MODULE 3: Local Doctors Must Be Integral To The Program
Medical care should not be provided unless local doctors are integral to the program
For many reasons, partnering with local doctors is essential for efficient and effective healthcare delivery. The needs of the local community are known by those who have the best understanding of the local situation. Local providers are familiar with the etiologies and distributions of diseases in their communities. They are also keenly aware of regional aspects of public health such as hospital patterns, who has access to care and how to best distribute resources. Additionally, many Western physicians are unfamiliar with tropical disease and rely on the expertise of local doctors to learn to make correct diagnoses and dispense effective treatments. Dr. Edward O’Neil, Jr., president and founder of Omni Med, has experienced first-hand the vital role that local doctors play in global health programs:
“…most visitors – including ours – to poor countries are amazed at just how much local providers are able to do with so little. Many visiting clinicians find themselves learning much from their hosts. Indeed, few US or European clinicians have seen many of the tropical illnesses that local providers recognize so readily. Even the best-trained Western physicians initially flounder.”(1)
As a volunteer with Unite for Sight, American ophthalmologist Dr. Aron Rose discovered the quality and importance of local doctors. He explains this by detailing his own experience working as a foreign doctor in partnership with local ophthalmologists in Ghana:
“As a microsurgeon, it’s extraordinarily challenging to be out of your element. In this society we’re used to using absolutely top-notch equipment… What I have found is that working overseas challenges a surgeon tremendously… In many ways I think that surgeons operating in underdeveloped or developing countries have to be even better doctors because 1. They’re dealing with an array of pathology that is much greater than we generally see in the developed world, and 2. They’re being forced to use what they have… I end up learning so much more when I travel than anything I could possibly teach.”(2)
Integrating local doctors into global health programs is similarly essential for sustainability. A global health program that does not seek to prop up local healthcare providers can only yield temporary improvements, if any. Long-term improvements in community health require follow-up care, ongoing care, and broadening the reach of local doctors’ practices so that more patients have access to care year-round.
Failure to involve local doctors in global health programs can yield various deleterious effects. For instance, medical treatment without follow-up care can be more harmful than helpful, and foreign medical providers unfamiliar with cultural norms often struggle to communicate with patients. More importantly, excluding local doctors subverts community trust in local healthcare programs. Dr. Edward O’Neil, Jr. notes that in spite of their expertise, there exists a widespread belief among locals and foreigners alike that local doctors are “inferior clinicians.”(3) This belief is reinforced when Western physicians refuse to collaborate with their local counterparts. Undermining the legitimacy of local doctors can only harm community health.
Go to Module 4: Build Effective, Sustainable Programs With Measurable Results>>
Footnotes
(2) “Dr. Aron Rose: Volunteering Abroad.” Online video clip. Uniteforsight.org. Accessed on 01 October 2008. <http://www.uniteforsight.org/videos/drrose>