CHAPEL HILL -- Dr. Georgine Lamvu-Schooler grew up spending time with her mother, a nurse, in hospitals in her native Romania and in other developing nations. She knows how few supplies some medical facilities have to work with.
That's why the already-busy third-year obstetrics and gynecology resident at the University of North Carolina at Chapel Hill volunteered to lead UNC Hospitals' first efforts to ship medical supplies and equipment that won't be used here to clinics in poor countries.
"Both Dr. Jeff Wilkinson, a former fellow at the School of Medicine, and I have traveled to developing countries, where providing medical care is completely different," Lamvu-Schooler said. "Doctors working there have minimal supplies and sometimes patients have to bring their own sutures and medicines. Physicians have to rewash disposable gloves, surgical gowns and gauze. We began to think about recycling some of the supplies that we throw out - things that could be used several times before tossing."
In the United States, re-using such items is considered sub-standard medicine, she said.
"We cannot use them in the interest of optimal surgical management and because of technological change and regulatory requirements," she said. "However, in a developing nation, these supplies could make a real difference and could save lives. We wanted to pack these things up and send them out, so we created a program called MEDWorld (Medical Equipment for the Developing World)."
She took a proposal for the project to the hospital's legal department, then to the infectious disease department and the nursing manager. In the end, it was agreed that the project could proceed if donated items had not touched patients and could not be sterilized and used at the hospital.
Doctors, operating room nurses and volunteers were told what to collect and how to collect it, as well as what needed to be re-sterilized. For the past six months or so, collection bins have been strategically placed around operating rooms. Lamvu-Schooler would like to see bins also in the emergency room, intensive care units and labor and delivery.
What started as a two-person team now has 13 volunteers and six medical student/coordinators. Volunteers pick up the bins, which were donated by Wal-Mart, and bring them to central distribution. There, they sort, inspect, inventory, package, label (with notices that the supplies are clean but not sterile) and send out the donated goods.
Much of the collection is sent to Global Links, a Pittsburgh company that works with ministries of health and the Pan-American Health Association. Global Links collects from 50 hospitals across the United States, sorts, re-sterilizes and sends supplies to more than 30 countries.
"Using Global Links is easy and convenient, and we know our material is sent to established charities, where it's distributed correctly and not sold on the black market or lost," said Lamvu-Schooler, who earned undergraduate and medical degrees at Duke.
The project is growing. The last shipment included 5,400 steel surgical instruments, more than 400 gowns, 250 pairs of surgical gloves, pounds and pounds of gauze, tape, IV tubing, sutures, stapling devices, towels and pacifiers and an old but still usable defibrillator.
As word gets out, many smaller charities are calling, and Lamvu-Schooler personally investigates each and sees that there's a good contact person involved. During a recent visit to Chapel Hill, the deputy prime minister of Moldova, a small country near Romania, suggested to Lamvu-Schooler that the program "adopt" the Little Samaritan Mission in his country. The mission hospital serves only orphans, and it desperately needed supplies.
"We also have residents who have done clinics in other places like Cambodia and Kenya," she said. "We get them supplies and train them in what needs re-sterilization before use. We want to help those who need it and also to build up our own resource base so we can send residents to do clinics in these under-served areas."
Dr. Robert Cefalo, professor of obstetrics and gynecology, praised Lamvu-Schooler for her leadership.
"She works from 60 to 80 hours a week and yet she still has the energy and organization to think of someone else besides herself," he said. "The project stemmed from her participation in the UNC Hospitals' House Staff Council, an organization doing substantial things to bring about effective patient care and improve community health through outreach projects. I'm proud of Georgine and the whole House Staff Council."
Lamvu-Schooler said all the hard work -- by dozens of people within and outside UNC -- has been well worth it. "We wanted to create greater awareness of how much we waste, to decrease waste and disposal costs, to provide supplies where needed and to enable more residents to go overseas to practice medicine with limited resources. It makes you smarter, more creative and more cost-effective."
MEDWorld's goal is to become an integrated part of the hospital.
"There are around 150 programs like this in the United States, so we're playing catch-up," said Lamvu-Schooler, who speaks five languages and visits her extended family in Romania each year. "The pilot was at Yale many years ago so we modeled ourselves after that. I'm hoping that when I leave, someone else will jump in and take over and make a long-term commitment to MEDWorld, UNC hospitals and the charities we supply."
Note: Lamvu-Schooler can be reached through paging at 919-966-4131. For a photo of the physician, call Dan Sears at 919-962-8592. Contact: David Williamson, 919-962-8596.