Global Good Health: Providing Medical Supplies to Needy Countries
Danielle Butin is changing international health care through her organization, Afya, and countless teens are helping her along the way.
As she climbed into a tent in Tanzania for dinner in June 2007, 47-year-old Danielle Butin looked forward to swapping stories with fellow campers about the breathtaking countryside. Instead she found a British physician—who was on a short holiday from a three-month medical mission in Uganda—on the verge of tears. "She said that in her practice in England, where the patients were generally healthy, she has access to every kind of medical equipment she could possibly need," remembers Danielle, a divorced mother of three from Hastings-on-Hudson, New York. "Yet in Africa, surrounded by people in desperate need of urgent care, she felt helpless: Her office supply cabinet was completely bare."
Recently laid off from her position as an executive of a health care company, Danielle had decided to spend her unexpected free time fulfilling a long-held dream to visit Africa. Yet, while hiking and camping up and down the scenic coastline, her attention was continually drawn to the country's medical needs. "At almost every stop along the way I would hear a story from a traveling nurse or doctor about the lack of resources," she remembers. "I started thinking about finding a way to merge my connection to Africa with my health care background, but until that moment, I just didn't know how."
Listening to the doctor's story that evening made Danielle realize that something as simple as providing bandages (which are so scarce in some areas of Africa that doctors are often forced to wash and reuse them) would make a difference, and she knew exactly where she could get them. From all her years of working in various areas of health care—clinical, corporate, and academic—Danielle was well aware of the astonishing number of new materials regularly discarded by U.S. hospitals.
Global Links, an organization dedicated to making health care facilities more environmentally friendly, estimates that as much as 2,000 tons, or $200 million worth, of supplies are thrown away each year from operating rooms alone. One reason for the extraordinary amount of waste: the strict coding and regulations in place to protect patients.
If a surgical team lays out a supply of sutures, bandages, syringes, and gauze before an operation, all of the supplies in the room—even those never opened—must be thrown away afterward to prevent possible cross-contamination. Perfectly good medical equipment, such as X-ray machines, microscopes, and operating tables, becomes quickly outdated and replaced with cutting-edge models.
Danielle learned the same regulations didn't apply in developing countries, and that the equipment would be extremely valuable too. Unopened packages of rubber gloves, gently used incubators, and slightly worn delivery tables routinely discarded from American maternity wards would be welcome relief to laboring mothers in Rwanda, where physicians were delivering babies on lawn furniture and, in worse cases, dirt floors.
During her flight home from Africa, Danielle wrote up a list of all the people she knew in New York City hospitals who might help her acquire equipment. By the time her kids, Sally, Caroline, and Sam (then 9, 13, and 15), were back in school in September, Danielle was determined to launch a nonprofit foundation dedicated to collecting and redistributing discarded medical supplies. One month later she teamed up with Partners in Health (PIH), a Boston-based nonprofit that sends medical provisions to developing nations. "They started by giving me a wish list of items several hospitals in Haiti had specifically requested," Danielle says. With PIH's reputation and her own corporate health care connections to back her, Danielle found that persuading hospitals to donate was surprisingly easy. Just two months into her pursuit Danielle, who had expected to
run the entire organization from her home office, ran out of storage space.
In November 2007 Danielle had to make the tough call of dipping into the modest income she was living on—which came from a severance package and part-time salary she earned teaching—to fund a lease on a warehouse space. There, she finally had a place to stock the ever-growing flood of catheters, IV poles, bandages, sutures, wheelchairs, side tables, and stretchers flooding in from area medical centers. At the same time, she started the application process for nonprofit status for her foundation, which she named Afya, meaning "good health" in Swahili. She put the word out to friends and former colleagues—including people from the medical field, attorneys who had worked in health care, and people with experience founding other grassroots organizations—asking them to volunteer to work on Afya's board of directors.
Within weeks a group of five professionals rallied behind Danielle to pitch in with the advice and guidance she needed to run her new foundation. On a cold day in March 2008, after months of sorting and packing, Danielle, along with a group of a dozen volunteers—including her children, boyfriend Tracy Allan, neighbors, and friends—stood outside Afya's warehouse and watched as the lid was sealed shut on a packed 40-foot container. PIH was footing the costs of this first shipment, headed for Haiti, which would then be distributed by officials to several facilities. "When they closed that crate people were crying," says Danielle. "We all knew what was inside was going to breathe life into another place far away. I remember thinking, I never want this feeling to end."
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."
Danielle's enthusiasm can also be credited with galvanizing kids to initiate their own projects. When Courtney Hughson, 13, learned that women in Malawi walk barefoot for miles to reach clinics to deliver babies, and the blisters they develop on their feet can expose them to deadly diseases, she spearheaded a rain-boot drive; within three months she gathered 200 pairs.
Danielle Polland, 17, collected over 1,000 pens through a drive at her Long Island high school to enable African doctors to keep medical records. After being told that patients' children often wait for hours outside Tanzanian hospitals with nothing to do, Alex Strauss, 14, acquired enough soccer cleats, balls, nets, and shin guards to start an entire league. There are so many kids rounding up the much needed ancillary supplies (like sporting equipment and kitchen utensils) requested by the hospitals that Danielle's 18-year-old son, Sam, produced a video about them. "The film helps spread my mom's work across the country so kids will know exactly what they can do in their own communities," he says. Sam's film is included in the information packets that Afya sends to teens interested in helping out, which tells kids how to start an official Afya Club— there are now a dozen in middle schools, high schools, and colleges nationwide. The packets also include handouts about the foundation, a list of the most-needed items, and directions on starting a fundraiser or collection drive.
During the five subsequent trips Danielle has made to medical facilities in Africa and Haiti, she's seen firsthand how the supplies are making a significant difference in the lives of patients, and the doctors and nurses who treat them. As word spreads about Afya's success, the number of requests has skyrocketed too. To meet the growing demand, she has ramped up collections and now receives supplies from as many as 40 different hospitals, nursing homes, clinics, and rehab centers in the greater New York area. Danielle's aiming to at least double the number of Afya Clubs in the U.S. and abroad to increase nonmedical supply donations. "Kids give Afya enormous support. When we say, 'here's a need,' whether it's funds or footwear, they're very creative about coming up with a way to fulfill it," she says.
There's another vision for the future that Danielle holds close to her heart: To get everyone, from young children to older adults, to realize they can repurpose almost anything—unused surgical supplies and hospital beds, rain boots and soccer balls. "It'll help create a world," says Danielle, "where nothing valuable ever goes to waste."
Originally published in the March 2010 issue of Family Circle magazine.