Pay it Forward: Medical Bridges

By Matt Skoufalos

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Throughout the United States, billions of dollars in surplus medical equipment goes to waste every year, victims of a domestic expiration date or the newest available technology. Yet many countries the world over would still find the bulk of these supplies perfectly suitable for their purposes, if only they could get their hands on them. That’s why a Houston, Texas-based nonprofit called Medical Bridges took up the mission to deliver that technology to the communities who could best make use of it.
The organization traces its roots to 1997, when surgeon Patricia Brock Howard and her pediatrician colleague, Margaret Goetz, took a mission trip to El Salvador. Flying out of Houston, home to one of the largest medical centers in the country, in which they were surrounded by state-of-the-art technology, nothing could have prepared them for the absence of basic equipment on the ground, said Medical Bridges President-CEO Dorothy Bolettieri.

“They were using plastic bread sleeves as gloves when they were doing surgery, or washing the gloves from patient to patient to patient,” Bolettieri said.
When they returned to the United States, the women brought back a deepened appreciation for how much of the technology discarded in their daily practices could make a life-saving difference for patients overseas. Together with a handful of their church congregants, they formed Medical Bridges around Howard’s dining room table. In between going to work and building their organizational charter, the group collected medical equipment to deliver overseas, until Howard’s house was “overrun by the generosity of the institutions in the Texas Medical Center,” Bolettieri said.

“They leased a small run-down warehouse, where everything was managed by volunteers,” she said. “When they outgrew that space, they moved to a second warehouse, and hired their first employee. In 2005, the Board of Directors was able to buy a 30,000-square-foot warehouse, and in 2006, they decided it was time to get professional about their operation.”
That meant that Medical Bridges had to start charging for the services it delivered, “which was a very difficult thing for this group to do,” Bolettieri said. In 2007, she was recruited to help grow the organization into a nonprofit business. By increasing its efficiencies, the group realized it could help more people “with product that they really need versus product that is available to be shipped,” she said.

Today, Medical Bridges has a strong presence in West Africa and South America. Last year, the group shipped 43 containers of medical supplies and equipment. This year, it’s on target for 50. In its 20 years of operations, the nonprofit has distributed more than $80 million in medical equipment, even after valuing “brand-new, within date, sterile” products at a 50 percent markdown for having been donated, Bolettieri said. Some of the efficiencies came from concentrating their efforts on a small number of targeted recipients.

“We’d gone to 82 countries, realizing we’d send one shipment here, one there, and we weren’t making a significant impact in any one location,” Bolettieri said. “We try to focus on multiple shipments to single locations through a single sponsor. Rather than being a mile wide and an inch deep, sustainable, quality health care is what’s important.”

Medical Bridges gathers and donates every kind of medical equipment, from tongue depressors and surgical gowns to imaging equipment and blood analyzers. A mobile blood testing van the organization shipped to Nigeria was converted into a mobile care clinic that delivered primary care and basic testing to rural villages that wouldn’t otherwise have had access to those services. In Ogun State, Nigeria, Medical Bridges helped supply and equip a 240-bed hospital and a medical school on the campus of Babcock University; in Ivory Coast, it has delivered disposable supplies and durable equipment needed for any setting from a primary care clinic to an operating room.

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The organization has also leveraged special partnerships. Together with BUILD, a student group from Texas A&M University that works to create mobile clinics out of shipping containers, Medical Bridges has helped vet and locate overseas communities in which to house those ersatz clinics. Students at the university work with volunteers to gather the materials to outfit the containers and manufacture them with guidance from professionals.

Since its inception, Medical Bridges has also hired an onsite medical technician to provide maintenance and support for the equipment it repurposes and ships. In 2012, when the nonprofit opened its first biomedical testing lab, its tech roster developed from young, student engineers to trained professional biomedical technicians. Today, any piece of equipment that comes into the organization is tested, repaired and shipped overseas with every accompanying piece of paperwork available.

“The World Health Organization says at least 70-80 percent of equipment that is donated from the developed world doesn’t work, is inappropriate for the location that it’s being sent to; they can’t get supplies, they can’t get parts if a piece of equipment breaks down,” Bolettieri said. “They haven’t been trained on the units. Those are things that we’re really cognizant of when we prepare cargo for shipment.”

“We are also offering online maintenance support where, if there’s a problem, we can Skype with the technician in-country, similar to telemedicine communication,” she said. “We make every attempt to send equipment that has at least a five-year shelf life.”

Following the vision of its founders – outreach to entities in need of high-quality, basic health care – provides all the focus the organization requires, Bolettieri said. Put simply, Medical Bridges’ mission is to build a bridge between those who have and those who don’t.

“There are people dying simply because health care providers do not have an antiseptic to clean a wound properly,” Bolettieri said.