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Liberia: "You need to be able to adapt to the context"

29 Aug 2018

Siry Ibrahim is an experienced logistician, administrator and Head of Mission with Médecins Sans Frontières (MSF)—and now, Supply Manager. Recently returned home to Wellington, Siry compares theory and practice supplying MSF projects in Monrovia, Liberia. 

“I arrived in Monrovia just as MSF’s new surgical project was starting in the Liberian capital. It was at a teaching children’s hospital where we already had what we call an IPD (or inpatient department). We were expanding operations to provide elective and emergency surgery for children under 15 years old.

Following on from my predecessor, my role involved modifying and reviewing the medical and non-medical supply chain so that we could accelerate to meet all the needs for this new activity. I had been working for MSF for over five years, but it was my first time in a pure “supply” role. Last year I completed post-graduate study in supply change management and logistics in New Zealand, and I wanted to put my academic knowledge into practice. 

"You want every dollar contributed to support our work to be used and managed in the right way"

When I arrived the new government had just been sworn in, so I took over my position almost the same time as the new president. That immediately added a certain complexity—as is often the case, a new administration means change, so we had to adapt to a new regime. Stakeholder relationships have been an important part of every role that I have taken on in MSF, and supply is no exception.

The theory around optimising supply chains is looking more and more across the whole chain and at the relationships that an organisation has with supply chain stakeholders, both internal and external. In Monrovia I was presented with a great opportunity to further develop and improve MSF’s relationships. By reaching out, we were able to renegotiate contracts and facilitate the release of goods from ports and airports despite the changing faces there.

It’s true that when you study, the methodologies and theories that you learn paint a rosy picture of the systems available to support supply chain management. In practice, you may have to deal with a lot of bureaucracy, corruption, or poorly developed markets. Thus humanitarian supply chain management is not just about applying the theory—you need to be able to adapt to the context, and to understand the limitations and constraints. There is also an opportunity to pass on knowledge to local staff, and to others that you deal with. I managed a team of two, but worked closely with a range of people both in MSF’s Liberian headquarters and in the individual projects.

Talking about context, one constant battle in Monrovia is the traffic! It’s crazy. You can spend the whole day just visiting one supplier for five minutes because the rest is spent out on the congested roads.

Good supply chain management means having life-saving drugs in time to the patient. It means saving donor funds so that MSF can save more lives.

Without a doubt, an efficient supply department contributes to overall efficiency and also to potential reductions in the use of resources. It is good to see that sometimes you can be more efficient and you can save money just by doing things better. Leakage is a hot topic in supply—intentional and unintentional leakage. You want every dollar contributed to support our work to be used and managed in the right way. Of course MSF is a not-for-profit organisation, but at the same time we want to maximise our return on investment.

This is why warehouse management is very important. In Monrovia our warehouse was two large rub halls (tent-like structures) totalling 572m2, three 20-foot containers and a large pharmacy. An MSF warehouse has high turnover, regardless of its size. Unless you know exactly what you have in stock, it is difficult to accurately order new items. Good warehouse management is often overlooked but, when done well, can contribute significantly to cost savings and reduced waste as well as reduced leakage.

Supply has proved to be a nice connecting point for all the roles that I’ve fulfilled in MSF. I started as an administrator, looking at human resources and finance. I moved on to the logistics side and then into field coordination, which broadened my understanding about the organisation and required me to coordinate across all the departments (medical and non-medical, international and local staff). On my last assignment I oversaw multiple projects as head of mission in Afghanistan.

In a supply role, you can see exactly how money is spent in detail, and how this fits with delivering on the medical needs we’re aiming to meet. There are opportunities to critique decisions, and consider where efficiency can be improved; you get to analyse and give advice.

I cannot emphasise enough the importance of good supply chain management for the success of any MSF programme. Good supply chain management means having life-saving drugs in time to the patient. It means saving donor funds so that MSF can save more lives.”