Why? Medicine in Developing Countries is Different
American physicians who go and serve in developing nations can have a tremendous impact, literally saving lives and helping to train and equip national health providers to do the same. However, those who do serve internationally often discover that their Western medical education has poorly prepared them to work effectively in poorer nations, and they are faced with several major challenges such as:
- Medical resources that are limited. There are seldom advanced diagnostic tools and available labs are quite limited. Supplies are limited, forcing difficult triage decisions such as “Who gets the only oxygen mask?” “Who gets surgery and who doesn’t?” even, “Who gets to see me and who will only see a nurse or community health educator?”
- Human resources that are limited. It is not uncommon to be the only physician for more than 100,000 people.
- Diseases are different. The preponderance of disease burden is infectious, the majority of which simply do not exist here.
- Cultural context is different. Success in impacting health requires a profound understanding of human behavior and the underlying values and belief systems that inform it, many of which contrast sharply with those of developed nations.
- The scope of your specialty practice is different. By necessity, you become the proverbial “Jack MD-of-all-trades” and are required to develop new skill sets to confront an incredibly broad scope of health issues. As family physicians you are often required to become the primary care physician and the referral physician because no sub-specialists may exist in the country of service.