Far from Midtown

Consulting gig takes Francine Disla Freise out of Brooklyn and into Botswana

As manager of operations for Nexera, a New York-based provider of consulting and project management services, Francine Disla Freise is used to spending time in the field, offering her expertise in process improvement and supply chain management to hospitals. But the trip she made immediately following her presentation at the recent AHRMM conference (see related article) this summer took her quite a ways out of the New York metro area.

The job was in Botswana, where two of the country’s insurance firms – Botswana Public Officers Medical Aid Scheme and PULA Medical Aid Fund – are finishing a state-of-the-art, 200-bed facility in the country’s capital, Gabarone. Freise’s job was to help the hospital source the med/surg supplies it would need prior to opening in late November.

Located near the southern tip of Africa, adjoining South Africa, Botswana was formerly known as Bechuanaland before achieving independence in 1966. Its capital, Gaborone, is at the southern tip of the country, just a few miles from the South African border. The country has been a stable democracy for years, says Freise, who spent a week there. Unlike many other African countries, corruption is minimal. What’s more, Botswana is relatively wealthy, thanks to diamond mining, tourism (safaris) and other industries. “They are a lovely group of people,” she adds.

Botswana has a network of government-sponsored hospitals. But the new facility, Bokamoso Private Hospital, is a private facility. The insurers funded the project in the belief that it would be advantageous and cheaper for their clients to get care in their own country, as opposed to, say, South Africa. The Vanderbilt University School of Nursing at Vanderbilt University Medical Center in Nashville, Tenn., has been providing clinical guidance. Nexera and others have been called in for operational assistance.

Fragmented distribution network
Upon arriving in Africa, Freise first went to South Africa, where she met with various suppliers of med/surg products. (Equipment is being handled by another Nexera consultant.) Unlike that of the United States, the acute-care distribution infrastructure in southern Africa is extremely fragmented. Manufacturers and larger distributors rely on a network of distribution agents, each of whom have the exclusive right to carry their lines in designated countries. The result is that hospitals can’t rely on the one-stop-shop service that U.S. distributors can offer.

Bokamoso will feature high-tech equipment, including the country’s first MRI unit, as well as a variety of sophisticated medical services, including cardiology, neurology and dialysis treatment. It was scheduled to open Nov. 23.

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