Three Critical Cautions for Newbie International Volunteers—Part II

Once you’ve received that final commission to prepare for deployment, you energetically get to work on the checklist. There’s only so much a brochure can include in the area of cross-cultural issues. Most of the sticky areas pop up while you’re on-site. To give the rookies an edge, I’m sharing three critical cautions for newbie international volunteers—Part II.

In each of the three posts, I use illustrations from my personal experiences to demonstrate how I came up with these three particular cautions. I include tips that helped me avoid similar problems over the subsequent years.

Before moving on to Caution Two’s illustrations and tips, Caution One has been repeated here with a brief summary. If you’d prefer to read that post first, click here.

Caution ONE: The nationals want to make you feel welcome at any cost.

Summary: The two main areas discussed under this caution are food and advice/opinion.

• Food. The hosts often provide more than their budget allows to make you feel welcome. What can you do or not do?
  

• Advice/Opinion. The nationals believe they need to agree with you to make you feel welcome. What can you do to get a genuine opinion?

Where do you find the whole post? Click this link.

Caution TWO: The nationals seek your medical counsel, regardless of your training or the consequences.

One of the saddest things about life in the Third World is just how gullible their desperation makes the people. Often their own physicians are poorly trained, so the nationals search for and believe the advice of anyone who comes from outside their country.

The assumption is that you must know better than the people who say they’re doctors because you received your education outside the country. Telling the nationals that your education is in computer programming doesn’t matter; you’re from outside, so you must know how to treat sick people.

A couple of examples may help you understand why anyone would sink their hopes in your help for treatment.

Licensed local physicians

There are medical schools operating in all of the Third World countries where I’ve served. The physician with a framed license doesn’t mean he’s got the patient’s welfare in mind. Sadly, it can also mean his family bought it for him, or that he’s a political appointee.

For example, I had one patient, close to six months pregnant, who purchased the medications ordered by the Head of the Department of Obstetrics in the capital’s largest hospital. The patient sought advice from the physician because she felt her baby kick. Being her first pregnancy, she wanted to be sure everything was fine.

The medication did include the routine iron/folic acid and multivitamins. The doctor had added a hefty pain pill, which the patient should take every four hours whenever she felt the baby kick. Two other medications in the sack had warnings not to take during pregnancy.

Newbies are often asked to help buy the medications for the low-income patient. It’s not always the best offering you can give.

Tip: Resist assuming what the doctor ordered is what the patient needs. If you can check the list with one of the medical/nursing people in your own organization, you may save both a bit of your money and further suffering for the patient.

Tip: Check the date on the paper with the prescription. Sometimes, the national uses the old prescriptions he’s kept to obtain money from the newbies. He has no intention of trying to buy the medication with that four-year-old prescription.

Unlicensed local medical care

Sometimes, the local healers do have good advice for the sick, so don’t discount them immediately. All of them don’t belong in the same bag.

However, many of the local vendors and healers use a variety of slight-of-hand tricks to get money from the suffering.

One of my patients presented at the clinic with back pain. For some time, he’d followed the local vendor’s advice but had no resolution of his pain. The advice: Purchase two three-inch strips of adhesive tape. Stick one strip on either side of the backbone in the area of pain.

In this case, most newbie volunteers could have helped this man in the same way I did. Two aspirin tablets took his pain away.

Tip: Listen to what the patient says is his problem and what he’s already tried. As in the above case, you might be able to help him.

Tip: Take CPR and First Aid classes from the Red Cross in your area. They have a wide-range of good offerings. It’s likely you’ll be able to help someone.

Volunteers with no formal medical/nursing training

Many missions offer a two-week course on specific diseases and treatments their missionaries may encounter if assigned to a remote location. The purpose is to equip those they’re sending out to care for the needs of their own family in an emergency. It’s not intended to give them a license to hang out their shingle to practice medicine.

Unfortunately for some individuals whose genuine compassion exceeds their medical training, the short-course becomes the catalyst to practice medicine on the local population. I’ve seen some tragic results for the nationals and their children; though the untrained volunteer meant well.

Tip: Don’t exceed your training when asked for medical help. You can do a lot of good by sticking to the over-the-counter medicines when responding to nationals’ request for help.

Licensed medical/nursing volunteers

I’ve been amazed how many times over the years while speaking to groups in America and Europe, someone greeted me with the following: I bet you’ve done some things over there that you never learned to do here in the States, huh? Of course, the questioner has something akin to brain surgery in mind, by the wide eyes and sparkle in the excited expression.

My response never fails to disappoint. “No, actually, I never have. I’m a highly trained pediatric nurse practitioner with a Master of Nursing degree in Pediatrics. That allows me to set the normal physiology of the child alongside the unwell parts—pathophysiology—and figure out what’s wrong. Knowing that leads to the diagnosis, which in turn, leads to a treatment plan.

I don’t do things in Africa that I haven’t learned to do in the States.

Caring for adults can be more challenging, but I ask others if I don’t know. Fortunately, our jungle clinic had radio contact with a mission across the country, so I could consult with their midwife if I had maternity issues unfamiliar to me.

Tip: Don’t exceed your formal training or expertise. Do what you can safely do to assist the sick/injured, but let the Lord fill in where you aren’t equipped.

The main thing we all need to remember in foreign lands is our purpose, in being there and the responsibilities expected of us. Don’t fall into the temptation to exceed your training. One of my discouraged nursing friends said of some of the folks in her mission: If you wanted to be a doctor but didn’t want those four years of undergraduate study, four years of medical school, and three years of residency, just be a missionary to Africa. You can be treating lines of sick people after only two weeks.

Definitely, resist that temptation. There’s still a lot you can do to help the nationals if you restrict your assistance to what you could offer your friends at home—from over-the-counter shelves. The wrong medication or dosage of the right one can kill people, especially where the children need weight-related doses.

Don’t let yourself be talked into practicing medicine without a license. The nationals also appreciate you praying for their sick, so you can always do something to help.

That leads me to the third caution. It came about because I wanted to use the training I had to see that the patient got the best care. For those of you not that interested in medical examples, I discovered the same principal applied early on in one of our construction projects. You can read about it next week in the final post, Three Critical Cautions for Newbie International Volunteers—Part III.

Please, share any experiences you’ve had overseas, along with any tips you found helpful. We can all learn from one another.

If you’re considering an assignment overseas and have questions, feel free to ask in the comments area. If I can’t answer, maybe another reader can.