Developing Countries

[travelingdoctor]

I have a passion for working in developing countries, and would eventually like to be able to do both short term trips on the scale of weeks to maybe longer terms like months-year.

I've been to Africa with a EM doc and some nurses. We saw hundreds over patients, but I honestly dont know how much of a difference we made in just a few weeks. Most of those people had chronic issues like HTN, diabetes, etc which we cannot just give 1 pack of meds and just leave them. Some had some minor cuts and bruises.

Not to be negative, but can general practioners such as FM and IM really make a significant difference without staying there for years? What kind of docs are really needed in developing countries?

I am now thinking that surgeons and their teams can be quite useful providing emergent surgeries, but how much can a primary care doc really do?

---

Members don't see this ad.

 

[BlondeDocteur]

The first step towards meaningful engagement in a global health career is giving up illusions of being the Great White Hope.

It sounds like you're halfway there, which is great.

What developing countries *need* is longitudinal involvement, training of local staff / docs, and systems capacity-building. I think it is a grave injustice to provide transient care (and I include surgical missions without adequate post-op followup). Unfortunately for most MDs, most of the truly helpful work will not involve the direct delivery of clinical medical care. Serving as a visiting professor in a developing country medical school would be the closest-- there you'd be seeing patients, exchanging knowledge and practices, and helping to train students and postgrad trainees.

 

[dmal]

What developing countries *need* is longitudinal involvement, training of local staff / docs, and systems capacity-building.

Funny you mention the issue of the “Great White Hope.” Sometimes you find the locals have this illusion as well. I was talking to a friend yesterday, general surgeon, trained and working in Africa complaining about his most recent experience at trying to volunteer at a rural hospital in his country. This is a hospital that has been frequented by several volunteer European surgeons in the past. He was complaining about patients refusing to see him or have him do their surgery because they wanted a white doctor.

As someone hoping to do long-term, permanent “international health”, I have to cosign Blondocteur’s statement, especially with the need for systems capacity-building. These short term trips of transient care mostly have psychological benefit for local people more than anything else.

I'd say, all kinds of doctors are needed in developing countries, just in different capacities. Those capacities are dictated largely by whatever system that is place.

 

[notinkansas]

Might want to look into residency programs (FM) that have global health tracks associated with the organization Shoulder to Shoulder. That organization has a mission of working with the locals and within the local parameters. I don't have a list of programs, but it's not that hard to find out with Google.

I have a similar interest. So far what I've learned about the group, it seems to make sense.

 

[doc20]

its very easy... pick a country or place and then open up your charity hospital... rotate there with few of your american friend doctors, staff the hospital with excellent doctors and train them to work at your hospital.. and continue the good work, instead of being a professor and what not...
that is how continuity of care is provided in developing countries..building infrastructure and providing the best brain power to run such infrastructure

 

[canadia22]

I think there's an idea out there that perhaps a doctor may venture into the slums/jungle/whatever and selflessly save lives all day long. While this is true to a small extent, a lot of success or lack thereof has to do with $$$ because:

- Your patient can't pay for his meds to begin with.
- Your hospital has no equipment, space, meds, CT etc. If you have a hospital.
- Patient education is low, superstition high
- Corruption rules the day
- Preventative care...no way.
- Your local staff and fellow-physicians are burnt out, underpaid and jaded
- Poverty means patients wait forever to seek care & domestic conditions are appalling.

So all your efforts go to the wind and long-term, you'll see absolutely no change in outcomes. If, one wants to do real good, you have to bring the cash, the knowledge of social issues affecting health, and a good measure of understanding concerning the laundry-list of issues affecting outcomes.
It's not just doctors we need, rather, it's new governments, new standards of education, and some kind of normal working society.
You can't change these things, but be prepared to deal with this when managing patients. It's not so easy.