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Mar/Apr 2009 e-Edition
Missions of Mercy
Volunteer physicians find great satisfaction—and a wealth of opportunities—in using their talents to help Third World patients. It’s a working vacation you’ll never forget.
By lori herring and tyson volkmann
Unique Opportunities The Physician’s Resource    Jan/Feb 2008
When 21-year-old Shannae, emaciated and depressed, boarded the Mercy Ships vessel in Monrovia, Liberia, she could not see whether the seas were green or if the sky was blue. In fact, Shannae could not see anything—her sight had been stolen in a bomb blast during Liberia’s civil war 10 years earlier. She could not read or sew, or even take care of herself. The only sure thing she could do, it seemed, was progress almost inevitably down the slow road of her decline.
But on board the ship, one of two currently operated vessels of the medical volunteer organization Mercy Ships, Shannae would receive two operations from Glenn Strauss, MD, and associates—one
on each eye—and she would regain her sight. She would learn to sew on the ship, thereby acquiring a skill that would feed and clothe her. Most importantly, with her sight she would regain hope, thanks to a crew of volunteer physicians, all of whom had given freely of their skills and knowledge in return for the opportunity to help people like her, people who may otherwise have little help—or hope—for the chance to experience a part of the world they otherwise may not ever have seen.
“The best part of volunteering is the opportunity to do what I do professionally already, with the motives being pure,” says Strauss, 52, who is both a volunteer and the vice president of international health care and programs for the Tyler, Texas-based organization Mercy Ships. Although Strauss gave up his practice as an ophthalmologist in 2006 in order to become a full-time medical volunteer for Mercy Ships, many others serve shorter stints, offering anywhere from two weeks to several months of their time to help others in developing countries receive health care.
Globally, more than three billion people live without basic health services. At least one billion do not even have access to clean drinking water. These staggering statistics stem from multiple causes, from civil strife to government corruption, from misuse of natural resources to income disparities. The underlying cause is poverty, however, and although it is not limited to the Third World, its effects are inequitably distributed there, leading many physicians to volunteer their skills in those countries.
As Steve Klotz, MD, an infectious disease specialist and a professor of medicine at the University of Arizona, says, “Somewhere along the line I said, ‘Hey, I want to try do something of value for Third-World nations with no resources.’” Since then, Klotz has volunteered in Vietnam, Ethiopia, and Seychelles, a nation of 155 islands in the Indian Ocean. “I work harder out of country than at home,” he says. “It’s extremely difficult but satisfying.”
Physicians who volunteer abroad are not always blazing new trails. However, now more doctors than ever are traveling those roads that are less traveled, into countries without regular health-care systems, enough physicians, or the infrastructure needed to put programs in place. Volunteer doctors have a wealth of opportunities available to them. Worldwide, there are literally hundreds, if not thousands, of internationally-aimed, volunteer-based medical charities, foundations, non-governmental organizations (NGOs), projects, and programs.
“I think there is a lot more media focus on global health issues, and that has permeated within the health-care community in the United States,” says Nancy Kelly, the executive director of Health Volunteers Overseas (HVO). “People are wondering what they can do, what kind of contribution they can make.
“Look at HIV and SARS, for example,” Kelly says. “This is bad news, but it does make people realize there’s an enormous need in developing countries. Especially for the baby boomers, who are looking at retirement and who may have always wanted to do the Peace Corps, who have always wanted to give back—now they see a way they can use their professional training to give back.”
Although the immediate post-9/11 years saw America’s gaze turn inward, the general trend across the country has for some time been pointing toward an increase in international philanthropy and volunteerism. Physicians are taking a leading role as better-organized and better-funded operations continually present more exciting and rewarding opportunities.

To go or not to go
The decision to volunteer in a foreign country is not an easy one. Layers of factors must be considered simultaneously. A potential volunteer is forced to rank criteria normally considered intangible—psychological, emotional, and financial, for example—according to a series of value judgments, and then come to an often difficult decision.
“What’s important for anyone who is interested in volunteering is to ask themselves what they value and whether volunteering is something that will help them experience that,” Strauss says. “Candidates should be introspective and ask what is important to them.”
For many, just the process of deciding whether or not they want to volunteer is somewhat overwhelming, stressful, and time-consuming. An informed decision can, and realistically should, take months. “Making that first step is tough,” says Tom Fell, MD, a retired Washington-based anesthesiologist, who has nearly 35 years of international volunteer experience in more than 20 countries. “After that first step, it gets much easier.” Still, the apprehension inherent in taking that first step is enough to frighten even the most stalwart adventurers.
As in any important decision-making process, there are myriad of ways to build one’s confidence in making an informed decision. One of the first and most important should be finding appropriate planning resources. As always, the Internet is a suitable place to begin. However, due to a lack of one unifying clearinghouse of international-based physician opportunities, wading through the muck via a World Wide Web search can be a cumbersome and clumsy experience. Although it can be difficult to know where to begin the search, the Journal of the American Medical Association publishes a fairly exhaustive list of international medical volunteer organizations.
The International Medical Volunteers Association’s Web site, www.imva.org, is compulsory reading as well, including background information on volunteering, tips for future volunteers, and even stories from the road. In case there is not enough evidence that the world needs to be saved, this Web site contains an entire section on global health statistics.
One factor that often holds potential volunteers back is the trepidation of interfering with a comfortable routine. For most physicians, this fear is well-founded. Who has time to get away for weeks to months when ER shifts need to be covered, staffs need to be paid, and families need to be taken care of? Gary Doolittle, MD, an anesthesiologist who still manages to volunteer internationally at least once a year, suggests that just about any physician with the motivation can go.
“I usually don’t take trips that last longer than two weeks,” he says, explaining his solution to juggling both professional and volunteer careers. “And when I go, I just have a few partners cover for me, which they are usually glad to do.”
As for how to manage the family, Doolittle presents a logical solution. “One of the factors for my decision of where I volunteer in the world is my family. I take them along with me to interesting places. My middle daughter has come with me three times.”
Before You Go   Veteran volunteers share a list of things to consider before hitting the road

4 Do the research before deciding. Consider all different types of volunteer work. There is an ever-widening spectrum of possibilities in the volunteer sector. A well-thought-out choice is a wise choice.
4Develop some goals and expectations in advance. Understand the limitations of working in a developing country.
4Read up on what is needed on the road. The International Medical Volunteers Association Web site, www.IMVA.org, provides packing lists and has information on ways to prepare, keep safe, stay healthy, and what to expect abroad.
4Know the faith obligations of an organization. Before signing on the dotted line, read the fine print about which beliefs your organization holds and in which activities a volunteer is expected to participate.
4 Plan the financial aspects in advance. Months and even years of preparation may be necessary to ensure a financially responsible volunteer experience.
4Get immunized. Attend a good travel clinic to sort this out. Clinics across the country specialize in specific immunizations, prophylaxis, and treatment for diseases endemic to every region of the world.
4Learn the language if possible. Especially if volunteering for an extended time, understand the people who are being served, their history and culture. Even a baseline grasp will serve to prevent unnecessary embarrassment.
4Make sure to have a job. Don’t arrive abroad without knowing your responsibilities.
4Have a sense of humor. Laughing is the ultimate way to breeze through an unfamiliar or potentially awkward situation.
4Keep an open mind. Cultural differences are often difficult or nearly impossible for someone from another world to understand. Remember, you are the foreigner.
4Work hard. There is nothing more rewarding than the feeling of a job well done.
4Remember, these are real people. A volunteer must know that he will be dealing with specific individuals rather than faceless people. Even if it’s difficult, a volunteer must be willing to deal honestly and openly with the individuals he is serving.
4Just do it! The experience will never be regrettable. If it doesn’t work perfectly the first time, try again until it feels right.
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Rachel, a British nurse, instructs parents in Sierra Leone about parasites, diarrhea, and malaria.  above right, A group of people gather to be screened in the West African country of Benin.
Above, Dr. Tony Giles and nurse, Ann, screen patients with tumors in Sierra Leone. Right, a group of people gather to be screened in the West African country of Benin.  
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Africa Mercy, part of the Mercy Ships fleet, heads out to the North Sea.  Right,  Dr. Gary Parker of Mercy Ships checks a patient in Togo in Western Africa.
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