The benefits and costs of volunteering your health care services abroad
Almost a year after Hurricane Maria devastated Puerto Rico, we’ve learned that the death toll is nearly 3,000—much higher than originally reported. And yet that number could be even higher were it not for the brave and dedicated medical providers who traveled to the U.S. territory to help in the aftermath of the storm.
One of those people was Wil Nieves, RN, MS, FACHE(R), from Boston. “Hearing the constant news about the damage was very disturbing to me because Puerto Rico is my homeland and many of my relatives still live there,” he wrote in an article for Atrius Health, his employer since 1998. After researching online how he could help, he embarked on a 15-day medical mission to Puerto Rico with Project HOPE last November.
Here’s what Nieves and other health care professionals have to say about their experiences volunteering abroad.
Leading the world in doctor volunteers
U.S. physicians lead the world in short-term medical mission (STMM) participation, according to a 2016 study published in the journal Global Health. The authors define STMMs as “a form of unregulated and unsanctioned, grass roots, direct medical service aid from wealthier countries to low and middle income countries.”
An estimated 7.5 to 10 percent of U.S. doctors have participated in international mission work.
These volunteer trips are differentiated from full-time relief practice such as Médecins Sans Frontières (MSF), military or other governmental relief expeditions, and officially sanctioned medical student or residency training programs, noted the authors, and are not usually affiliated with a religious organization.
Recent surveys indicate that STMM participation and mission numbers have been increasing, with an estimated 7.5 percent to 10 percent of doctors participating in some form of “international mission work.” Some consider it a calling, some go to gain experience, and some seek the perspective that traveling and serving patients in low and middle income countries provides.
Offering patient care, gaining perspective
Medical providers who travel on mission trips must be prepared for rustic living conditions, long hours, and treating patients without the benefit of many of the tools and resources they are accustomed to in the U.S.
Stephen H. Hanson, PA-C, has been on three missions with HELPS International Bakersfield, Calif. surgical team, most recently in Cobán, Guatemala. In an article for Physicians Practice, he described how he and his team saw thousands of clinical patients in remote villages and a field hospital they set up themselves. They completed hundreds of surgeries and procedures using gowns, gloves, medications, and sutures that they brought with them, without any diagnostics aside from ultrasounds and MRI/CT scans if patients provided them. Hanson lived in barracks-type accommodations, ate cafeteria food, and endured “interesting” plumbing.
Mission trips allow providers, especially PAs, to practice at the top of their training; there are needs in every specialty.
For him, it was worth it to be able to work in an environment where he is not judged for or constrained by his license or state regulation, he wrote. “It is the highlight of my year each time I am on mission to practice at the very top of my training, experience, and scope of practice, and be respected by all the members of the surgical team beyond my status as a PA.”
Dermatology PA Savanna Perry, PA-C, of Georgia, who has also been on several mission trips, initially worried that her specialization could limit her ability to provide care internationally. “But I’ve since learned that there are needs in every area,” she wrote in Clinician Today.
Perry has also learned that despite differences in culture and practice environment, patients are patients no matter where they are. “They typically have the same conditions, the same concerns, and the same fears when it comes to health. Whenever I’m able to see patients in a different setting, it helps to remind me that we are so lucky to have the resources we can access in the U.S.”
The costs of a mission trip
The cost of going on a medical mission trip varies. Some organizations require participants to pay a flat fee for food and lodging, with doctors responsible for their own airfare, vaccinations, and other costs. The Global Health study reported that “including opportunity cost, average total economic inputs for an individual physician pursuing an STMM exceed $11,000.” This article in The DO, the blog of the American Osteopathic Association, breaks down the expenses and offers tips for financing medical mission trips.
Despite the cost, the experience of going on a medical mission trip is invaluable and life-changing, say those who have done it.
One theme is consistent from medical professionals who have gone on missions: the experience is invaluable and life-changing. Nieves wrote, “On the flight back to Boston I reflected on how I served in the U.S. Army Medical Department for more than 28 years. Now this mission provided me an opportunity to serve my people in need in Puerto Rico. It was a very satisfying experience that I will cherish for a lifetime.”
Hanson stated, “Every American should go on mission once in their lives to the third world.”