You are the mission director for a short-term medical mission to a less developed country with a need for otolaryngology. The country, which is poor, has few physicians, with otolaryngologists located only in the larger cities. After locating the sleeping quarters and stowing the team’s equipment, you and your team are given a tour of the clinic and regional hospital and find them to be quite basic—that is, the resources provided to care for patients are minimal. You see that the diagnostic equipment, operating room, and recovery room facilities are far less adequate than you had been led to believe. It becomes apparent that the scope of the surgical procedures you and your team came prepared to perform may need to be reconsidered.
Explore this issue:July 2016
Your otolaryngologist host has mobilized a number of nurses and translators to assist the team in obtaining histories and performing physicals on the patients, many of whom have walked for several days to be seen. The translators seem to have a serious lack of medical knowledge, however, and it is difficult to determine just how well your questions and comments are being translated to the patients.
In spite of the agreement with your hosts that you and your team would only be addressing otolaryngologic clinical issues, quite a few of the patients are requesting care for medical issues outside of the scope of otolaryngology—such as diabetes, skin sores, burns on the extremities, hernias, and deformities of the fingers and toes. One family has carried in a grandmother in a makeshift gurney to see your team, when in fact she has suffered a severe stroke from hypertension.