First experience- Ethiopia- from a non-medial

In November of 2014, I found myself, very spontaneously, on a mission trip to Ethiopia.  I have no medical experience, nor have I ever been on a mission trip, or even left the United States. I had always been moved to help others, and gravitated towards experiences that allow me to learn about other cultures. So when the opportunity presented itself, to be the photographer for a medical mission trip, leaving in 3 weeks; I did all that I could to find myself there.
Read on…

Seen for Syria

I was on a bus from DC to NYC to arrange for an art show about my home (Syria) when I thought: what if I could do more? What if I can use art to do more than raise awareness about what’s going on at home! That’s when I thought of “Blooming Syria” a simple project where I work with Syrian kids to plant garden in the shape of the Syrian map. From that point on, the ideas were flowing and the end result was my project “Seen for Syria” which combined art education/ therapy with gardening and exchanging letters and drawings between Syrian refugee children and children in the U.S.

On May 29th 2014, I arrived to Amman, Jordan to start my 10-week long project with SCM and little did I know that by joining two medical missions as a humanitarian, my whole perspective on the Syrian crisis will change: I expected to see children that are depressed, and had lost all child-like qualities because of what they’ve been though. To my great surprise, these kids had a lot more to offer that I thought: while we offered them toys and candy and did face painting and planted vegetables, they offered all of us, especially me a lesson in survival; a lesson in the true meaning of hope. They shared the sincerest and heart-breaking stories about their lives in Syria, the people they had lost and what they hope to happen.

Many kids asked me to be their teacher. They’d give me hugs and kisses and shook hands with me. Not for a second did I feel that I was helping. The whole time I was at any camp, I felt that I was being showered with love. The kids I had worked with during the medical missions and at the SCM center had proven true what Vincent Van Gogh said two hundred years ago: “There’s no art like loving other people”. Today I have more hope than ever that we will have our beautiful Syria one plant at a time and one hug at a time, and like a phoenix, my beautiful Syria will rise from the ashes.

Nonmedical Volunteers!!

Mission trips as a non-medical volunteer …. Think you don’t have a skill set that can help on a mission trip? You are wrong! Just because you are not a health provider does not mean you have nothing to offer on mission trips! There is much more than just seeing and treating patients on these trips. Health education, triage, pharmacy, and social services are all aspects which you may find yourself doing. There is no way the mission work can proceed without these services! Often volunteers may find themselves helping out in villages as well aiding in community development. Home repairs, building homes, aiding in agricultural practices, and helping out in community planning are more examples of tasks which a volunteer may find themselves involved in on these trips.  Bottom line: everyone has something to offer on these trips, and your help is definitely needed!

Health Education in the Field

Health education in the field
This is a very important topic that I believe is often overlooked on many mission trips! While it’s wonderful to go spend a week doing clinic work, the reality of these mission trips is that it’s a short-term mission trip, and when the week or so is over, clinic ends! While your group may have treated many during the week, the week has ended. This is why health education on these trips is of vital importance. Education topics could include basic hygiene, diet, exercise education, and diabetes education. These are all topics that can be easily taught and can go far in helping keep a community healthy. For medical providers, teaching the local nurses and med students is a great idea! This can include lessons on medications, imaging such as Ultrasound, IV starts, line placements, etc. Be vigilant and prepared, and bring some prepared classes to the field for the community you will be working in!

Key Traits for a Relief Trip

Flexibility, Adaptability, Patience and Enthusiasm

 

All of the above traits are very important on relief trips! I believe that each warrants a word when it comes to relief work.

Flexibility – Be very flexible with your expectations. Despite a given itinerary, on some trips the plan changes as soon as you land. Timelines often fall apart and days may run very late with earlier mornings then expected. Transportation may not always be on time, and this may change plans. Keep in mind you are often working in an unfamiliar environment. Expect the unexpected.

Patience – Be patient and expect delays, long days and nights, and communication barriers.

Adaptability – I cannot stress this enough. Be prepared to work outside your normal work skills and parameters. For example, this might mean you doing wound care rounding on medical patients or seeing pediatric patients when you are an adult internist. For a nurse, this may mean working with adults despite being a pediatric nurse. Be a team player, and don’t complain about duties assigned to you. Often everyone is working a bit out of their norm when it comes to relief work. Work as a team and assist in anyway you can when out in the field.

Enthusiasm – Get excited about your trip and show it in the field. Get plenty of rest prior to your trip, for you may be working long hours. However, proper rest at night can sometimes be difficult depending on the environment you are working in.

 

 

Imaging in the Field

Imaging in the Field- ULTRASOUND

1. If you are lucky enough on a field mission to have an ultrasound handy, you will find this of great use. The portable models are lightweight and easy to pack. Ultrasound can be used for a number of things including abdominal scans, pelvic scans, fetal ultrasounds as well as cardiac and chest scans. No matter what setting whether it be hospital or field, ultrasound can be very useful. Included in this section in the future will be ultrasound courses designed for the field physician. Standby!

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2. If working in a hospital setting, keep in mind you will likely be the radiologist, so brush up your radiology skills if need be.

Pharmacy and the Field

Pharmacy in the FIELD!!

This is a very important aspect of field trips. Often times you may be fortunate and have a pharmacist come along on the trip. A couple of pre-trip rules I have learned when it comes to this aspect of the operation…

1. Have someone in charge of pharmacy well before the trip. This person should be responsible for generating a master list of what medications are being brought on the trip. The list should be updated weekly and distributed to the entire team. Often different group members can bring different meds, and if there is an identified shortage on one, this can be addressed.

2. Keep in mind that just about any medication is needed. You will be surprised how much tylenol and motrin can help in certain areas. If you have any excess meds lying around that are not expired, bring them. Someone out there could benefit from them, I promise!

3. If you are looking for places to donate meds, there are plenty of places that may be willing as long as you present it in an organized and effective way. Show them a pamphlet or brochure identifying your mission and express your passion for your mission. Walmart, local pharmacies like Walgreens, etc. might be willing to help. We recently received a $200 donation from Walmart by simply showing them a mission brochure. If they do donate, bring them back a photo showing your work in the field. This is a great way of saying thank you. (You may want them to contribute again on another one of your missions!)

4. There are organizations/agencies that can help supply you with meds for these types of relief trips. I will soon be providing this list in a section on the site.

5. You can never bring too much of any medication…better more than less in the field!

6. Commonly used and most distributed meds: motrin, tylenol, cimetidine, multivitamins, meclizine, raglan, antidiarrheals, lotrimin, diflucan, albendazole, mebendazole, prednisone, albuterol, anti-hypertensives, flail, amoxicillin, cipro, kefex, ancef, acyclovir, aspirin, metformin…just to name a few off the top of my head!

7. Make sure and clarify with your trip coordinator what type of meds to bring to the field, for example, IV meds vs. oral meds only.

IV meds and fluids can take up a little more space and weigh more than oral meds. Make sure you will be allowed and able to use IV meds in the field…otherwise they may go to waste and cost you more money to fly over.

8. Make a final check of the master pharmacy list prior to departure. Identify med shortages and make one last ditch effort to collect what you can! Make sure the physicians, PA, and NPs all have a master list prior to leaving. Too many times I have not had a list, and items I could have found before leaving home did not get supplied for the trip!

9. Be prepared to show these meds when arriving at Customs. Have a master list, smile a lot, and tell them what you are there to do.They usually won’t make a big issue of this, but it has occurred before.

Field operations and Pharmacy!!

Day 1 of clinic operations…BE PREPARED FOR CHAOS! This always seems to be the case of relief operations that require a setup. If you are in a hospital or town clinic then you need not worry about this. Setting up pharmacy can be quite tedious as all the meds need to be distributed in small packets written in the native language CLEARLY AND SIMPLY!!  This can take hours to do, and you will often find yourself working late into the night after clinic days to reorganize the pharmacy for the next day. It’s a work-in-progress indeed!

1. Rule number one – Have one person in charge, not several.

2. Don’t forget to bring many small plastic packets and a felt tip marker for writing instructions on meds.

3. When a patient approaches to pick up a medication, take your time with them. Do not rush things and just give them the medication. Assume, rightfully so, that they do NOT understand how to take the meds. Explain precisely how to take the medication. Otherwise, you may have them taking an antibiotic the wrong way and taking the pen med every 4 hours. I cannot stress this enough!! WAY TOO OFTEN, PATIENTS LEAVE THE PHARMACY CONFUSED!! Have them go through the instructions verbally with you after you explain them to them!

4. Help the pharmacy with cleanup at the end of the day. They are often the last part of clinic to break down at days end and will be working late into the night to reorganize.

5. If you have the supplies and there is a high incidence of parasite, DEWORM everyone. Also, give vitamins to everyone as well… iron supplements along with b12 and folate are good options as well.

6. If you have the supply to do so, give everyone a small supply of motrin and tylenol. Everyone has aches and pains from time to time that could benefit from one or both of these.

7. You may find out that by the end of the trip, you are short of needed meds. Try and keep this in mind all week so the folks you see on the last day don’t end up shorthanded. Unfortunately, this occurs all too often.

8. Prior to the end of the trip, make arrangements to leave any extra medications with a organization that can get them to the right people.

Safe Travel Tips

SAFE TRAVELS ABROAD

Mission work abroad can be very exciting and rewarding…truly an adventure you will remember the rest of your life. There are multiple ways to assure your safety on such missions. Here are a few I’ve learned along the way.

Prior to your trip:

1. Do some research on not only the agency you will be working with but also the country you will be working in as well. I’ve provided links to all of this information as you will see. The state department website is a wonderful resource and provides up to date travel advisories for all countries across the globe.

2. Register yourself with the state dept. smart traveler program. This program lets the state dept. know when and where you will be and gives them contact information in case of an emergency.

3. Get travelers medical insurance! Too many times, I have seen people injured while doing mission work abroad. Treatment overseas can be very costly as well as the cost of transportation home after the injury if serious enough to require a medevac. I’ve provided a section on this alone and listed multiple providers for this type of insurance. On the bright side, it’s really not that costly and it’s definitely worth the cost.

4. Make multiple copies of all your agency’s information and your locations and leave a copy with your spouse or family.

While in country:

1. ALWAYS TRAVEL WITH A BUDDY OR A GROUP!! In the Marine Corps, we called this the buddy system. You are responsible for your buddy, he or she for you. You travel together and return together.

2. Keep your passport on your person at all times. I recommend a money belt.

3. Try and keep the trip coordinator in the loop as to your whereabouts in case you and your buddy turn up missing.

4. In some countries, the agency you are working with may prohibit you from traveling on your own. This is the case for the work I did with Medicare, and it is for very good reason. Understand and respect these rules set forth as most times they are put in place for very good reason.

Translators in the Field

Translators in the Field:

Providing aid in many countries will require translators. Often your group is fortunate to have one or several individuals who speak the native dialect. This is a definite plus.

A couple points to be aware of with the use of translators:

You may notice, as I often have, when using translators during relief work, that dialogue between translator and patient is lengthy  and you feel you are missing some vital information which is not translated to you. Don’t get frustrated even though its easy to be sometimes. The translators will often say that much of the chatter with the patient was not important even though you may feel it is important. My recommendations:

1. Let the translator know if you feel you are missing something, and ask the question again until you get the type of answer you want.

2. HAVE PATIENCE!!!!!! HAVE PATIENCE!!! It’s easy to get a bit frustrated at times with translation services especially when there are large numbers of patients to be seen. But keep in mind that you are there to serve and help, and these translators are there to do the same.

3. Don’t get rushed!! It’s easy to do if you have a large number of patients. Take your time especially when using translators and addressing the pertinent issues on your exam with the patient.

4.  Most translators are usually paid by the agencies you will be working with, but in some cases, they may not be, and you might be expected to leave a tip or give payment.

Staying Fit in the Field

If you are like me, it’s often hard to spend a week or two away from the gym. What’s gained is lost quickly, and it’s so nice to keep a weekly routine. I’ve gotten around this by doing a few morning exercises to keep the muscles toned and adrenaline pumping.   Often it’s fun to incorporate the rest of the team in morning exercises. While in Kenya, my colleague and I often did morning calisthenics to a little music. This kept the muscles toned and helped get the blood flowing in the morning. Pretty amazing to workout in such a beautiful setting as the Kenyan countryside. No matter where you are serving, a bit of daily exercise goes a long way. Feel free to share your experiences with this subject!! 🙂

Communications Abroad

Communications are obviously a key component in planning a trip and coordinating logistics. Depending on the country, there may be several options available. Several aspects of communication are discussed here to help you along.

Cell phones – Cellular phone technology is usually an option in most countries, but varies depending on your type of carrier. To check and see if your carrier has coverage in the area you are operating in, or if they have a contract with another carrier in the area for coverage, simply give them a call. There may be an international plan available from your carrier if you do many of these trips. Be sure and make note of the rates with these plans as they can be a bit expensive. Data roaming fees can be very pricey so be sure you shut this option off on your phone as soon as you arrive in country unless you have a very good plan. Ask me sometime about the $900 dollar fee at@t leveraged on me for having my data roaming on for five minutes while in Peru…not a fun thing to deal with!!!

Satellite phones – These are always an option and provide coverage no matter what location you are in. There are numerous sites you can go to to either buy or rent a satellite phone.

Local area disposable phones –  Another option available is to buy or rent a temporary phone with a local carrier while in country.   Often this is simply accomplished by asking the agency you are traveling with how this can be done. This is a good way to save money if your home carrier will not suffice.

Walkie talkies – These are always good to have on hand to allow for easy communication while on ground with your team or group. Available for purchase online or at most chain stores like Walmart or Target.