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.