Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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34 Surgery and Healing in the Developing World
• What are priorities for the local doctors that I can focus on during a
limited stay?
• Whom do I contact to find out about recommended immunizations
and prophylaxis?
• How do I deal with the language barriers?
• What do I need to do before arriving “in-country”?
• How can I leave a busy practice?
• What will I get out of it?
• How do I arrange follow-up for cases I do?
• What about malpractice insurance coverage and lawsuits?
I think this format will be a great way to convey the message that this type of
undertaking is both possible and that it is highly rewarding.
Love, Doug
And so begins the collaborative effort on this chapter between father and son,
both Board-certified Urologists. I, the senior, await the day my son can join me on
a medical mission, for I know full well the value of exposure to the vagaries of
medicine in developing nations. Thirty-five years ago I experienced a “reorientation
of life” perspective and goals after a three-month term of service in Swaziland. Other
mission sites over the years included New Guinea, India, Indonesia, the Ukraine,
several island-nations of Micronesia, Bangladesh, Kenya, Gabon, Cameroon,
Mongolia and the People’s Republic of China. Tours have varied from two weeks to
six months. Each in its unique way has reinforced the desire to share resources and
expertise with those far, far less fortunate than we in the West.
At home, most American doctors would never think of working in places where
vermin scurry about the operating room floor, supplies are so short that bloody
gloves are washed, sterilized and reused until they break, and gratitude comes in
smiles, tears of joy and occasional gifts from the village. But, oddly, in my experience
the volunteers who labor under such daunting circumstances usually can’t wait
to repeat the effort. Simply, it seems that taking your two-week vacation, covering
expenses out-of-pocket, and enduring formidable hardship make a significant difference,
certainly for the recipients of your largesse, but also in your life. My barber
calls it ‘paying your dues’, which reasonably well summarizes the whole undertaking.
Gone are the onerous burdens imposed by a healthcare bureaucracy run amok.
An American colleague says, “The most difficult thing about surgery is getting to do
it!” Further, he observes, “Fully ninety percent of the world’s surgical needs are outside
of the U.S.A. and Europe.” Welcome to medicine in its purest form.
Colleagues’ reactions to my accounts of these missions include keen interest, surprise
that such medical practice differences exist in the day of ‘a global village’, a polite
hearing, an indifference to investment of self apart from a carefully-circumscribed
agenda and a vague desire to ‘just do it’ without a clue respecting virtually any of the
logistics of such an undertaking. “Wow!” “Unbelievable!” “Tell me more!” “How can
it be?” “Oh, I’m so glad that you enjoyed yourself. It’s good to help people so incredibly
needy.” “I wish that I could do that, but you know well enough how busy I am,
how great the cost would be, how it would disrupt my family’s life, how unprepared I
am for the rigors of practice away from the familiar and routine.” “I share your burden
for the underserved in the developing/re-developing (e.g., the Ukraine) nations
of the world, and I believe I’d like to help. Will you answer my questions?” Bottom
line? Most physicians don’t make it to volunteering, not because of lack of desire, but
because they are bogged down in the myriad of details to make it happen.