“I’ve lost three more patients today,” writes Ben Cavilla, MD, from the Lubango Evangelical Medical Center in Angola, southern Africa. “One had terminal AIDS. Another had a liter of puss in her belly. And the third was a young child with typhoid fever.” Dr. Cavilla gave up the comforts of British Columbia, paid his own expenses, entered into a foreign culture, and learned a new language – all for the privilege of volunteering his time and talent.
Consider also Rick Donlon, founder of Christ Community Health Services in South Memphis. “We took a dramatic pay cut to help the poor,” says Dr. Donlon with all humility. “Some of us mortgaged our houses to pay bills and salaries so we could impact the most largely underserved part of the city.”
Why did these individuals make such sacrifices? What is the genesis of this allure; the allure of international medicine? Let’s begin by defining just what we mean by the words international medicine. While various interpretations are in use, most fundamentally international medicine means healthcare for all people – especially those on the margins.
And here begins the first allure of international medicine: We want to care for those who are most marginalized. As I read applications for the INMED International Medicine Certificate, I encounter professionals inspired over the prospect of investing their time, talent and treasure for which their only likely recompense will be a “Thank you” and a sense of satisfaction. In an age of economic crisis, why is this so attractive? Because, first of all, it is consistent with the ethics we most admire; also, because it resonates with the faith possessed by many; and because we realize that somehow this kind of self-sacrifice is intensely good for our souls.
But caring for those most poor presents daunting obstacles. And here originates the second allure of international medicine: We like a challenge, something difficult; something that demands innovation and often brings out the very best in us. Those who are truly poor, whether in the United States or in other nations, are often separated by divergent culture and low-resources. Providing effective health intervention requires mature skills in crossing cultural divides – skills in language, worldview, and health beliefs – as well as unique abilities in community health assessment, managing diseases of poverty, and health leadership.
The third allure of international medicine touches on a deeply personal note: We want a healthy legacy. I am struck by the frequency with which healthcare professionals reflect on their experience in medical missions or free health clinics or community health centers, even years removed. Though their service was often difficult and marked by failures, it also created intense personal meaning and deep significance. And while pride did not prompt the service, they are intensely gratified that it became part of their personal history.
So how shall we respond to the allure of international medicine? For those new to the field, I would first recommend volunteering in your current community. Displaced people, minorities, and neglected citizens are almost ubiquitous. Also, seek out like-hearted individuals for collaboration and encouragement. The meld of similar conviction produces success unthinkable by those working alone. Strengthen your understanding and skills in the field. It is for this very reason that INMED exists: to so equip healthcare professionals. Finally, realize that the allure is not simply intellectual, but one that originates in our souls, and happy are those who permit themselves to be lured on behalf of those who are least served.