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Two local residents in Honduras assist the lead surgeon as they treat a patient's fracture.
Courtesy of Health Volunteers Overseas

AAOS Now

Published 2/1/2018
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Katie McMullen; Amanda Decker

Global Volunteerism: Learn How to Maximize Your Impact

AAOS Annual Meeting boasts Global Volunteerism ICL
There is a long and rich history of volunteerism in the orthopaedic community, and in recent years, the interest in global volunteerism has grown.

"There's certainly more people who are interested in doing this work, particularly younger people," said Coleen Sabatini, MD. "There's an incredible interest, enthusiasm, and true passion for this work."

Dr. Sabatini, an associate professor at University of California San Francisco, serves on the AAOS International Committee, chairing the International Scholarship Program Project Team. She is active in international orthopaedic work, including education and research in Uganda through the Pediatric Orthopaedic Society of North America (POSNA).

At the AAOS Annual meeting in March, Dr. Sabatini will moderate a conversation about international volunteer work during the Global Volunteerism for Orthopaedic Surgeons Instructional Course Lecture (ICL) on Tuesday, March 6, 1:30–3:30 p.m. Speakers will include Todd Kim, MD; Peter Trafton, MD; and Divya Singh, MD.

"There's been an explosion of interest [in global volunteerism] in the last decade, which is really exciting," continued Dr. Sabatini, "but with that comes a need to take a step back and really have an honest conversation about where can our impact be the greatest, and how do we do the best work we can and not cause harm."

A discussion of impact
Dr. Singh, a hand surgeon from Seattle, has been volunteering internationally for nearly a decade. She went on her first volunteer excursion in 2009, participating in a medical mission to Rwanda.

"My first volunteer activity was a surgery-based mission…you operated and left," Dr. Singh shared. "Everyone has really good intentions and really wants to take good care of patients, but, unfortunately, sometimes there's no follow up, or there's no one who can continue the care once you are gone."

On that first assignment, Dr. Singh and her team operated on a young patient with a tibia fracture and who suffered from chronic osteomyelitis. Although it appeared the infection had cleared prior to surgery, Dr. Singh learned the young patient developed another infection following surgery.

"That really drove the point home that we all think we're all doing the best thing we can, but this is a resource-poor setting with different factors, so things you may think will work in [the United States], won't work overseas," Dr. Singh said.

Two local residents in Honduras assist the lead surgeon as they treat a patient's fracture.
Courtesy of Health Volunteers Overseas
An HVO volunteer consults with a local orthopaedic care provider in Bhutan.
Courtesy of Health Volunteers Overseas

"That encouraged me to shift from a surgery-based mission to a teaching-based mission. I think education is the way we have the most impact," she added.

In 2011, Dr. Singh became a member of Health Volunteers Overseas (HVO), a nonprofit organization dedicated to improving global health through education. She has completed numerous HVO volunteer assignments, which focus on sustainable improvements in care through the education and professional development of the local health workforce in resource-scarce countries.

Through her work with HVO, Dr. Singh has observed the importance of appropriate and sustainable contributions. "Don't do anything [local surgeons] couldn't do themselves," she advised, "and don't do anything that they can't manage complications from."

Dr. Sabatini concurred with Dr. Singh and added, "If you're going to go in and do a lot of surgery, you should have people who work and live in that environment everyday with you because, one, they can teach you a lot…and, two, it's an opportunity to teach and expand the skills of the folks who are there."

Drs. Sabatini and Singh both agree there are many ways to approach a sustainable, impactful volunteer experience.

"I think teaching missions are where we should be focused, but there are other opportunities for people who may not be able to do teaching-based missions," Dr. Singh commented. "There is value in surgical and disaster-relief missions. There are different things for different volunteers based on their time, their level of expertise, and their interest."

Getting down to the nuts and bolts
In addition to the discussion of impact, the Global Volunteerism ICL will provide a platform to discuss the details and considerations essential to a successful global volunteer experience.

"We're not just going to talk vaguely about the importance of being good people," Dr. Sabatini said. "We're going to talk about the nuts and bolts so that people leaving this ICL are going to feel better equipped to do this work in whatever way they want to do it. Attendees will see multiple examples of what those options are and how to make them successful."

Other information presented during the course will include ways to prepare for an overseas assignment, challenges volunteers often face and how to overcome them, and examples of volunteer organizations like HVO and POSNA. The course will provide ample time for questions and discussion.
"We are taking all this enthusiasm and energy and trying to empower people to do the best good that they can," Dr. Sabatini explained.

Katie McMullen is communications manager, Health Volunteers Overseas. Amanda Decker is manager, AAOS international programs.