I didn’t know what to expect,” says Roy Morris, CBET, director of clinical engineering at the University of Arkansas for Medical Sciences (UAMS) Medical Center in Little Rock. “I walked in the door—this was in Odessa, Ukraine—and they had one monitor, one ventilator, and boxes and boxes of stuff. And we were supposed to operate on 20 to 25 kids with that.”
Top Left: A Friday market in Haiti close to the hospital where Larry Walsh worked.(photo courtesy of Larry Walsh) Top Right: There was no respiratory therapist, so Roy Morris was asked to do the job. “Thankfully, I have a good understanding of ventilators and have been thrown into this position before,” he says.(photo courtesy of Roy Morris) Bottom Left: Carl Porter in Haiti.(photo courtesy of Carl Porter) Bottom Right: On a mission for ORBIS International in Syria, Robyn Frick (R) explains the function of an ophthalmic device. (photo courtesy of ORBIS International)
Morris was on a medical mission, one of many he has taken as a volunteer biomed. This particular mission was with the International Children’s Heart Foundation (ICHF), based in Memphis, Tenn. The organization aims to reduce undiagnosed and untreated congenital heart disease in pediatric populations of developing countries. Its efforts include direct care, such as on-site surgery, as well as the provision of resources, including equipment, medications, and training, to medical professionals in those regions. Morris participated as a clinical engineer, there to get equipment running and keep it running—which is what he did.
By the time he left, just days later, the facility had eight working ventilators and 22 monitors. “Sometimes, you have to put blinders on, focus on the task at hand, and try to do the best you can, knowing you won’t have everything there is to have and making do with what you’ve got,” Morris says.
Sometimes, however, a clinical/biomedical engineer volunteering on a medical mission will know exactly what he or she will be walking into. The first trip for Larry Walsh, a BMET II at Provena St Mary’s Hospital in Kankakee, Ill, was one of a progressive series of trips with the TriMedx Foundation, Indianapolis, to certain Haitian facilities. Early trips focused on inventory and troubleshooting; later trips targeted repair, maintenance, and training of local personnel. “I was able to look at a list of the equipment that needed to be worked on to make sure I had the equipment I needed to take care of it,” Walsh says.
Despite the different experiences, both men enjoyed the same feeling of reward upon completion of those first trips and now regularly volunteer time on medical missions. “The benefit is knowing that you’re able to do something for somebody less fortunate,” Walsh says.
Biomeds who participate in medical missions often echo this motivation, even though their volunteer experiences are as varied as their personal backgrounds and professional resumes. But just as they share a desire to do good things, there are other similar threads that run through their stories.
The First Step
“Well, you get out of college, and you want to make a career and have a family. And you climb the corporate ladder, and then …,” says Robyn W. Frick, CCE, biomedical engineer with Eastern Maine Medical Center in Bangor. Then something happens—or nothing happens—and the realization occurs that there may be another way to contribute.
For Frick, a physician approached the shared service company where he was employed for help repairing an EKG machine she wanted to take back to the Philippines. When it came time to invoice her, Frick tore up the bill. “It was such an insignificant amount of money for us, but a lot to help them turn things around,” he says. “And then I realized I had to do something else besides worry about collecting money and running a business all about profit.”
To achieve this new objective, Frick contacted Project HOPE, Millwood, Va, an organization he had seen advertised on television. Walsh went through his employer at the time, TriMedx Healthcare Equipment Services in Indianapolis.
After a lifetime of wanting to do something, Morris looked into opportunities after getting into a nearly fatal accident that caused him to rethink his life and finally make the move to “help others more.” His volunteer efforts inspired those around him, including Carl Porter, a UAMS team leader/CBET III. After the earthquake in Haiti, Porter thought he “might do something” and quickly found an opportunity through Morris, who had a contact at Project HOPE.
Resume Still Relevant
Even with the connection, however, Porter did not come by the position lightly. He had to complete an application, provide his passport and other documentation, and participate in an interview. Most volunteer biomed experiences are the same.
Frick, whose first experience was also with Project HOPE (in the 1980s), describes a 20-page application that asked about details such as foreign language abilities. “I thought, ‘Well, I’ll never work there, and next thing I knew, they called,’ ” Frick says. He found himself working in China for the next 2 years.
Matches are usually made based on the biomed’s experience. “Skill set is an absolute must with ICHF,” Morris says. “If a biomed were to come in without any anesthesia background and something were to happen, that could be potential lives. Any child we don’t get to may not survive until the next trip.”
Walsh believes his background was key to his acceptance to the mission. “I think one of the reasons that [TriMedx] picked me was because I was the first one who applied with any kind of experience with the specific anesthesia machines that needed to be repaired,” Walsh says.
Once in with an association, however, a biomed can look forward to future opportunities if he or she proves themselves a valuable team player. “The only place I ever applied was the first one,” Frick says.
Of course, even with a rigorous application process and intense (ideally) planning on the part of an organization, biomeds on medical missions should be prepared to do anything. Those going on progressive trips will, generally, be better prepared than those going into completely new situations, but resources tend to be scarce and conveniences (such as overnight parts delivery) nonexistent in many areas. Biomeds must be willing and resourceful.
On a trip with Project HOPE to Milot, Haiti, Morris was sent to train facility personnel how to use and maintain about $1,500,000 worth of donated equipment. “While I was there to teach, I repaired just about every piece of equipment under the sun,” he says. “And they didn’t have any respiratory therapists, so because my background is in ventilators and anesthesiology equipment, I worked with the anesthesiologist, basically, as the respiratory therapist.”
Generally, however, biomeds are not asked to work outside their scope, though they may find resource constraints. On his trip to Port-au-Prince, Haiti, Porter’s task was to evaluate the facility’s equipment, repairing what could be repaired. The drawback? Whatever was done was limited to use with the meter, “because that was all we had,” Porter says.
Simple and Minimalistic
For the most part, resources on medical missions are scarce, but accommodations are comfortable. Details vary, of course, with each organization and each situation; and no one reports a vacation-like experience, but the challenges can increase the feeling of reward.
Porter stayed in a house the organization used for medical staff that was outside of Port-au-Prince. “The air conditioning would cut off, but it was better than people living in tents in Port-au-Prince. I couldn’t complain,” Porter says.
Walsh describes his experience as a “warm day in August.” He stayed in dormitory-type facilities, where he shared a room with another; males and females had separate living quarters. “We slept on hospital beds, but had a bathroom with running water—which was cold, but still good to have,” Walsh says.
Drinking water was also available, although it was obtained fresh daily. “They wouldn’t let us drink the local water because we weren’t used to the stuff that was in it,” Walsh says. “They had a filtering system about 5 miles away that they went to every day with 5-gallon jugs to pick up our drinking water.”
Food may or may not be provided for all three meals (some biomeds found themselves on their own for dinner), but the organizations do make every effort to ensure the safety and well-being of their volunteers. In instances where necessary, they will even provide security. Morris has never been afraid for his safety, even though he has witnessed food riots in Haiti and recently returned from a mission to Iraq, working near its northern border. “Not once did I feel unsafe,” Morris says, reporting instead that the people were friendly, the food great, and ICHF is thinking of expanding its program in the region.
Teaching to Fish
While in Iraq, Morris met with 10 biomeds from the area as part of the education portion of the program. The objective was to share knowledge so that the local professionals could assume responsibility and sustain their own programs. “Our job is to go in there and train their doctors how to do it themselves, so that 5 or 6 years down the road, they can take care of their own kids. And eventually, they can help us help others,” Morris says.
Many organizations that are not focused on disaster relief share similar objectives. Much of the work Frick has done has involved training others on topics from equipment repair and maintenance to business practices and operations. Formats have also been broad, ranging from formal seminars and classroom situations to on-site, hands-on instruction given while servicing equipment.
“What works best is the old medical school adage, ‘See one, do one, teach one.’ I’ll show them how to check an anesthesia machine. Then they do a couple. And then, they teach someone else in their own language so that you don’t have to have a translator,” Frick says.
Frick will teach whoever wants to learn, and in some facilities he has found himself engaging with clinical professionals from throughout the hospital at many different levels. Patience is key. “We might work on a simple suction pump all day, taking it apart and putting it back together,” Frick says. “Sometimes, we have to show them how to use a screwdriver and which way to turn the screw. It can take half-an-hour to take out three screws, and it takes a lot of patience.”
To be ready for any situation, biomeds heading out on medical missions must properly prepare, mentally and physically. “It helps to have a certain character and a certain demeanor,” Frick says, referring to the challenges of travel in developing nations and foreign countries. For those who find this challenge too great, there are opportunities within the United States, though not as many.
Of course, every volunteer will need appropriate documentation, including a passport (unless staying in the United States). Depending on the destination, shots may be necessary. Walsh was immunized against hepatitis A, hepatitis B, malaria, and others.
Porter advises bringing along basic survival gear—flashlights/batteries, bandages, pan/knife/fork, napkins, energy bars, etc—and had his iPhone, which allowed him to make calls and access the Internet. Frick notes the world is nearly ‘wired’ everywhere, and though it may not always be high-speed (or convenient), Internet access can be found even in some remote spots.
Internet access may be helpful to obtain information but not parts. Therefore, when possible, biomeds heading out on a mission should learn as much as possible about the equipment on which they will be working. “You definitely want to research what you’re doing to make sure you bring plenty of equipment because once you get there, what you’ve got is what you’ve got,” Walsh says.
Sometimes, however, information is unavailable or incomplete, and biomeds must, again, be flexible and ready for anything. The work is likely to be intense. Most biomeds report full workloads. “I was there for about 4 days and worked as much as I could because of what I needed to get done,” Walsh says.
Trip lengths vary, from long weekends to years. “There are places in Africa that would be happy to take you for a year,” Frick says. Many retired biomeds devote their time to these types of causes, working as consultants, writing textbooks, or developing training programs for translation.
Very rarely, there is compensation; most often, time is volunteered. Biomeds who participate in these missions use their holidays and vacation; occasionally, the institution for which they are regularly employed full-time will allow them extra time off. Porter was able to gain an extra week for a 3-week trip through his employer’s generosity. When Walsh worked for TriMedx and participated in its trips, time off was fairly easy to obtain; Morris also finds it easy with 6 weeks of vacation a year.
Travel expenses are typically paid and arranged through the organization. The more remote or damaged the location, the more difficult the trip. Walsh endured a 4-hour jeep ride over rough terrain that included ditches and creeks from Port-au-Prince to the hospital in which he would be working. “In the rainy season, it would be a lot harder to get there,” Walsh says.
But the challenges add to the experience and the reward. Sometimes, there may be time to sightsee and experience the culture; other times, not at all. Yet, a volunteer biomed on a medical mission often develops a new appreciation for his or her own life. “Sometimes, we want to complain about what we have or difficult situations, but you go on these trips, and you see how the rest of the world has it, and you will never complain again,” Morris says.
Renee Diiulio is a contributing writer for 24×7. For more information, contact .