La Basura Bodega

I spent this afternoon helping another volunteer organize “the bodega”. The bodega is the storage garage at the hospital where donations of medicines, medical supplies, and medical equipment are kept. When I first saw the hospital bodega during my April visit to San Lucas, I was impressed by its size and by how much stuff there was. On first glance, what stands out are a stack of probably 60 crutches, a hospital crib, numerous orthopedic braces, and a ton of overflowing boxes. It seems there is a veritable wealth of supplies and it’s exciting to imagine all the people who will be so gratefully helped by these things.

Here’s the reality of the bodega and I am quite sure ours is not unique. This reality surely applies to the thousands of medical storehouses around the “developing” world supplied by well-meaning visiting doctors from the “developed world.” In any given unlabeled or incorrectly labeled box, there is an incredibly mix of supplies, often old or useless in our setting, thrown together without any semblance of order. For example, the first box I unpacked had arm slings and soft restraints on top, most having fallen out of their original crushed boxes. Under these were about 15 bottles of pills and syrups without any labels (all had to be thrown out). Then there were feeding tubes, staple guns (neither of which are accepted medical technology here), PICC line kits (not even close to useful here). There were bottles of iodoform-soaked abcess packing gauze that had been previously opened and were now dry. Betadyne sponges for skin cleansing that had expired in 1997 and were partially dried. At the bottom of the box, I got to IO needles, cardiac catheterization tubing, a fallopian ring kit (not even sure what that is), and a whole host of unidentifiable sterile equipment.

It took me a good half-an-hour in the hot bodega with no working lights to whitle the large box down to about 10 things I thought we might use here. Much was thrown out (I’d like to say it was that simple but actually it was set aside to be reviewed by the hospital administrator who is non-medical and doesn’t want anything thrown out without his permission…often denied, meaning the supplies end up back in a box for this cycle to be repeated in a year or two). Some were boxed to be sent to a larger hospital, which will likely also not be able to use such a random assortment of supplies.

I have to admit, I would never have believed someone telling me that it wasn’t better to bring things from the US to Guatemala that would otherwise be thrown out in case they could use them. After experiencing the bodega today, I came up with this analogy. Imagine yourself faced with the bad luck of having had your house burn down with no money saved. Your neighbors decide to help you by giving you nice things they have but never use: a badmitton set, a brand new Lexus engine, a direct TV remote control, and a pad of Post-It notes. Several other neighbors give you a similar assortment of things. While each in itself is valuable, it’s no good to you. You have to figure out how to get rid of it all and when you need a Post-It, it is so lost below the stack of useless items that you forget it exists. It ends up water damaged before it’s uncovered years later. So what’s the answer? Don’t send a random assortment of supplies to the developing world, much less old, worn supplies that you wouldn't want used on your own child. Try to find out what’s needed and help provide funds to buy those things locally.