Donations, kit and chucking out rubbish

It seems to be a peculiarity of this place that everyone becomes a hoarder. Theatres are remarkably well equipped, but not a lot of what is there gets used, and the stuff that is used is invariably the really old battered stuff.

This morning Prof and I had planned to put an external fixator on a child's severely broken forearm following a crocodile attack. We were delayed by a C section so had ample opportunity to have a hunt through the store room (which was needed as all the external fixators had been creatively filed away). There is an incredible amount of stuff there, stored as best as possible in the limited space:

• Loads of orthopaedic kit (screws, plates, k wires, nails)
• Vascular grafts (not sure when we'd ever use those but they went out of date 18 years ago)
• A full urological kit for doing cystoscopy and trans-urethral resection (currently no one here does these)
• Cupboards full of random elderly instruments (including some old wooden mallets)
• Tracheostomy tubes
• Endoscopic kit including biopsy forceps
• More orthopaedic kit
• Loads of basic instruments (brand new, really good quality)

It's a bit challenging to find all of this, given we use needle holders which have all the grip worn off and forceps with bits broken off. Some of the kit is clearly decades old. I think there really is a mentality that if something just works it has to be used, so nothing is ever discarded.

We're now working on getting the new kit into circulation and throwing away some old stuff. Maybe it will be a start on getting things organised and a proper flow of kit through ordering, stores and theatres. I suspect that this will only really happen once they no longer depend on donations and have to pay for their own kit.