A few days after the January earthquake that left Haiti in ruins, the Afya Foundation of America’s warehouse in Yonkers, New York, buzzed with volunteers speedily sorting huge piles of donated medical and humanitarian supplies. Bundled against frigid temperatures, the volunteers, many of them students from local schools and scout troops, worked with a sense of urgency, loading shipping containers with crutches, syringes, IV starter kits, bandages and more—much of the material recovered from hospitals that would otherwise have discarded it as waste, all of it collected by Afya and now destined for the island’s stricken people.
At the center of the action, Afya’s founder, Danielle Butin, 47, a warmly forceful former health insurance company executive, fielded nonstop phone calls. A local nursing home had 100 mattresses. Filmmaker Jonathan Demme and colleagues wanted to donate generators and lighting equipment. An anonymous benefactor from Dartmouth College offered to use his private plane to airlift supplies to Haiti; a local restaurateur suggested a fund-raising dinner to defray shipping costs—$6,000 to send one container to the island.
“The earthquake was so incomprehensible and intolerable that giving a check wasn’t enough,” Butin says. “People needed a way to act.” Afya (the word is Swahili for “health”) offered them a way. By the end of January, donor institutions and individuals had committed more than a million dollars’ worth of relief supplies. And over 1,000 volunteers had helped fill seven jam-packed 40-foot containers headed for one of the clinics in Haiti run by Partners in Health (PIH), a U.S.-based nonprofit that provides health care to poor communities in 12 countries around the world.
Afya’s prompt and effective response to the devastating earthquake put the fledgling foundation, barely two years old at the time, “on the world health map overnight,” Butin says. PIH, which coordinated medical relief in Haiti, began referring institutions, individuals and charities to Afya. “Until then,” Butin says, “we’d been a mom-and-pop organization with slim exposure nationally.” The referrals brought in more materials, and more funds for shipping them. “We started getting calls from hospitals around the country that had supplies to donate,” she says.
Butin, who trained as an occupational therapist and still teaches the subject at Columbia University, launched Afya (afyafoundation.org) after a trip to Tanzania in 2007. She’d just been downsized from the Fortune 500 health insurance company where she’d created and run wellness programs focusing on elder- and end-of-life care. Instead of moping or plunging into a job search, Butin decided to spend part of her severance package on a long-held dream: a trip to Africa. “For 10 years, I’d been taking African dance classes that were accompanied by six to 12 African drummers,” she says. “That drumming became my heartbeat.”
During her sojourn, she visited Masai healers, hiked through Tanzanian forests and got unexpected glimpses of the challenges faced by health care providers in rural Africa. At a tented camp, she met an English doctor, on leave from her work at a Ugandan hospital, who wept in frustration as she recounted how donated supplies too often didn’t match the clinic’s needs: There would be ECG leads but no ECG machine, let alone electricity to run one. American nurses working at an HIV clinic in rural Tanzania told her they lacked the equipment needed to start IV lines. “I couldn’t understand it,” Butin says. “I knew the stuff was out there, and I knew there was this huge need. I thought, ‘This is insanity! I’m going to do something.’ As an occupational therapist, I’m trained to assess specific health care challenges and meet them. To me, getting surplus supplies to where they were needed was just another challenge, on a larger scale.”
Butin’s resolve crystallized on the return flight as she read Tracy Kidder’s best-selling book Mountains Beyond Mountains, about acclaimed Harvard physician-anthropologist Paul Farmer, who founded PIH in rural Haiti. She was deeply moved by Farmer’s dedication. “I thought, ‘I can do this. I have the training and experience. This is what I’m supposed to do.’ ”
Back home in the riverside village of Hastings-on-Hudson, a half-hour train ride from New York City, Butin, the divorced mother of three, felt the sting of financial doubt. As an executive, she’d earned $150,000 a year and also had income from teaching and consulting. “We didn’t lead an extravagant lifestyle,” she says. Still, she knew that pursuing her mission meant the family would be living on less. She worried that the change wouldn’t be fair to her son and two daughters, then ages 15, 13 and nine. So for a month and a half, she went on interviews for executive health care positions at large corporations. But every time, she says, “I felt nauseous. My head was saying one thing, and my gut was saying another. I went out to dinner with close friends, had a glass of wine and bawled my eyes out. Finally my friends said, ‘You gotta do it.’ And the next morning I woke up and knew they were right.” One of the people urging Butin on, she says, was her significant other, Tracy Allan, a photographer and filmmaker. Allan pitched in from the start, picking up donated supplies in a rented truck, helping Butin set up a warehouse and designing Afya’s website; now he documents the foundation’s work on video.
Armed with a renewed sense of purpose, Butin began by doing something radical in its simplicity: cold-calling. Her old insurance-job contacts weren’t appropriate for this new enterprise, she says, so she had to build a network from scratch. She cold-called people at New York hospitals and asked if they had equipment to donate; she cold-called PIH to ask how she could become involved. She cold-called landlords to find a warehouse and was offered a 4,000-square-foot space in Yonkers. (Afya moved to its current 14,000-square-foot space in September 2009. “That was a stroke of luck,” says Butin, “because we would never have had the space for all the supplies we collected in January for Haiti if we hadn’t moved then.”)
The response to her calls was overwhelmingly positive. “You really want to go the extra mile for her,” says Kathy Smith-Bernier, director of environmental services at St. John’s Riverside Hospital in Yonkers and one of the first to be swayed by Butin. “Her passion and dedication come through almost immediately.” St. John’s has since donated unopened operating-room tools, four dialysis machines, six CPR mannequins and roughly 30 wheelchairs, among other supplies. All the equipment is in good condition, but it’s no longer state of the art—which in the competitive American health care market means it gets replaced. “Think of buying a computer that’s outdated as soon as you get it,” says Smith-Bernier. If the equipment isn’t donated, it is either medically incinerated or sent to landfills. So far, Afya has spared two million pounds of medical supplies and equipment from what Butin calls premature burial.
Gradually her plans for Afya took shape. Butin would collect donated supplies in her warehouse. She’d identify needy institutions with input from PIH and other nonprofit organizations that would arrange to distribute the supplies in impoverished regions. Eventually, Butin secured the help of more global-aid groups, such as U.S. Doctors for Africa, and government health agencies in specific countries. Aid groups or sponsors pay freight costs and a per shipment recovery fee to Afya to offset operating expenses. Community organizations and schools looking for class projects also help by raising funds to cover specific shipments. The foundation avoids the problem of theft that sometimes besets aid organizations by choosing recipients very carefully. “We work only with clinics that have credible oversight and a strong infrastructure,” says Butin.
She estimates that each of the 44 containers Afya has shipped during its nearly three years of existence—to hospitals, clinics and schools in Malawi, Rwanda, Ethiopia, Tanzania, Nigeria, Sierra Leone and Haiti—carried at least $150,000 worth of goods, which puts their total value somewhere north of $6.6 million. Of course, on a human level, the benefits to communities Afya has served are immeasurable. “Her supplies really allowed the district hospital where we work to begin functioning,” says Keith Joseph, MD, of PIH, who oversees the organization’s work in rural Malawi. “Thousands of people here have been directly helped by her efforts.”
Afya isn’t the only medical-supply-recovery organization sending goods overseas, though it is the only major group operating in the New York metro area. What sets Afya apart is its founder’s occupational therapy training and her personal contact with needy institutions. Butin is attuned to how products can improve patients’ outcome, and she frequently visits clinics and other client organizations overseas—she’s in Haiti every six weeks, Africa twice a year—so she can understand exactly what supplies will make a difference. For example, in Haiti, women whose breasts were injured during the earthquake are getting sports bras (“Compression relieves the pain”); those who had amputations and live in tented camps are especially vulnerable to assault when they go out at night to find a portable toilet, “so we’re sending them commodes,” she says.
Butin’s huge network of young, enthusiastic volunteers also sets her team apart. Last year she received an award from her alma mater, Scarsdale High School, not far from her warehouse, and after the Haiti earthquake the principal sent an e?mail message to all the students saying Butin could use their support. Since then, hundreds of kids have contacted Afya offering their help. One of the teen volunteers took over when a doctor in Malawi who’s also a rock musician asked Afya for musical instruments, thinking his HIV-infected adolescent patients might be inspired to stay on their medications if they learned to play. “This high school kid got a whole community to donate instruments,” Butin says. Another teen volunteering for Afya as part of a community-service project ended up collecting enough supplies to start three soccer leagues in rural Malawi. One group of students raised funds by making bracelets, another by holding a fashion show. And high school seniors who went to Afya in response to President Obama’s call for national service on Martin Luther King Jr. Day are forming Afya clubs on their college campuses to collect supplies and raise money for shipping.
“It makes people feel good to know they can give back,” Butin says. “I’m just helping them do it.”
Despite Afya’s successes over the past three years, some hospitals Butin has contacted have declined to participate and still consign usable equipment to the dump. “Some only collect supplies for their own medical staff’s mission trips,” she explains. “Others don’t fully understand the benefits of our recovery program.” Afya is also constantly scrounging for sponsors to pick up shipping costs. But Butin is unfazed by these challenges. “I am wired to jump over hurdles,” she says.
Besides Butin, Afya’s paid staff consists of four part-timers and only one other full-time person, Sarah Schuyler. “She does everything from loading thousands of pounds of materials into containers to organizing complicated customs clearance with officials in foreign countries,” says Butin. For a year and a half after she launched Afya, Butin lived on her severance pay; her board of directors—drawn from the health care, education, nonprofit and business communities—has since approved a modest annual salary. “Yes, our lives changed,” she says. “The kids became very good at preparing their own meals.” And they pitched in at Afya. “My son, now in film school, shot video and stills for us, and the girls did all the box labeling in the beginning and still bring in friends to help.”
Butin yearns for funding to expand the foundation’s infrastructure. “Sarah and I are blessed with enormous energy, but we can’t get everything done,” she says.
Butin’s goals for Afya continually evolve. Thanks to a grant from the American Jewish Joint Distribution Committee, she’s started a program in Haiti to train rehab technicians to make products, such as special shoes, that will help people with disabilities. Stateside, she supervises a prevocational training program with occupational therapy graduate students from Columbia University and New York University: People with mental illness go to the Yonkers warehouse to learn how to function in a work environment as they sort donated goods for Afya.
Reflecting on Afya’s success and her midlife career change, she adds, “I never would have been able to do this when I was in my twenties. I didn’t have the range of interpersonal experience or the understanding of how to get things done, not to mention the confidence in my own decision making.” Is she ever discouraged by the magnitude of the problems she is addressing? Butin looks baffled, as if such a thought had never entered her mind. “No,” she says firmly. “I am inspired every day by what I do.
“But what would make me cry now”—she begins to as she says this—“is the realization that there is no bigger blessing than to be able to do this work. We’ve sent these supplies that have changed people’s lives. But we’ve also built a place where people can come and make a real difference.”
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