The storm surge had barely receded from the battered shoreline of Tacloban in the Philippines when the images began appearing online. The bodies strewn in the barely identifiable streets with the same randomness as the downed trees and detritus from the shattered dwellings foretold an even greater tragedy: that of the hundreds of thousands left without access to shelter, food, potable water, or basic health services.
Watching this unfold almost in real time, I began to search for information about medical relief missions that might be organizing in the Boston area. This was certainly better than keeping up with the latest antics of Toronto’s crack-smoking mayor, which I had been following for the previous several days. I couldn’t find anything, but kept going back to look as the scope of the humanitarian disaster caused by Haiyan revealed itself to be much larger than originally reported.
There must have been something in the way I described to my wife what I had seen which made her ears perk up. She turned to me and said simply: “You’re not going.” And it was at that moment that I realized that that was exactly what I wanted to do. I had only just returned from a medical mission to Guatemala a few weeks earlier, and it wouldn’t be easy for either my family or my colleagues and patients if I were to pick up again, this time with almost no advance notice, and disappear for another couple of weeks. I understood all this and realized it made no sense. That night, however, I found myself back once again on Google to see if there were any medical-relief groups that were organizing and in need of a pediatrician. Just looking, I told myself, though if the opportunity were there, I might be able to reschedule some clinics for later on in the month....
Because the focus of the mission is so clearly the well-being of others in a setting that is by definition temporary, it becomes easy to put aside egos and the petty political gamesmanship which so often dominates many workplace environments.
Those who have participated in disaster relief work, or who have volunteered in resource-poor settings, know just how satisfying it is, in ways which may not be immediately apparent to those who have not. Talking with a colleague prior to leaving on a trip that we had organized to work in a small hospital in Port-au-Prince just as cholera made its deadly comeback, she told me about a conversation she had had with a non-medical friend of hers. After telling him she’d be traveling to Haiti, he had asked her incredulously: “They’re making you go there?” We both laughed, feeling incredibly fortunate that we were able to go, and finding it funny and even a little odd that not everyone would see it this way.
What is it that pulls people to do this kind of volunteer work? From the outside, it seems a fair question to ask. The work is physically demanding, the hours long, and it often involves intense exposure to human suffering and death from conditions seldom seen back home, either because they are easily preventable in the first place, or because the cost of treatment is within reach. The living conditions on these trips are usually relatively sparse, with electricity, hot water, and flush toilets a luxury. The cost of participation, including airfare and time off from work, is almost always borne by the volunteers themselves.
From the inside, however, the answers—and there are many of them—are just as obvious. Having participated in five medical mission trips to Haiti and Guatemala over the last few years, I have met hundreds of people if not more, medical and non-medical, who have been bitten by the same bug. There are those who come once and never return, but many keep on coming back, and there are some who choose to leave their former lives behind to serve full-time.
Many volunteer out of religious convictions. To some, such as Iaomai Medical Ministries, this means extending “the healing ministry of Jesus Christ to underserved people around the world”; to others it means combining the notion of Tikkun Olam—repairing the world—with the values expressed in the biblical commandment ve’ahavta le’re’eha kamocha: “and you shall love your friend as yourself.”
There are those who thrive on the adrenaline rush the intensity of working in such chaotic conditions creates, which is then amplified by the breakdown of the usual rules that exist back home in the “normal” world. Four months after the earthquake which leveled large sections of Port au Prince, I met many young twenty-something Americans racing through the rubble-strewn streets in pickup trucks, bandanas aflutter and hunting knives strapped to their belts, tirelessly delivering gravely injured patients to the different foreign-operated health-care facilities and procuring life-saving equipment and medical supplies when these suddenly ran out. There were no traffic lights to worry about; no rigid hierarchies to consider; no annoying bosses; no dress codes; and no worries beyond the here and now. They were out there saving life and limb each day, and having a blast.
Without exception, all of the doctors and nurses I’ve met—myself included—revel in the absence of paperwork and bureaucratic and administrative stipulations that distract from what we’re really interested in doing: healing patients. One woman I met, a pediatric pulmonologist from Miami who volunteers with Operation Smile, explained that she does so to keep herself “grounded,” saying that “it reminds me why I went into medicine in the first place.” And then, there’s also the realization that if you weren’t there, there might well not be anyone else to take your place, as opposed to back home, where there are always others available to step in and fill the need as necessary.
It is true that sometimes this breakdown of the normal rules of how medicine is practiced can lead to serious abuses. Returning to Port-au-Prince the following November, I met a physiatrist whose days were spent in the operating room removing bone spurs from the stumps of patients who’d undergone emergency amputations after the earthquake at the hands of non-qualified medical professionals who really didn’t know what they were doing. By essentially experimenting on patients in ways they never would have allowed themselves or been allowed to back home without losing their licenses, being sued, thrown in jail, or all three, they left behind bony shards within the stumps that pinched on nerves and left their patients/victims in chronic and excruciating pain.
The dissolution of many of the rigid frameworks, including those which govern normal interpersonal relationships back home; the stress of working and living in unfamiliar and less than comfortable conditions, often in close quarters; and the sense of being united in pursuit of a common purpose that is larger than oneself all nurture an intense camaraderie among team members that is rarely encountered back home. Because the focus of the mission is so clearly the well-being of others in a setting that is by definition temporary, it becomes easy to put aside egos and the petty political gamesmanship which so often dominates many workplace environments. One of the nice things is that this willingness to see and approach people differently lingers on even after the return to one’s usual life. At the farewell dinner on the last night of the trip to Guatemala, Dr. Greg Imler, our team leader, advised us to expect to come back and find that people seem different. “It is not they who have changed,” he said, “but rather you who are different.”
For all of these reasons and many others, so many of us continue to volunteer, and to seek out opportunities to do so. The personal fulfillment that comes from serving others and being part of something larger than yourself is hard to beat. While I probably won’t end up going to the Philippines, I envy those who will. My heart goes out to the children, women, and men whose lives have been turned upside down by this storm, and I’ll have to find other ways of helping them: through donations, and by encouraging others to go. Until it’s my turn again.