Daily reports from the WHO-PDA Pharmaceutical Cold Chain Management on Wheels Learning Experience

 

DAY ONE:

ISTANBUL –

 

            Turkey is a land of extraordinay dichotomy. Among other things it is claustrophobic and sprawling; subtle yet dramatic; secularly conservative though socially progressive. It is an effusive blend of cultures, food and peoples. It is where east meets west. The country boasts of its beaches comprised of four different seas and shares borders with eight countries. The ancient city of Istanbul has been inhabited for at least 8,000 years and occupies two continents (Europe on the west, Asia on the east), equally separated by a narrow strait called the Bosporus. It is here we begin our journey down the pharmaceutical supply chain.

 

     Midnight in Istanbul

 

 

The Pharmaceutical Cold Chain Management on Wheels Course (PCCMoW) is a meticulously organized six day event – the brainchild of Dr. Umit Kartoglu of the World Health Organization, and held in conjunction with the Parenteral Drug Association and Tip Kurumu (a Turkish health NGO). We are 25 in number representing 16 different countries. We are course mentors, participants and industry observers – but it soon becomes obvious that we will soon become one big family.

            To begin the course we were each issued laptop shoulder bags crammed full of materials we will need for this unusual learning experience: notebooks, pens, pencils, markers, post-it’s, tape, scissors, a calculator, a blank CD – (even a disposable raincoat!) and a personalized red binder that contains nearly every conceivable fact related to our journey; from detailed information of the places we will visit, to explanations about local geography and culture.

            The morning began energetically at the Nippon Hotel in Istanbul with a uniquely devised introduction exercise. Everyone was handed a stringed bracelet of beads. There were 12 matching pairs. Participants had to seek out the individual with the identical bracelet and “interview” them - gather personal information unrelated to the course. We reassembled and name badges were drawn from a silver tray. Who ever interviewed the person whose name badge was drawn had to introduce them to the group by revealing the details of their interview. This set the tone that was to remain throughout the day. The rest of the morning was dedicated to a course overview and the week’s agenda and culminated with a group exercise called the “Pharmaceutical Transport Challenge” whereby five randomly selected teams (with little or no knowledge of insulated package design) had to develop, design and assemble a passive insulated shipping package from one of 5 different packaging technologies. Their designs had to be capable of maintaining 50 vials of vaccine within a refrigerated temperature range of 2-8°C for 72 hours during a simulated distribution process (stowed in the hold of our bus for 3 days). Internal package and external ambient temperatures would be recorded using electronic data loggers and milk chocolate (the significance of which will be revealed later in the week.). The temperature data would be downloaded onto a laptop computer for analysis at the conclusion of the exercise.

            The purpose of this activity is to introduce participants to various insulated packaging material technologies, passive refrigerants and temperature conditioning in order to understand their various applications and limits. Through simulation, participants would discover performance variations of these materials when subjected to identical transport environments. At the end of the exercise on Thursday we will discuss the results and the economic and environmental considerations of material selection.

 

Bruce McCormick, Apichai Supasansatorn, and Roger

Sabat working on the Pharmaceutical Transport Challenge 

 

            After lunch we loaded the 5 insulated shippers for the challenge into the belly of the bus and drove though the pouring rain to a DHL warehousing facility 28 km west of Istanbul. The folks at DHL could not have been more gracious. No question went unanswered; no area was off-limits. It was amazing to see the thoroughness and precision of their cold chain operations for pharma customers. A Novo-Nordisk pharmacist, the responsible person for release of product at the facility, took us through the step-by-step procedures for customs quarantine, receipt, storage, pick-list, and dispatch of product for distribution throughout Turkey.

 

Pick-pack process at DHL Istanbul. L to R in orange

vests: Jeff  Hawkins, Paulo Froes, Jose Rovira-Vilaplana,

Joseph Jayakar

 

            When we returned to the city center we walked (still raining) to a nearby restaurant where in the wine cellar-turned-make-shift conference room, participants prepared and presented their findings and observations from our visit to DHL.

 

 

   Standing: Alex de Beaupuy and Rafik Bishara delivering a group peresntation

              

A group dinner and a few adult beverages later, and everyone was ready to call it a night. A good night’s rest well deserved. All-in-all, a very satisfying start to the program. It’s back on the bus tomorrow at 8:00 AM as we head to Farmalojistik and on to Cumalikizik, a preserved 11th century Ottoman village.

 

It's nearly 3:00 AM here in Turkey so I'll bid you all a good night and hope to update you tomorrow.