Episode 3: Turning a trip abroad into a calling with Danielle Butin
Join your host Betsy Bush as she speaks with the founder and CEO of the Afya Foundation, Danielle Butin. They discuss Danielle's efforts to bring medical supplies to healthcare providers around the world, how a trip to Tanzania lead to the founding of her foundation, and her advice for anyone looking to start a new venture.
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Transcript:
Betsy Bush (00:02):
Welcome to the latest version. I'm Betsy Bush, your host with my guest, Danielle Butin. She's the founder and CEO of the Afya foundation. Danielle. I'm so excited to be talking with you now on The Latest Version, I can't think of anyone who personifies the purpose of this podcast more than you. Many of us have traveled to parts of the world where we're confronted with extreme need and realize the scope of the difference between the quality of life we take for granted and the reality that is for much of the planet and we resolved to do something but when we get home, we go back to our old lives and that urgency fades. But you, when you made a trip abroad, you actually kept that fire going. And when you came home, you did something about it. I am so excited because the story you have to tell is really inspiring and lets us know there's so much more we can do to make things better for the rest of the world. So please, um, tell me about, um, tell me about the trip you took to Africa.
Danielle Butin (01:35):
Oh, Betsy, first of all, it's such a pleasure to be here, thank you. So almost 13 years ago, I was wrapping up a career in an executive position in healthcare and I just -- I wanted something very different and I had no idea what that would be and went on vacation to Tanzania and there life presented what it was going to be. I was in the serengeti plains, which I think is just one of the most exquisite places on this earth. And a woman was bawling her eyes out in a tent by herself. And I sat down next to her and I put my hand on her arm and said, "are you all right? What's happening?" And she said, "I am the women's health physician in London. I came here to do medical mission work. There are no supplies anywhere I'm watching children die of conditions. I know I can treat with supplies and I am, I, I am beside myself and I don't know what to do."
Danielle Butin (02:37):
And she put her head on the table and bawled. And I was overtly aware of my own helplessness in this moment and I don't do helplessness well. And I felt like I was there for a reason. I believe in seeing beautiful signposts along the way throughout life. And so to me was one of those moments of the signpost. And I said to her, "do you think if there were supplies there from another creative way, it could make a difference?". She said "any supplies would make a difference." So I, there in the middle of the beautiful serengeti plains decided my next chapter of life was going to be that I was going to go home and figure out how to divert supplies from our waste stream and get them to sites in need abroad that have close to nothing to be able to deliver care.
Betsy Bush (03:33):
Wow. Now when you say diverge medical supplies, we are, I think generally unaware, the lay people here are unaware of the amount of supplies, healthcare supplies in hospitals, et cetera, that generally just go to landfill unused that are still usable.
Danielle Butin (03:54):
So here's the thing. We have extraordinary practice around sterility of product. And so if somebody has, for example, their elbow scoped, a surgery pack of supplies will be opened and only those items used are contaminated and on the medical stand and there could be easily 10 to 20 items that are still in sterile wrapping that were in the room with the patient that were not touched, but because they were in the room, they must be discarded. And so we're talking about millions and millions and millions of pounds of supplies are either buried in landfill or they're incinerated. And you juxtapose that against I was in Tanzania in the operating room years ago, where a woman was rushed in for an urgent cesarean section and halfway through the procedure, the doctor said, oh my gosh, we don't have sutures to close. And I remember saying, how can you open someone's body and not have sutures to close? And he said, well, when we're really stuck, this is what we do. And he pulled a piece of gauze out and they started creating fake sutures with the threads from this piece of gauze. And I'm thinking about the thousands of sutures that are thrown away because of our sterility practice in this country and how that's okay but then we have to save them and divert them to places like this where no one should be sutured up with pieces of thread from a piece of gauze.
Betsy Bush (05:34):
And talk about something that does not sound at all sterile, right?
Danielle Butin (05:39):
No, not at all. Or Betsy when people die a death with dignity at home in this country, most of the time, the bed, the hospital bed, the mattress, the commode, the wheelchair will not be picked up. Their family is told to find a way to donate it or discard it. And if you are in your seventies or eighties or nineties, that is an enormous feat. So we collect everything from hospital beds in homes to doctor's offices closing to materials from hospitals to x-ray machines and anesthesia machines. We sent a CAT scan to Africa. It is the whole composition of supplies that still have a second life in them that are worth rescuing
Betsy Bush (06:28):
So let's step back a bit. You came home from that trip to Tanzania and you had this, this desire to start a way of, of collecting all of these supplies and, equipment and sending it off to the places, you know, needed it. What did you do then? How did you go about starting that nonprofit organization that would allow you to do that?
Danielle Butin (07:00):
Well, the first thing I did was I did a needs assessment. And my idea of a needs assessment was to unannounced and uninvited walk through the tunnels of the major hospitals of New York City. So I could see firsthand what the garbage looks like -- "garbage". I don't consider anything that we have in our warehouse garbage, but this is, these are the items that are being discarded from hospitals. And I saw laundry bins and stretchers and pallets of first aid scissors because they were being flipped out for another kind of inventory. And I said, oh, and this is like, this is an extraordinary opportunity in New York. And the guys in the tunnels would laugh at me and say, lady, what are you doing down here? And I said, I want you to just show me what ends up in this part of the hospital. And they did.
Danielle Butin (07:51):
And then I went to Bellevue and in Bellevue I was given a tour of a warehouse room that had a tiny bit of water seep into it. But because this tiny bit of water had seeped in, they had to get rid of 27 pallets of goods because they were exposed to water. And they said to me, we're going to give this to you. Do you want it? And I thought, oh, I didn't even have a truck. I didn't have a warehouse. I didn't have a truck. I asked a friend to drive a truck. I live in Westchester county on a narrow road, the truck of 27 pallets sat outside my house for three weeks with the police knocking on the door, asking when the truck was going to be moved. Oh, no. I mean, this is literally the launch of this work. And, and I have to say that if I had the least bit of perfectionistic drive, it would have been a complete fail, but because it was just, I'm going to have faith. I literally had faith. It's something that could be so profoundly moving and meaningful and impactful to delivered to me in the Serengeti was not going to fail. So I would tolerate the police knocking on the door and the fact that I didn't have a warehouse, I really thought I would start this out of my garage, but it was, it took off so fast and so enormously that we grew out of the garage after the first week.
Betsy Bush (09:13):
You know, it sounds like one of these entrepreneurial ventures where someone comes up with this great software idea and suddenly everyone's like, I've always needed this. And it was, it was something meeting --was your idea meeting a moment of need where everyone just said it Of course this makes perfect sense.
Danielle Butin (09:37):
Yes, and I think that's a great way to describe it. The hospitals we worked with wanted to know that we would show up, you know, I think a lot of people have a lot of good ideas and then they just don't show up and they don't fulfill on what they promise. And I knew, and I continue to that I'm asking hospitals to do more. It's a lot easier for them to just throw stuff away than it is to invest the time to bag things up, store them, make sure that people know to donate to us. I know I'm asking them for more, but it's worth it. We are not going to throw away good supplies and people's lives are going to be saved because of it. There was one beautiful moment during the horrible disaster in the Philippines years ago. And I was in a New York City hospital at 5:00 AM training or group of OR nurses and how to recover from the operating room. And all of these ex-pat Philippine nurses came up to me, bwling, I mean, bawling their eyes out, saying where we feel like now we can help home during this horrible disaster. And we've been waiting for a chance to do something with the supplies that we've been seeing thrown away. And it resonates for everybody. It resonates for the donors. It resonates for the recipients. It just makes sense.
Betsy Bush (11:00):
And it makes you realize how much goes to waste in our society, doesn't it? It's not just medical supplies, it's food, it's clothing, it's all sorts of things that can be reused and repurposed.
Danielle Butin (11:16):
Yes, there's a second life for far more than we even realize.
Betsy Bush (11:21):
So when did you actually form your 501c3, your nonprofit organization, and how difficult was that? I mean, you need to find board members and people, you know, in that administrative realm, who can help you, that legal realm, who can help you, what was that like?
Danielle Butin (11:44):
I learned flying by the seat of my pants. So I started Afya and "afya" means "health" in the Kiswahili language. I named it that -- many people think it's an acronym -- but it's really my soulful hat tip to that land. And in the beginning, I really didn't know how to run a non-for-profit ,how to launch it, what was involved. I remember I found a firm online and I paid them a couple of hundred dollars to help me incorporate trademark the name. And it was not going as well as I really wanted it to and I knew how to lead and how to execute and nothing was going as I would've liked to lead. So an incredible donor read about our work in the New York Times. And he came to me and he said, how can I help you?
Danielle Butin (12:42):
And I said, number one, I needed a truck. And number two, I have got to get this 501c3 status pulled together. And he donated a truck and he donated to me, the funding needed to secure representation from a firm that does extraordinary work with non-for-profits and they helped move my application through and it was successful. So, I was clear where I needed help. It wasn't just, I didn't know what' was wrong. I did know what was wrong -- my paperwork wasn't appropriate or correct. I had made a mistake doing this online. And this firm helped me to understand the bylaws helped me to understand the role of a board of directors. And then I went out and recruited people I knew in medicine, people I knew in business, people who were my friends who really believed in this and I had an amazing initial board to advise me.
Betsy Bush (13:41):
What did you do when you encountered skepticism? Because I can imagine, you know, this sounds like a huge thing. Like, how are you going to do this? You know, where are you going to put all this stuff? How are you going to ship it? How are you? You know, I can imagine that a lot of people just said, you know, this is crazy. I can't believe you can do this.
Danielle Butin (14:01):
Yeah, that was, that was the, that was the chorus behind my life for awhile. Um, so, um, I haven't, first of all, I have an amazing mother who is the go girl go force. And she was loud and clear, um, around that. But there were many people in my life who thought this was a less than optimal plan and idea. And and I think if you're going to take a risk and this was a really big risk, I mean, I came back from Africa and I was being recruited and interviewed for major leadership positions in aging in New York. And I chose not to pursue that. And you know, on a personal level here, I was a divorced mother of three. I left an executive high paying, and now I didn't have a truck. I didn't have a warehouse. I had 27 pallets of inventory outside of my house and I wasn't making a salary.
Danielle Butin (15:01):
And so I, I have created enough in my life to trust my ability to create. And that was the voice I listened to. Wow. So the rest was just banter. I, you know, like this, this is really risky, Danielle, like, you don't know what you're doing. Do you know enough to be able to do this? What I knew was I could lead and I could figure things out. And I figured out unbelievably challenging circumstances before. And I'll figure this one out. I mean, you can learn about international shipping. You can learn about these things. It's not, it's not a secret sauce, but it takes time in the game. And I chose and made a commitment to myself that I would listen to and trust my own voice and my own experience. And I think that you have to hold true to, or else you can be swept up by the negativity of others.
Betsy Bush (15:58):
It would be very easy, I think trying to get something like this off the groundto listen to the negativity and to listen to the practical and to listen to the, oh, you need something to fall back on, or what happens if you fail. And you have absolutely not failed. I mean, when you and I encourage everyone to go to afyafoundation.org to see Danielle's organization, which is, -- well tell me how big your staff is and how big your warehouse is and how much medical supplies you shipped out.
Danielle Butin (16:33):
Three warehouses. Two in Yonkers we pay for, one [that ]has been generously donated to us by a donor. And so I'd say we're at about 35,000 square feet in total of the three. And by virtue of them all being in Yonkers, it helps us, I mean, it is unaffordable to have a warehouse in New York City. So Yonkers is a really good middle point for us. We have about 23 on staff now. We have thousands of volunteers. I mean, unfortunately not during COVID because we can't have our thousands of beautiful volunteers in the warehouse, but you know, one of the things that I learned very early was that we need partners. We need many different communities to come together. And to kind of bind hands around this as an effort. And so I'm a big believer in who could benefit from this as much as we need help.
Danielle Butin (17:43):
My background is I'm an occupational therapist. And so with that prism, we went out and found treatment programs like YAI and JCCA at the cottage school and children's village where we could be the place of giving back and their clientele would come and volunteer with Afya. And then I started adding a graduate occupational therapy internship, where these OTs are working with people on the spectrum, people with seriou, lifelong mental illness and dual diagnoses and then the DA and the police department started sending us referrals. And the work is gorgeous because under this umbrella of altruism, helping other people, they are giving to themselves and learning skills needed.
Betsy Bush (18:36):
So people would come in like sort put all the scissors in one pile and put all the sutures in another pile and things like that, is that how...?
Danielle Butin (18:46):
Yes. It comes to us, Betsy, the materials come to us in such a mishmash of stuff and I will never send to sites, that are in trouble and under-resourced, stuff how it comes to us. So if you're opening up a box of four by four gauze, that's all you're going to see in it, but it means we need a lot of hands on.
Betsy Bush (19:11):
So, um, how do you prioritize? I can imagine there, you have a to-do list and everything's like, you know, number one on the to-do list, do you have any, any tips you could pass along to someone who feels overwhelmed with all the different things she needs to do? How, how do you prioritize what really needs to happen first?
Danielle Butin (19:36):
Uh, well, it's interesting now that I have staff. If you'd asked me 11 years ago, what are, how do I do this, it probably would have been very different because now I, I look at what I can delegate that if I invest the time in right now than someone else is taking it and it's worth that time and investment. I ask myself questions every morning and every night, what requires my attention and me owning it versus somebody else being able to do it. I am trying desperately to stay involved in high-level kind of strategic design of where we can be the most helpful and who our partners can be there and how we can raise funds to support that effort and try to rely on my amazing team to make the rest of this magic happen. I think it is, it is really like, where am I needed right now? It is very tempting when you have a long list of things to accomplish, to be seduced by the easiest or the most gratifying first. But that's not how I look at my list. Um, and don't live with perfection vaccine. I think that's a big piece here -- being perfect isn't the goal. You give yourself a lot of slack in how you work it.
Betsy Bush (21:01):
Interesting. Tell me how you decide, who gets what and where does it go in the world and how do you decide or figure out who needs, what, and how does it get there?
Danielle Butin (21:18):
So we have some amazing partners around the world, um, that we've been, who we've been working with for years, there has to be a doctor and a nurse and a solid clinic. Like we've had people call us from a remote village, far away saying we really need your medical supplies. And then unless there's a doctor or a nurse there who can safeguard the materials -- I mean, I remember we worked with the Second Lady of Ghana years ago. She literally chained a ultrasound to a wall to make sure that it was never going to move from the hospital that she donated it to with us helping her and that you would never have to worry about it. And so we are working so hard on behalf of people we'll never know that we have to know that these goods are going to be put to use they're intended.
Danielle Butin (22:07):
So we have amazing partners worldwide. And when people come to us and say, I mean, one project that was so moving was when someone affiliated with the American Cancer Society live in The Bahamas long before the recent storm and said, I want to fund a hospice in The Bahamas. There's no hospice and I want to create it. And we have a building, but we've none of the supplies. And Betsy, we were able to like bring this person's vision to life. So people do come to us with special projects. We love that. But with COVID we have kept our partners abroad. We've done some amazing work abroad during this but we are turning our attention to the federally qualified health centers in our country and in New York because what people are not realizing is that, although the vaccine is now ramping up, thankfully ,there are health centers for people who are incredibly poor or undocumented or sites where they are serving families in desperate need.
Danielle Butin (24:10):
And some of these centers and said to us, we don't have a specimen cups, we don't have syringes. A whole bunch of these centers closed in New Jersey because they didn't have enough medical supplies and they didn't have PPE. So we are setting our sights on supporting them holistically. Like I, one of the centers in New York city called us and said, in addition to PPE, could you please send us wheelchairs and walkers and crutches and cains so that if the people who are at risk for falling have a way not to fall, they won't end up in the ER and they won't be exposed to COVID. Those holistic big picture thinking providers of care for people who are just impoverished. That's really, that's become our focus during COVID and we're doing that Navajo nation in spades. We just sent 1.6 million masks out to Navajo Nation but this is the work that now we're focusing on domestically while we're also still supporting people abroad.
Betsy Bush (24:23):
That's incredible. And it's, it is a little humbling to think that there are communities right around us who are in need of basic supplies as much as a community on the other part, on the other side of the world.
Danielle Butin (24:40):
It's shocking. It is shocking actually. And I think COVID has just shown us the lack of social justice around medical care and medicine in this nation. It is unbelievable to those of us on the side of the supply chain.
Betsy Bush (24:59):
In this whole venture of yours, what has been the biggest surprise?
Danielle Butin (25:09):
that's such an interesting question. I think, how eager, how eager people are to find their way to contributing to the lives of others. It has been humbling and an honor to serve as that place and for people to find a unique contribution to the work that we do. So I'm going to give you an example of this was during the Haiti earthquake, there was this delicious five-year-old boy who walked into the warehouse with this little Ziploc bag and his mother was holding his hand and he was, I can still see his face he's. He was such a delicious child. And I walked up, I said, hi, can I help you? And his mother looked at him and he said, I get 10 cents every week for my allowance. And I saved 10 dimes, and I put them in this bag so you can help kids in Haiti that I saw on TV. And my eyes welled up. And here's this child understanding like, go mama, as far as I'm concerned, I looked at her and I thought you are something to have this five-year-old showing up with his bag. And I looked at him and I said, I promise you, someone will benefit from what you're doing here. And you don't have to know people to help them. And this is so beautiful. And that's like, that's obvious goodness. People figure out a way to come in and give without specific rules and guidelines. They find their way.
Betsy Bush (26:47):
That's amazing. And it's great to have, to know that you you've started an organization where so many people can help others and how healing it is for those who are helping. It's not just about people who are on the receiving end. It's also about how good it feels to know that you're doing something good. Even if you'll never meet those people.
Danielle Butin (27:12):
I totally agree. I think all truism, you know, I'm a firm believer that if you're having a bad day, go help someone, go do something really lovely for another, and it was going to change you chemically.
Betsy Bush (27:29):
You know, you had an interesting -- I'm cheating a little bit cause I heard you interviewed about someone in Haiti who was offered a cane and did not want to take it. Maybe you can just kind of pick up that story.
Danielle Butin (27:54):
Yeah, so that was our... Haiti is a master teacher and every time I would leave Haiti, I would write because the lessons there were monstrous and life-changing. We were giving away, we were treating people who had been recently disabled after the earthquake, thousands of people had traumatic amputations [and] were really disabled. And we started a rehab program and we gave away and we trained Haitians to become rehab technicians and builders of products. It was fantastic. And we gave [items] away because how could you ever charge people for items when, you know, over 95% were unemployed? So we gave these items away and there was this beautiful farmer. He was in his seventies or eighties, hunched over, walked over with this huge branch of a tree. And the team in Creole said to him, please, please stay right here for a second. Let us go get a cane for you.
Danielle Butin (29:05):
And he said, no, no, no. Tomorrow I'll come back tomorrow. And he came back with this basket of peppers from his garden and he said, now I'll take the cane. And it was such a lesson in charity and not wanting a handout and wanting to be treated with dignity and integrity. And they traded the peppers for the cane and the staff. I remember the staff in that moment, looking over at a group of us, like, do we take the peppers? It was like, take the peppers. You have to take the peppers because he needed to just, he needed to feel that. And he deserved to feel that absolutely.
Betsy Bush (29:41):
It was so important to his dignity to know that he, he was not getting a handout. He didn't want a handout. He wanted something... he wanted to be able to exchange or in air quotes, "pay for it". It reminds me of a fundraising lesson I had heard long ago that continues to stay with me --never deny someone the opportunity to give.
Danielle Butin (30:07):
That's beautiful. That's beautiful.
Betsy Bush (30:11):
Danielle, I always try to end my podcasts with three pieces of advice that you would have for my listener, and your whole life's journey and the, the amazing work that you're doing with Afya. What three pieces of advice would you offer to someone who is really looking to pivot or make a change or reinvent herself? What would, what could you pass along?
Danielle Butin (30:39):
Okay. So first is there is something unrealistic grandiose about having an idea and then all of a sudden you're going to make money doing it. I made like practically nothing for the first few years. So I built a bridge between my old career consulting, and doing a lot of teaching so that I could make a living while I ramped up Afya. I think you got to build bridges in the ramping up or else it's just an unrealistic expectation and it's way too much pressure. Two, is you have to be really careful what voice inside of you you're going to listen to, and we talked about this earlier, but I think that, fear is not going to compel or move you forward. And you have to choose that every single day -- thanks for coming, but you're not staying at my table. 'm going to listen to the other voice. It just keeps me moving forward.
Danielle Butin (31:48):
And three -- perfection is a killer for innovation. So and when something becomes really absurd, like so absurd, I can't even begin to like wrap my arms around it, I burst out laughing. And my team has gotten to know that things are really bad as they're going on and on about something and I just burst out laughing because it's so absurd what I'm listening to you. I can't believe it. It helps me to stay in a place of being open to solutions so that if every time we were presented with something that is so mind-blowing absurd, instead of melting into our seat or becoming angry or becoming paralyzed, we could lighten it so that there's room for innovation, it stays us. So I have a senior team that when it gets really horrendous and I burst out laughing and they all burst out laughing, and then I say, now we got to like, come up with something. There's something about it regained the temperature of the room.
Betsy Bush (32:58):
I bet you are a great person to work for because, it just sounds like , you're just, you know, someone who can be, human and humane and again not letting the perfect be the enemy of the what is the expression, not letting the the perfect be the enemy of the good, right. Its, in the end, are we advancing the ball? How many, how many tons of medical supplies have you sent out to date? Um, I've seen a couple of different things. It must be hard to keep, keep all your social media posts updated with the absolute latest amount.
Danielle Butin (33:43):
We are over 11 million pounds. We have touched 83 nations. It's really, and it is an ongoing story of running locally, sorting and helping, and then making an enormous difference in the lives of people we will never know. And I really firmly believe this because the need exists, we do. And I think it is so extraordinary that people will go to their clinic or they'll go to their local hospital because we only support the infrastructure, I mentioned this earlier, I want to support the bones of the place we're serving, not people coming in. And I'll never know that all of these people are working so hard so that they can recover and live and every life matters.
Betsy Bush (34:43):
Amazing. Danielle Butin CEO and founder of Afya foundation -- A F Y A. Please go to their website afyafoundation.org. It is an amazing group. And Danielle, you are an amazing person. And thank you so much for taking the time to talk.