Medical Equipment Transport Service Savannah, Georgia USA A project of Rotary District 6920

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Medical Equipment Transport Service Savannah, Georgia USA A project of Rotary District 6920 www.medicalequipmenttransport.org Important Information For Potential Recipients of Medical Supplies & Equipment Rotary District 6920, located in the State of Georgia in the United States, has operated a Medical Equipment Transport Service (METS) since 2003 in order to provide used and surplus medical equipment and supplies to third world nations that do not have the financial resources to purchase the tools that they need to provide adequate medical care to much of their population. Through the generosity of the Rotarians in District 6920 and the participating medical facilities, avoidable deaths and suffering can, in many cases, be reduced and quality of life can be enhanced for those who need medical attention. This is accomplished by the shipment of containers filled with available medical equipment and supplies to those countries. What you can expect of us to: Collect sterile supplies from hospital operating rooms in our area Collect functional equipment for diagnosis and treatment from hospitals and doctors offices Collect beds, surgical tables, and ambulatory equipment Create documents indicating the contents of the container Load a full 40 foot container based on your needs to the extent practical Deliver the container to the Port of Savannah Keep you apprised of the status of your shipment once you have been approved What we expect of you to: Make all arrangements in your country to insure that the container and all of its contents arrive safely at your facility Identify the President of the Rotary Club near to your facility and involve him or her in this effort, if practical. o http://www.rotary.org/en/aboutus/sitetools/clublocator/pages/ridefault.aspx Provide a knowledgeable contact who can communicate with us in English by email and by phone Provide the funds for transporting the container by ship (ocean freight) from Savannah, Georgia USA and from your port of entry to your facility, prior to the container s departure from Savannah, Ga. Obtain documents that the shipment can enter your country free of duty when it arrives at the customs office at the port of entry Provide us with photographs and information on how the contents are used in service to serving the medical needs of the poor Understand that we may not always be able to predict what will be available to ship since we operate from donations

Application to Receive a Shipment From Medical Equipment Transport Service Savannah, Georgia USA A project of Rotary District 6920 www.medicalequipmenttransport.org Email application to: info@rotarymets.org 1. How did you find out about us? 2. Have you ever received assistance from us before? 3. Tell us about your organization and what it does: a. What is the name of the organization? b. Who does the organization serve? c. What are the major health problems of the communities served by your programs? d. What are your longer term objectives for addressing health of the people served? e. How will the population benefit from the medical equipment and supplies that we may provide? f. How many patients does your organization see in a month?

g. How many patients can you keep overnight in your facility? h. How long has the organization been in operation? i. What specific medical expertise and specialties, if any, does the organization provide? j. Does your organization provide preventive services and training? k. Is there a charge for services by this organization? If so, please explain. l. Are medical services and supplies available free of charge to patients who are unable to pay? m. Is there a requirement or expectation that those served must participate in any religious services in order to receive services? n. Describe the staff of your organization. o. Describe the background, training and specialty of each physician or principal medical officer:

4. Tell us about your facility: a. Where is your facility located? i. In a city or a rural area? ii. What is the nearest large city? b. How large is your facility in square meters (and send some photos if possible)? c. Do you have electricity and is it the same as in the US 120V 60Hz? d. Or, do you have the ability to provide electricity for equipment designed to run on 120V 60Hz? e. Do you have safe drinking water available? f. What are your plans or hopes to improve your services or facility? 5. How do you collaborate with or share resources with other medical facilities or international organizations in your area? If so, who are they?

6. We collect sterile supplies from operating rooms (such as syringes), furniture from hospitals and doctors (such as beds), diagnostic and treatment equipment, and various other items. Tell us specifically what materials or items would be most helpful to you if we could supply them: 7. Tell us about your relationship with Rotary and other organizations: a. Do you have a relationship with a Rotary Club? b. i. Name of the club ii. Name of the President iii. Email and telephone contact information for the President if he or she speaks English. iv. Are there other English speaking contacts that we should have? c. What other organizations provide support or supplies? 8. Tell us about communications for your organization: a. Who is available who can write emails to us in English? b. Do you have access to the internet? c. Do you ever use Skype for telephone calls? 9. Tell us about transportation and delivery of a standard intermodal 40ft container:

a. What port of entry should be used for the shipment? b. How will you get the container from the port to your facility? c. How can you insure that the contents clear customs and arrive safely at your facility? d. Can you obtain a letter from your government indicating that the container can move through customs without the payment of duty or fees? 10. Tell us about your safe storage of the medical supplies and equipment: a. Do you have a place to keep the supplies that they will be secure? b. How is it locked or protected at all hours? 11. Other a. The packaging of our supplies is in English. Is that a problem for you? b. Tell us of any items that should not be shipped to you because of local regulations: 12. References Please provide the names of several individuals who are familiar with your organization, programs and facility. Describe their positions and contact information: a. b. c. Signature: Title: Date:

Name of Organization: Reference Page Please summarize key information here: Date of Submission: City, State, Country: Port of Entry: Contact Name: Contact Title or Position: Contact Email: Contact Phone: