Jayson Marwaha '14 first got the idea to start a non-profit organization in a setting where all good ideas are born — a high school party. Two years later, he decided to take action, founding Medical Equipment Donations International — a nonprofit that aims to donate unused medical equipment in the United States to facilities in developing countries.
At a party during his junior year of high school, Marwaha said he learned from a recent graduate working with a diagnostics facility that the U.S. is home to an abundance of medical technology waste waiting to be tossed or scrapped for metal.
"I thought I could make something of that," Marwaha said. He researched the issue further, and in August 2011, MED International — as Marwaha refers to the organization — was officially incorporated.
"There's a tremendous surplus of obsolete medical equipment in the first world that is actually still quite useful, but it's been superseded by something newer or better," said Alan Harlam, director of social entrepreneurship at the Swearer Center for Public Service. "Most of that equipment goes to waste."
A few months after the incorporation of MED International, Harlam suggested another student, Han Sheng Chia '14, partner with Marwaha, who was still working by himself to get the organization off the ground.
"I think they both are really strong learners with potential as entrepreneurs, so I really encouraged them to maybe join forces," Harlam said.
It turned out Chia and Marwaha were both in the same class, Professor of Epidemiology Stephen McGarvey's PHP 1070: "Burden of Disease in Developing Countries." "I got up in the middle of class to go to the bathroom, and (Chia) took my seat," Marwaha said. The two started talking, and soon became partners.
While many large-scale nonprofits have worked to donate unused medical equipment in the past, Marwaha and Chia said they hope to succeed where others have faltered.
"What we're trying to do is address what we call the barriers of utilization," Marwaha said. While donated machines make up 80 percent of medical technology in developing countries, only 30 percent of those machines are actually used once donated, he said.
Marwaha and Chia have broken the process into three steps — supply, delivery and utilization. The supply — the actual medical machines — comes from hospitals and companies. Institutions get technology write-offs as an incentive to donate, Chia said, so they do not lose money by supplying. The delivery is transporting those machines to the clinics and facilities in developing countries. Finally, there is utilization, the step most efforts tend to overlook, Marwaha and Chia said.
"If you don't have the third part, you're essentially transferring waste from one country to another," Chia said.
Harlam said Marwaha and Chia have explored three reasons why equipment often cannot be used in the facilities where they are donated. First, there are infrastructure needs, such as electricity and water, which facilities may not have the means to maintain. Second, many machines require that operators undergo specialized training, so the personnel in these health facilities may not have the skills to use them. Third, some medical technology has high operating costs — even after a machine is donated, the materials needed to use it may be too expensive for a facility to purchase.
McGarvey said he has observed the effect of some of these problems. "Many times we'll be walking through a laboratory — whether it's an actual clinical laboratory or a research laboratory — and there's many pieces of equipment that are just basically gathering dust," he said.
While solving these problems will be MED International's main focus, the nonprofit will not deal exclusively with implementation of technology. Marwaha said to focus on maximum utilization, the other two steps are necessary prerequisites.
Marwaha and Chia have concluded through their research that the key to utilizing the donated technology is familiarity with the needs of the recipients of that technology.
In October 2011, Marwaha visited the Tanzanian Embassy in Washington D.C. to meet with Vice President of Zanzibar Seif Ali Iddi and Deputy Minister of Health of Zanzibar Dr. Sira Ubwa Mamboya, who expressed interest in what MED International is attempting to accomplish. Marwaha said they told him Zanzibar was undergoing an extensive, government-run, health facility overhaul and that they were looking for equipment to put in the renovated health facilities.
"They demonstrated the strongest capacity to receive and implement because of the nature of this massive overhaul," Chia said. Because of this, MED International is focusing on Zanzibar as the first recipient of donations.
To see the clinics of Zanzibar for themselves, Chia and Marwaha have applied for funding to conduct a study on the ground this summer to assess barriers to utilization. Marwaha and Chia are already planning the study, in collaboration with professors at Brown and at the University of Singapore.
Marwaha and Chia have solicited the help of numerous experts and professionals, including their advisers at Brown — professors of public health and commerce,
organizations and entrepreneurship — in addition to various administrators.
"I would definitely say that Brown is the place to start a nonprofit," Marwaha said. "There's tons of resources here."
The two have also contacted professionals off College Hill, such as faculty members at the University of Singapore, pro bono legal support at the firm Cadwalader, Wickersham and Taft LLP and officials at the Tanzanian Embassy. "We're always aware that we're college kids, which is why we network widely," Chia said.
"It's no small feat to find your way into the office of the vice president of even a small country," Harlam said. "That to me is an indicator that (Marwaha and Chia) are both studying the field that they hope to operate in, thinking strategically about how to solve the problems that others have encountered before them."
