Doctor's Review: Medicine on the Move

December 11, 2017
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Tour of duty

Whether you’re in a war-torn region or a developing country, a medical mission abroad isn’t your average day on the job

If you’ve wondered what it would be like to stuff only your most essential belongings into a canvas duffel bag, set off for another continent and attend to the victims of natural disasters or civil unrest,

then there are certainly organizations that will find a place for you.

But the first thing their recruiters will tell you is that there’s a little more involved than just packing a bag.

Then again, jumping into the wake of a catastrophe or a conflict zone isn’t for everyone. What if you want to bring your spouse or family? What if you can only commit for a few weeks? No matter what you’re looking for, there’s an organization that’s right for you.


Unattached and Adventurous

Organizations such as Doctors Without Borders (or MSF, the acronym for the original French Médecins Sans Frontières) and the Canadian Red Cross will, depending on need, place appropriate candidates, but not without a thorough vetting.

The decision to commit to overseas work for an extended period of time in situations that can be both traumatic and frustrating, as well as promise only sweltering accommodations, consistently bad food and irksome bugs, demands a clear-headed self-assessment.

Of course, medical skills are essential, but so are a talent for communication, a sound state of mind and an adaptability that can be tested by impossible to anticipate situations. Personnel from extremely different cultures must work co-operatively in stressful situations. Field operations can be in settings where there is no regard for human rights. Rape is sometimes used as a military tactic.

The security of the unit has to be a priority, which can mean the personal mobility of field workers is tightly restricted. The International Committee of the Red Cross (ICRC) and MSF include a series of self-assessment questions on their websites since both place medical professionals near conflict zones.

Personnel from both organizations have been killed in the field, but MSF reports that it is the far more mundane problem of automobile accidents that poses the greatest risk to workers.

A mix of local and international workers staffs field operations. Healthcare professionals work in cooperation with administrators and logistical experts.

Operations in contested territories demand that both aid agencies promote and maintain political independence, neutrality and impartiality. Their workers are obliged to provide medical assistance to whoever needs attention. The ICRC will not enter a country unless its government has granted permission, whereas MSF will.

As a professional with sought-after skills, you’ll find scores of opportunities to contribute to humanitarian aid and development projects. Not all agencies, however, have the same values or defined strategy to meet the long-term needs of the people they assist.

Essential elements of any well-run charitable organization are a critical perspective on itself, both how it operates internally and how it builds the capacity of the community it aims to assist, and an openness to a critique of its principles and practices.

You may want to get a better understanding of development issues by doing some reading. Condemned to Repeat? The Paradox of Humanitarian Action by Fiona Terry (a director of research with MSF) and A Bed for the Night: Humanitarianism in Crisis by David Rieff and Joanne Myers, are good places to start.


Travelling as A Couple

Voluntary Service Overseas Canada (VSO) (www.vsocan.org) is one of a number of organizations that arranges placements with aid agencies in more stable regions around the world. The VSO is open to working with couples as well, but the emphasis is on finding a volunteer who is right for the position available, not the reverse. Partners with similar professional backgrounds are more likely to be placed. Agencies looking for long-term volunteers, however, do have a vested interest in nurturing contented workers.

There are other organizations that play a similar role to VSO Canada. The Mennonite Central Committee (http://mcc.org/canada), for example, does require that its service workers be active in a Christian church — denomination is not important — but itself is non-proselytizing and evaluates aid projects from a secular health perspective. They place married couples and families if the location is suitable and education affordable.

Neither MSF nor the Canadian Red Cross rule out the possibility of married couples or partners being sent out to the field to work together. Each would have to have relevant skills that mesh with the demands of specific situations. A pair of healthcare professionals has the potential to be placed, but both organizations also need administrators/financial controllers, logistics experts, and water and sanitation specialists.

Couples deployed must be ready to accept that life in the field revolves around the team — privacy is a luxury.


To Bring or Not to Bring the Kids

Dr Tracy Mihalynuk, a Victoria-based GP, committed half a year to the Victoria Vanuatu Physician Project (http://pacificcoast.net/~slbdn/). She pulled up stakes and took her husband and four kids to Vanuatu, an archipelago in the South Pacific, for half of 2005. She worked as a volunteer hospital superintendent and practitioner on one of the country’s southern islands.

Doctors recruited from the Vancouver Island medical community rotate through the hospital six months at a time, supporting local health workers and attending to patients. Funding is generated by charitable events in BC and buys equipment for the hospital. Volunteers pay the travel expenses for themselves and their families and receive a small monthly stipend during their term.

The experience made better generalists of Mihalynuk and her husband, a geologist-cum-homeschool teacher and hospital handyman. Knowing that there would be no specialists to turn to for support in Vanuatu, Mihalynuk relied on her colleagues to help sharpen her skills in preparation for her time abroad.

The hardest challenge she faced was reducing her role as a parent to meet the demands of her profession. Her kids, however, adapted easily to life in the South Pacific. They were sorry to give up their “totally hedonistic” lives once they returned from the tropics.

The overall experience, she said, was wonderful: “If it were [rated] out of 10, I would have given it a 20.”


Time for a Quickie

Darlene Hammell, also a family physician in Victoria, spent a week this past winter in Quito, Ecuador, as a part of the orthopedic surgery unit of Canadian Medical Teams Abroad (CAMTA) (www.camta.com).

She was one of four GPs who worked as hospitalists with CAMTA for its two-week surgery clinic. Hammell said the professional reputation of the group’s organizers inspired her to commit to the short-term volunteer position for the first time in 2007.

She had volunteered in Latin America before, but the inevitable limitations of providing general healthcare during short-term stays frustrated her. The group’s openness to suggestions on how to improve the project the following year — CAMTA was only formed in 2001 — helped recruit her for a second trip.


Locating a Locum

If your wanderlust is tempered by the desire to keep drawing steady pay, there are a number of organizations that can help you locate a gig in a nonetheless exotic locale.

For those who want a change of scenery but familiar culture, both New Zealand (www.mcnz.org.nz) and Australia (www.doctorconnect.gov.au) have a demand for family physicians.

The state of Queensland, in northeastern Australia, is currently recruiting. New Zealand has a steady demand for locums outside metropolitan areas that can include subsidized accommodations and transportation. Canadian certification is recognized in both countries.

Canada’s own “outback” has ample territory for the adventurous spirit. The Northwest Territories (tel: 877-241-9356; www.hlthss.gov.nt.ca/Careers/Physicians/contracts.asp) and Nunavut (tel: 877-979- 7343; www.nunavut-physicians.gov.nu.ca) offer incentives for longer contracts, including pro-rated recruitment bonuses, isolation compensation and retention bonuses. All three territories, including the Yukon (tel: 867-667-5620; www.hss.gov.yk.ca/professionals/) need locums for short-term vacancies.

Paul Moreau, an orthopedic surgeon and “restless soul,” spent four weeks this winter as a locum in Yellowknife. The work hours — like the December nights — were long, but the easy manner of the residents charmed him: “It attracts people who are a little different.” He found that working at the hospital and flying into smaller communities for a day’s clinic provided good variety. It fit his own flexibility and distaste for too much structure.

To broaden the search to more exotic locales, try MedHunters (www.medhunters.com), an international job board sorted by region or specialty, or Beresford Blake Thomas (www.bbtglobal.ca), a recruitment agency with offices around the world that places professionals in temporary and permanent positions. Splashing out for a copy of The Big Guide to Living and Working Overseas or subscribing to its Web-based incarnation at www.workingoverseas.com is also a good idea.

This article was accurate when it was published. Please confirm rates and details directly with the companies in question.

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