5 considerations before becoming an international EMS volunteer

Preparing ahead is extremely important when volunteering in a developing country

By Stacy Fiscus

Coordinating the volunteer program for Haiti Air Ambulance has never left me with a lack of questions to answer from my American counterparts. When natural disasters occur, many countries count on foreign paramedics to help with the search and recovery. But for some countries, the need for medical volunteers goes beyond that. Here are five important things to consider before volunteering in a foreign country.

1. Research. Research. Research.

Health care standards in foreign countries can be among the hardest things to accept. But it’s important to understand that you can’t change a developing country’s health care system in one trip.
Health care standards in foreign countries can be among the hardest things to accept. But it’s important to understand that you can’t change a developing country’s health care system in one trip. (Photo courtesy of Stacy Fiscus)

Just as you practice scene safety and situational awareness when working on any rig or helicopter, don’t blindly go into a foreign country without doing your homework. Most countries that require foreign aid are developing nations, and come with a certain amount of risk unfamiliar to many. The Internet and social networks offer a plethora of resources to someone planning a volunteer trip.

First, check the Centers for Disease and Control and Prevention and U.S. embassy websites for information on your destination. There you’ll find security alerts, health and vaccine recommendations and other pertinent information. Many social networks have experienced expatriate groups for the country you are visiting. These can be very useful for asking questions and getting current information on your destination. Many of those who belong to these groups have lived in the area for an extended period of time, and they could also prove to be a valuable resource in the event of an emergency.

2. Make sure your goals align with the organization

What are you trying to accomplish during the time you’ll be volunteering? What skills and benefits can you bring to the organization that they don’t already possess or may have in short supply?

Ensure that the organization you are working with is capable of sustaining any forward progress made by volunteers. It’s important to understand that a short commitment may yield limited progress toward a larger goal. Don’t be disappointed or discouraged if you can’t fix everything you see that’s broken. Choose a program that you believe will build on your contribution and continue to move forward long after you're gone. Take every opportunity to teach the local health care providers – both verbally and with practical demonstrations – in order to increase their knowledge base and skill sets. Don’t push them aside to take care of a patient without showing them the steps you’re taking to improve the situation.

3. Embrace the culture and accept what you cannot change

It’s important that you learn the basics of the culture of the people you’re there to help. Most countries have a customary greeting such as a handshake, kiss on the cheek or phrase. Prepare yourself ahead of time by learning useful words and phrases in their language. This will help you accomplish many tasks and show that you respect their culture. Sometimes a simple smile or greeting is all it takes to gain the assistance of a helpful citizen.

Developing countries come with standards of practice unfamiliar in the U.S. You may see their wages as unfair, but what you may not see is the balance that has developed over time to create the standard. Giving excessive amounts of money above the standard disrupts this balance. 

Health care standards in foreign countries can be among the hardest things to accept. Due to the lack of resources, equipment and money, you may have to stand on the sidelines and watch patients receive a level of care far below what they need to survive. In some cases, they won’t. It’s likely to be difficult, as a new volunteer, to witness such an event as a bystander. Being in that situation will undoubtedly generate a feeling of helplessness. It’s important to understand that you can’t change a developing country’s health care system in one trip. The reward is knowing that you have made an impact, regardless of the size, that will encourage future change. Keep in mind that they don’t want your pity, but your help is appreciated.

4. Be physically and mentally ready

Volunteering in a developing country for the first time can be overwhelming. Your senses will be overloaded with new sights, smells, and sounds. Processing all of this at once is not going to be easy. It may even take months after you leave to adequately quantify and categorize all that happened. Whether you make a short or extended trip, there will be many physical and mental stressors you’ll encounter, the least of which may be a lack of hot water for a soothing shower or electricity to power a coffee maker. That can be surprisingly stressful when you’re already dealing with so many environmental changes.

There’s always the possibility that you become ill while your body acclimates itself to a drastic change in diet. You need to stay hydrated and take care of yourself. In addition, communication with family and friends can be crucial to your mental wellness. Prior to departing, find out if you’ll have Internet access where you’re staying and contact your phone service provider to ensure coverage and avoid high charges. Foreign environments and physical demands can be hard enough on your body, but the mental demands can easily surpass that. You may see things that you’ll never be able to forget, but I believe you’ll also find the strength that you never thought you possessed. Volunteer trips can be extremely rewarding and satisfying, but they can also be highly difficult and demanding.

5. Prepare yourself and have an emergency plan

When a national emergency or natural disaster occurs in the U.S., an army of first responders subdue the chaos in a short period of time. In a developing country, the chaos is multiplied and there is no intervention to stop it. In many countries where volunteers are needed, self-rescue is the only 911. Create an emergency plan for you and your family prior to the trip. If it exists, become familiar with the "911" system and how to utilize it. As EMS workers, we’re conditioned to jump into harm’s way without hesitation. In many circumstances abroad, this may not be the correct approach. Remain aware of your surroundings and the situation, and act accordingly.  

Photocopy your passport and keep a copy with you and in each bag you take. Register with the U.S. Department of State STEP program so that the local embassy is aware of your travel plans and itinerary. Ensure that someone in your party or stateside knows of your location at all times. Purchase and understand your medical evacuation insurance prior to your trip, and obtain all recommended vaccines. Prepare yourself with the mindset that unexpected events will happen, instead of hoping they won’t.

Here are some useful items that you should keep in your backpack: flashlight, signaling device, water purification tablets, wet wipes, electrolyte drink mix, multi-tool, painkillers and fever reducers, external cellphone battery and charging cord, food bars, bug spray, sunscreen.

In conclusion, be prepared for your trip, but don’t become so consumed with preparation that you forget to enjoy it. This opportunity can be a once-in-a-lifetime experience that can create brilliant memories and teach life lessons. Keep an open mind and heart, and pay forward all of the comforts we’re afforded at home.

About the author:
Stacy Fiscus is the chief flight paramedic for Haiti Air Ambulance based in Port Au Prince, Haiti. Stacy is the Vision Zero chair for the Association of Air Medical Services, as well as a board member at large for the International Association of Flight and Critical Care Paramedics. For more information on the air medical work being done in Haiti, visit www.haitiairambulance.org.

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