Surgery and Healing in the Developing World - Dartmouth-Hitchcock

CHAPTER 1
CHAPTER 1
Preparation Time
Harvey Bratt
Now that you have decided, for humanitarian reasons, for adventure, for a religious
medical mission experience, or just to broaden your horizons, it is time to look
seriously into the decisions you must make to ensure that this will be the fulfilling
experience that you wish it to be. And hopefully, this will be an experience you wish
to repeat, perhaps many times. Be forewarned, the journey you are about to take
may result in an “addiction” which will motivate you for years to come.
An important first decision is whether your spouse accompanies you. For several
reasons, I would strongly advise that he/she come along if at all possible. Selfish
reasons would include the companionship you are accustomed to, but of much
greater importance is the sharing of the experience; this can be so meaningful to
both of you in your personal interactions forever after. The same reasoning would
pertain to other family members. Children (especially teenagers) are often welcome
and can work in a wide variety of positions, ranging from general helpers to interpreters
if they have language proficiency such as in Spanish or French.
Next comes the selection of the country you wish to work in. There are opportunities
all over the world and you should pick a place or places in which you will most
likely be able to work comfortably. If you strongly dislike hot weather, it would be a
sizeable mistake to sign up to go to equatorial Africa. Conversely, if you despise the
cold, Juneau, Alaska, would be a poor choice.
Many/most Third World opportunities will be associated with organizations which
have resources and facilities to assist you in your planning. This is certainly true of
most missionary organizations. One organization whose focus is strongly Christian
is World Medical Mission (www.samaritan-purse.org); it lists opportunities all over
the world. But some opportunities will require you to do many or most of the
planning details yourself. Regardless of whether you must do your own arranging or
whether you will receive organizational support, be certain to allow a considerable
amount of time; details always take more time than expected and there may be
numerous dips and detours and perhaps frustrations in the process.
When you have decided where you will be going, it will be very important to
contact that hospital or clinic. It will be very important to clarify exactly what types
of surgery you will be expected to perform. In most Third World settings, obstetrical
and gynecological procedures will be very commonly necessary. Being a general
surgeon, trained, in gynecologic surgery as well, I always found it helpful to observe
or preferably scrub in on a few C-sections before going. In many areas, vesicovaginal
fistulae are commonly found, secondary to prolonged obstetrical obstruction; reading
in advance in this area may be helpful. Observation of some common plastic
surgery procedures such as cleft lip repair will be helpful if this type of challenge may
be expected. Also, a good basic surgical textbook, oriented to the area where you will
Surgery and Healing in the Developing World, edited by Glenn Geelhoed.