule two times per week to keep the pharmacy clean,

tidy, and organized.

Don’t forget

to set up a

work space

for staff

LCD Digital

Temperature

Humidity Meter

Thermometer HTC-

2

KitLog --> Supply

Chain -->

Storage -->

Standard Tools


I hope that this case study will assist somebody somewhere in the world in need to setting

up a pharmacy in a short time frame. I would encourage everyone to set their goals high

and work towards them every day. Anything is possible – keep working hard with your team

and follow your dreams.

Key Challenges: • Finding the appropriate location for a pharmacy

• Limited time frame to set up pharmacy

Success Factors: • Strong communication and support from Logistics Coordinator

• Planning, communicating ideas clearly, and sharing a vision as a team

• Support from Field Coordinator

• Timely arrival of pharmacist and working closely with the Health team

Iryna Lukyanova Oluwamayowa Adeoye

pharmacy establishment in maiduguri,...

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