Less doing, more teaching
(Photos: Courtesy of Leslee Jaeger, M.D.)
Early this year, I took two months away from my private obstetrics/gynecology practice and traveled to Haiti and Vietnam to teach surgical and clinical skills to physicians, working with Health Volunteers Overseas. This was not my first medical mission trip; I have been leading surgical teams to Haiti every year since 2006.
However, by providing a “fly-in” package, I realized that we were contributing more to the long-term problem of developing-world medical care than we were helping.
Haitian physicians were so busy taking care of the day-to-day needs of their patients that they seldom had time to participate in learning new skills when our surgical team arrived. The Haitian patients saw the doctors from the United States as better doctors because they did the more complicated surgeries.
Instead of working ourselves out of a job, which should be the aim of medical missions, we were making the problem even worse.
Health Volunteers Overseas provides physicians and other health care providers with a different option. They coordinate with hospitals throughout the world to improve the availability and quality of health care through the education, training, and professional development of the health workforce. Less doing and more teaching, in the hope that improved health care can be provided by an in-country workforce that has both the cultural background to understand patient care and the skills to provide the health care that is needed.
The physicians from these countries should be in charge of what is “taught.” What we as outsiders think is helpful may result in untoward consequences because of cultural misunderstandings. After all, we are only in the country for a short time. An experienced provider needs to be available to deal with both short- and long-term complications.
There are still circumstances where fly-in trips to provide medical care may be helpful — but they should be the exception and not the rule. Empowering indigenous health care providers should be the primary aim of most medical mission trips.
Excerpted from jaegerleslee.wordpress.com, where Jaeger blogs about childbirth and mothering across ages and cultures. Jaeger, Medical School Class of 1983, is a Twin Cities–based obstetrician/gynecologist.