Building bridges, overcoming roadblocks

Guatemalan and U.S. clubs use relationship with Engineers Without Borders to meet COVID-19 crisis

by Claire Zulkey

Shoulder-to-shoulder work on years of infrastructure projects by Rotary clubs in Guatemala and the U.S. built a foundation that supported a swift and informed response when COVID-19 brought new challenges.

The clubs and some partners formed an emergency committee in March that raised money to buy protective equipment for medical workers, found Guatemalan manufacturers that could produce other needed items, and leveraged members’ connections to make sure technicians could travel to repair faulty ventilators. Their longer-term plans include major infrastructure improvements at a hospital.

Their well-coordinated response is now seen as a model for others.

“This is a worldwide emergency, and we have a lot of support from national clubs, even [as] they have their issues there,” says Julio Grazioso, of the Rotary Club of Guatemala Vista Hermosa, Guatemala. “Because of the close and strong relationship between Rotary clubs in this case, we were able to react very fast.”

The groundwork was laid years earlier. Grazioso and Mike Paddock, of the Rotary Club of Milwaukee, Wisconsin, USA, are civil engineers who met while working on infrastructure projects in Guatemala with other organizations, including Engineers Without Borders (EWB).

Their Rotary clubs began forming a bond in 2013, when Paddock and other members of his club visited Guatemala to work on pedestrian bridges and water initiatives. Every year, members from Paddock’s district travel to meet with Guatemalan officials and see the EWB and Rotary projects.

After the Volcán de Fuego in Guatemala erupted in 2018, killing hundreds of people and destroying communities, the U.S. EWB group and the two clubs worked together to construct bridges that gave people access to health clinics, schools, and markets.

So when the COVID-19 pandemic began to develop in early 2020, and Paddock and his partners saw the scramble for adequate personal protective equipment in the United States, they understood that Guatemalans would be much more at risk when the virus reached their communities.

Paddock said Guatemalan hospitals told their Rotary and EWB partners that newly constructed temporary COVID-19 hospitals were being overwhelmed by a surge of patients. An additional challenge, Paddock says, was the demand on the water supply. “Each patient needs twice as much water as they would in the past, with additional hand washing and cleaning needs.”

The Milwaukee Rotary club and the Guatemalan district raised $14,000 for protective equipment for emergency responders and midwives and ventilator repairs. The two clubs also, partnered on a global grant of more than $200,000 that will be used to drill a new well, pump and water tower at a 270-bed hospital in the city of Escuintla.

The Rotary Foundation also approved two global grants related to COVID-19 for $150,000, with about $600,000 in additional grants to come. EWB’s has received a $250,000 grant from Open Philanthropy and $70,000 from other grants to contribute to the Rotary / EWB projects.

Connecting the past with the present

The COVID-19 emergency committee formed by the Rotary clubs, EWB, and other consultants benefited from the past bridge-building.

“They’d invested so much in these relationships with the ministry of health and the Guatemalan army corps and other entities, there was a tremendous amount of respect and trust, and the business community responded with significant donations,” Paddock says. “Julio said, ‘Many organizations have boots on the ground, but Rotary has homes on the ground.’”

The committee delivered a significant amount of equipment — surgical masks, N95 masks, protective lenses, face shields, gowns, protective suits, disinfectant gel, soap, boots, and gloves — despite disruptions in the supply chain.

Rotary members and EWB were inspired by Ford Motor Co.’s initiative to produce ventilators, and wanted to follow that example to expedite other items medical workers needed. Through the Rotary members’ professional networks, EWB could identify Guatemalan manufacturers that could provide materials, and the group could act as a link among biomedical engineers, health care workers, and manufacturers. EWB volunteers designed equipment including face masks and shields, hospital gowns that offer varying levels of protection, intubation boxes, and protective sheets.

EWB engineers also helped repair 40 broken ventilators in Guatemalan hospitals. “This is an important number of ventilators, considering the current availability we have in the country,” says Grazioso (the number at the time, according to EWB, was 60 for the entire country.) The 12 Guatemalan hospitals that are working with the committee can also now assess their equipment supplies and communicate with EWB through an app designed to help smaller hospitals in low-income countries tell others what they need.

Not everything went smoothly. The lockdown prohibited nonessential driving, which was a problem for the EWB technician who was evaluating hospital ventilators. “We needed to get special approval from the ministry of health to allow him to pass through roadblocks,” says Paddock. But the relationship between EWB, the clubs, and the ministry enabled them to get the necessary permission so the engineer could get to work.

Within five weeks of the initial emergency committee meeting, prototypes of protective equipment were in production to be tested at participating hospitals.

Lessons learned from the collaboration been shared with the UN Technology Bank’s Technology Access Platform (TAP), which supports developing countries’ local manufacturing of personal protective equipment (PPE), diagnostics and medical devices for COVID-19. Paddock, now on sabbatical from EWB to assist as a senior advisor to the UN Development Programme, says that thus far twelve other countries, including Yemen, Sudan, Malawi, Vietnam, and Malaysia have accessed and utilized the plans put in place in Guatemala, which he calls the “Rotary roadmap.”