Module 3: Working at Clinics in Resource-Poor Settings(1)

Global health work in resource-poor settings often poses considerable challenges to the health worker. As a result of war, poverty or neglect, healthcare infrastructure in these areas is often understaffed, under-funded and ill-equipped. Foreign clinical workers are challenged to achieve optimal results with minimal tools. Accustomed to the sophisticated technologies of large, modern hospitals, they often have to make do with sub-par facilities.

Sometimes, foreign health workers, through their expertise and resourcefulness, transform these resource-deficient health facilities into oases of healing. For instance, in 1987, anthropologist-physician Paul Farmer founded Partners in Health, a nonprofit whose “mission is both medical and moral.”(2) Partners in Health rejuvenated the dilapidated health system in Haiti, setting up a modern hospital complex to treat diseases that disproportionately afflict the poor as well as partnering with the Haitian Ministry of Health to revitalize existing healthcare resources.(3)

Sometimes, physicians from developed countries may undertake short-term assignments to resource-poor countries to provide training and education to domestic healthcare providers. George Washington University Medical Center, for instance, has created a partnership with the Eritrean Ministry of Health to address the country’s severe physician shortage. Under this arrangement, medical faculty from the university will visit Eritrea to provide residency training to local doctors.

Oftentimes physicians may even decide to undertake full-time, permanent employment in poorly-developed areas. Well-known examples include Australian gynecologists Dr. Catherine Hamlin and her late husband, Dr. Reginald Hamlin, who went to Ethiopia in 1959 on what was initially a temporary assignment to help set up a school of midwifery. After seeing the plight of women suffering from serious birth injuries, they decided to stay and help. In 1974, they founded the Addis Ababa Fistula Hospital, which, to this day, continues to provide fistula treatment to women free of charge.

War takes a toll on human health and well-being, and global health work targeting the victims of war is often undertaken with disaster relief organizations like Doctors Without Borders, whose teams of health experts penetrate war-torn or other dangerous territories to render emergency medical assistance, distribute food and fight disease. They hire medical as well as non-medical personnel on short-term assignments of a few weeks to longer assignments of one or two years, accompanied with a modest stipend. Another well-known organization active in refugee and disaster relief is the International Committee of the Red Cross (ICRC).

Besides physicians and nurses, non-clinical expertise, such as public health workers, is necessary to help poor communities develop effective healthcare infrastructure. Non-clinical expertise is varied, and includes medical anthropologists who study the interrelationships between disease and culture, epidemiologists who locate the causes of disease, health policy-makers who enact policies to improve healthcare services and access to healthcare etc. Non-clinical global health workers repair fragmented health systems through organization, financing and management. 

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(1) " Career Overview - Global Health." 14 May 2008. 15 Jul 2009.

(2) "The Quest of Dr. Paul Farmer." All Things Considered. Host Melissa Block. NPR, 20 Oct 2003. TV.

(3) "Partners in Health: Haiti/ Zanmi Lasante." Partners in Health. Partners in Health. 15 Jul 2009.