When members of the Jamaican government visited Direct Relief in the fall of 2019, they said something that intrigued the organization’s leaders.

Juliet Holness, a member of Jamaica’s Parliament and the country’s first lady, and Everton W. Anderson, CEO of Jamaica’s National Health Fund, explained that the country “wanted to improve and strengthen cold chain capacity,” recalled Genevieve Bitter, Direct Relief’s director of program operations. (“Cold chain” refers to the equipment and procedures used to safely store and transport temperature-sensitive medications.)

Direct Relief had already supported Puerto Rico’s health centers with 164 refrigerators. Tropical storms posed a serious and ongoing threat to the Caribbean island’s power, and climate change only threatened to make the situation worse. Jamaica, also vulnerable to storms, seemed like a perfect candidate for similar support.

But with one important change: This time, the organization would provide refrigerators with a lower environmental impact, said Gordon Willcock, Direct Relief’s deputy director of emergency response. “We also recognize that global warming is creating more disasters, and creating more vulnerability…We don’t want to create long-term challenges due to contributing more to global warming.”

Refrigeration, Willcock explained, has become an increasingly important part of the medical supply chain. “There are more and more humanitarian cold-chain products,” he said.

Jamaica’s hospitals in particular needed medical-grade refrigerators that could store large amounts of insulin and cancer drugs, explained Keron Mais, senior director of pharmacy services delivery for the country’s National Health Fund.

“We didn’t have a lot of medical-grade refrigerators in the hospital pharmacies, and that was important, because you would want the technology that comes with a medical-grade refrigerator,” including the ability to set temperature and receive alerts if a refrigerator’s temperature moved out of range, Mais said.

Direct Relief and the National Health Fund arranged for 20 low global warming potential refrigerators, worth more than $140,000, to be distributed to 14 hospitals and six health centers across the island.

“This is truly a significant contribution to the public health system in Jamaica,” said Anderson, the National Health Fund’s CEO. “Safety and quality are of utmost importance to the NHF and these high-quality refrigerators…will strengthen the cold chain capacity for essential drugs.”

Staff members “love the visual temperature display and alerts,” Mais said. In addition, pharmacies can order more medications because the refrigerators are large, decreasing delivery fees and allowing them to have more essential medications on hand.

“It has impacted patient care because we’re able to store more drugs,” said Carol Staple, chief pharmacist at Cornwall Regional Hospital. “It is of great benefit to the staff here at the hospital pharmacy.”

“It has been so much easier and helpful for us to organize our cold chain items….and also to organize and monitor our stock level and to see exactly what we have on hand,” said Simone Palmer, a pharmacy technician at Princess Margaret Hospital’s pharmacy.

This isn’t the first time that Direct Relief and Jamaica’s National Health Fund have worked together. Among other medical support, Direct Relief has supplied Jamaica with factor VIII, a protein that patients with hemophilia lack and that helps blood to clot. “The demand is very sporadic, because you never know when [patients] will need it,” Mais said.

The organization has also provided Survanta, a drug that’s used to treat respiratory distress syndrome in premature babies. Mais recalled that one infant, the child of a medical warehouse worker, was able to receive the medication and survived.

“The partnership with Direct Relief is an important one to the NHF and to the Jamaican people, as the entity has become one of Jamaica’s major sources of donated pharmaceuticals, medical sundries, and personal care items, which has aided the stable supply of essential medicines to public hospitals,” Anderson said.

Asked about working with Direct Relief, Mais said, “They’re very flexible, and very responsive to our needs. And we also get items with good expiry dates.”