MedShare

The challenges faced by MedShare illustrate some of the difficulties of humanitarian logistics. Unlike for typical commercial enterprises, it is nearly impossible to plan ahead in any detail. Instead, operations must be simple, flexible, robust, and quickly scalable.

MedShare collects unused or re-usable medical supplies that would otherwise be discarded by hospitals. They then repackage the supplies and advertise them on a web page, from which hospitals in developing countries can order. MedShare relies on donations to pay for its operating costs, but gives the medical supplies free to the recipient.

MedShare has no control or even advance notice over what product arrives into its warehouses. Most is collected regularly from discard bins in regional hospitals, and some is donated by manufacturers. All must be sorted and evaluated to make sure it is usable. (For example, some product is perishable and must have sufficient remaining shelf-life.)

In many ways, receiving is the most important activity in the warehouse. Newly-arriving product must be identified, approved, packaged, and recorded so that it can be made available as quickly as possible to those who need it.

On arrival, product is sorted by volunteers, which means that it is impossible to tell how many workers will be available or when. Since few have any specialized knowledge of medical supplies, they are asked only to choose which of 50 barrels in which to place each item. They are helped in this by a supervisor and by example items mounted above each barrel.

After the initial sort, trained specialists perform a final sort of the contents of each barrel into bins or cartons, which are then sealed and labeled. If there are sufficiently many cartons of a single item, they may be palletized. Then product is moved into the warehouse for storage.

Since there is no way to know how much of any item will be in the warehouse, product is stored in any convenient location. This might mean mixing different types of item on the same pallet. Yes, this can slow order-picking, but that does not matter: Order-fulfillment is necessarily a slow process. MedShare does not ship less than a full 40-foot container and so waits until the customer has chosen enough product. Only then do they book transportation and pick the order.

Transport is typically by truck or rail to the Port of Savannah, for loading aboard a container ship. Most destinations are somewhat remote from the major trade lanes and so it can easily take a few weeks or a month for the container to arrive at its destination. Along the way, it is more subject to most to being “bumped” due to overbooking, because MedShare is a small shipper and always books the cheapest route. Furthermore, being a small shipper, MedShare has no leverage with the transportation companies and so shipping costs are relatively high. In addition, the destination is likely to be remote and unpracticed in receiving containers; therefore the shipping company has incentive to charge extra, to compensate for the lost use of their container while it is inland.

Donated medical supplies These arrive unpredictably, in unpredictable amounts and types, and in unpredictable packaging.	Initial sort of incoming product Product is sorted by volunteers into 50 barrels according to type.	Sorting The workforce is motivated but unpredictable, and can vary from hour to hour.
Barrels for initial sort Note examples of appropriate items posted above each barrel.	Second sort into product Items from the barrels are further sorted into bins by trained personnel.	Boxed for storage After the final sort, product is counted, boxed, and labeled for storage.
Palletization If there are sufficiently many boxes, they are palletized before storage in the warehouse.	Labels Each carton is labeled and entered into inventory.	Pallet rack Most product is stored in cartons on pallets.
Awkward product Some items are bulky, unboxed, and hard to handle.	Mixed pallet in storage To get space efficiency, products must be mixed within the same location, or even on the same pallet.	Piece-picking area Small, important, frequently used items are available to support quick-deploying medical teams.
Loading a container MedShare sends full 40-foot shipping containers.	Ready to depart The container will travel to the Port of Savannah, and from there, by ship, and again truck, to the hospital that requested it.