Doc-In-A-Box: Using Our Trash To Deliver Health Services To The Worlds Poor

At first glance, the doc-in-a-box seems like a novel and innovative idea that can help save the worlds poor while simultaneously recycling for the worlds wealthy.  What can be bad about recycling and providing health services?

Yet since its creation in 2006, the doc-in-the-box has yet to take off as a groundbreaking solution to close the gap between the lack of health service professionals in developing countries as well as alleviate some of the burden of overcrowded hospitals, and create a greater access to health services.

A doc-in-a-box is a discarded shipping container that is approximately 8 feet wide, 8 ½ feet high, and 20 feet long.  The shelves are made from broken down packing containers, the sink is a punctured washing-up bowl, and the curtain is made of sheets.[1] The doc-in-a-box is designed to contain a patient-intake room; two gender-specific examination rooms; a staff room with a small solar-powered refrigerator for vaccines and heat-sensitive medicines and diagnostics; storage; and space for processing simple saliva based tests.[2] The doc-in-a-box is to be run by a trained community health worker, and not a nurse or a doctor. Finally, there would be a computer that is connected to a central computer database, and nurses and doctors available over the phone should the community health worker have emergencies or questions.

Clearing the world’s ports and landfills of these disposed shipping containers, recycling and reusing other refuse, and creating a product that provides health supplies and services appears to come with many benefits.  However the hopes of creating new and more informative databases of regional illnesses, delivering health services to the poor, and the real-time tracking of the spread of infectious disease is not a realistic hope through this invention alone.

Logistically, much more information and research is needed into the methods of how a doc-in-a-box would be distributed, how supplies would be stocked and re-stocked, how community health workers would be trained and by who, how would a coordinating or central office be created and then expected to run this operation, how would cultural stigmas surrounding diseases be addressed, and how to spark interests in investments in these types of mini-franchises.  These are major questions that need to be answered, and from my research have not been addressed.

Laurie Garret, the creator of the doc-in-the-box, examines many of the problems facing the global health community in her article, “The Challenge of Global Health.”  She describes the problems with the lack of a coordinated effort in the global health field, points out that more than just money is required to attack global health problems, explains that a shortage of health-care workers already exists, demonstrates the large problem that corruption creates in developing countries, and argues that the United States and other wealthy nations need to “clean up their own houses” before moving to the crisis in the developing world.  With all of her enlightening insights on such an important topic, I find it surprising that she does not provide additional information or address the logistical issues of her own invention.

The doc-in-a-box is a great invention, and has the potential to turn into an amazing idea that changes aspects in the global health community.  However, much more research and thought is needed to convince donors, recipients, and the public at large the success and benefits that this device can produce.  In conclusion, while the creation of brilliant inventions is needed in this world to address issues faced by global public health, as well as other fields, innovation in re-making and re-modeling existing systems is also necessary to challenge the status quo and provide an opportunity for a successful social entrepreneurial venture that can change the world as we know it.


[1] Helen Pearson. “Doc-in-a-Box Springs Open– Turning the ubiquitous hipping container into a mobile clinic.” http://www.bioedonline.org/news/news.cfm?art=2587.

[2] The Council on Foreign Relations.  “Doc-in-a-box: a conceptual framework by the Global Health Program.” http://www.cfr.org/content/meetings/global_health_rt/doc_in_a_box.pdf

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