Acting Pharmacy Director

I have felt important for the last few days. Anne-the field nurse—has been away since Saturday, leaving me in charge of the pharmacy. Managing the pharmacy is a big part of all MSF projects. Every project is different, but most require: hundreds of pharmaceuticals, ready to use foods, IV fluids, needles, cannulas and plastic tubing, gloves and sterile dressing materials, laboratory reagents and tests, vaccines, and all the other equipment necessary to run a medical ward. Storage and management of the equipment is more complicated than it looks; it involves inventory, meticulous organization of materials, quarterly domestic and international orders, and temperature control. Our project requires importation and storage of liposomal amphoteracin B, which requires strict cold chain from the factory in the UK to the patient’s bedside.

I have never managed a pharmacy before. Even though it was only for three days, and I did not have to order or take inventory, I was still nervous when the hospital nurses told me they needed IV infusion sets, mosquito nets, dressing materials, and sterile water for injections. Which bottles are those? Do you need the size in the red package or the size in the blue package or the size in the green package? Are they in the room with the medicines or the room with the tubing or the room with the dressings? How many come in a bag? How many bags in each box? What's the difference between a lot number and a batch number. Where do I record the expiry date?

I also had to send the Ambisome to the hospital each day in cold chain. I’m proud to say that I mastered this without too much difficulty. All I had to do was ask the nurses how many patients were due for infusions that day, then estimate the number of vials per each patient. I checked the thermometer on the pharmacy refrigerator, packed the vials in coolers lined with ice packs and insulation, and noted down how many vials I sent out each morning and got back each evening.