VOLUME 26, ISSUE 2

The first, and probably the most important, decision is to pick a volunteer organization. Lena Dohlman has written about this choice.1 She lists online resources such as the Society for Pediatric Anesthesia website that helps match a volunteer’s preferences such as religion and geographic location. Equipment available in the host facility can be modern or ancient. Cynthia Cappello et al2, Quentin Fisher and colleagues3 from several academic institutions describe many issues in detail. Surgery performed should allow for rapid recovery and avoid complications that cannot be managed by local staff when volunteers leave. Screening patients is difficult due to large numbers in a short time, unfamiliar, neglected or undiagnosed coexisting diseases, and families reluctant to share information that might cancel the surgery. Equipment may be poorly maintained (e.g. uncalibrated vaporizers). There may be intermittent failures of power, oxygen sources, and suction and there may be no facility for scavenging of volatile agents. Surgery schedules should start with less challenging cases to work out any “bugs”.

Risks to volunteers include exposure to local endemic diseases, altitude of work site, and local crime. Malpractice has not been a problem in the past, but unfortunately there has been increasing concern with globalization of everything. Tetsu Uejima covered this topic in a recent ASA Newsletter.4

Volunteering is a very rewarding and enjoyable experience. There are risks but these can be managed with planning, vigilance, and flexibility.

  1. Dohlman L. “Successful Volunteering-Matching the Anesthesia Volunteer and the Aid Organization. International Clinics. Spring 2010;48(2):151-163
  2. Cappello C et al. The Safe Practice of Anesthesia in Developing Countries. The Clinical Forum for Nurse Anesthetists. 1995; (2):91-95.
  3. Fisher Q et al. Pediatric Anesthesia for Voluntary Services Abroad. Anesth Analg 2002;95:336-350.
  4. Uejima T. Medical Missions and Medical Malpractice: The Current State of Medical Malpractice Overseas. ASA Newletter February 2011;75(2):22-24.
  5. Traveler’s Health Information: http://wwwnc.cdc.gov/travel/

Inset photos are courtsey of Austin Smiles – The Austin Plastic Surgery Foundation. Please visit Austin Smiles at http://www.austinsmiles.org/.

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