A Time to Give

Volunteering positively affects those you help--and your career

by Anne Baye Ericksen

"It's all about the people." That's what so many health care professionals say when asked about their career choices. Regardless of specialty-physician, nurse and, of course, allied health practitioner-the majority of providers are there to assist their patients on a journey back to a healthy life. For some, however, it's more than just a job. Rather, it is a calling that can take them to exotic locales and challenging endeavors as humanitarians.

A Worldwide Need

For more than a decade, news about cultural, ethnic and military conflicts has ruled the airwaves and newspapers. In Rwanda, ethnic tribes were at war, displacing thousands of people. In Kosovo and Serbia, civil war raged for years leaving countless civilians maimed and disabled. More recently, battles in Iraq and Afghanistan have torn apart communities' health care structures. This has been particularly detrimental to regions that had very few services in the first place.

And that's just the result of manmade disasters. There have been devastating earthquakes, hurricanes, typhoons and even volcanic eruptions. Catastrophic events such as these leave their imprints on developing nations' efforts to sustain and advance their medical support systems. That's why health care volunteers who are willing to lend a hand have become an invaluable commodity abroad.

Since World War II, non-government organizations (NGOs) have been addressing the ongoing needs of developing countries around the globe. Some specialize in supplying equipment, medications and creating the necessary infrastructure. Others, like the American Red Cross or the Red Crescent, respond immediately following a disaster, such as the earthquake in Bam, Iran, late last year. Yet there are still other NGOs that arrange for health care professionals to volunteer their expertise.

Humanitarian opportunities are typically divided into two categories. The first, and perhaps most common, is the short-term assignment. These stints can last from 14 days to a few weeks or even a couple of months. Many times, volunteers are sent to provide clinical support to a community after a specific event, such as a hurricane. Short-term jobs aren't regulated to just disaster response, however. An area's dominant medical needs dictate what type of humanitarian aid is required. For example, a physical therapist (PT) may be called in to help children who suffer from congenital birth defects. Or a radiologic technologist (RT) may be needed to operate and instruct others about newly delivered ultrasound equipment. There are also times when volunteers simply play second string; they provide relief to the full-time staff-allowing them to step away to catch their breath.

These limited positions are usually unpaid. In fact, depending on the NGO specifics, volunteers might be expected to pay their own travel and living expenses. Oftentimes trips are sponsored by religious organizations or even employers that provide stipends to help alleviate costs. Each venture is different.

The long-term volunteer assignments traditionally have been more of a consulting expedition. Organizations like the Peace Corps send experts abroad for months or years at a time, commonly as paid employees. These individuals are sent to educate, update and train the local health care staff so they can eventually become autonomous, which was the case for both Ans Timmerman, PharmD, and Jessica Sanchez, CO, CP, an orthotist with Arimed Inc., based in New York.

Dispensing Knowledge

Originally from Belgium, Timmerman is the global technical advisor in the pharmaceuticals and medical logistics health unit for the International Rescue Committee (IRC). She's currently stationed in Nairobi, Kenya, where she develops and approves medication dispensing guidelines and protocols for the NGO. "I represent the IRC on every issue that deals with drug management," she explains.enough."

Timmerman was introduced to humanitarianism through word of mouth, one of the most effective and prominent forms of NGO promotion for potential volunteering. After she received her graduate degree in 1999, Timmerman took some time off to travel through Asia. Nepal was one of her destinations because a friend was working for a French NGO there. Timmerman's time in Nepal allowed her a first-hand glimpse into an international assistance program. "Before that, I had no idea what humanitarian aid organizations did. I was surprised at how professional things looked. At that point, I knew it was an option for me professionally.

"When I returned to Belgium," she continues, "I found myself at a point of choosing between a community and hospital pharmacist, both of which are worthwhile jobs. But for me, I had a feeling I wouldn't be doing enough. The impact was limited."

After some research, Timmerman realized her skill set was applicable to working with humanitarian aid organizations, especially since she is bilingual in French and English. "In Africa, most people speak English and French or maybe Portuguese," she notes.

Her first assignment was in Tanzania where she assisted the program coordinator by distributing medications. It didn't take her long to realize there was very little established protocol and even fewer long-term training plans in place for this aspect of delivery. "At the time, the drug dispensing was being done by refugees," she explains. "They were very neglected in terms of ongoing training."

Relying on her previous graduate student experience of teaching pharmacology undergraduates, Timmerman took on the task of creating a two-day seminar. Not only did it turn out well for the Tanzanian IRC program, but it also helped Timmerman promote her career within the organization. First, she had to secure funding from New York headquarters. Then she followed it up with a report detailing the results. The positive report prompted a request for Timmerman to present a proposal to set up similar training sessions elsewhere.

"I was asked to do a presentation at the annual health coordinators' conference about the drug management training," she explains. "They thought it could be applied to other field programs. Tanzania was just the first unit to recruit a pharmacist."

Since then, Timmerman has worked in Eastern and Western Congo, Thailand and, now, Kenya. "I was recently able to get an update on the Tanzanian project and they are still working with the local pharmacists."

Lending a Hand

While Timmerman turned a volunteer position into a career choice, Sanchez's time abroad was more of a short-term task. As an orthotist and prosthetist, Sanchez regularly works with orthopedic surgeons, one of whom was associated with A Leg to Stand On (ALTSO), a New York-based NGO that works with disabled children around the world. "When he brought it up to me, I thought why not? It was a privilege and not a gray area decision," she retells.

Sanchez quickly signed on and after an ALTSO orientation she was headed to India. Her team was charged with modernizing local facilities and instructing its specialists. She explains, "Part of our mission was to design an operating prosthetics manufacturing facility. Prosthetics were nearly nonexistent there or you saw a five-year-old wearing an adult-size product. Some items were made out of plastics that aren't even being used anymore."

Despite the rudimentary standards, Sanchez was impressed with the abilities of the local specialists. "These people were making braces by hand," she says. "Their skill level was amazing because they had the knowledge to do it with so little resources, and I was astounded by the lack of resources and equipment."

Additionally, the ALTSO mission started the process of fitting 10 children for artificial limbs. Although general health conditions in Indian cities and urban areas have made great strides during the past 10 to 15 years, rural communities still lag very far behind. These are also areas that are more severely affected when disaster strikes and are slower to recover.

In Gujarat, where Sanchez visited, the village was still trying to clean up after an earthquake in January 2001. Children had lost limbs from coming in contact with downed, live power lines. "The children run around without shoes and step on a line. The current goes into one limb and out another, and the exiting limb burns off," Sanchez states. "There were also a lot of amputations and congenital birth defects."

The manufacturing process continues now in the United States through Sanchez's employer, Arimed. In fact, the company is sponsoring the local experts to fly to New York to observe the final steps. In the meantime, ALTSO plans for a manufacturing facility in India continue to move forward. "We're helping them learn how to do more and do it modernly so we don't need to be present," comments Sanchez.

Unforeseen Benefits

Whenever you give of yourself, personally or professionally, those efforts are often returned in full with feelings of satisfaction. "It changed how I look at things," notes Sanchez. "I had come to expect and demand only the best, but now I've learned that sometimes two different roads lead to the same place. It's changed my view of life and work."

"Humanitarian work is more likely a public health position, rather than the individual health care they're probably used to administering," advises Timmerman. "NGOs need people who can think in terms of what is beneficial for the majority of the population they're serving."

But there's more to be gained by volunteering than merely indulging altruism. Indeed, it poses unique and challenging professional opportunities. For one thing, the change of environment and different equipment forces practitioners to be quick learners and test their confidence in their abilities. Limited resources push individuals to get creative and find ways to carry out tasks by thinking outside of the norm.

There are also moments for volunteers to stretch their managerial wings by delegating, guiding and training others within a program or the local people themselves. All of these experiences can easily carry over into the work environment. Employers are often impressed when therapists and techs take the initiative to develop new skills.

And there are plenty of opportunities for allied health professionals. NGOs have a virtually constant call out to medical professionals. In fact, the International Medical Volunteers Association (IMVA) states that virtually every medical profession is needed in developing countries.

"In the months following a crisis, humanitarian agencies like American Rescue Committee (ARC) provide a basic level of care, simply helping people stay alive. But in the long term, as these people return home, many will need physical and occupational therapy as well as appropriate skills training," explains Martha Naegeli, ARC spokesperson. "This is especially true in conflict regions where civilians are the target of military activity, in places like Liberia, Sudan and the Congo. Without treatment, the injuries they suffer can rob them of their mobility, their livelihood and their will to survive."

A Unique Perspective

Finding a volunteer position is a lot like a job search. Specifically, you have to investigate the NGO before making a commitment because a good match can make all the difference between a positive and less-than-positive experience. Interestingly, it's one's background as much as his or her skill set that impresses NGOs. Working within diverse communities in the United States can prepare people for other multicultural encounters. "You should be open-minded and have an interest in other cultures and have respect for them," notes Timmerman.

Being a minority yourself, however, may be a factor in your favor. Just like in American ethnic neighborhoods, patients and clients abroad tend to have more trust and compliance with providers who look like them. "There are more minorities being affected by diabetes, breast cancer and multiple sclerosis," adds Sanchez. "Patients want to be with someone who they are comfortable with."

Of course, practitioners who are multilingual are exceptionally valuable. Although most international missions provide interpreters for medical personnel, there's always a chance for misinterpretation or incomplete translations. This is particularly important when it comes to medications and specific instructions. Therefore, a multilingual clinician who understands both the language and medical jargon is well suited for international humanitarian positions.

Still, there are occasional episodes in which race or gender can be a momentary obstacle. For example, being a Latina was less of an issue for Sanchez's trip to India than her gender. She explains, "It's a very traditional system there, and they don't typically see other professional women in the rural areas. They thought I was a secretary or an assistant. By the third day, however, they finally grasped it.

"The same scenario translates here in the United States, except I finder it harder to be a Latina here," she continues. "This industry is still about 90% Caucasian males. However, there is a change underway. There are a lot more women entering orthotics and prosthetics, but I have yet to run into another Latina."

Keeping It Close to Home

Do you want to get involved but aren't in a position to leave the country? You don't necessarily have to pack your bags and board an international flight in order to volunteer. In fact, there are opportunities virtually around every corner. School districts, private athletic associations and senior centers are just a few suggestions where people could benefit from the time and expertise of PTs, speech-language pathologists, occupational therapists and athletic trainers.

Neither must all volunteer positions be clinically based in order for them to be effective professionally. Use the opportunity to explore other arenas, such as fundraising or marketing. When employers see they have a talented practitioner who also knows about budgets, teamwork and promotion, then your marketability automatically jumps up a few notches. Although these skills might not be immediately applicable in the clinical environment, you're displaying an open attitude and aptitude to take on challenges outside of your "normal" realm. To employers, that's an intangible quality that makes for a vital employee.

Anne Baye Ericksen is a free-lance writer based in Southern California.