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One Hospital's Trash, Another Hospital's Treasure


The day after the Tepa District Hospital in Ghana, on the west coast of Africa, received its first sonogram machine, a life was saved. The scan picked up placenta previa in a young woman who was seven months pregnant, a complication that causes hundreds of maternal and fetal deaths each year in rural Africa.

Not this time. The ultrasound’s advance warning gave Isaac Boetang, MD, chief medical officer at Tepa District Hospital, the ability to plan ahead. Instead of facing a life-threatening hemorrhage at birth, which likely would tax his hospital’s limited resources, Dr. Boetang had time to prepare for a C-section and deliver a healthy baby to a healthy mother. In the seven months since the donated instrument arrived, Dr. Boetang estimates at least 30 more babies and mothers have been saved. Tepa’s sonogram machine was supplied by Doc to Dock, a non-profit organization working on a simple premise: Collect unused, surplus supplies from U.S. hospitals for distribution to needy hospitals in emerging countries.

Doc to Dock was born as the result of a call to charitable arms sounded by former President Bill Clinton in 2005 at his first summit meeting for the Clinton Global Initiative. He told the gathering his new foundation’s goal was “to help turn good intentions into good action and results.” Among the elite crowd of CEOs and celebrities in attendance that day was an unassuming New York cardiologist, Bruce Charash, MD, a clinical associate professor at New York University and former chief of cardiac care at Lenox Hospital in New York City. “It’s possible that year I was the only person who wasn’t a celebrity,” Dr. Charash says with a humble laugh. “They were asking us to do something to make an impact on the world, but until then my only developing world experience was spring break in 1975.”

As the former president challenged his guests to change the world, an idea Dr. Charash had long been mulling over crystallized. “I took it seriously and created a new charity,” he explains. “Send medical supplies to Africa.” When he was asked about a name, he thought slowly—and out loud. Doc, of course, his profession, to Dock, he says, as the image of a ship at a foreign port popped into his head. And that is how Dr. Charash made his own personal commitment to the Clinton Global Initiative. Doc to Dock was incorporated as a 501(c)(3) non-profit organization in February 2006. “We were the first charity formed under their umbrella,” he says. “and though we have no affiliation with them, they are an amazing support group.”

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TOP: Isaac Boetang, MD, chief medical officer at Tepa District Hospital in Ghana, uses a sonogram machine that was donated in America and delivered through the Doc to Dock program.ABOVE: Doc to Dock delivers everything from dressings and linens to syringes and chest tubes.

Good Deeds

The Greek poet Homer noted some 3,000 years ago, “the charity that is a trifle to us can be precious to others.” Dr. Charash knew American hospitals, doctors’ offices, pharmacies, and clinics, housed tons of unused medical supplies. In fact, the United Way estimates more than 7,000 tons of unused medical supplies and outdated equipment are discarded every day, either incinerated or carted off to landfills. At the same time in developing countries, thousands of patients are turned away from hospitals and medical centers due to a lack of medical supplies and equipment. Doc to Dock’s mission is to correct this imbalance.

Dr. Charash began conceiving a plan to somehow turn America’s trash—precious medical resources—into treasure, channeling the leftover sutures, scalpel blades, IV tubing, bandages, outdated equipment and machinery, old hospital beds and wheelchairs to hospitals in Africa.

Then Dr. Charash stumbled across a program, aptly named Merci, at The University of Virginia Medical Center, which collects its surplus supplies and used equipment for distribution to non-profit organizations, such as the Red Cross and Project Smile. The hospital invited Dr. Charash to take a look, and he was impressed by what he saw. Since its inception in 1992, Merci has collected more than 400 tons of medical materials worth more than $80 million.

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Dr. Charash then set about soliciting donations from hospitals in his own backyard, New York City. It was a tall order. He and his small staff (one doctor, five staffers) needed to gather the surplus supplies and equipment, find a place to store it, recruit volunteers to inventory the items, and then enlist trucking and shipping companies to move the donations overseas. To find his supplies, he turned to hospitals, corporations, pharmaceutical companies, and even medical meetings. He found government and non-governmental organization partners willing to help him identify hospitals in need of and willing to receive the supplies. And, once identified, his team of volunteers began the process of matching the need with the goods collected, utilizing an online ordering system to supply the hospitals in Africa.

The Clinton name helped the cause enormously. In March, 2006, Dr. Charash reported to the Clinton Global Initiative (CGI) “the prestige of being a CGI commitment has opened many corporate doors that I do not necessarily believe would have opened without being identified with this effort.” Those open doors, coupled with Dr. Charash’s persistence, set Doc to Dock in motion.

It is proving a worthwhile voyage. One of the first partners to jump on board was Franklin Hospital in Valley Stream, N.Y., which is a part of the 305-bed North Shore Hospital System. Mary Hynes, a perioperative nurse educator, long had been discouraged by the waste of perfectly good supplies, some never even opened or routinely discarded from operating room packs. “I embraced it the nanosecond I heard it. We’d been wanting something for so long,” Hynes says. “For years, we had been throwing out stuff. It was almost criminal.”

Super Simple System

The Doc to Dock system is simple. Bright, electric-blue recycling barrels, emblazoned with the Doc to Dock logo, are stationed in the operating room and other easily accessible areas where hospital personnel can toss surplus supplies. Wrapped, sterile items, such as latex gloves, suture packs, scalpels, and bandages, routinely are overstocked in customized sterile packs as a bit of surgical “insurance.” Anything not used is discarded, still in a sterile wrap. “If a case is cancelled or something else happens,” Hynes says, “there is a sterile field with hundreds of dollars worth of supplies, which could not be reused. Everything has to be discarded and thrown away. You can’t reprocess it because there is too much liability involved.”

When Hynes switched jobs a few months ago, she transported her enthusiasm for Doc to Dock with her to the 371-bed Southside Hospital in Bay Shore, N.Y. Aided by a documentary DVD, which she showed her new colleagues, she instituted the Doc to Dock program at her new hospital. To date, the operating room and radiology department are donating excess supplies, and Hynes is planning to talk to the delivery room nurses soon.

“The barrels get filled right up,” Hynes explains. “This one hospital fills about six bins a week. Every two weeks, I call a trucker to pick them up.” Doc to Dock has arrangements with a dozen New York-area hospitals, thus far, including partnerships with the North Shore System and the Greater New York Hospital Association.

How Hospitalists Can Help

The Doc to Dock initiative collects two types of supplies. The first is disposable, generally sterile, one-time-use supplies through a recycling program in operating rooms. Collection bins are placed in the operating rooms of hospitals, and the organization and the hospital arrange a procedure to regularly collect these supplies. “This is more labor intensive for us, and is a bit less practical if the hospitals are outside of our region,” Dr. Charash says. “Although it could be done on a case-by-case basis.”

The second type of supplies the Doc to Dock initiative focuses on are known within the organization as “capital equipment.” These donations range from hospital beds and stretchers, to sonogram machines and neo-natal incubators and defibrillators. These supplies usually come available when an institution renovates or upgrades equipment. “These are very important and a very high priority for us,” Dr. Charash explains. “It would be very helpful if a hospitalist would serve as a liaison with the hospital’s administration, to allow us to present our case to the hospital and to be kept in mind when renovations/replacements are scheduled.”

Doc to Dock pays for the donation retrieval and the overseas shipment costs. “Our success depends on establishing a large hospital donor network,” Dr. Charash says.

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The supplies may be donated, but it takes money to truck them, warehouse them and ship them to Africa. Doc to Dock relies on funding raised from corporations and philanthropic sources, plus in-kind donations from trucking and shipping companies who often move supplies for minimal or no cost.

In addition to supplies, Dr. Charash is looking for equipment. Many hospitals and clinics replace equipment, still in perfect working order, with newer models. Anesthesia machines, cryosurgery machines, mammogram machines, and cancer screening equipment, have found their way to African hospitals.

The sonogram traveled to Tepa District Hospital by way of a 40-foot shipping container, along with other supplies and equipment once destined for a U.S. scrap heap. The district serves about 100,000 villagers, and the hospital had been saving its nickels—one at a time—to purchase its own sonogram. The fundraising drive would have taken 10 years. One can only guess how many babies would have died in the meantime.

Through 2008, Doc to Dock had shipped nine containers to Ghana, Benin, Liberia, East Africa, Ethiopia, Kenya, and Uganda. Another container went to Haiti following a devastating hurricane. Four or five additional containers are just about ready to ship, Dr. Charash says. Each container costs about $25,000 per shipment. Dr. Charash estimates each shipment delivers approximately $500,000 worth of supplies and equipment.

Dr. Charash, who maintains privileges at Lenox and Mt. Sinai Medical Center in Manhattan, dreams big. He defines success by growing Doc to Dock to 100 containers per year within five years. He also wants to increase the number of hospitals donating goods, and the number of third-world hospitals receiving the supplies. Additionally, he wants to make the charity self-sustaining, as the need is always greater than the resources available.

“It’s a moral issue,” he says. “I have an obligation not to let it go to waste.” TH

Carol Berczuk is a freelance writer in New York CIty.

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