Its like a scene from “Naked Lunch,” the perverse nightmare of a novel William S. Burroughs wrote over half a century ago…
The brothel in Bangladesh is roughly the size of a football field, surrounded by a brick wall and a ditch full of fetid human sewage. Trees grow through gaps in the rusty tin roof. Inside is a maze of hallways and tiny rooms where over 900 young women and teenage girls, many sold into sex slavery by destitute families from the countryside, work as prostitutes. The youngest are forced to ingest a steroid, commonly used by farmers to fatten cows, to speed the appearance of puberty.
There are two hospitals nearby, each with about 250 beds and 350 patients, a hundred of whom sleep on the floor. The medical staff are not sadists, like Burroughs’ notorious Dr. Benway, pumping a heart with a toilet plunger, but their lack of medical equipment and training can lead to mistakes not much different than the sick slapstick of Benway’s operating room. Failing to gather the surgical team to go over details before the procedure, the wrong kidney is removed, the wrong leg cut off. Because the nurses on the day shift don’t communicate with those on the night shift, a baby in an incubator dies unnoticed late in the afternoon.
These conditions are hardly unique to Bangladesh. Hospitals and makeshift clinics in poverty-stricken and war-torn countries all over the world lack basic equipment and supplies (bandages, tourniquets, gloves, gurneys). Meanwhile, in this country, hospitals throw away uncounted tons of perfectly usable and sanitary medical materials every year.
Elizabeth McLellan, a nurse and administrator at Maine Medical Center, witnessed the shocking shortages in poor hospitals overseas during numerous medical missions and recognized the shameful wastefulness in our own institutions. In 2007, she decided to do something about it. She got permission from Maine Med President and CEO Rich Petersen to leave two boxes at the hospital for clean medical supplies that otherwise would be thrown away.
“It just kind of blossomed,” McLellan recalled this week. “I took it all home to my house. I had 11,000 pounds of medical supplies in my house, but I couldn’t stand the fact that it was going to be thrown away.”
We were sitting in the new South Portland office and warehouse of the nonprofit McLellan founded for the task, Partners for World Health. The all-volunteer organization collects cast-off medical supplies and equipment from health-care facilities throughout the state; transports, sorts and organizes everything; and arranges deliveries (typically via 40-foot-long shipping containers) to overseas hospitals and clinics in need. Last Monday, behind a huge mound of plastic bags full of as-yet-unsorted materials, there was a tall stack of boxes labeled for delivery to Syria. PWH has another storage space full of hospital beds and operating tables that otherwise would be in a landfill.
McLellan stresses that this is not medical “waste” — PWH does not handle dirty or contaminated materials. It’s typically “the stuff that’s being left behind in the [hospital] room,” she said. “The stuff that you paid for, but you didn’t take home,” but which policies dictate must be discarded when you leave — even, for example, a bandage still in its sterile wrapping, or the other 40 facial wipes in a box of 50. PWH also receives items a facility has replaced with a cheaper or updated version.
There are several similar organizations in other parts of the U.S. McLellan said it’s estimated that only about 5 percent of all the usable medical supplies health-care facilities send to the trash are diverted for future use. Changing the practices of huge institutions like Maine Med takes time, money and effort that administrators have shown little willingness to spend, even though diversion saves money on disposal fees, lessens pressure on landfills, and could very well save someone’s life.
PWH also organizes medical missions to places like Pakistan and Haiti, where doctors and nurses administer to the sick and educate local providers on best practices. McLellan said the organization’s goal for this year is to ship 10 containers of supplies and conduct at least five medical missions. She and a team are leaving in early March for a three-week mission to the slums of Bangladesh. A fundraiser for that trip takes place this Friday night, from 6 p.m. to 8 p.m., at Vena’s Fizz House, a “mocktail” bar on Fore Street in Portland, where people can learn more about efforts to improve the lives of young women trapped in the brothels. Donations of condoms, Tylenol and ibuprofen will also be accepted.
Burroughs’ book was famously banned on grounds it was obscene. But the ongoing destruction of medical supplies in the face of desperate need for them proves that truth can be more obscene than fiction.