Global Volunteerism for Orthopaedic Surgeons-A Primer.

The burden of unmet surgical need is heavily weighted toward low-income and middle-income countries. North American orthopaedic surgeons are increasingly interested in volunteer activities in resource-limited areas around the globe. There are multiple avenues through which an orthopaedic surgeon can positively contribute to improving musculoskeletal care around the world. Unfortunately, short-term missions are at risk of undermining local long-term development efforts if they do not mitigate harm and optimize benefit for host communities. Work in this area should be grounded in beneficence and sustainability with an emphasis on mutual respect, exchange, and a commitment to capacity building. All of the necessary information for adequate preparation for these activities is beyond the scope of this chapter, but the goal is to introduce a range of volunteer options, ethical considerations, cultural competence and volunteer preparedness principles, considerations when including trainees in global health work, and some nuts-and-bolts details on trip planning.

Applying global standards to short-term global health clinical experiences: the case of Project Salud y Paz.

This case study was extracted from an administrative report generated for Project Salud y Paz (SYP), a non-governmental organization (NGO) that supports short term global health clinical experiences (STGHCE) in Guatemala. As a basis to generate criticisms and offer recommendations, the analysis used the shared themes of two sets of standards recently published by Globalization and Health (GH) and the American College of Physicians (ACP). These standards respectively address the ethical responsibilities of organizations and of physicians in the conduct of STGHCE. Information used in the original quality analysis and quality improvement consultation for SYP was gathered from interviews, medical committee minutes, output statistics, and observations in the course of a real-time trip. This case study describes how the standards served as a useful lens to assess SYP and as a platform from which to make recommendations for improved compliance with global conventions. Additionally, the standards provide SYP a body of consensus wisdom for holding itself accountable to patients, host communities, volunteers, and the donor community on a continuing basis. While the shared themes of these standards are intentionally broad and require context in their application, NGOs that support STGHCE may find it instructive to benchmark them to assure their own compliance with global standards for both the organization and their volunteer physicians.

Economic assessment of US physician participation in short-term medical missions.

BACKGROUND: Short term medical missions (STMMs) are a form of unregulated and unsanctioned, grass roots, direct medical service aid from wealthier countries to low and middle income countries. The US leads the world in STMM activity. The magnitude of monetary and man power inputs towards STMMs is not clear. The objective of this study is to estimate the prevalence of physician participation in STMMs from the US and the related expenditures of cash and resources. METHODS: An online survey solicited information on physician participation in STMMs. Responses regarding costs were aggregated to estimate individual and global expenditures. RESULTS: Sample statistics from 601 respondent physicians indicate an increasing participation by US physicians in STMMs. Including opportunity cost, average total economic inputs for an individual physician pursuing an STMM exceed $11,000. Composite expenditures for STMM deployment from the US are estimated at near $3.7 billion annually and the resource investment equates with nearly 5800 physician fulltime equivalents. CONCLUSIONS: STMM participation and mission numbers have been increasing in the millennium. The aggregate costs are material when benchmarked against formal US aid transfers. Understanding the drivers of physician volunteerism in this activity is thereby worthy of study and relevant to future policy deliberation.

The history of dental hygiene in South Korea.

This historical narrative highlights the origin and development of the dental hygiene profession in South Korea. The legacy of early American missionaries to Korea includes profound and long-lasting contributions in medicine, education and theology. Many of Korea's top universities today have their roots in the missionary schools of the late nineteenth century, including Yonsei University, home of the first dental hygiene program in Korea. From Yonsei in Seoul, the dental hygiene profession spread throughout the country, includingtheAmerican missionary-based program in Kwangju in 1977. Contributions included clinical and didactic education, as well as professional leadership and development. American dental missionaries developed the profession of dental hygiene in Korea, and provided guidance to Korean dentists and hygienists for its growth and expansion.

PT EMT - Portuguese Emergency Medical Team Type 1 Relief Mission in Mozambique.

INTRODUCTION: The tropical cyclone Idai hit Mozambique in the city of Beira on March 15, 2019. During the following days, the Portuguese Emergency Medical Team (PT EMT) and its infrastructure deployed to Mozambique with the mission of helping local people and collaborating with the authorities. METHODS: Data analyzed were collected in the period of the deployment, from April 1-April 30, 2019. All patients admitted to PT EMT were registered through the Clinical Record of PT EMT. RESULTS: In total, 1,662 patients were admitted to PT EMT during the 30-day mission. The five most prevalent diagnoses were: 61.49% classified with "code 29" (which corresponds to "other unspecified diagnoses"), 9.15% of cases of skin disease, 8.90% of minor injuries, 6.74% of acute respiratory infection, and 3.19% of obstetric/genecology complications. DISCUSSION AND CHALLENGES: An important challenge identified was the need for a robust and effective network for transporting patients, allowing transfers between EMTs, enabling a true network response in the provision of care to disaster victims. CONCLUSIONS: The benefit of the deployment of PT EMT in Mozambique after Cyclone Idai was in line with the EMT initiative standards, allowing a direct delivery of care to the affected Mozambican population and support to the local health authorities.

Engaging Students and Pharmacists in Medical Missions.

Medical mission trips help meet the needs of underserved populations in the United States and abroad. As the medication experts, pharmacists play an important role in providing pharmacy services during these trips. Students can serve as pharmacist extenders by applying the knowledge, skills, and values learned in the classroom to reach more patients in resourcelimited settings. This paper describes the experience of the Gregory School of Pharmacy in sponsoring faithbased domestic and international medical missions. We believe that medical missions not only benefit those in need, but also foster professional growth and provide an opportunity for participants to develop a servantleadership mindset. Unlike the traditional leader, the servant-leader shares power, puts the needs of others first, and helps people develop and perform as highly as possible.

Voluntourism.

A rise in international medical volunteering (IMV) poses complex issues for organizations, clinicians, and trainees to navigate. This article explores ethical implications of IMV, such as scope of practice, continuity of care, and erosion of local health systems, and offers a personal perspective from a related field.