Health care volunteerism: What PAs need to know before making a trip by ProQuest


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									                                            Special Article

Health care volunteerism: What PAs
 need to know before making a trip
“I spend one week every year in South America working with           about volunteering for a short-term global medical mission
a university-based group that provides pediatric surgical care.      (Resources for information on global volunteerism).
When I volunteered, I just assumed everything was arranged.
Boy was I surprised! On our first trip, even though we had           BEST PRACTICES
worked with the government to arrange the trip, the govern-          Agencies that work directly with existing systems or orga-
ment clearly was not in charge of what was happening on the          nizations in developing countries—even those limited by
ground. The local military junta controlled everything; we had       Western standards—have the best chance of making a posi-
to go through them to do anything. Getting equipment into and        tive, sustainable impact on community health.2,3 Working
out of the country intact was a challenge. We lost a lot of equip-   with community leaders allows short-term medical teams to
ment that first year. Also immediately clear was that the nurs-      learn local customs and culture, understand the local “heal-
ing staff did not have the education to provide safe, effective      er” and “healing arts,” and avoid making erroneous assump-
postoperative care.                                                  tions about local needs.4,5 This cultural sensitivity increases
   “Now, we partner one of our nurses with two local nurses          the effectiveness of care and may facilitate long-term relation-
on every case so the local nurses will have the skills needed to     ships that help build local health care infrastructure.
take care of the children after we go home. We also collaborate         Shoulder to Shoulder, a private, nonprofit, nongov-
with the local providers concerning the care and maintenance of      ernmental organization (NGO) incorporated in 1996, is
equipment. They are much better at getting what patients need        Continued on page 36
locally than we are. I love going. If we did not go, these kids
would not get the surgery they need, but I wish I had known a
lot more before making that first trip.”
          —A volunteer, in a conversation on January 27, 2009

            eople reach out to impoverished or devastated
            global communities as a profound expression
            of basic humanity. Participation in short-term
            medical missions—whether religious, secular,
            professional, or academic—is at an all-time high.
Annually, approximately 6,000 short-term missions from
                                                                                                                                        Photo courtesy of Shoulder to Shoulder

the United States provide care in resource-poor countries at
an estimated cost of $250 million.1 Physician assistants can
and do play an important role in these medical missions as
partners with physicians, nurses, pharmacists, dentists, and
other health care professionals. The desire and commit-
ment to help is made clear by the time, effort, expertise, and
money that are committed to these efforts.
  The goal of this article is to provide the PA with back-
ground information, questions to consider before volunteer-
ing, a familiarity with the ethics of providing care abroad,         A Honduran family physician treats a young boy with burns in
and suggested readings to assist with decision-making                Shoulder to Shoulder’s medical center in Santa Lucia.

28 JAAPA • MAY 2010 • 23(5) •
                                                                                               Special Article
                                         an example of a program founded in the United States                Africa, Asia, Central America, and the Caribbean (www.
                                         (Cincinnati, Ohio) with strong partners abroad (www.       The primary focus of the organiza-
                                Six years before its official incor-       tion is to provide “long-term, sustainable, replicable medical
                                         poration, Shoulder to Shoulder worked with local com-               education and training.” While educating local providers,
                                         munity leaders in Honduras to form Hombro a Hombro,                 teams of health care professionals provide rehabilitation to
                                         a grassroots, community-based nonprofit NGO registered               amputees; promote the establishment of burn clinics and
                                         in Honduras. The organization states on its Web site,               reconstructive surgery; train midwives, with a focus on
                                         “Shoulder to Shoulder and Hombro a Hombro work in                   abnormal labor, postpartum hemorrhage, eclampsia, and
                                         tandem to achieve a single mission: to develop educational
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