Medical surplus from Minnesota vital to Bolivia

by Scott Wooldridge

The gap between wealthy countries and poor countries can be illustrated in many ways; in the health care field, one person’s surplus is another’s treasure. Brooks Donald, M.D., M.P.H., is part of a group that takes medical equipment discarded or unused in the United States and uses it to save lives and improve health in Bolivia.

Mano a Mano Medical Resources is a group that shipped 200,000 pounds of medical surplus from the United States to Bolivia in 2003. The group incorporated in 1994 and has become a major presence in rural areas of Bolivia, not only distributing medical supplies but building clinics, supplying providers, and creating long-term partnerships with communities to provide health care services and public health infrastructure.

Donald, a pediatrician with HealthPartners Riverside Clinic in Minneapolis, says the original mission of Mano a Mano has expanded very quickly. “They started small and now they’ve actually become quite large,” he says. The group has developed a model in which Mano a Mano enters into partnerships with communities. The group builds a clinic and pays salaries for providers and teachers, and the communities agree to fund the clinics after the first three years.

“They realized early on that community involvement is really what’s going to sustain these clinics,” says Donald. “I think that is unique about what they’re doing.” The group has now built more than 40 clinics in Bolivia, and has expanded its work into areas such as building roads, public water supplies, and schools.

The contribution that U.S. physicians make to the program is mostly in the areas of teaching, fundraising, and finding supplies to donate. Donald says supplies from Minnesota and the upper Midwest are crucial to the group’s efforts. He says there are many cases where U.S. clinics or systems throw away out-dated but perfectly usable items such as beds, clinic furnishings, dental chairs, or surgical equipment. “We’re in a wasteful society here when it comes to medical equipment,” he says. “These are perfectly usable items that people there consider new.”

In Minnesota, the group collects most of its supplies from the Twin Cities area, which are then shipped to Bolivia in container ships. Mano a Mano has one full-time coordinator in Minnesota; the rest of the work here is done by volunteers.

Donald traveled to Bolivia in February of 2003 to see some of the work Mano a Mano is doing in the countryside. He says the trip was a life-changing experience because he was not prepared for the kind of poverty he saw. “It was shocking to me,” he says. “ You read about it, but to see it firsthand…it was pretty incredible.”

In addition to giving U.S. physicians a closer look at Bolivian communities, the visit also allowed Mano a Mano’s Bolivian organizers a chance to show local residents some of the people working for them. “When we got down there it became obvious that they wanted us to be a presence in these communities, to show the people of these very small, poverty-stricken areas that there were people on the other side of the world that cared about them,” Donald says, “people who were not only putting up money, but also volunteer time in order to help them.”

- reprinted with permission from Minnesota Physician, March 2005