Balancing Altruism With Realistic Expectations
An altruistic sentiment is a good start, but it's not enough. Even the most enthusiastic doctors don't always thrive in disaster zones, or in places where the needs are very different from those in North America.
Roger van Helmond has worked with MSF since 1995 and has been on eight missions. "Each one requires a cultural adaptation," he says. He now works as a recruiter from MSF's New York office, where they recruited 46 American doctors last year. In total, MSF deployed 445 people in 2014.
Their process is rigorous because it has to be. Although 63% of doctors want a second assignment after their first, others don't make it past the first month.
"We had a young physician—a great guy—who went to medical school with his heart set on working for MSF. He did everything to prepare for working with us. He volunteered in Nepal (before the earthquake). He did fundraising for us; he was ready to go."
First-time MSF deployments typically last 9-12 months, and are rarely to disaster zones. South Sudan is one of MSF's "benchmark" countries, where the organization is well established. New recruits are sent to benchmark countries to experience a conflict zone—epidemics, malnutrition, and refugee camps. "We have many very basic programs there," van Helmond explains.
The young doctor was deployed for his first assignment to South Sudan, and was back after 2 weeks. He explained that he had put MSF on a pedestal; his expectations had been too high. "He was crushed," van Helmond says.
But that has become the exception for MSF. The organization's recruiters try to discover the "soft skills" offered by physicians who are interested in joining the team. Have you been abroad? Do you have travel experience in developing countries? Are you flexible—can you "go with the flow"? Do you have management and coaching experience? Van Helmond says it's important to be flexible and open to the unknown. "We deal with 109 nationalities. Are you okay in an emergency department, not knowing what will be there? If you are a pediatrician, will you be okay working with adults?"
A 3-day training course is part of the recruitment process. Since establishing the course, says van Helmond, the success rate with candidates has improved. "We get to know each other better, and are able to assess how well the person will fit in a multicultural environment. Sometimes people back out; they find it's not what they expected."
"You have to be level-headed," he explains. "If you have a dispute with the nurse in the operating room, you have to know that you will be sitting down to dinner together that evening and be okay."
Van Helmond says he advises people to stay for at least 2 months before calling it quits. It takes time to get used to the environment and teammates. "Even after my eight assignments, the cultural adaptation is never the same," he says.
Medscape Public Health © 2015 WebMD, LLC
Cite this: Ingrid G. Hein. Should You Volunteer in a Disaster? Advice for Physicians - Medscape - Jun 04, 2015.