For Doctors, Volunteering Overseas Brings Rewards, Safety Concerns

The bombing of a Doctors Without Borders hospital in Afghanistan earlier this month continues to be in the news. Political ramifications aside, the bombing, which claimed the lives of 22 doctors, nurses, and patients, raises anew concerns about the risks that physician face when traveling overseas to volunteer.

For most physicians, the decision to practice medicine is intricately intertwined with a call to serve society through the delivery of medical care — a calling that is so powerful that it is unlikely to be deterred by the many risks involved. But there are some things all individuals considering volunteering – including physicians – should consider.

Assessing the Risks

There is a degree of risk in every decision we make every day, including the simple task of driving to your practice or institution. But that risk is significantly heightened in war-torn or disease-ravaged areas where healthcare volunteers are needed most. Risk of physical harm to a volunteer is among the most notable and terrifying risks, but it is certainly not the only one. Others may include, but are not limited to:

Risks of the environment. Preparation for placement overseas must be accompanied by an understanding of the risks posed by infection from tropical diseases, environmental risks, and even the psychological issues of being subjected to harsh living conditions, the potential scarcity of good medical equipment in the area, and the overall feeling of helplessness that can overcome anyone in the face of overwhelming medical need.

Risk of unsafe medical or handling practices. US-based care centers have strict guidelines for who is qualified to treat, how medications and medical devices will be handled, and accepted tenets of patient care. Volunteers overseas may often find these standards to be much less strictly enforced, or, at worst, absent altogether. You may find yourself, for example, providing patient care among individuals with much less training and experience than you have, or working solo in a situation in which you would normally have a full care team.

Risk of misunderstanding cultural norms or preferences. Before locking yourself into a location, consider your knowledge of the local culture, the medical norms in that location, and possible resistance to “Western” medicine you may face from those you’re seeking to help. Consider any potential language barriers as well. In some countries, patients may refuse to be treated at all by physicians based on gender, race, or ethnicity. All of these factors should strongly considered before you select a location to volunteer.

Ask, Ask, and Then Ask Again

Organizations such as Doctors Without Borders and the dozens of other groups that make overseas volunteering a viable option go to great lengths to identify those risks with all potential volunteers and to minimize the risks wherever possible. But prior to seeking a volunteer engagement, you should supplement those efforts with a great deal of research on your own.

Ask the organization you’re considering working with how they handle such barriers, how deep their experience is in a given region, and what safeguards are in place. Consider the organization’s reputation and experience, speak to the leadership about anything that may be troubling you, and strongly consider speaking to physicians who have served with the organization and in the area you’ll be serving.