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Volunteers See the World and Help Its People

Volunteers See the World and Help Its People The case was unusual, even in a developing country such as Jamaica: a 40-year-old woman with a large ovarian tumor—45 pounds large. With medical services scant, the patient waited until a volunteer team from Medical Ministry International (MMI) (see Table 1a) arrived. An obstetrician from the United States excised the benign mass—which turned out not to be so benign. The tumor had been crushing the vena cava, squeezing a great quantity of blood into myriad clots. Released from the pressure, a large clot broke free and lodged in the patient's lung, killing her. View LargeDownload Physician Service Opportunities Abroad Table 1 View LargeDownload b Table 1 View LargeDownload c Table 1 View LargeDownload d Table 1 View LargeDownload e The next day, the obstetrician walked out of the clinic and found herself surrounded by the patient's family. She assumed they would be angry. Instead, they were grateful, offering gifts and thanks. "Whenever I tell that story about another volunteer, I say, ‘How could you not go back?'" said George E. (Ged) Deering, MD, an MMI volunteer and emergency physician at Berkshire Medical Center in Pittsfield, Mass. Indeed, Deering has made many visits to the Caribbean island. "I always tell people it's selfish," he said. "We pay our way, our room and board, our airfare, we work for nothing, and we come back feeling like somebody gave us a million bucks." That sum would go a long way toward staffing the hospital where Deering volunteers. Serving 50 000 scattered residents of St Elizabeth township, the 110-bed facility typically operates with one or two physicians. While the Jamaican health care system is "fairly good," said Deering, scant resources render surgery infrequent. Each time an MMI team arrives, three or four times a year, Jamaicans line up. While "overseas volunteering" often conjures images of bespectacled blonds inoculating brown children in jungle villages, opportunities also await in relatively modern clinics and hospitals, where "developing" is a verb, not a label. David Kuehler, MD, a surgeon at Albany Medical College in New York and a volunteer with World Medical Mission (see Table 1), said that many city hospitals and town clinics in nonindustrialized countries improve yearly. Some offer a modest range of laboratory services, own third-hand ultrasound and computed tomography machines, and house well-stocked pharmacies. In the 30 facilities he's visited during the past 15 years in Africa, Asia, and the Middle East, Kuehler said, specialty care is what is most often lacking. Recognizing that brief visits can help only so much, some physician groups organize long-term improvements to facilitate specialty care. One group, CURE International (see Table 1), has built orthopedic hospitals for children in Kenya, Malawi, and Uganda, staffed by overseas volunteers and local physicians and nurses. Broadened experience Volunteers say that they broaden their expertise by treating patients with conditions virtually unseen in the United States. Ned Schwentker, MD, an orthopedic surgeon at Pennsylvania State University's Hershey Medical Center and a volunteer with CURE, said that in Honduras he frequently operates on children born with club feet. Deering once surgically repaired the shark-bitten hand of an unfortunate fisherman who was washing his arm in the ocean after tossing fish entrails overboard. And as a general surgeon, Kuehler finds himself performing unfamiliar operations with little preparation. "Sometimes I have to read a textbook and try to decide if it's safe [to operate]," he said. "But you do what you can—or the patient could be dead." Emotional challenges While volunteering in the best local facilities can provide hands-on skill building, other volunteers visit the impoverished end of the overseas spectrum, where they encounter more emotional challenges. As a fourth-year medical student in 1994, another Albany physician, Bob Paeglow, MD, traveled to a refugee camp in war-ravaged Mozambique. Although he knew he wanted to tend to the unfortunate, the pull of African adventure also beckoned. Any visions of Hemingway faded quickly. "I was kind of clueless and my heart was really broken," he said. "It was totally overwhelming; I could talk for hours and hours about the horrors." Yet he returned again and again, tallying 18 trips in 8 years. Now he brings his own medical students and watches them struggle, cope, and—usually—find fulfillment amidst the chaos. But some young physicians simply break down. "I don't think that kind of traumatic experience is good for everybody," he said. "Some struggle mightily." Many of the rest, though, get struck by the volunteer bug—Schwentker calls it "an infectious disease." He credits the tenacity of volunteers he's worked with to "the intrinsic altruism that I think all physicians start out with." And, he added, he also gives credit for spurring volunteerism to some lawyers and health maintenance organizations. "They kind of take away some of the rewards of medicine," he said—rewards that working far afield can bring back. Working at home, Kuehler said he envisions medical charts stacked on his grave. The headstone offers a reproach: "You can't die, you have to finish these." Volunteering overseas, he said he enjoys "sticking to the basics" of patient care. "One of these times," he muses, "I might not come back." http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Volunteers See the World and Help Its People

JAMA , Volume 288 (5) – Aug 7, 2002

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Publisher
American Medical Association
Copyright
Copyright © 2002 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.288.5.559
Publisher site
See Article on Publisher Site

Abstract

The case was unusual, even in a developing country such as Jamaica: a 40-year-old woman with a large ovarian tumor—45 pounds large. With medical services scant, the patient waited until a volunteer team from Medical Ministry International (MMI) (see Table 1a) arrived. An obstetrician from the United States excised the benign mass—which turned out not to be so benign. The tumor had been crushing the vena cava, squeezing a great quantity of blood into myriad clots. Released from the pressure, a large clot broke free and lodged in the patient's lung, killing her. View LargeDownload Physician Service Opportunities Abroad Table 1 View LargeDownload b Table 1 View LargeDownload c Table 1 View LargeDownload d Table 1 View LargeDownload e The next day, the obstetrician walked out of the clinic and found herself surrounded by the patient's family. She assumed they would be angry. Instead, they were grateful, offering gifts and thanks. "Whenever I tell that story about another volunteer, I say, ‘How could you not go back?'" said George E. (Ged) Deering, MD, an MMI volunteer and emergency physician at Berkshire Medical Center in Pittsfield, Mass. Indeed, Deering has made many visits to the Caribbean island. "I always tell people it's selfish," he said. "We pay our way, our room and board, our airfare, we work for nothing, and we come back feeling like somebody gave us a million bucks." That sum would go a long way toward staffing the hospital where Deering volunteers. Serving 50 000 scattered residents of St Elizabeth township, the 110-bed facility typically operates with one or two physicians. While the Jamaican health care system is "fairly good," said Deering, scant resources render surgery infrequent. Each time an MMI team arrives, three or four times a year, Jamaicans line up. While "overseas volunteering" often conjures images of bespectacled blonds inoculating brown children in jungle villages, opportunities also await in relatively modern clinics and hospitals, where "developing" is a verb, not a label. David Kuehler, MD, a surgeon at Albany Medical College in New York and a volunteer with World Medical Mission (see Table 1), said that many city hospitals and town clinics in nonindustrialized countries improve yearly. Some offer a modest range of laboratory services, own third-hand ultrasound and computed tomography machines, and house well-stocked pharmacies. In the 30 facilities he's visited during the past 15 years in Africa, Asia, and the Middle East, Kuehler said, specialty care is what is most often lacking. Recognizing that brief visits can help only so much, some physician groups organize long-term improvements to facilitate specialty care. One group, CURE International (see Table 1), has built orthopedic hospitals for children in Kenya, Malawi, and Uganda, staffed by overseas volunteers and local physicians and nurses. Broadened experience Volunteers say that they broaden their expertise by treating patients with conditions virtually unseen in the United States. Ned Schwentker, MD, an orthopedic surgeon at Pennsylvania State University's Hershey Medical Center and a volunteer with CURE, said that in Honduras he frequently operates on children born with club feet. Deering once surgically repaired the shark-bitten hand of an unfortunate fisherman who was washing his arm in the ocean after tossing fish entrails overboard. And as a general surgeon, Kuehler finds himself performing unfamiliar operations with little preparation. "Sometimes I have to read a textbook and try to decide if it's safe [to operate]," he said. "But you do what you can—or the patient could be dead." Emotional challenges While volunteering in the best local facilities can provide hands-on skill building, other volunteers visit the impoverished end of the overseas spectrum, where they encounter more emotional challenges. As a fourth-year medical student in 1994, another Albany physician, Bob Paeglow, MD, traveled to a refugee camp in war-ravaged Mozambique. Although he knew he wanted to tend to the unfortunate, the pull of African adventure also beckoned. Any visions of Hemingway faded quickly. "I was kind of clueless and my heart was really broken," he said. "It was totally overwhelming; I could talk for hours and hours about the horrors." Yet he returned again and again, tallying 18 trips in 8 years. Now he brings his own medical students and watches them struggle, cope, and—usually—find fulfillment amidst the chaos. But some young physicians simply break down. "I don't think that kind of traumatic experience is good for everybody," he said. "Some struggle mightily." Many of the rest, though, get struck by the volunteer bug—Schwentker calls it "an infectious disease." He credits the tenacity of volunteers he's worked with to "the intrinsic altruism that I think all physicians start out with." And, he added, he also gives credit for spurring volunteerism to some lawyers and health maintenance organizations. "They kind of take away some of the rewards of medicine," he said—rewards that working far afield can bring back. Working at home, Kuehler said he envisions medical charts stacked on his grave. The headstone offers a reproach: "You can't die, you have to finish these." Volunteering overseas, he said he enjoys "sticking to the basics" of patient care. "One of these times," he muses, "I might not come back."

Journal

JAMAAmerican Medical Association

Published: Aug 7, 2002

Keywords: emotions,africa,child,students, medical,surgical procedures, operative,voluntary workers,surgeons,asia,caribbean region,kenya,middle east,mozambique,nurses,uganda,honduras,orthopedics,internship and residency,medical residencies,medical missions,developing countries

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