Why

“It is worth asking why a health care professional who is capable, respected and experienced would leave his or her home, job and loved ones to go to a challenging, exhausting and possibly dangerous destination.”

This sentence leads off a very insightful section in the Global Humanitarian Medicine and Disaster Relief chapter in Wilderness Medicine, a fascinating textbook in the medical library here. 

According to the authors, providing medical relief is the primary motivation for most involved in this work. This relief first involves action such as a surgical procedure or consult, then being with patients physically and emotionally in their suffering and then bearing witness so that those suffering do not do so alone.

It has been helpful to read a concise list of potential answers to this “why” question, to reflect on my own motives and to understand where others involved in this type work might be coming from. Each reason listed in the chapter has merits and drawbacks and it is noted that many ideals are “mulled over” in the course of these deployments. Here are my take-home notes from the textbook on this subject.

1. Help people in need / relieve suffering - This is a laudable goal that the world could aspire toward more. One drawback is when the “helper’s high” or “doing something good” can be self-serving and used as a means to a personal end. This desire might not suffice if the culture served in has no grid for “volunteering” and assumes an ulterior motive for the service. While volunteerism is commendable it can lead to financial and domestic difficulties if not done with balance.
2. Testing oneself - In the absence of diagnostic technology or readily available specialists, an austere environment might hone physical exam skills, resurrect knowledge from medical school days or push some into learning new procedures. In contrast - skills needed in your home role might be neglected and require re-learning.
3. Medical tourism / adventurism - Our credentials can be a ticket to world travel. Having a “cross-cultural experience” has many benefits but this attitude might segue to “voyeurism and reductionism that can trivialize patients and their situation.”
4. “Check-mark syndrome” - Working in an emergency situation is just “one more box to tick off the list of having done it all.”
5. Fleeing a negative situation / finding oneself - Some may be looking to get away from personal relationship failure, professional frustration, or disillusionment with values of their home society. They might find a cause to channel their energy toward. 
6. Personal conviction, philosophy or religious belief - These ideals can serve as a sufficient motivation to serve and advocate. People of this mindset might feel that the suffering they see needs be shared with a wider audience and speak up on behalf of their patients. Local governments might not share the worker’s sense of social justice or beliefs which can limit their advocacy in the interest of patient or team safety.  Challenges arise when “there is discordance between foreign ideals and local culture, politics and traditional power structures.”

The section in the textbook concludes with an observation that we are all complicated humans who sometimes experience boredom and ambivalence in the midst of joy and fulfillment. However, we better understand the human condition when we enter into and see the “beauty and brutality” of the lives of others. This challenges our ideas about how the world works. Also, we see what we have in common can transcend great distance and our differences in language and culture.