Their country needs you

Being a medical volunteer can build trust, help others and bring personal rewards – but it has to be done the right way, writes CLAIRE O'CONNELL

WITH SO much news of deceit and corruption swirling around, public trust can generally be in short supply these days. But when done properly, volunteerism can help foster trust in the medical profession and improve patient care, according to a US ophthalmologist who has worked to support colleagues in the Middle East and Haiti.

“I think it continues to establish the profession of medicine as more than just direct patient care, that we have a big picture in mind,” says Dr Mike Brennan, following a lecture to the annual meeting of the Irish College of Ophthalmologists at the Royal College of Surgeons in Ireland.

Going to Iraq was a turning point for Brennan, who sought to establish links there with medical professionals. “I was there as a volunteer and sponsored by the department of defense. Before that I was an international traveller and I would meet colleagues at international meetings, but this trip to Iraq changed my life,” he recalls.

“Things were so quiet there in late 2003 that the Iraqi physicians were seeking relationships with the US and the UK, so I was trying to link them with organisations, getting them to come together.”

Brennan criss-crossed the country with his driver in an old VW Passat, meeting physicians and politicians, and finding out what the needs were – mainly expertise in primary care, burn management and trauma surgery.

“The medical profession was technologically challenged because of sanctions,” he says. “In terms of adapting technologies in hospitals they were way behind, and doctors couldn’t get out to go to international meetings.”

Brennan worked on linking physicians there with partner organisations overseas to help build up expertise and to allow Iraq-based doctors continue their professional development.

“Many of the specialties are now becoming cohesive and returning to international standards,” he says. “And the same model will work in Afghanistan. Our volunteers are ready to go, but Haiti has intervened.”

After the earthquake there, Brennan visited the stricken zone as leader of a task force from the American Academy of Ophthalmology. “We didn’t have a good natural disaster relief plan, so we put one together fast,” he says.

Working with Haitian colleagues and other associations, he helped to organise mobile equipment for eye surgery and set up shared facilities in the longer term, but he describes a disorganised volunteer situation there and a “flag flurry” among organisations to get their colours flying first and highest.

So what is his advice for health professionals who want to offer their services in areas of conflict or chaos? His golden rules include not going it alone, and ensuring you sign up with the appropriate authorities if you want to practise medicine.

“It is possible to be a solo volunteer and show up, find someone and help them, but it’s better to do it in a structured relationship,” says Brennan. “I’m not denying that there are a lot of well-designed humanitarian charities that do a lot of good things, but sometimes they do them in a non-integrated way, so do it in collaboration with from the host country.”

Volunteers also need to be sensitive to the local culture, religion, political climate and issues around solicitation, he adds. “Don’t try to sell something, like your organisation or your product, unless you are there as a registered salesperson.”

And it’s not enough to just talk the talk, says Brennan. “If you go somewhere and make a lot of promises and don’t keep them, then you are disingenuous, you are not being loyal to the cause and you lose the friendship.

“A second visit cements the relationship and you will then be forced to deliver on your promises,” he says, but adds that volunteers also need to step back out at the appropriate time.

When done effectively, volunteering your expertise can draw rewards from many quarters, he assures.

“You learn to feel more comfortable about yourself if you go and share, and it’s not just sharing surgical skills, it could be sharing the relationship as much as the direct talents that you offer. You certainly feel good yourself knowing you have done it and you can help others feel good, too.”

RIGHT TO SIGHT: 'I SAW THE FIXABILITY IN BLINDNESS. THAT WAS MY INSPIRATIONAL MOMENT'

TEN YEARS ago, Dr Kate Coleman was sitting in a lecture theatre in Dublin when she suddenly saw things in a new light.

Listening to a talk at the annual Irish College of Ophthamologists conference about "needless blindness" from cataracts and other treatable conditions which affect an estimated 45 million people worldwide, it suddenly struck Coleman that we now had the means to eradicate it.

"For the first time I saw the fixability in blindness," she recalls. "That was my inspirational moment – I heard this and I thought this is completely solvable. Now we have the treatment, we cannot sit still."

Fast forward a decade and Coleman is back at the ICO conference in the Royal College of Surgeons (RCSI) in Ireland, but this time she's addressing the audience – urging them to lend their expertise to Right to Sight, a charity she founded to help counter preventable blindness by taking advantage of recent improvements in technology and clinical procedures.

Working with NGOs, hospitals, clinics and governments in India and Africa, the charity offers clinical and management training to support treatments such as cataract removal or even just getting glasses.

During her talk she also ran a video of a cataract being removed, but she says you don't have to be a surgeon to help - as well as fundraising, there are other projects where anyone can chip in, including one to simply provide people with the glasses they need, she explains.

"It drives me mad because we can now buy glasses for a dollar. Ten years ago they didn't make cheap over-the-counter glasses," she says.

Right to Sight volunteer Enda Barron, a third-year medical student from RCSI, is just back from India where he learned how to prescribe glasses at eye camps set up in slums and rural areas.

"If you are in India and you work as a hairdresser or seamstress or mending shoes, as a lot of people do, if you can no longer see up close, then instead of earning $20 a month they can now earn maybe only €1 per month – just because they don't have access to a $1 pair of glasses," says Barron.

Within a few weeks the local experts were comfortable with his skills and Barron was able to prescribe glasses in the camps and also help to develop a manual for others to learn.

"It's about sustainability and skills transfer and ensuring that when

Right to Sight leaves, people have the capacity to do it themselves," he says.

Coleman stresses that anyone can get involved: "There is room for everyone to help in a structured system," she says.

"And I really do feel quite privileged to be alive right now when we can do something."

See righttosight.com