Nearly three years later, in addition to the requests provided by PIH on an ongoing basis, Afya now also responds to individual hospitals, medical missions, and health clinics around the world. "I have no idea how they hear about us. It's word of mouth, really," says Danielle. To be sure that those making requests have the infrastructure to support the items they're asking for, Danielle conducts an informal screening process via telephone before supplies are sent. "I don't want to give a dialysis machine to a hospital that doesn't have a technician trained to run it, so I'll ask questions about what they already have, who their patients and doctors are, and what their plans are for the long term," she explains.
Facilities making requests also pay a procurement fee (a tiny fraction of the value of the medical supplies requested) and the shipping costs—a model Danielle learned from PIH. "The sum helps cover Afya's operating costs, including the warehouse, truck rentals, and staff salaries, but, more important, being willing and able to cover the shipping expense proves to us that these facilities are serious about receiving them," says Danielle. Afya also survives with financial support from direct donations and various fundraising events.
Thanks to a full-time staff of two (including Danielle), a group of more than 10 medical school interns, and around 450 volunteers—many of whom are teenagers pitching in at the warehouse for weekly sorting, labeling, and packing events—Afya has successfully shipped more than 700,000 tons of medical supplies to countries such as Cape Verde, Ethiopia, Ghana, Haiti, Malawi, Rwanda, Sierra Leone, and Tanzania. Hospital leaders are just as likely to call Danielle with a donation as she is to contact them with a request. Before discarding 15 slightly worn conference room chairs, Von E. Chaney, Memorial Sloan-Kettering Cancer Center's director of patient support services, contacted her. "Months later she told me that instead of being in a landfill somewhere, the chairs were being used to give people a comfortable place to sit while having blood taken," says Chaney. "Knowing this stuff is being repurposed makes my own job more gratifying."