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The following is a recommendation from a veteran of traveling medical missions:
FamilyDoctor.org is a great on-line resource for medical issues seen in Guatemalan clinics. This website has photos, very informative and fast access.
It is important to know the right information to ask from your prospective group members. Below is a sample application form contributed by our friends at Children of the Americas. Click here to download the form in a Word document.
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Applicant Information
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| Name as it appears on your passport: (Last, First, M.I.) |
Degree: Area of Expertise: |
| Occupation: |
Social Security Number: |
| Home Address: |
City: |
State: |
Zip: |
| Office Address: |
City: |
State: |
Zip: |
| How were you referred to Children of the Americas, Inc.? |
| Office Phone: |
Cell Phone: |
Home Phone: |
| Prefer to be contacted at: Office Home |
E-mail address: |
| Besides English, other language(s) spoken & how fluent: |
| Emergency Contact: Name: Address: Phone & / or Cell: E-mail: Relationship: |
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Passport Information
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| Passport Number: |
Expires: |
Date of Birth: |
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Mission Experience
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| Prior medical missions participated in, if any: |
| What role(s) anticipated in other mission trips: |
| Special skills & Interests: |
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References
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| Reference(s) : |
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Travel Information
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| Airport departure city: Primary: Secondary: |
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Health Information
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| Health status: Allergies: |
| Any activities unable to perform while on the mission with or without accommodation? |
| Current medications: |
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Other
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| Please include any other relevant information: |
| T-shirt Size: S M L XL 2X Other
Please include the following with your completed application:
- Signed waiver form
- Curriculum Vitae (physicians only)
- Recent photograph
- Copy of current state medical license
- Copy of passport
If the Team Coordinator has the above mentioned information on file from previous mission trips, it is not necessary to resend the information.
Signature/Print Name: /
Return by mail to: ________, or send completed application as an attachment to e-mail to ______________ at _____@__ . Applications are due by __________. Applicants will be notified of the status of their applications by _____________. |
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It is very important to have each traveller sign a liability waiver, both for legal protection, and to set expectations for the trip. The following is an example provided by Children of the Americas. Be sure to review it, and tailor it to your particular trip. Click here to download the waiver in a Word document.
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GENERAL RELEASE AND ASSUMPTION OF RISKS OF TRAVEL
Please read this general release and assumption of risks of travel (“Agreement”) carefully before you sign it. This is a legal document which affects your legal rights. If you have any questions about this agreement, please consult an attorney before you sign it.
I am applying for volunteer service with [NAME OF ORGANIZATION], whose primary purpose is to [BRIEF DESCRIPTION OF PURPOSE]. I certify that all statements made in my application are true and complete. I hereby expressly authorize [NAME OF ORGANIZATION], its officers, agents, and employees, to investigate in any manner they deem appropriate, at their sole discretion, educational, employment, community service or professional background, and public or private records, including but not limited to law enforcement and court records and personal references. I further consent to have [NAME OF ORGANIZATION] communicate with any and all of my previous or current employers relating to my work record and experience.
I certify that I am not aware of any physical or mental restriction or condition that would impair my ability to perform the essential functions of the volunteer position for which I am applying, and I am fully capable of responding to the physical and mental demands of the volunteer position I seek.
Assumption of Risk
I, ________________, acknowledge that I have applied to be a volunteer in the work of [NAME OF ORGANIZATION]. I am aware and acknowledge that the work of [NAME OF ORGANIZATION] may subject me to a number of risks and dangers. I understand and acknowledge that the work of [NAME OF ORGANIZATION] may involve hazardous and dangerous activities and that my participation in such work may subject me to the risk of injury, illness, or death. I have volunteered to participate in the work of [NAME OF ORGANIZATION] in Guatemala. I understand and acknowledge that I may be subject to a number of additional risks and dangers involved in transportation to and in Guatemala (including traveling in light airplanes), the risk and danger that adequate medical facilities may not be available should I require medical attention, and the risks and dangers of residing in and being subject to the laws of a foreign country. I have been made aware of the conditions that presently exist in Guatemala, specifically, but not limited to, social and political unrest, terrorist activity, unsanitary health conditions in villages and other municipalities, including the risk of hepatitis, malaria, cholera, polio, and other diseases. I voluntarily agree to assume all the above risks, and all other risks associated with my participation in the work of [NAME OF ORGANIZATION], whether known or unknown.
I understand that I am not an employee of [NAME OF ORGANIZATION] because I participate as a volunteer in the work of [NAME OF ORGANIZATION]. I understand and agree that [NAME OF ORGANIZATION] is under no obligation to provide, and does not provide, worker’s compensation or malpractice insurance or any other employee benefits of any kind.
General Release
I, ________________, in consideration of [NAME OF ORGANIZATION]’s arranging a volunteer assignment for me, and with the intention of binding myself, my heirs, legal representatives, successors and assigns, do hereby expressly RELEASE AND FOREVER DISCHARGE [NAME OF ORGANIZATION], its officers, directors, employees, volunteers, agents, legal representatives, insurers, successors, and assigns from any and all claims, demands, damages, liabilities, and causes of action that I now have or may in the future have, whether known or unknown, of whatsoever nature, relating to or arising out of my selection as a volunteer by, or my service as a volunteer with, [NAME OF ORGANIZATION] whether or not due to [NAME OF ORGANIZATION]’s negligence, strict liability, or any other breach or fault. This includes, but is not expressly limited to, death, bodily injury, personal injury, property damage, loss or theft of property, economic loss, or any other damage, loss, or cost.
As further consideration for being permitted by [NAME OF ORGANIZATION] to participate in their work, I hereby release and forever discharge [NAME OF ORGANIZATION], their directors, officers, agents, employees, representatives, volunteers, attorneys, assigns, and affiliates from any and all claims and demands of whatever kinds of nature, whether known or unknown, that rise out or are connected in any way whatsoever with any first aid, medical treatment, or services rendered to me during my participation in or in any way related to [NAME OF ORGANIZATION] work.
This document shall be construed according to the laws of the state of [STATE OF INCORPORATION]. Any litigation, administration proceeding, or arbitration concerning this Agreement or participation in the work of [NAME OF ORGANIZATION] shall be brought and conducted within the state of [STATE OF INCORPORATION]. If a dispute should arise with respect to the meaning of any of the terms of this Agreement, the rule of construction that an Agreement is construed against the party preparing such document shall specifically not be applicable to the interpretation of this document.
This General Release represents the entire agreement of the parties hereto and supercedes any and all prior or contemporaneous oral or written understandings, statements, representations, or promises. I understand and acknowledge that this Agreement is a binding legal document that affects my rights and remedies.
My application to [NAME OF ORGANIZATION] for travel with their [TYPE OF GROUP] team to Guatemala is hereby submitted with the following understandings:
1) I will be a guest in Guatemala and therefore subject to the laws and customs of that country and to the policies of [NAME OF ORGANIZATION];
2) I will be working under, and subject to, the authority of the [NAME OF ORGANIZATION] Board or Directors and its agents, and will abide by their direction and recommendation while visiting and working in Guatemala;
3) I will be responsible for obtaining the funds necessary to cover my transportation, lodging, meals, and any other expenses incidentally incurred on the trip.
I, _________, have carefully read this agreement and fully understand its contents and binding effect. I acknowledge that I have had the opportunity to have this agreement reviewed by an attorney prior to the time I signed it. I understand that this agreement is a legal contract between me and [NAME OF ORGANIZATION] that affects my legal rights. I represent that I am signing this agreement knowingly, voluntarily, and of my own free will.
Signature/Print Name: / ______ _____
Signature/Print Name of Spouse or Significant Other: / _______
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Here are some tips from Children of the Americas: Please feel free to add your own thoughts or feedback by clicking on “Leave A Comment”, below.
- Phone Numbers: Have a printed information sheet for each team member with contact information on it. This should include contact information for team members, host group, and your hotel. Also, rent some cell phones when you get to Guatemala for several key team members and give out the phone number to all members for communications. This saves major frustration during the week to be able to communicate.
- Emergency Contacts: Leave 2 emergency contact numbers behind in the US for team member’s families.
- Clinic Paperwork: Have prepared clinic sheets, prescription pads and note pads packed. Number each clinic sheet at the top so you can later determine how many patients you saw. Gather each clinic sheet after patient is seen. This provides invaluable information for future trips, and is excellent support documentation for the IRS or your donors.
- Feedback: Ask team members to send thoughts within 3-4 days of arriving back home: It is good to get ideas on what worked and what needed to be tweaked. It may be helpful to pre-determine a date and time for a conference call or meeting for after your return.
- Embassy: Have each team member register with consulate.
- Passports: Have each team member supply you with a copy of their passport. This is invaluable if their luggage is stolen or passport lost.
- Photographs: Warn team members against photographing children without consent (fear of child abduction).
- Meds: Have your pharmacist pack Cipro for team members who might get sick on local food or water.
- Papers: Keep a three ring binder for team with passport copies, copy of their application and liability waiver, and emergency U.S. contact person.
- Safety: Advise caution when using Guatemalan banks, tourists are easy targets when exiting. Most U.S. banks will wire in Quetzales for a small fee but they need at least 8-10 days to do so.
- Documentation: Remind team members that expenses, hotel, flights, etc. are tax deductions, but they must keep receipts.
This article has been reproduced with permission from Phil Plunk, at Salud y Paz.
- When you arrive at your location look around the site and find a location with light and if possible good air circulation. Plan for good patient flow in and out too. You also need access to electricity for your headlight.
- When you decide on your area, ask the local translators or officials to find you at least 1 table, 2-3 benches, 1 chair for you to sit on, and 2 concrete blocks for the patient if a portable dentist chair is not available.
- On the table, spread out the picnic plastic tablecloth you have brought and find the two plastic tubs. Fill one with the cold sterile solution you brought and the other with plain rinse water. Find the scrub brush for brushing the instruments. You will clean the instruments in the cold sterile solution, let them soak as long as feasible, and then rinse them off in the water.
- Lay out your instruments, gauze, anesthetic and needles on the table. Teach someone how to load the syringes for you. Keep the sharps and bring them back with you for disposal at the clinic. Empty vitamin bottles from your pharmacy work well as sharps containers.
- You will also need 1-2 boxes, buckets, pails, etc. to use for trash. Line them with a plastic trash bag.
- Set up your headlight next to your chair. Stack the two concrete blocks in front of you and cover with a towel or something. The patient will sit down with their back to you, and then you can lean them back, resting their neck, head, on your knee. Keep their head out toward the knee, not in close to your stomach so you have the correct angle. That way you can sit and work all day without breaking your back. No, this is not a joke. TRY IT! It works. It’s Phil’s inventive attribution to the humanitarian aid dental world.
- It works well to anesthetize 5-6 people, marking on their papers what teeth will be extracted. Then go back and do the extractions. Place 2-3 folded gauze in place and instruct them to hold pressure for an hour then discard the gauze. There is typically little problem with bleeding, and the people seem to know how to take care of it.
- Throw the excess bloody gauze and teeth into the trashcan with the plastic bag liner. Every one gets something for pain. Have your pharmacy make up packets of Tylenol 500mg or Ibuprofen 400mg, #10, with instructions for TID or QID for the pain. They are not used to taking meds here so lower doses work well.
- Antibiotics are rarely necessary. Once you remove the source of infection, the body heals quickly, but do what you feel is right on a case-by-case basis. Antibiotics are typically a good idea when there is acute pus present.
- Then repeat, repeat, REPEAT, until exhausted or through for the day. Do take breaks as needed.
- You will need to decide how many patients you want to see at the BEGINNING of the day. Be sure and see all that are given out numbers. Keep an eye out for how many patients you have left in the afternoon and you can gauge how many extractions to do for each one so you can get finished. You can do only single extractions if you begin to run out of time.
- Most of the extractions are simple and routine due to malnutrition. The bone is softer, and most of the extractions are chronic abscesses so there is already bone breakdown.
- If you do break off a root, you can try to retrieve it, but don’t try to be Super Doc. If you can’t get it, don’t worry. Give them medications and have your translator explain to them they need to come to the clinic in Camanchaj on Monday or Tuesday. I will take care of it there with the proper equipment. The patients understand. Much of the dentistry done here is terrible, and root tips are a common occurrence.
- When you have finished for the day, clean all the instruments up and re-pack. Please be sure they all get back, we tend to frequently lose instruments and forceps, and would like to have some left for your next trip!
- Pour the cold sterile back into its bottle. You can filter it through some folded gauze. You need to use that solution for the entire week you work.
- Remember to bring back the needles and sharps for disposal.
- Pack up all the other trash and gauze into plastic trash bags. The village will dispose of it. (Don’t ask.)
- Sit down and drink some water, you probably need it!
- Feel really, really good about what you have done for the people. You have eliminated many sources of pain and infection that would still be there if it were not for you.
- Load up the suitcases and head for home.
- Let God’s grace fill you and take away your tension and fatigue. Feel the presence of God as you get ready for the next day.
Tyler Green1 , Heidi Green1 , Jean Scandlyn2 and Andrew Kestler3
1School of Medicine, University of Colorado Denver, Denver, Colorado, USA
2Departments of Anthropology and Health and Behavioral Sciences, University of Colorado Denver, Denver, Colorado, USA
3Division of Emergency Medicine, University of Colorado Denver, Denver, Colorado, USA
Click here to view this article in its entirety.
© 2009 Green et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
Each year medical providers from wealthy countries participate in short-term medical volunteer work in resource-poor countries. Various authors have raised concern that such work has the potential to be harmful to recipient communities; however, the social science and medical literature contains little research into the perceptions of short-term medical volunteer work from the perspective of members of recipient communities. This exploratory study examines the perception of short-term medical volunteer work in Guatemala among groups of actors affected by or participating in these programs.
Methods
The researchers conducted in-depth, semi-structured interviews with 72 individuals, including Guatemalan healthcare providers and health authorities, foreign medical providers, non-medical personnel working on health projects, and Guatemalan parents of children treated by a short-term volunteer group. Detailed notes and summaries of these interviews were uploaded, coded and annotated using Atlas.ti (Scientific Software Development GmbH, Berlin) to identify recurrent themes from the interviews.
Results
Informants commonly identified a need for increased access to medical services in Guatemala, and many believed that short-term medical volunteers are in a position to offer improved access to medical care in the communities where they serve. Informants most frequently cited appropriate patient selection and attention to payment systems as the best means to avoid creating dependence on foreign aid. The most frequent suggestion to improve short-term medical volunteer work was coordination with and respect for local Guatemalan healthcare providers and their communities, as insufficient understanding of the country’s existing healthcare resources and needs may result in perceived harm to the recipient community.
Conclusion
The perceived impact of short-term medical volunteer projects in Guatemala is highly variable and dependent upon the individual project. In this exploratory study, project characteristics were identified that are consistently perceived to be either positive or negative. These findings have direct implications for anyone involved in the planning and execution of short-term medical volunteer projects, including local and foreign medical team members, project planners and coordinators, and health authorities. Most importantly, this preliminary study suggests avenues for future study and evaluation of the impact of short-term medical volunteer programs on local health care services.
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