Cold Chain II

Maintaining the cold chain is difficult out bush. I wrote in August about the high temperatures reached in the planes transporting our pharmaceuticals. Power failures are regular in many remote communities and can lead to failure of the cold chain rendering the vaccines and other refrigerated items unusable. Over time I have built up a reasonable database of various drug stabilities at higher temperatures. However many of these studies do not reflect the temperatures to which these drugs may be exposed to.

These community generator power failures often necessitates removing these drugs in a safe and approved manner from these communities and replacing them quickly. This often means items transported from another community.

from "Strive for 5" guidelines 2005We could use foam containers and freezer blocks. During summer the ideal method is that mentioned (p31) in the “Strive for 5” vaccine storage guidelines, placing a polystyrene container in a much larger cooler and surrounding the container with freezer blocks or using a specialised vaccine cold box as recommended by the WHO.

Some emergency missions to overseas disasters have used large portable fridges. However these have needed careful monitoring with certain drugs placed in certain areas and adjustments to the thermostat if numbers of items are removed. Whilst these are good for setting up a remote emergency clinic they do require some specialised knowledge to maintain the correct storage for various drugs.

I have been trialling a new portable refrigerator. It has a volume of 25 litres which allows us to transfer adequate quantities of drugs urgently to a clinic until bulk supplies arrive in a week or two by plane.

Twinbird Vaccine Fridge
Twinbird Vaccine Fridge

We obtained the Twinbird from Rollex Group Australia. While considerably more expensive than say an Engel, it performs very well.

I have been using it for several months monitoring temperatures with a third party data logger. The temperature monitoring and alarm system seem quite accurate. The fridge does use a different sort of cooling system than the compressor style, allowing more accurate temperature control. There are two baskets inside the refrigerator so there is no direct contact by the vaccine or blood products with the sides where they may freeze.

The power cord could be more robust, and it requires an optional DC converter to run inside on AC power (Engel etc require just a separate cord to plug into the unit). It is light, but seems quite solid and has handled rough bush trips with ease.. I would have liked some way to be able to lock the fridge. It also now comes with a printer option for temperature recording and I will be including this option in future purchases as we expand our on-lands logistics capability.

But then I think we have it easy compared to some locations around the world! This is the Vaccine Fridge CFS49IS System with CFS standing for “Camel Fridge System”.

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