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Is the value in volunteering professional or personal?
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Volunteerism provides personal and professional value
Volunteerism is a personal choice, but it does have professional implications. It is one of those things where it is always good that your patients feel that you are doing something in a humanitarian sense because that is really, after all, what they think of their doctors. They like to think their doctors are going into the profession for humanitarian reasons, not financial ones.
We all want to look good in the viewpoint of our patients. All of us wanted to do something to benefit mankind. Patients will Google you now. They will look at your CV, and they ask me all the time if I am going back to Armenia, if I am doing more trips overseas. They know you volunteer.
Nowadays, the more information that patients get about you, the better it is. When they come in, in my profession, they know exactly what they want. They will tell you they want to have the cataract on the right eye removed and a lens implant put in. They will tell you the type of implant they want in and the type of vision they want after. It is a new era with the ability of patients to be quite knowledgeable. It does not hurt that they become knowledgeable about what you are doing.
I had a patient, and I can still remember his last name — it was Flint, not an Armenian name. He ended up working with me to build the mobile eye hospital that we brought to Armenia with the Armenian EyeCare Project. He became very interested in the work I was doing, to the point where his help with the design — he was an engineer — made all the difference for me. Not only did he give a very significant donation for the building of this massive mobile eye hospital, but he also left us in his will and died very shortly afterward. So, this bequest of $2 million was instrumental toward the completion of this 18-wheel mobile eye hospital that had two exam rooms, two lasers and a full-on operating room.
The Armenians have been very clever, and I have learned from them. The gentleman who designed the mobile eye hospital has also developed several surgical techniques that I have learned from him and encompassed. Because they do not have every bell and whistle, every instrument, they have had to invent a couple of ways to be able to treat a patient. If they have a loose capsule or bleeding within the eye at the time of the procedure, they have developed techniques that are quite remarkable and have been very beneficial should it ever happen. These are exceedingly rare things, and that is the trouble, because if they are rare, you never develop a technique to treat them. While I have never had bleeding within the eye, I have certainly had capsules that are loose, and the technique he developed was terrific.
Roger V. Ohanesian, MD, FACS, is founder of the Armenian EyeCare Project and founder of Harvard Eye Associates. Disclosure: Ohanesian reports no relevant financial disclosures.
Personal choice, with professional implications
My first experience volunteering in a developing country was after high school graduation. At that time, I had no specific skills and I traveled to Burundi in a small village where the main unmet need was to build an aqueduct that would have brought clean water to many local families. This was the time when I first learned that helping and caring for others means in fact to help and care for ourselves.
Soon after I graduated in medicine, I spent my summer time in Togo in a rural hospital where the main activities were visiting patients and doing intracapsular cataract extractions with no IOL implantation. Since then, there was a long interval with no further missions, but thereafter I traveled to Ghana in 2008 and 2009 at the Comboni Hospital in Sogakope where a very well-organized eye service was regularly run by local health personnel and a number of volunteer eye surgeons mostly from Italy. Honestly, I must say that Ghana was love at first sight thanks to the very friendly people and excellent working conditions. More than that, it is definitely true that the African continent has a unique appeal that is so frequently reported as “mal d’Africa.”
I have been in Sogakope four times now in 4 different years with my wife and my daughter, a student in medicine, as assistants. I have also been joined by my OR nurse and one of my co-workers. We have always worked as a team, sharing all the problems and critical issues that you can encounter when traveling and acting in a completely different environment. Our group has cooperated with the resident team and has interacted with the local patients. We have learned many lessons in terms of creating the right empathy and understanding the specific needs and mentality. Also, although Sogakope is a well-managed and efficient hospital with a number of skilled doctors, you obviously do not find all the equipment and devices that are usually available in our centers. This forces a volunteer to find alternative solutions, often during surgical activities.
One of the most relevant examples relates to cataract surgery. Modern phacoemulsification techniques are now based on sophisticated machines that utilize single-use cassettes and instrumentation. Unfortunately, in many places this is not affordable. Therefore, a surgeon must be very familiar with alternative and still efficient techniques with early recovery in terms of postoperative refraction. Manual small-incision cataract surgery with its different variations is the solution and a must-know surgical technique if a surgeon wants to volunteer in developing countries.
To summarize a comprehensive answer to the above question, the value of volunteering is primarily a personal choice possibly with very relevant professional implications that translate in improved knowledge and skillfulness ultimately applied to our daily activities at home. Most of all, remember that the economic and social value of volunteering is far overcome by the benefit that each of us can gain by donating time to our sisters and brothers.
Paolo Lanzetta, MD, is founder and scientific director of IEMO – Istituto Europeo di Microchirurgia Oculare. Disclosure: Lanzetta reports no relevant financial disclosures.