International Volunteerism Experiences from the Field

What follows are personal stories from your colleagues who have already participated in rewarding international volunteer programs. Learn first-hand what their work has accomplished and how you can get involved as well. If you have a story you would like to share, click here.

Example of academic-based experience

W. Zack Taylor, MD (drzacktaylor@aol.com)
Gastroenterology in Afghanistan (2002-2007)

After the fall of the Taliban in November 2001, a group of individuals touched by the courage and spirit of the Afghan people looked for a way to positively impact this country at war for 30 years. Afghan government leaders traveled to meet with a handful of volunteers from Memphis, Tennessee in October of 2002. The one-week Memphis-Afghan Friendship Summit interfaced the Afghan leaders with The University of Memphis as well as other levels of local education, the Fed Ex Leadership Institute, the University of Tennessee Trauma Center at The Med, and St. Jude Children’s Research Hospital. A Memorandum of Understanding was signed by both parties pledging cooperation and mutual efforts to build lasting friendship. Four Memphians then traveled to Kabul one month later and laid the groundwork for medical teaching, leadership development training, and humanitarian assistance. The Memphis-Afghan Friendship (MAF) organization has thus far taken over twenty teams of physicians, dentists, nurses, teachers, and business leaders to five cities in Afghanistan since 2003.

The MAF medical focus centers on teaching students, residents, and practicing physicians in hospitals, mentoring on a long term basis, procurement of equipment, and teaching primary care skills to leaders in rural villages. We have directed medicine distributions to remote areas devoid of medical care in the Afghan mountains. MAF gastroenterology assistance began in November 2002. At that time I met Dr. K.Q. Sediqi, a 35-year-old gastroenterologist who had just returned to his country. There was very limited diagnostic upper endoscopic capability in the country and no colonoscopy or therapeutic endoscopy. Over the next four years I assisted Dr. Sediqi in acquiring functional video-endoscopic equipment and developing numerous therapeutic techniques. These included stenting of GI malignancies (without fluoroscopy…sorry, none exist in the country) and management of GI bleeding. Colonoscopy was introduced in 2003. With the help of the late Dr. Martin Wienbeck of Germany, Dr. Sediqi began training other endoscopists and now has proficient student endoscopists in several of the larger cities in Afghanistan. He maintains the only therapeutic endoscopy center in the country in Kabul. My involvement with him continues to be through short-term trips several times a year, bringing new technology, equipment, and improving skills. Dr. Sediqi recently formed the first Afghan Endoscopy Society and is actively seeking international collaboration.

MAF has also been supporting and attempting to upgrade GI and endoscopic skills at CURE International Hospital in Kabul. This hospital is managed by a western charitable organization and has the only Afghan residency program (Family Medicine) in the country. We are breaking ground on improving diagnostic endoscopy and plan to try and implement therapeutic endoscopy within the next few months. The need for updated equipment is critical!

In 2007, wide gaps remain in gastroenterology training and advanced endoscopy in Afghanistan. There is a critical need for gastroenterologists, GI assistants, and nurses to go and help teach, equip, and mentor. Unfortunately, sustainability in maintaining equipment is non-existent. Partnerships with endoscopic companies and suppliers must be forged. Those prepared to go on short term, one time visits and those who sense the call for long-term work are needed. Our work with MAF will be a life long project as success in Afghanistan is usually realized with the passing of generations and not shorter time intervals. Afghanistan’s security and new democracy remain fragile. I have realized that true international alliances and understanding between different cultures depend more on developing friendships and giving than on politics and military strength. Professional fulfillment is truly magnified when we give from who we are and what we have to those who have a need. We remain committed to sharing from what we have as long as there is a need.

Example of faith-based experience

Edward L. Cattau, Jr., MD, FACG (ecattau@memphisgastro.com)

A variety of opportunities to serve exist through faith-based organizations. As with secular sponsors, they include primary care, clinical gastroenterology and medical education. Needs exist almost everywhere in the world. The duration of service can be from days to months but is most commonly one to two weeks.

A difference between faith-based mission trips and other service opportunities is that of motivation. While we all have a desire to offer humanitarian aid to those in need, faith-based organizations acknowledge that our motivation to serve is a joyful, obedient response to commands from God. These trips are intended, in part, to demonstrate our faith through our loving service and may be coupled with more direct evangelistic efforts by team members or our host nationals.

My own experience has been through my church. I have done site visits in Haiti, Hungary and the Ukraine. But, my first medical mission was in 2002 when I was invited to go to Guatemala with a pediatrician who had extensive mission experience. Since then, I have led three teams to Guatemala, one to Belize and am currently organizing a second Indian trip. These teams with twelve to twenty-two members, consisted of doctors, dentists, nurses, pharmacists, as well as individuals with no previous medical experience.

The most medically primitive area I have served is rural India where most people have never seen a physician and almost none have ever seen an American. We had electricity supplied by generators, minimal equipment (only what you could carry in your pockets) and essentially no laboratory support. The real test of faith was practicing outside my comfort zone. However, there were two Indian physicians working with us who could get people into the healthcare system if necessary. Although the level of sophistication of the care delivered was minimal, it was more than most had ever received. More importantly, I believe our presence, our smiles and our desire to love these people had much more impact than the healthcare we delivered.

While I am currently looking for opportunities to serve using my “skills” as a gastroenterologist, I plan to continue leading short-term medical teams. And, as with most everything I do, it’s not without selfish motivation. As I mentioned, there is a true joy in obedient service to our Lord and Savior. These trips also afford a unique opportunity to grow in faith. When we leave our comfort zones, we have to put more trust in Him. When we are in strange environments, we can no longer pretend we are in control. And, there is the personal delight in seeing the response of fellow missionaries, particularly first-timers, as you witness them developing world views that can only be obtained by going and serving the most needy.

Yes, we all need to send as much money as we can to support the work of feeding the hungry and caring for the sick. However, if you want to receive infinitely more than you give, step outside the Shire and experience the mission field.

Examples of humanitarian organization experience

Edward L. Lilly, MD (lpad23508@yahoo.com)

Volunteering with a humanitarian organization has many of the same characteristics as volunteering with educational or religious organizations. We are all motivated by a desire to help less fortunate people solve their health care needs. Humanitarian organizations often offer a particular focus of their work and generally have extensive experience and knowledge in their fields of service. They often partner with educational institutions to draw on the expertise of people in those facilities, frequently expatriates who want to serve in their native countries. Some organizations have ongoing programs, but in most cases projects depend on the initiative of someone who has an idea which can then be developed into a project.

My experience with Physicians For Peace has made me much more aware of the needs throughout the world and the complexities of medical service in underdeveloped countries. It has also given me a framework in which to work, with logistical support and tactical planning to insure that we address the particular needs of the locality to be served.

I chafed as a younger gastroenterologist at what I saw as the ability of surgeons to be of immediate service in medical mission projects, recognizing that internal medical problems usually require long term treatment which could not be addressed in short term medical trips. But then at DDW one year, a friend mentioned that the Hôpital Ste. Croix in Léogane, Haiti was trying to obtain GI services, and I realized I could have an impact there. My wife and our younger son and I took a large number of donated scopes, light sources, and supplies and worked with a visiting gastroenterologist who would come weekly from Port-au-Prince. PFP subsequently asked me to head up their efforts in Haiti, and this has led to eleven trips there since 1990. We continued to support HSC with several follow-up trips of various types, and we developed a similar program at the Hôpital Albert Schweitzer in Deschapelles, Haiti. PFP had major roles in supporting the first and subsequent continuing medical, nursing, and dental educational programs in Haiti, developed a simple health care system for the schools and orphanages of the Silesian Sisters in Haiti, and led the pediatric faculty of Eastern Virginia Medical School in a multi-day program at the medical school in Port-au-Prince. There have also been several other short term trips by students, residents, and faculty from EVMS through PFP. In July 2007 I went to Mali and Senegal to find ways for PFP to work within the guidelines of the Millennium Project of the United Nations.

It has been amazing, but also very gratifying to see how one activity often leads to the next. I am humbled and immensely grateful to realize how these opportunities have enriched my life and enlarged my world view.


George W. Meyer, MD, FACG (geowmeyer1@earthlink.net)

Health Volunteers Overseas is a private non-profit organization dedicated to improving the availability and quality of health care in developing countries through the training and education of local health care providers. Whenever possible, programs focus on training local personnel who will assume the roles of both educator and provider.

Currently HVO sponsors internal medicine visits to five locations in four countries, Cambodia, India, Peru, and Uganda (2). Each facility has specifically requested gastroenterology volunteers. The goal is not for the volunteer to go to provide care but to assist the local physicians deliver quality care as well as to teach their physicians the skills they need to deliver this care.

For example:  In Cambodia the Sihanouk Hospital Center for Hope (SHCH) opened in December of 1996. Though started as a small charity hospital for the poor, it has evolved into an important center for medical education in the country. The hospital has a 24-hour emergency room, an 11-bed medical ward, a 13-bed surgical ward, 2 operating rooms, as well as on-site Radiology, Laboratory and Pathology departments, an inpatient and outpatient pharmacy, an outpatient medical clinic, an HIV clinic and an HIV hospice. The focus of the hospital is adult medical care and it is the only free health care facility in the city.

SHCH is primarily a teaching institution with a Cambodian staff of approximately 25 general internal medicine physicians, 6 surgeons and 4 trainees and an international supervising staff of about 3 doctors. Each morning, more than 300 patients with their families wait at the hospital entrance. Approximately 175 have an appointment in the OPD, 75 will be seen in the ER, around 75 have appointments in the infectious disease department, and the stable patients are triaged to other places or receive appointments for other days.

Medical care is currently provided by about 23 Cambodian physicians who work closely with expatriate doctors. Of these 23, about 4 are senior physicians who are learning to be more active in teaching their colleagues.

Educational experiences with the World Gastroenterology Organization (WGO)

Eamonn M. M. Quigley, MD, FACG (equigley@ucc.ie)

The WGO now runs several training centers throughout the world but concentrated in emerging areas. It actively participates in training and educational programs at these sites, often in close collaboration with other GI organizations (e.g. ASGE, ASNEMGE, Canadian, Spanish, French and Belgian societies) and utilizes volunteer faculty whose travel is either supported by their national organization or raised by their own individual efforts. These individuals stay for variable periods of time from a few days to up to 2 weeks and participate in a variety of teaching encounters. Here are some comments based on our personal experiences as well as observations from the various volunteer faculty over the past several years:

  1. Very short, “in-and-out” visits are of little value; volunteers for teaching activities must be prepared to spend more than one or two days; it takes time to acclimate and develop rapport with students who really value the one-on-one contacts that take time to evolve.
  1. Do you have real teaching experience? Here we are not referring to your ability to give rounds at your local hospital but to your skills at running a small group, interactive session etc.
  1. Understand your audience; do they speak/understand English, or do you speak their language? If no is the response to both of these questions, is translation available and do you have experience in speaking through translation?
  1. In preparing your talks, hand-outs, etc., be aware of the extra time involved in either speaking through translation or allowing for an audience whose first language is not English understanding your slides and commentary in English. Be aware of the intelligibility of your idiom, terminology and phrases, etc. Most acronyms do NOT translate into other languages and are meaningless unless spelt out. There is a real art to these presentations which can be readily learned.
  1. Know the relevant GI issues in the region in which you are going to teach; your “pet” topic may be irrelevant and the diagnostic and therapeutic approach that you recommend may not be feasible.
  1. Be prepared to “hang out” with your fellow faculty, students, hosts; they usually set great store in looking after you and expect to have a chance to chat and socialize with you informally. If we were to select the characteristics that separate the successful volunteer faculty in the teaching environment from the failure, they are the abilities to interact, show interest in and understanding of the participants in your teaching activity. You must be knowledgeable but you do not have to be the world’s expert to be a great success.
  1. Do NOT underestimate your audience; without exception, in our experience, your audience (be they trainees or practitioners) will be very well informed on GI topics; they come to listen to your lectures but, above all, they come to have the opportunity to interact with you, ask questions, challenge you with their difficult cases.