Penn State doctors volunteer in underserved areas across the globe—and change their lives in the process
By Karen Zitomer
Dr. A. Mark Boustred (left) has trained doctors in several countries, including Peru. Here he performs surgery with a Peruvian surgeon.
It was not common to see a child so close to death’s door. In the United States, doctors hardly ever encountered a child in the end stage of heart disease; she would have received treatment much sooner than this. And yet here she was—a little girl so ill no one thought she would make it through surgery.
“It was our last day in Ecuador. We had a very difficult decision to make. We chose to operate,” said Dr. Patrick McQuillan, director of pediatric anesthesiology and vice chair for clinical affairs at Penn State Milton S. Hershey Medical Center.
She survived.
This was why McQuillan became an international medical volunteer 20 years ago. It was more than a chance to put his professional convictions as a pediatric anesthesiologist into action; it was an opportunity to truly change someone’s life.
“Every time you go on one of these trips, you have an experience that enriches your life,” said McQuillan, who has volunteered all over the globe with the missionary program of the Penn State Children’s Heart Group, and Operation Smile, a nonprofit organization specializing in the correction of facial deformities.
McQuillan is one of a group of Penn State health professionals who have elected to spend their free time combating disease and sickness abroad. With a worldwide shortage of health-care personnel, particularly in developing countries, the need for volunteers who can provide care to less-privileged individuals has reached a critical level.
Those who respond to the call for help are few and far between. Despite the overwhelming number of doctors in the United States, less than 3 percent of physicians have had any experience in international outreach, according to International Health Volunteers, a nonprofit organization specializing in global medical volunteerism.
By providing clinical care to patients and training to doctors in developing nations, physicians like McQuillan are helping to bridge the gap of health-care disparity worldwide.
Dr. Joel Weinstein, an ophthalmologist at Penn State Hershey Medical Center and an associate professor of ophthalmology and pediatrics at Penn State College of Medicine, said he became hooked after his first trip to the Philippines in the mid-1980s. “I had fallen in love with the people,” he said.
Coping With Limitations
Over the past 20 years, Weinstein has worked primarily with ORBIS, a nonprofit organization specializing in ophthalmic surgery and training, providing expertise in neuro-opthalmology (the study of visual problems related to the nervous system) and pediatric ophthalmology.
Weinstein’s volunteer missions have taken him to Guatemala, Ethiopia, Nigeria, Uzbekistan and Syria. In each country, he has seen conditions in individuals that have gone untreated for years due to lack of proper medical care. ORBIS as well as other volunteer health organizations are usually inundated with patient requests during each mission.
McQuillan said it is not uncommon for Operation Smile to prescreen up to 1,000 children who have the cleft lip and cleft palate facial deformities. Unfortunately, it is possible for the medical team to treat only the 200 most serious cases in the five days they perform surgery.
Since access to state-of-the-art medical equipment is hard to come by in most developing countries, medical outreach organizations typically meet this challenge by bringing in what is needed. “We’re committed to making sure that whatever we have in the United States is made available to the patients we serve in other countries,” said McQuillan, who has volunteered in Africa, Asia, South America and the Middle East.
Permanent Solutions Needed
One of Weinstein’s most memorable cases involved a young Filipino girl whose drooping eyelids and weakened facial muscles affected her vision and made it nearly impossible for her to smile. The condition was dramatically improved upon administration of medication. Her mother burst into tears upon seeing her daughter smile for the first time in years.
Weinstein said this touching story took a sad and all-to-common turn. Last he heard, the girl’s chronic condition had returned. Her family did not have the means to pay for medication or bring her to the nearest specialist in Manila.
Weinstein said that this story underscores a critical point about the role of medical outreach organizations: Volunteers cannot be relied upon as a permanent solution to insufficient medical care. Although many developing nations simply do not have the financial means to build a health-care infrastructure, some governments seem to have little interest in improving health care whether due to corruption or even complacency about the disparity in that country.
“In some countries, the gap
is considered something that is
there and will always be there,” Weinstein said.
According to the World Health Organization (WHO), the minimum spending per person per year needed to provide basic, life-saving services is somewhere between $35 to $50. Of its 194 member states, one-third spend less than $50, and nearly half of those nations spend less than $20 per person. WHO also reports that 57 countries, most of them in Africa and Asia, face severe workforce shortages.
In addition to encouraging political leadership to make health care a priority worldwide, WHO recommends additional training and support of health-care workers. This is where education provided by volunteers can be vital.
Since the early 1980s, Dr. A. Mark Boustred, associate professor of plastic surgery at the College of Medicine, has trained doctors in his home country of South Africa, as well as in Namibia, Uganda, Zululand, Lesotho, Iran and Peru.
Boustred said the key to providing effective education is to offer it in a respectful and humble manner. “You can’t go in thinking of yourself as some great foreign expert who is going to train the lowly locals,” he said. “You go in as a colleague—with humility and graciousness. The keys are to develop trust and a good friendship and to train foreign colleagues in their own environment.”
Penn State professor of orthopaedics and rehabilitation Dr. Edwards Schwentker, who leads a team of physicians, nurses, medical students and other health professionals to Honduras to perform a series of corrective surgical procedures on children, also offers training to Honduran orthopaedic surgeons. “They’re a very dedicated, skillful group, and one of the goals is to create an ongoing program to train local doctors to provide orthopaedic care,” said Schwentker.
Inspiring the Next Generation
Many physicians believe international volunteerism should be part of standard medical school curricula. In fact, Boustred said his own department is hoping to incorporate an overseas experience as part of its residency program.
“A two-week trip might not be able to change the world,” he said. “But it does change the person who takes that trip.”