What Sub-Speciality Is Most Wanted By Aid Organiztions?

[benyjets23]

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Hey,

I was curious, is there a particular branch of medicine that seems to be in high demand by Humanitarian aid organizations and medical missionary groups? I would like to determine if I can get in to countries like the DRC, the Sudan and other disaster areas.

Ben

 

[alreadylernd]

Hmm, this is just a guess, but maybe:

ID? I think there's even like tropical medicine as a field of ID. That's if you really mean SUB-specialty. I would imagine that aid organizations really just need doctors, period. And therefore, a generalist - like IM or EM - would be of great value. Slightly farther down on the list might be rad. onc 😉

 

[footcramp]

general surgery. greatest need are engineers to build clean water systems.

 

[DOCTORSAIB]

Ophthalmologists. Cataracts are a leading cause of blindness!

 

[flighterdoc]

Any primary care, or general surg, EM maybe....

Other specialties? Ortho, reconstructive plastics are in high demand.

High-order specialties (Ophtho, Derm, Neurosurgery, etc) only for special organizations with the infrastructure to support them (including pharm and tissues)

Other high-order specialties? Not so much.

Radiology? Bring equipment

Onc? Sorry, next. Triage is a mother.

Check the websites or email the various organizations - but ask them what KIND of medicine a physician with various specialties will practice, not what kind of physicians they'll take (mainly licensed and breathing).

 

[flighterdoc]

Ophthalmologists. Cataracts are a leading cause of blindness!

And in most third-world countries, clean water systems will do more to prevent blindness than all the ophthos in the world will cure it.

 

[The White Coat Investor]

Hmm, this is just a guess, but maybe:

ID? I think there's even like tropical medicine as a field of ID. That's if you really mean SUB-specialty. I would imagine that aid organizations really just need doctors, period. And therefore, a generalist - like IM or EM - would be of great value. Slightly farther down on the list might be rad. onc 😉

Ha ha ha! ROTFL! I would hate to be stuck in a rural third world village armed with nothing but an ID doc. I mean, come on, give me a break. In my experience, an FP with extra OB training and a few appys under his belt is incredibly helpful. A general surgeon is nice too. Peds/IM/EM come next. I actually was in Guatemala with an oncologist earlier this year. He was useless! One of the rest of us had to take call with him because he didn't know how to take care of jack. Couldn't deliver a baby, couldn't sew a lac, couldn't distinguish the BS from the sick....on and on and on.

 

[madcadaver]

Hey,

I was curious, is there a particular branch of medicine that seems to be in high demand by Humanitarian aid organizations and medical missionary groups? I would like to determine if I can get in to countries like the DRC, the Sudan and other disaster areas.

Ben

Highest demand for MSF (Doctors Without Borders) is for general surgeons and anesthesiologists.

 

[alreadylernd]

Ha ha ha! ROTFL! I would hate to be stuck in a rural third world village armed with nothing but an ID doc. I mean, come on, give me a break. In my experience, an FP with extra OB training and a few appys under his belt is incredibly helpful. A general surgeon is nice too. Peds/IM/EM come next. I actually was in Guatemala with an oncologist earlier this year. He was useless! One of the rest of us had to take call with him because he didn't know how to take care of jack. Couldn't deliver a baby, couldn't sew a lac, couldn't distinguish the BS from the sick....on and on and on.

I don't know, all the ID docs I've met really know there stuff - they're awesome. Plus with all the bizarre infections/parasites...

 

[a_ditchdoc]

Actually, an ID physician is extraordinarily helpful in third world countries. Knowing the transmission cycles of disease and the sources of outbreaks goes far in preventing illness and saving lives without needing expensive equipment. In most disaster situations, disease outbreaks are among the largest killers

I suppose the answer depends on what kind of area you happen to be working in and what kink of support mechanisms you have in place. Rad-onc obviously would be usless in most of the third world, as would an interventional radiologist. Surgeons work well in most parts of the world so long as there is a makeshift OR around. Most of the higher end specialties are not useful unless they go with a larger group, charity organization, or associate themselves with a hospital within the country. Even then, without the expensive equipment, what is left for them to do?

Any generalist is very useful: Peds, family, and of course EM for disaster medicine. And while I agree that sanitation engineers providing clean water to the population will prevent more death and disease than most physicians can, I fail to see the relationship to blindness? Am I missing a parasite somewhere?

 

[babycapybara]

trachoma. caused by Chlamydia trachomitis.

 

[skypilot]

trachoma. caused by Chlamydia trachomitis.

Well that is an STD passed to the baby's eyes in the birth canal so I am not sure that is a good example since it is cured with tetracycline eyedrops.

Maybe HepA, cholera, or diarrhea which kill millions would be better examples of diseases that can be cured by engineers. Also millions of people could avoid malaria with a better bug spray or the return of DDT! 🙂

 

[a_ditchdoc]

Well that is an STD passed to the baby's eyes in the birth canal so I am not sure that is a good example since it is cured with tetracycline eyedrops.

Maybe HepA, cholera, or diarrhea which kill millions would be better examples of diseases that can be cured by engineers. Also millions of people could avoid malaria with a better bug spray or the return of DDT! 🙂

Grasshopper...grasshopper...grasshopper... One day you will be able to take the stone from my hand...

You are correct, Trachoma is not caused by a water borne vector (Which is what we were discussing by the way...water sanitation). However, the old blind men you see in villages were not engaged in perversive ritualistic rites of "passage" before they developed Trachoma. Flies are the vector for the illness.

Same goes with River Blindness, Onchocerciasis. It is caused by the bite of black flies. The flies, incidentally, live near rivers.

And I am certain you didn't mean to infer that Hep-A kills millions....

Good luck on your exam...it's a monster....

 

[skypilot]

Grasshopper...grasshopper...grasshopper... One day you will be able to take the stone from my hand...

You are correct, Trachoma is not caused by a water borne vector (Which is what we were discussing by the way...water sanitation). However, the old blind men you see in villages were not engaged in perversive ritualistic rites of "passage" before they developed Trachoma. Flies are the vector for the illness....

So Trachoma is also spread by flies? Ok thanks, I will never forget that factoid now!

As I said it can also be spread by passage through the infected birth canal though. Hence the tetracycline drops for neonates.

So you are wrong and I am right. Okay Bambi?




http://pathmicro.med.sc.edu/mayer/chlamyd.htm

D. Epidemiology

1. Ocular infections

a. C. trachomatis (biovar: trachoma) is found worldwide primarily in areas of poverty and overcrowding (Figure 4). It is estimated that 500 million people are infected worldwide and 7 - 9 million people are blind as a consequence. C. trachomatis biovar: trachoma is endemic in Africa, the Middle East, India and Southeast Asia. In the United States, Native Americans are most commonly infected. Infections occur most commonly in children. The organism can be transmitted by droplets, hands, contaminated clothing, flies, and by passage through an infected birth canal.

 

[kheergurl]

Just curious...anyone know if psychiatrists are needed by aid organizations? A friend of mine told me that Peace Corps psychiatrists only work out of Washington,DC. ANybody have some info on this? Thanks...

 

[Vox Animo]

Well that is an STD passed to the baby's eyes in the birth canal so I am not sure that is a good example since it is cured with tetracycline eyedrops.

Maybe HepA, cholera, or diarrhea which kill millions would be better examples of diseases that can be cured by engineers. Also millions of people could avoid malaria with a better bug spray or the return of DDT! 🙂

DDT is still widely used in parts of Africa. Death by malaria is a bigger scare then all the things DDT causes. Hell, now penguins have DDT in their system. The madness spreads...

 

[skypilot]

DDT is still widely used in parts of Africa. Death by malaria is a bigger scare then all the things DDT causes. Hell, now penguins have DDT in their system. The madness spreads...

Are there good alternatives? I know DDT is nasty but so is Malaria, especially to kids. If only there was a vaccine.

 

[flighterdoc]

Are there good alternatives? I know DDT is nasty but so is Malaria, especially to kids. If only there was a vaccine.

DDT is now sprayed twice a year on the walls inside a house - keeping the mosquitos from lighting on the walls and hence, outsidet the house.

This is an environmentally safe (and effective) way of applying it.

And, malaria kills a million people a year...and renders millions more chronically malnourished, stunting physical and cognitive growth.

 

[Surgeon24]

Hi,

I would say general surgery.

A general surgeon in a medical missionary group will do ALL kind of stuff...and a lot of things he never done before. This is great for exposure to a great variety of pathologies/surgeries. I personally know a general surgeon who went to africa, south america and middle east. He went there and was 'The surgeon': doing orthopedics, thoracic surgery, lots and lots of trauma, lots and lots of ob/gyn, and of course abdominal surgeries. Bear in mind though that it isn't the most meticulous good-looking surgeries : often you have very few tools. Scalpel, sutures, antibiotics, and 1 mechanical ventilator for the entire clinic. Forget about laparoscope. It can get pretty sad and disappointing (i.e. you have to choose between 2 patients who gets the ventilator and who dies). You have to go by the motto 'I do all I can; if I wasn't there, the patient would probably die anyways'.

Bear in mind that there's a lot of ups and downs of doing that sort of work. It's not always safe (i.e. war), you're far far away from your family, you're not paid well, you're not at all in vacation (i.e. lots of work), lots of patients die for stupid avoidable $$$ reasons (i.e. not enough ATB), lots of HIV (hope that you don't stick a needle in you).

But, from what I hear, it's a great experience and I know a few doctors who are hooked to this kind of stuff. They go there a couple of months each year. The organization I know is: http://www.msf.org/

 

[The White Coat Investor]

Just curious...anyone know if psychiatrists are needed by aid organizations? A friend of mine told me that Peace Corps psychiatrists only work out of Washington,DC. ANybody have some info on this? Thanks...

I just read about one psychiatrist doing international work. She retrained in clinical medicine and had to be supervised by an internist.

 

[pgg]

Veterinary medicine. Really.