Volunteers Overseas Research Articles

Building capacity and promoting health through online volunteering

Purpose Significant changes to in-person volunteering were necessary during the COVID-19 pandemic. Health Volunteers Overseas (HVO) responded to the pandemic by developing an online education platform and pivoting to online volunteering. This qualitative study explores the dynamics of online volunteering and provides visibility to this novel trend in the training of health professionals in resource-scarce countries. Methodology/approach Barriers and facilitators, actual and potential outcomes, and recommendations for online volunteering were addressed through a comparative case study approach focusing on three HVO global projects: physical therapy in Rwanda and Ghana, oral health in Nepal, and anesthesiology—a multi-country collaboration between Bhutan, Cambodia, and Laos. Findings A total of 15 participants, including project directors, host country representatives, and teaching volunteers, were interviewed online. Three themes emerged through the online interviews with HVO volunteers, project directors, and host country directors: Creating Space, the Future is Hybrid, and Geographical Expansion. Research implications Online volunteering provides a new opportunity for volunteers to expand their networks, learn new skills, and meet the needs of the host country participants. There is also an opportunity to expand projects beyond national boundaries, but logistical, cultural, and linguistic challenges must be considered. Practical implications Online volunteering is a feasible approach for building teaching and research capacity globally, and volunteer agencies should consider a hybrid model combining online volunteering with in-person volunteering. Originality Online volunteering provides support to meet the needs of both volunteers and in-country program participants. Limitations This study focused on the volunteer, project director, and host coordinator experience and not on the learner. More research is needed to investigate how online and in-person dynamics coalesce.

Opportunities for International Orthopaedic Volunteerism: An Exploration of United States and Canada-Based Nonprofit Organizations.

In low and middle-income countries (LMICs), there are often not enough orthopaedic surgeons to treat musculoskeletal conditions. International volunteerism is 1 way that the orthopaedic community seeks to meet this need. This study explored the opportunities available for orthopaedic surgeons to volunteer overseas as offered by nonprofit organizations in the United States and Canada. A systematic internet search was conducted using 2 distinct search strategies. A website was considered a "hit" if it was that of a U.S. or Canada-based nonprofit, volunteer, or non-governmental organization that had opportunities for international orthopaedic volunteerism. Duplicate hits were eliminated to identify distinct organizations. Data regarding the work and geographical reach of the organization, as well as changes to its volunteer programs as a result of COVID-19, were extracted from each hit. Of the 38 distinct organizations identified in the U.S. and Canada, the most common orthopaedic subspecialties represented were pediatrics (37%), hand (24%), and arthroplasty (18%). Foot and ankle (4 organizations; 11%), sports medicine (2 organizations; 5%), and oncology (1 organization; 3%) were the least represented subspecialities. The most common regions for volunteer trips included Latin America and the Caribbean, followed by West and East Africa. Twelve organizations (32%) were identified as having a religious affiliation. For most organizations, the trip duration was a minimum of 1 week. All volunteer organizations included operative or clinical experiences as part of their trips, and the majority of organizations (58%) reported that their trips included opportunities for training local surgeons. Many organizations (71%) reported having resumed trips after halting them during the COVID-19 pandemic. Many opportunities exist for orthopaedic surgeons to volunteer their time and skills abroad. Future directions for the improvement of international volunteer efforts among the orthopaedic community could include expanding the number of existing volunteer opportunities and assessing the ethics, safety, efficacy, and longevity of these programs.

Health Volunteers Overseas: A Model for Ethical and Effective Short-Term Global Health Training in Low-Resource Countries.

Health Volunteers Overseas: A Model for Ethical and Effective Short-Term Global Health Training in Low-Resource Countries.

Health Volunteers Overseas: The Long-Term Impact of Short-Term Volunteers

Health Volunteers Overseas: The Long-Term Impact of Short-Term Volunteers

Health Volunteers Overseas: The Long-Term Impact of Short-Term Volunteers

HEALTH VOLUNTEERS OVERSEAS: THE LONG-TERM IMPACT OF SHORT-TERM VOLUNTEERS Yvonne E. Vaucher, M.D., M.P.H.; April Pinner, MSPH, RD; Beth MacNairn, MA Approximately 5.6 million children under-5 died in 2016 - more than half from preventable or treatable conditions. Mortality rates are highest among children living in the world’s poorest households, specifically in Sub-Saharan Africa and Southern Asia where 80% of under-5 …

The Impact of an International Elective on Anesthesiology Residents as Assessed by a Longitudinal Study.

Introduction:Participation of anesthesiology residents in international electives may lead to the acquisition of skills as described in the Accreditation Council for Graduate Medical Education (ACGME) competencies. There is great interest in participating in such electives, but it is not clear there are educational or professional benefits. The purpose of this study was to evaluate the educational benefits of participating in overseas electives among anesthesiology residents.Methods:A longitudinal study design was used between 2010 and 2015 to survey all anesthesiology residents selected to participate in the nationally competitive Society for Education in Anesthesia-Health Volunteers Overseas (SEA-HVO) Traveling Fellowship Program in which third-year residents receive scholarships and ABA credit for 1-month teaching electives in a low-resource country. Pre-elective and post-elective surveys were sent via de-identified e-mails during the third year of residency. We investigated residents’ expectations, plans, and comfort level with teaching techniques prior to the elective and after and asked about perceived benefits.Results:The response rate was 68.8% of the 45 residents who received the survey. Participants were motivated by professional and humanitarian goals. Residents reported improved comfort with teaching techniques, especially lecturing and giving feedback. Participants acquired better skills in assessing the learning needs of students. There was a slight but nonsignificant increased comfort dealing with cultural and language barriers. The major self-perceived unique benefit of international electives was improvement in intercultural communication. The systems’ changes reported by residents as the most important to improve were those that affected patient safety.Conclusion:Global health electives have a small positive effect on teaching, cultural proficiency, and systems assessment skills. Residents improve in their ability to identify educational needs and to give feedback. Patient safety during anesthetic care is appreciated as the most important systems’ need.

Foundations of Practice.

A highly disproportionate burden of cancer is manifested in the world's poorest societies. Since 2016, I have volunteered with the Washington, DC-based organization Health Volunteers Overseas and have provided oncology and palliative nursing education and consultation in Vietnam, Honduras, and Bhutan. In addition, I have volunteered with Living Room International in Kenya, focusing on hospice nursing resource enhancement. I have traveled more than 50,000 miles to those four resource-impoverished nations and witnessed hardships beyond description.

A Physician’s Perspective on Volunteering Overseas… It Is Not All about Sharing the Latest Technology

As health-care professionals, there often comes a time in our career when we are intrigued by the possibility of participating in humanitarian work in underserved countries. However, the desire to serve is often tempered by some ambivalence about whether our skill sets are applicable in less technologically advanced health-care settings. Furthermore, there may be some concern about the cultural and logistical challenges one might face while working overseas. A volunteer may also be worried that, despite their best intentions, the medical personnel in the host country will not take advantage of our knowledge and their patients will not achieve the best results. As a consequence, a talented and well-intentioned professional may decide not to volunteer, resulting in a lost opportunity to participate in what can be an extremely rewarding experience. I will be discussing a number of key factors that can strongly influence the quality of one’s experience from the perspective of a Hand Specialist. My comments will primarily be a reflection of my personal experience over 20 years as a member of Health Volunteers Overseas (www.hvousa.org).

The development of the American Society of Hematology Health Volunteers Overseas Hematology Program in Arequipa, Peru

The American Society of Hematology-Health Volunteers Overseas (ASH-HVO) hematology program in Peru was initiated in 2008 with EsSalud, the National Social Security Health Service, and included 4 hospitals (2 in Lima, 1 in Arequipa, and 1 in Cusco). Between 2009 and 2013, there were 14 volunteers, 8

Promoting synergistic partnerships in low resource countries: a case study exemplar

Objectives/Aims: The purpose of this discussion is to explore the dynamics of partnership and its impact on both nursing faculty at Hue University of Medicine and Pharmacy (HueUMP) and Health Volunteers Overseas (HVO) volunteers.Design: A case study approach was used to promote understanding of partnerships in global health.Discussion: Collaboration between HueUMP’s nursing program and HVO is one of the most dynamic HVO nurse educator programs with five volunteer visits to Vietnam within a two-year period. Volunteer efforts include workshops to meet the diverse needs and interests of nursng faculty. We also emphasize the potential for ongoing strategic program planning integrating components from other nursing partnerships in the Southeast Asian region.Conclusions/Implications for practice: If we are to continue meeting partnership goals, we must recognize that partnerships should evolve according to the goals of HueUMP nursing faculty and the context of nursing in Vietnam.

Crisis Team Management in a Scarce Resource Setting: Angkor Hospital for Children in Siem Reap, Cambodia.

A crisis team management (CTM) simulation course was developed by volunteers from Health Volunteers Overseas for physicians and nurses at Angkor Hospital for Children (AHC) in Siem Reap, Cambodia. The framework for the course was adapted from crisis resource management (1, 2), crisis team training (3), and TeamSTEPPs© models (4). The CTM course focused on teaching physicians and nurses on the development of team performance knowledge, skills, and attitudes. Challenges to providing this course at AHC included availability of simulation equipment, cultural differences in learning, and language barriers. The purpose of this project was to evaluate the impact of a CTM simulation course at AHC on attitudes and perceptions of participants on concepts related to team performance. Each of the CTM courses consisted of three lectures, including team performance concepts, communication, and debriefing followed by rotation through four simulation scenarios. The evaluation instrument used to evaluate the AHC CTM course was developed for Cambodian staff at AHC based on TeamSTEPPs© instruments evaluating attitude and perceptions of team performance (5). CTM team performance concepts included in lectures, debriefing sessions, and the evaluation instrument were: team structure, leadership, situation monitoring, mutual support, and communication. The Wilcoxon signed-rank test was used to analyze pre- and post-test paired data from participants in the course. Of the 54 participants completing the three CTM courses at AHC, 27 were nurses, 6 were anesthetists, and 21 were physicians. Attitude and perception scores were found to significantly improve (p < 0.05) for team structure, leadership, situation monitoring, and communication. Team performance areas that improved the most were: discussion of team performance, communication, and exchange of information. Teaching of non-technical skills can be effective in a setting with scarce resources in a Southeastern Asian country.

Health Volunteers Overseas: 30 Years of Leveraging International Partnerships to Strengthen Health Worker Capacity

Health Volunteers Overseas (HVO) is a United States based non-profit that collaborates with over eighty universities and health institutions around the world to send volunteer health professionals to provide continuing education, train the trainer courses, professional support, and consultation on academic programs and curricula development. By establishing mutually beneficial partnerships, HVO is able to deliver effective models of collaborative education that contribute sustainable solutions to strengthen health workforce capacity in resource-scarce countries – ultimately improving health outcomes and the quality of life for millions throughout the world. This paper provides an overview of HVO, outlines the role of international partnerships within HVO’s structure, describes the processes used to select partners, and analyzes lessons learned around the key indicators of how to establish and maintain successful international partnerships in education and health worker capacity building.

Assessment of Health Needs in Children with Congenital Upper Limb Differences in Nicaragua: Community Case Study.

Congenital anomalies are prevalent in Nicaragua, and disability is estimated to be 10% in the general population. We studied children with congenital upper limb differences, as they are vulnerable to disability. This case study documents a collaborative effort between American and Nicaraguan orthopedic surgeons to determine unmet health needs of children with congenital upper limb differences at Hospital Manuel de Jesus Rivera (“La Mascota” Hospital) in Nicaragua, with the goal of developing programs that successfully address these needs within the context of the priorities of the community. Participants were recruited during one of the biannual pediatric hand specialty clinics held by a partnership of pediatric hand surgeons and occupational therapists under the auspices of Health Volunteers Overseas (La Brigada de las Manos, or “La Brigada”) and Nicaraguan orthopedic surgeons. Structured interviews were performed with 34 parents or caregivers of patients with the diagnosis of a congenital upper limb difference. Parents were asked to rank the social, economic, environmental, and biological factors that determine health according to priority. Using the Hanlon Method for prioritizing health problems, in consultation with local providers and the program director of La Brigada, five needs were identified: (1) improvements in access to specialized care from hand surgeons and (2) rehabilitation specialists; (3) improvements in upper extremity function; (4) access to transportation; and (5) improvement in physical activity and sports participation. Based on the results of this needs assessment, we learned that some of the needs were already part of the ongoing work of the partnership, but in addition, more needs became evident; for that reason, local health care providers and members of La Brigada identified potential solutions to these needs and are currently working to translate these in future interventions.

Utilizing the "Plan, Do, Study, Act" Framework to Explore the Process of Curricular Assessment and Redesign in a Physical Therapy Education Program in Suriname.

To describe how a multinational team worked together to transition a physical therapy (PT) educational program in Paramaribo, Suriname, from a Bachelor level to a Master of Science in Physical Therapy (MSPT) level. The team was made up of PT faculty from Anton De Kom Universiteit van Suriname (AdeKUS), the Flemish Interuniversity Council University Development Cooperation (VLIR-UOS) leadership, and Health Volunteers Overseas volunteers. In this case study, the process for curricular assessment, redesign, and upgrade is described retrospectively using a Plan, Do, Study, Act (PDSA) framework. PT educational programs in developing countries are eager for upgrade to meet international expectations and to better meet community health-care needs. An ongoing process which included baseline assessment of all aspects of the existing bachelor's program in PT, development of a plan for a MSPT, implementation of the master's program, and evaluation following implementation is described. Curricular assessment and upgrade in resource-limited countries requires the implementation of process-oriented methods. The PDSA process is a useful tool to explore curricular development. The international collaboration described in this paper provides an example of the diligence, consistency, and dedication required to see a project through and achieve success while providing adequate support to the host site. This project might provide valuable insights for those involved in curricular redesign in similar settings.

A Multiorganization Approach to Improving Palliative Care in Honduras.

Since 2011, oncology nurses and physicians in the United States have been volunteering in Honduras with the International Cancer Corps (ICC), organized by the American Society of Clinical Oncology (ASCO), in partnership with Health Volunteers Overseas (HVO). In this article, the authors will summarize the work of the ASCO/HVO ICC teams that developed educational programs with local partners to improve cancer and palliative care in Honduras.

Health Volunteers Overseas: On Site in Peru

Health Volunteers Overseas: On Site in Peru

Volunteering in Honduras: Results and Reflections.

According to the GLOBOCAN 2012 data released by the International Agency for Research on Cancer, an estimated 14.1 million new cancer cases and 8.2 million cancer deaths occurred worldwide in 2012. This is an immense increase compared with 2008 statistics, which reported 12.7 and 7.6 million new cases and deaths, respectively. Lowand low-middle–income countries accounted for more than half of the new cancer cases and nearly two thirds of all cancerrelated deaths. The social and economic disparities in cancer prevention and treatment present a disproportionate burden in these low-resource settings. Honduras is a low-middle–income country with a total population of 8.3 million. Cancer accounts for 13% of deaths each year. The most common cancers reported are prostate, gastric, cervix, liver, and breast. The mortality rates from cervix and gastric cancers are among the highest globally, at 18.5 and 8.8%, respectively. There are 24 surgical, eight gynecologic, 13 medical, and four radiation oncologists in Honduras. Hospital General San Felipe (HGSF) is the only public cancer hospital in Honduras that treats underserved patients. Currently, there is only one surgical oncology training program in Honduras. During the 4-year curriculum, residents are taught to provide surgical care for men and women with a wide spectrum of malignancies. Efforts to improve the education and training of residents in surgery and oncology in countries with limited specialists have been growing in the last decade. Medical volunteerism in such countries has become an area of interest for medical students, residents, fellows, and attending physicians from outside of the affected countries, and there are a number of models for providing this assistance. Barriers to successful exchanges between volunteers and in-country physicians include time constraints of the volunteers and infrastructure deficits in low-resource settings that prohibit optimal learning environments. Increasingly, a combination of short-term, hands-on teaching sessions coupled with ongoing Internet-based instruction by volunteers at a distance has emerged as a successful model for supporting incountry physicians to provide increasingly sophisticated medical and surgical care within the limits of available resources. For example, a successful program of surgical training to perform radical hysterectomies in patients with cervical cancer has been implemented in Kenya through collaboration with the Society of Gynaecologic Oncology of Canada. The 2-week intensive program, which is staffed by one expert Canadian surgeon, included seven video didactics, a preand post-test, and seven live surgical sessions with oral and written feedback after each patient case. Short-term follow-up revealed four successful radical hysterectomies by the Kenyan surgeons after the Canadian trainer had left. Similarly, the Central America Gynecologic Oncology Education Program, an initiative that is focused on the education and training of obstetrics and gynecology residents in the prevention and treatment of gynecologic cancers, is a collaboration between the American College of Obstetrics and Gynecology and six Central American countries and includes in-country training trips with US gynecologic oncologists with ongoing distance learning and support. Another option for training physicians from low-resource settings is for these individuals to travel to high-resource settings for training. However, this approach has drawbacks. A recent report suggests that the numbers of physicians emigrating from Sub-Saharan Africa to the US is increasing and will negatively affect low-resource countries, where there is a great need for health care providers. Training of physicians in their respective countries offers the advantage of hands-on training, given that direct patient contact is not allowed during an observership in the United States. In addition, the context of care and the resources available for treatment are different in settings such as Honduras compared with the United States. Despite increasing numbers of medical missions to assist underserved countries, there is still a lack of formalized educational curricula and supervised training in these countries. In this article, we describe the Health Volunteers Overseas (HVO) Oncology Training Program in Honduras, which focuses on providing education, surgical training, and research mentorship to surgical oncology residents, nurses, and other health care providers in Tegucigalpa, Honduras.

Analysis of field reports from anaesthesia volunteers in low- to middle-income countries

The objective of this study was to identify key experiences and common motifs of volunteer doctors who have participated in anaesthesia-related volunteer experiences abroad through the Health Volunteers Overseas (HVO) programme. An additional goal was to understand the effects of medical volunteerism in developing countries on the volunteers themselves. After a medical mission with HVO, anaesthesia volunteers submit a post-experience report. Twenty-five reports were randomly selected from the 58 available trip reports, including five from each of the five countries collaborating with HVO. Data in the reports were analysed using a modified grounded theory and constant comparative technique until thematic saturation was achieved. Three major discoveries emerged from the analysis of post-experience reports: (i) anaesthesia residents and attending physicians find their volunteer experiences in the developing world to be personally rewarding and positive; (ii) most participants feel their educational interventions have a positive impact on local students and anaesthesia providers, and (iii) global volunteerism poses challenges, primarily caused by lack of resource availability and communication issues. Our results give new insight into the experiences of and challenges faced by a cohort of HVO-sponsored anaesthesia volunteers while abroad and validates the positive effects these global health experiences have on the volunteers themselves. This group of anaesthesia volunteers was able to further their personal and professional growth, sharpen their physical diagnosis and clinical reasoning skills in resource-poor environments and, most importantly, provide education and promote an exchange of ideas and information.

‘Tanzania changed me’

NHS clinicians who volunteer overseas contribute to developing countries' health services by providing local staff with training. The volunteers also enhance their leadership skills. Many forward-thinking NHS trusts actively support relationships with overseas organisations but barriers remain.

The Motivational Roots of International Volunteering: A cross-disciplinary framework

Drawing on literature into ethical consumerism, we present a framework for understanding the motivations underpinning the decision to volunteers overseas. The framework identifies four categories o...