At $4,000 for a pacemaker and $20,000 for an ICD, a second-hand implant is the only way that millions of people will be able to afford this life-saving equipment. In the UK, charity Pace4Life collects functioning pacemakers from funeral parlours for use in India. In a similar effort, the journal Annals of Internal Medicine recently published the results of a US programme called Project My Heart Your Heart, which found that 75 patients who received second-hand ICDs showed no evidence of infection or malfunction. The group are now applying for FDA approval to send recycled heart devices overseas.

Back in Nashville, Standing With Hope has adopted a similar approach by shipping prosthetic limbs to Ghana. The charity’s co-founder, Gracie Rosenberger, was badly injured in a traffic accident at 17, an incident which cost her both legs. Like many amputees, Gracie acquired a stockpile of prosthetics over the years, which made her wonder whether they could be put to better use. As limbs are replaced or outgrown, the old ones gather dust in the backs of closets. When an amputee passes away, the family are often left with a cache of working limbs but no one to take them.

“The private insurers do not want it back, I don’t even think Medicare wants it back,” explains Rosenberger’s husband Peter, who is president of Standing With Hope. “There are all kinds of liabilities. So a lot of this stuff is discarded, unfortunately.”

Now amputees and their families can send old limbs in the mail to the Rosenbergers. When asking for donations, Standing With Hope’s website reads: “We’re not asking for an arm and a leg... just a leg”.