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Caring for the world: Giving medical treatment in foreign lands

The need is great -- as is the appreciation and fulfillment, say physicians who donate their time and money to medical missions overseas.

By Damon Adams, amednews staff. Jan. 14, 2002.

Community Spirit
An occasional series exploring how physicians take extra steps to ensure the well-being of those in need. Contribute

On more than a dozen occasions, Grat Correll, MD, has given up the comforts of Bristol, Tenn., for adventure abroad.

He volunteered to vaccinate villagers for yellow fever in the Amazon jungle, where the only source of water for drinking and bathing was a piranha-filled river. During political turmoil in Ecuador, the bus in which he rode had to plow through burning barricades to reach safety. He provided care to the Quechua tribe in Ecuador, including many men and women who had never seen a doctor.

Where do I sign up?

"I take my vacation time to do this," said Dr. Correll, a family physician whose family accompanies him on his worldwide trips. "Instead of spending it golfing or skiing somewhere, we go to South America."

Dr. Correll and scores of other U.S. doctors devote anywhere from a week to a year overseas, caring for the needy in foreign lands. Some travel as teams with fellow hospital employees; others go with organizations such as Doctors Without Borders, Health Volunteers Overseas or Operation Smile.

Most of these volunteers pay their own way -- sometimes an average of $2,200 for a month-long journey. And they get partners or other doctors to fill in for them while they're away.

For Dr. Correll and the other physician volunteers, going on overseas medical missions in countries such as Honduras, China, Uganda and Russia allows them the opportunity to give medical care to those who might not otherwise get it.

Most physicians doing medical relief work abroad pay their own way.

"The need for us to be there is pretty obvious," said Randy Sherman, MD, professor and chief of plastic and reconstructive surgery at the Keck School of Medicine of the University of Southern California in Los Angeles. He has done reconstructive surgeries around the world with Operation Smile.

For many doctors, these medical missions let them treat patients without the hassles they find here.

"When you're there, there are no [health maintenance organizations]. It's just you and the patient and your diagnostic abilities," Dr. Correll said. "Finally, you're able to fulfill that dream you had as a medical student trying to help people."

Brenda Kiessling, MD, a family physician in Arlington, Va., originally went on a medical trip for the adventure. But she soon saw the impact a doctor can have in countries where the need is great.

"It's nice to help one person feel better. You don't have to try to help the whole world," she said.

Few modern conveniences

In 1999 and 2000, Dr. Kiessling journeyed to Honduras with medical teams from Virginia Hospital Center-Arlington. Early on, she and the others had to adjust to primitive working conditions in a Honduran hospital and area villages.

"There were flies on the instruments and bats flying around. I saw women out back washing bloody sheets in washtubs with their bare hands," she said.

The pharmacy had a dirt floor and little light. In one village, electricity flickered during medical procedures, prompting nurses to provide light with pen lights.

"You just do the best you can," Dr. Kiessling said.

Thanks to their efforts in 2000, 2,700 people were seen by primary care doctors over five days, 85 major surgeries were conducted and about 2,500 pairs of glasses were distributed. The teams were aided with supplies from CrossLink International, a nonprofit organization based in San Diego that provides medicine and materials to medical mission teams and other volunteers.

"If [villagers] did not get help from us, they might not get help," said Barry Byer, MD, chief of family medicine at Virginia Hospital Center-Arlington and group leader of the hospital's two Honduran trips.

When the hospital's teams stayed at a military base on their second trip to Honduras, soldiers escorted them to clinics.

"We were told absolutely not to go out in the town alone, and don't wear jewelry. On the streets, people will actually come and take your earrings," Dr. Kiessling said.

Despite the warnings, Dr. Kiessling had no problems. In fact, she was touched by patients' responses.

They often told her que Dios te vendiga --God bless you.

"That means they were happy with what I did," Dr. Kiessling said.

The first medical trip overseas for J. Scott Ries, MD, took the family physician from Indianapolis to San Juan de Lurigancho Prison in Peru.

The maximum-security prison squeezed 6,000 inmates into cement cells with dirt floors intended for 2,000.

"About half of the inmates are convicted drug dealers; the other half are convicted terrorists," said Dr. Ries, who also is a family medicine professor at the Indiana University School of Medicine in Indianapolis. "We were told by the guards, 'Don't take $1 in there because people in here will kill you for that $1.' "

Dr. Ries and other physicians treated the prisoners for fungal diseases, parasites and other afflictions.

"There were a number of bullets we removed during our stay," he said.

Many prisoners were surprised that American doctors would give up their vacations and pay their own way to volunteer at a prison in Peru. Dr. Ries, who sees his involvement as both a physical and spiritual ministry, would share his Christian faith when curious inmates asked what fueled his compassion.

The helping hand that Dr. Ries extended also touched him back.

"I really feel like I get more than I give when I go on these trips," said Dr. Ries, who goes on the missions with Global Health Outreach, the mission arm of the Christian Medical and Dental Assns. "It's easy to lose your focus sometimes. When I go away on these, it really charges my batteries, spiritually and emotionally."

Sept. 11 effect

Dr. Ries plans to go on a mission to Honduras this March. But other doctors have postponed trips due to the Sept. 11, 2001, terrorist attacks and concerns that Americans could be targets abroad.

Virginia Hospital Center-Arlington pushed back its November 2001 mission to fall 2002. More than 30 volunteers dropped trips with Health Volunteers Overseas following the attacks.

But while some doctors are putting off missions, others are enrolling in programs, driven by a sense of duty after Sept. 11.

"They say, 'I need to do something.' They feel they want to make a contribution to the world," said Nancy Kelly, executive director of Health Volunteers Overseas, which sends doctors to 20 countries.

Norman Peeler, MD, is among those who is not afraid to take risks.

Through Doctors Without Borders, he has been on missions to war-torn places such as Burundi and Congo. One time he treated the wounded following a massacre in a village in Congo.

"After a while, you realize you're always taking chances on missions. You just try to be very cautious," said Dr. Peeler, who left his internal medicine practice in New York City to devote time to medical mission work. "It's just a whole different way of using your medicine rather than having a Park Avenue practice."

For Michael Carmichael, MD, doing heart surgery in China was a world of difference from the Ocala (Fla.) Heart Institute, where he is president and chief of cardiovascular surgery.

"It was like operating back in the '50s," he said. "There were birds sitting on the windowsill on my first heart operation."

Dr. Carmichael and others from the Ocala institute have taken numerous trips to China and helped start three heart centers, one each in Yanji, Fuzhou and Nanjing. In May, Dr. Carmichael will dedicate the Nanjing-Ocala Heart Institute in China.

Along with performing heart surgery, another big part of the missions is teaching doctors in China how to perform such procedures. Chinese medical teams go to Ocala to observe the latest techniques.

The interaction has led to friendships. Dr. Carmichael gets e-mails from a Chinese doctor about how to handle certain cases.

"Some of my best friends are Chinese now," he said.

Richard Mier, MD, a pediatrician at Shriners Hospital for Children in Lexington, Ky., has kept in touch with a doctor he met in Ecuador, exchanging Christmas cards each year. Dr. Mier also used to ship medical equipment parts when that doctor needed them.

Besides providing medical care and aiding fellow doctors, Dr. Mier said the mission trips leave a lasting impression, one that volunteer physicians bring back home with them.

"You end up being a lot more tolerant of the little glitches and little annoyances that we deal with all the time," Dr. Mier said. "We take for granted picking up a prescription pad and writing a prescription and expecting that the medicine is going to be ready at the pharmacy. I always feel like I've been rejuvenated."

AMNews is looking for physicians to feature in this monthly series. If you know of a doctor who has a unique way of volunteering or giving back to the community, contact Damon Adams (312) 464-5411.