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A shipment of 30,000 personal protective equipment (PPE) kits -vital to the safety of front-line healthcare workers in the treatment of COVID-19 patients - arrived in the Cayman Islands on Thursday, April 30. The chartered cargo flight was the result of much behind-the-scenes work and a public sector/private sector partnership between the Cayman Islands Government and Health City Cayman Islands.

The story of how the equipment arrived in Cayman from China, with the help of an Indian-owned hospital chain is a tale fraught with logistical and political challenges, and some nail-biting plot twists.

PPE kits have been hard to come by for many governments and healthcare facilities worldwide due to the COVID-19 pandemic.

As the numbers of suspected and confirmed cases of the virus increased dramatically around the world and especially in populous countries such as the United States, it became increasingly difficult for smaller territories such as the Cayman Islands to source the in-demand protective equipment.

The Cayman Islands Health Services Authority procurement team, led by CEO Lizzette Yearwood and CFO Dawn Cummings, was working tirelessly to acquire the equipment but running short on options as time raced on.

To start with, full PPE kits - which consist of a protective coverall, goggles, face shield, KN95 mask, nitrile gloves and shoe covers, were almost impossible to come by. Large quantities weren’t moving after being ordered due to the size of demand and internal issues in China, where most of the equipment is currently manufactured. Additionally, while individual items such as KN95 masks or gloves were available separately, the Cayman authorities could not access any full kits. Larger countries were being given priority due to greater diplomatic reach and buying power.

This is where Health City came in.

“Understanding the challenges globally in procuring these items, I reached out to the Hon. Minister of Health Dwayne Seymour and Cabinet Secretary Samuel Rose as well as Lizzette Yearwood and Dawn Cummings at the HSA to understand if they needed any help. They explained that the growing global demand for PPE kits as the severity of the crisis increased in various countries put additional pressure on their traditional suppliers and supply lines. After some discussion, we realized how Health City could assist in procuring these vital protective suits that medical personnel need when dealing directly with COVID-19 patients,” said Health City Director of Business Development Shomari Scott.

Scott explained that Health City was strategically positioned to help in this effort based on many years of partnership with the large government-owned Chinese manufacturers through its parent company Narayana Health, which had built relationships with these manufacturers over the last decade and more.

“Due to these over-a-decade-long partnerships, Health City was able to get a quick production slot with the manufacturers ahead of much larger countries. We were also able to procure the full kits, at a quantity of some 30, 000. Additionally, we had the increased assurance of working with the government manufactures to ensure we were getting authentic and not counterfeit medical supplies. After Health City started the procurement process, the Chinese government stopped the majority of companies that had only recently started producing these supplies in order to curb issues with the quality of the supplies. Thankfully, Health City was well placed with one of the established manufacturing companies that was approved to produce the authentic goods,” Scott revealed.

However, the story was far from over and there were still hurdles to overcome in order to get the kits to Cayman’s shores.

The usual transshipment methods were no longer working for such large orders. Shipments from China typically come to the Cayman Islands via Miami. However, at that point in time the U.S. Government had begun seizing medical and PPE equipment manufactured in the US and preventing the goods from leaving American borders due to the growing medical crisis in that country. With this uncertainty looming and out of an abundance of caution the decision was made to find another way.

Scott explained, “Due to relationships with the manufacturer and distributor in China we were able to charter a flight from Zhengzhou, China to Grand Cayman. The original flight path was Zhengzhou through Miami to Grand Cayman. Due to some uncertainty at the time with shipments of certain medical supplies being seized in Miami, when we were booking the charter flight the decision was made that a different route would be best.”

The new plan took the charter flight using a Boeing 787-9 aircraft from Zhengzhou to Mexico before continuing on to the Cayman Islands. However, then came another snag. The Boeing 787-9 is too large and heavy to land at Grand Cayman’s Owen Roberts International Airport. It could potentially break the runway if landing directly in Cayman.

So from Mexico, after refueling and changing crew, it was decided that the aircraft would then fly onwards to Kingston, Jamaica to land. Based on the amount of freight on the aircraft – weighing over 17,000 kg and measuring 148 cubic meters, it would then have to be broken down and reloaded into a B737 freighter plane which would then make two back-to-back cargo trips from Jamaica to Cayman.

But once that obstacle was cleared, yet another appeared on the path.

“When we were getting ready to schedule the flight from Zhengzhou, we found out that the airport no longer was in-network with the charter company we were using based on some issues with the airport from the week prior. So then we had to figure out how to get the shipment from the warehouse to an airport in Shanghai. Eventually, we worked out the packaging and driving of the cargo from Zhengzhou to Shanghai and were on our way,” Scott narrated.

Yet again, another major barrier arose.

“While our medical supplies were being manufactured, the Chinese government introduced a new rule that all medical supplies leaving the country would need to be inspected by the government prior to leaving. This was great on one hand as it gives a higher level of comfort with regard to the quality of the supplies. However, it could have really slowed us down as the inspectors could come anytime from one day to 14 days or longer after your cargo is ready to fly,” Scott explained.

Luckily Health City had planned for a five-day buffer between when the goods were ready until the day the plane would depart. This was important, as when booking a cargo plane if you miss the departure date then the deposit payment would be forfeited.

Cabinet Secretary Samuel Rose, who was instrumental throughout the procurement process, took on even more of a prominent role at this critical juncture. Rose worked closely with HE Governor Martyn Roper and Head of the Governor’s Office Matthew Forbes to use their diplomatic channels to help garner an inspection spot within five days of delivery to Shanghai and the flight’s scheduled departure.

Finally, the inspectors gave the seal of approval and the flight left China on Tuesday, April 28. It reached Mexico, where it refueled and changed crew and then arrived in Jamaica late on Tuesday night. The shipment was broken down and loaded into a B737 freighter to make the first trip to Cayman landing at 11:30am on Thursday, April 30. The plane then offloaded, made a return trip to Kingston to get the remaining load and flew back to Cayman with the last of the supplies at 3:30pm the same day.

“It was a long haul, but we at Health City Cayman Islands are happy to use our resources to help the Cayman Islands get this vital protective equipment for the country’s front line health workers at this critical time. We are fortunate that our parent company was well-placed to assist us, having experience with large-scale emergency orders of medical equipment. It was this experience that allowed us to jump into action. Receiving these PPE kits now is extremely important as the Cayman Islands continue with a large-scale testing and screening program as well as vital insurance if we were to have an outbreak. We’ve spent countless hours, sleepless nights and early mornings dealing with different time zones and all of the logistical hurdles. But with the kits arriving here, it was all worth it,” Scott said.

Health City Cayman Islands is assisting the Cayman Islands Government and the HSA with further shipments of medical equipment needed in the fight against COVID-19 and the next two will arrive over the next two weeks.

Scott said, “Health City is proud to be able to collaborate with the government and HSA in a national emergency like this. We just celebrated our sixth year, and while the circumstances surrounding that anniversary are far from ideal, we are genuinely honoured to stand shoulder to shoulder with our government, Ministry of Health and HSA at the front of the battle lines. We at Health City are ready as always to serve in any capacity that we can to benefit the health of these Islands’ people.”

Minister of Health Hon. Dwayne Seymour was pleased with the results of the public/private partnership.

He said, “After realizing quite early on in the procurement process that there may be problems with sourcing PPE kits for Cayman’s frontline medical personnel due to the global shortage on the production of these items, I gave my full endorsement to the HSA and Health City Cayman Islands to work together on this vital effort. Together, they focused on the key single purpose of securing this critical protective gear for our frontline medical staff in the fight against COVID-19. I am immensely grateful for their combined efforts and extremely pleased to see how well these public and private sector entities have been working in tandem. This success shows that together we really can be Cayman strong.”