Once is not enough: Volunteering abroad brings repeated rewards

Aug. 1, 2010

When Michele G. Harms, MS, MLS(ASCP), program director, WCA Hospital School of Medical Technology, Jamestown, NY, prepared for her first voluntary overseas medical-missions trip, she packed a slew of laboratory supplies — a microscope, Wright’s stain, Gram stain, AFB stain, slides, pipettes, and more. “In hindsight, I was very na”ive about what ‘bush medicine’ was all about,” says Harms, who has served on weeklong mobile medical teams in Haiti since 2000.

Since laboratory testing is not feasible in such a rural setting — other than urine test strips and pregnancy tests — due to a lack of electricity and the rapid pace of clinics with more than 150 patients per day, Harms’ role has varied over the years.

She has worked in a pharmacist capacity by preparing prescriptions from a medical cart, and also in triage filling out patient information and taking vital signs. She once worked with a mission organization to create a drug formulary and drug labels (in the country’s native language) for consistent patient care and to meet the World Health Organization’s recommendations for treatment.

Even though there was not much actual laboratory work, Harms’ laboratory knowledge base was invaluable when helping clinicians select appropriate treatments or collaborate on diagnoses. “When a patient says they have worms because they have seen them, we do not have to prove it,” Harms says.

“When they have fevers every three days, we do not have to prove malaria. For patients with high blood pressure, possible diabetes, and other diseases in need of long-term care, we refer them to a mission clinic for appropriate laboratory work, treatment, and follow up.” Patient issues have included aches and pains, worms, high blood pressure, skin infections (e.g., fungal, scabies, and burns), the common cold, respiratory infections, and eye irritations.

Beyond the bench
“As laboratory professionals, we can teach the importance of choosing fresh fruits and vegetables over fried foods, the value of breast feeding over bottle feeding, the importance of using clean well water for cooking and washing dishes, and the timing of the menstrual cycle for natural birth control,” she says.
“… working with clinicians in a mission setting has opened
their eyes to the potential of a laboratory professional being
a resource for patient diagnosis and care.”

Harms explains, “Our laboratory and medical knowledge extends far beyond the ‘pushing buttons’ stereotype that many clinicians have. In a way, working with clinicians in a mission setting has opened their eyes to the potential of a laboratory professional being a resource for patient diagnosis and care.”

As a program director for her hospital’s School of Medical Technology, Harms tries to instill in students the need to learn knowledge “beyond the bench” as they strive to be a vital part of healthcare in the United States or, possibly, abroad. She has also been honored to have a few of the school’s students join her on trips and has enjoyed sharing in the experience.

Harms was initially prompted to volunteer after a construction/Bible-school mission trip to Oaxaca, Mexico. She teamed up with a local surgeon who was taking a group to Haiti to serve in a new clinic being built in Croix-des-Bouquet by Christian Service International.

She also worked with TEAMS for Medical Missions for a 2008 Jamaica trip. Both organizations are based on living by Christian principles and serving with cultural sensitivity. “They are well established in the countries they serve, which brings safety and security to short-term mission-team service,” Harms says.

A thousand preparatory details
To prepare for a project, Harms solicits funds and medications needed to stock the mobile medical pharmacy cart, supplies for the clinicians, and food items for the team. Team members must raise their own trip funds (e.g., airfare, room, and board) and take vacation time from work. A valid passport is required and any necessary shots or antimalarial medications. The personal rewards are so gratifying, however, that Harms has found herself returning year after year.

“It is amazing to serve others; we go with the intent to make a difference in the lives of others but get blessings in return.”

The days are long and temperatures can reach 100^0F or more, and the clinics are noisy and full of waiting patient chaos. Interpreters must translate patient needs. “But the joy in this type of service gives you strength for the next day,” Harms concludes.

Another kind of serving
In contrast to the service of a caregiver, Jeanne M. Isabel, program director and associate professor, Clinical Laboratory Sciences, Northern Illinois University, DeKalb, IL, voluntarily travels abroad to serve in the role of situational analyst.

In October 2009, she traveled to Kenya as an American Society for Clinical Pathology (ASCP) consultant with the U.S. PEPFAR [President’s Emergency Plan for AIDS Relief] project. Kenya Medical Training College (KMTC) requested assistance from ASCP to assist with performing situational analyses at each of its 11 campuses that has a Medical Laboratory Science (MLS) department. The analysis questions were compiled jointly by KMTC and ASCP to evaluate the effectiveness of the implementation process of the new curriculum and to identify any gaps or challenges encountered.

Participants did a walking tour of the classrooms, student laboratory, library, computer rooms, and other relevant structures. They took photos to complement the report. After visiting the academic area, they walked to the associated hospital where student attachments, or clinical instruction, occurred, first meeting with the laboratory manager and then with some additional clinical instructors.

Because most of Isabel’s trips are made to developing countries, new technology is minimal. Most of the African and Middle Eastern laboratory supplies are from Europe, so familiarity with certain instrumentation can have a learning curve.

“I am always in awe of the techniques that can be performed with meager resources,” she says. “Probably the biggest need I see lies with a thirst for up-to-date books and materials. There is not always access to the Internet which can be detrimental to adding new resources and teaching materials.”

Decades of volunteer rewards
Isabel’s first experience volunteering abroad was with the U.S. Peace Corps in 1976 shortly after completing her training in medical technology as it was then called then. “Ever since that time, I have been aware of opportunities to assist with professional projects globally,” she says. “For most of my experiences, the destination has been chosen for me.”

Other organizations that have played a role in Isabel’s international volunteer experiences include USAID, U.S. Embassy in Mogadishu, Somalia, and the Association of Baptists for World Evangelism in Bangladesh.

“My personal rewards have always been the experience of being immersed in a different culture and offering ways to facilitate learning with what resources are available,” Isabel says. “The gratitude that comes from assisting individuals is worth all the effort.”

Karen Lynn is a freelance medical writer and editor. She covers issues around the globe.

Rice students’ Sally Centrifuge could
help diagnose anemia globally

Rice University students Lauren Theis and Lila Kerr. Photo by Jeff Fitlow.

Challenged to find a way to diagnose anemia that is affordable, mobile, and requires no electricity, two Rice University students created a centrifuge out of a salad spinner for medical clinics in developing countries. When capillary tubes containing 15μL of blood are spun — at up to 950 rpm — in the salad spinner for 10 minutes, the blood separates into heavier red blood cells and lighter plasma. The resulting hematocrit determines whether a patient is anemic. The students named the device the Sally Centrifuge and are taking it to Ecuador, Swaziland, and Malawi this summer as part of Beyond Traditional Borders (BTB), Rice’s global health initiative. The centrifuge — assembled using plastic lids, cut-up combs, yogurt containers, and a hot-glue gun — costs about $30 in parts. The students expect to continue work on the device after their summer treks. Learn more about BTB at beyondtraditionalborders.rice.edu.