We’ve moved!

Come visit us at our new website: www.the53rdweek.org

Our blog is also at http://www.53rdweek.org/blog – same great thought-provoking posts.

And… we’re back!

By Lawrence Loh, MD MPH

We’re back after a long-absence: it has been a busy few months this winter here at The 53rd Week. Some of the highlights include:

  • Ongoing work towards launching the web platform: with the help of a great team out of the University of Massachusetts, we went live with the La Romana collaborative platform early in March. Since then, we have been working hard in recruiting local leadership as well as other team leaders to join the website and make use of its tools, particularly the discussion forums and calendar. The response we have received are has so far been encouraging, and our hope is to launch collaborative projects once we have a critical mass of data and teams on the website.
  • We have continued our research work into the needs and baseline trends of disease of the Haitian refugee community in La Romana. We have received ethics approval for two studies: a quantitative analysis of charts collected by visiting medical teams, together with our partners at the University of Massachusetts, and a qualitative analysis of themes in semi-structured surveys examining the basic needs and concerns of batey residents and hospital personnel in the local community. Initial analyses have been conducted and draft manuscripts are being prepared for publication! Ongoing research into the phenomenon of short-term medical volunteer trips in general also continues, with a commentary as well as an economic analysis due out in short order thanks to the great work of our volunteers.
  • We have also begun to carry out our work in advocating for more ethical and responsible volunteer work abroad, speaking out against self-serving “voluntourism” and highlighting that short-term trips can be useful, provided volunteers are realistic surrounding their scope and limitations and conduct themselves to a responsible ethical standard. Our talks highlight The 53rd Week’s philosophy: that in their current form, short-term medical experiences are limited in outcome, but modern life constraints in finances and time make them attractive to young professionals, students, and sending institutions alike, who benefit largely at the expense of the local community partners. Later blog entries will talk about our presentations McMaster University, the March Meeting of the International Federation of Medical Students’ Associations, and the Consortium of Universities for Global Health meeting.
  • Our organization continues to complete the process towards applying for 501(c)3 status, and is also doing some other administrative work (e.g. filing our taxes for 2012!) towards building our profile and infrastructure. A lot of this is being taken on by great new volunteers who will be introducing in future blog entries.
  • At the same time, we are in the process of migrating to our new website (launching soon)! So stay tuned, and we look forward to bringing you more regular updates once we’ve transitioned
  • over to our brand new home on the web.

A productive few months, as evidenced by our inability to update our web, but hopefully we’ll share our new space soon. In the meantime, you can check out some of our recent talks on our YouTube channel at http://www.youtube.com/The53rdWeek – feel free to share widely with your friends and family.

Dr. Lawrence Loh is Chief Medical Officer of The 53rd Week.


New year, new relationships… new potential

By Lawrence Loh, MD MPH

We’ve returned from yet another successful trip to La Romana. With a team of 19 people who hailed from Vancouver, San Diego, Denver, Kansas City, Chicago, Toronto, Washington DC, Baltimore, Philadelphia, and New York, The 53rd Week provided primary pediatric care to over 500 children in the bateyes of La Romana, Dominican Republic in concert with our partners at Hospital Buen Samaritano.

Grateful to our financial and in-kind sponsors who provided monetary, medicinal, and general supply assistance, we were able to make a small impact among the pediatric patients we saw in communities. For many members of our team, this was their first time on a service trip, and they also experienced enormous personal growth and benefit. Many were able to develop their clinical acumen while seeing first-hand the nature of global health primary care.


Some members of our team. “We’re kind of from everywhere.”

While the literature always talks about the enormous costs and harms associated with short-term trips there are also those intangible benefits that our participants were able to derive. There was the forging of relationships between members of the groups – relationships that have the potential to last over the course of a professional career. As is usually the case when Canadians and Americans meet in the same place, there was plenty of comparisons and discussions – that veritable exchange of ideas and viewpoints that challenged minds and provoked deeper questions (in addition to the more simply fun ones, like trying to figure out what the American equivalent of “eh” is or comparing cereal brands for sale on either side of 49.)

There were also, however, the relationships we forged with the local leadership and team that we worked in partnership with. We know in this life that a lot of it comes down to who you know and relate to personally – it is different seeing someone and knowing them face to face than it is through an email or a wire money transfer. Here there is a reference point, a memory, time spent in their house trying to build that link. What could potentially come of it remains to be seen – but most important is that potential that is there, far beyond just handing out resources for distribution – there is a more important personal connection which can be relied on as the foundation for change and greater efforts together.

Learner and teacher, but also, friends.

The other intangible benefits derived by our team were individual perspectives and viewpoints on the work being done there. It allowed many of our participants to ask the hard questions about the work they were doing. They were able to immerse themselves in the work and environment while considering the sustainability and ethics surrounding short-term medical trips, as well as the overarching picture and systems view that leads to the poverty that give rise to the related health and social concerns seen in the communities.

For all these benefits, The 53rd Week continues to work on implementing a collaborative model for existing short-term teams in La Romana. With the help of the hospital we’ve been given the go-ahead to launch the web-based collaboration platform. It’s now a matter of persuading other teams that head down that we are stronger together. Indeed, with some of the other teams, we have already begun having monthly teleconferences and initiated research projects together, all with the aim of improving outcomes for the folks down there. Our hope is that the benefit will not solely be borne by us, the visitors, but that some tangible, long-lasting benefit may come for the local community in La Romana as we move these efforts to more than just a week down there – to something bigger than the whole of its parts.

Individually, can’t lift much, but together, we can lift our trip leader.
Tangible evidence of the power of collaboration.

The relationship piece was something I tackled in a recent publication in the Canadian Medical Association Journal. There is something to be said for being there in person, for building that relationship – the potential for further work and change is that much more real when those networks are maintained.

The 53rd Week continues to be committed to forging connections between groups and individuals both within their home environments and with areas further abroad. We believe that the collaborative benefit of friendships and relationships that transcend artificial divisions is transformative and represents a lifetime of potential good. It’s our hope that  the new year will provide us an opportunity to grow new networks which will be indispensable to creating those multidisciplinary, multinational, multi-idea solutions that will support today’s global health efforts.

You can read my article here. (institution access may be required)


Photo: this year’s 53rd Week team to La Romana with our local partners from Good Samaritan Hospital.
Thanks again to all our sponsors for their kind support!

Dr. Lawrence Loh is Chief Medical Officer of The 53rd Week.

Another year, another step closer – happy holidays to all!

By Lawrence Loh, MD MPH

Our team is in the midst of final preparations now for our trip down to the Dominican this year. This time, our trip has a different sense of purpose – the thrill of experimentation and trying to see if our crazy idea to optimize short-term trips will be received by the community. Our website is in its final stages of completion, and we will be conducting a needs assessment in the community, using surveys and interviewing key people to figure out how we can best start to deploy the numerous volunteer teams that will come down in 2013.

We have also received tremendous support from family and friends who have given funds to support our volunteers in their expenses. Much of the money donated will go to helping students participate in the experience, which we hope will be both a valuable learning experience for them while allowing them to meaningfully contribute to improving the health of the indigent in La Romana. It’s not too late to donate still if you’re up for it, visit the website here at: http://www.crowdrise.com/53rdweek

While our tax receipts this year will come through our partners at the Whites School of the Arts Community Development Programs, exciting changes are afoot for The 53rd Week. The plan will be to file for 501(c)3 status upon our return from the Dominican Republic to allow us to better source funding for our organization individually. At the same time, we are looking forward to welcoming new members to our team, and undergoing a website revamp here (the blog will continue, but we hope to be able to provide more detailed, exciting content about the work that we’re trying to put together.)

Being believers of collaboration and networking, we know the best ideas are spread if they come from those closest to us. It’s a great time to chat with our family and friends to ask the simple question of what we can do to make this world a better place and what work that would ultimately entail. With the holiday season coming up, it’s always a good chance to use the time with family and friends to push forward the cause of good. Instead of just remembering the less fortunate in your thoughts this year, consider quality time with family and friends to push and ask the wider questions of – what can we do about it? And why aren’t we doing something about it?

The old adage goes that nothing is more powerful than an idea—but beyond that, nothing is more powerful than an idea that has been challenged and vetted by those around us. Having our ideas and dreams challenged is a sure way to work towards making them more robust and feasible. Imagine how much would change if everyone just took this special time to truly describe their dreams and ideals and the opportunity and advice that could arise from sharing. In the busyness of our day to day life, the holidays are always a mind-oasis and respite.

The 53rd Week wishes you all a restful, relaxing, and meaningful holiday filled with the conversations that matter. We’ll see you in 2013!

Lawrence Loh is Chief Medical Officer of The 53rd Week.

A reminder of what we’re trying to accomplish – and why

This fortnight’s posting, which comes from Dr. Christine Thorne, comes on the heels of Thanksgiving and into the traditional holiday season of giving and our team’s trip down to the Dominican Republic. Using a recent World Bank publication, she reminds of us of the deeper purpose of The 53rd Week’s work: the idea that young professionals, given the right environment, guidance, and tools, can help to address the root causes of poverty and inequity that exist in our world… and that this is what makes our attempts to optimize their deeply personal investments ever more valuable – because of the opportunity to take something that seems otherwise futile and push it towards a belief in achieving greater things together.


Recently, I read excepts from a book, Voice of the Poor, published by the World Bank.  I was struck by the quotes of the impoverished people as to how they saw their lives and their futures and how this impacted the work we are trying to do as The 53rd Week.

All quotes in this blog post are taken from  Voice of the Poor and it’s subsequent document related to health, Dying for Change.

“For a poor person everything is terrible – illness, humiliation, shame.  We are cripples; we are afraid of everything; we depend on everyone. No one needs us.”

–          Blind woman, Tiraspol, Moldova, 1997

It is important for us to remember, especially as we head into the upcoming trip to the Dominican Republic, what our organization is working towards and whom it is helping.  We are working to help the poor, to eliminate ill-health and to end the shame associated with poverty.  To do this, The 53rd Week is working to achieve long-term change in the La Romana community of Haitian refugees so that there is adequate health care and long-term projects that provide a bridge out of poverty.

“We do not think that life will become any better for our children and even for generations to come.”
– a woman, Malawi

Together with our partners, we want to empower the powerless, to provide hope to the poor, to given them the idea that the future can be better for their children than it has been for them.  We all recognize this cannot be achieved only in 1 week trips that address downstream, short-term needs.  There needs to be long-term involvement in the community, a collaboration with the people locally and between groups working within the community, both internationally and domestically in order to provide lasting hope and change.

“To summarize: Poor people want institutions that are honest, accountable, treat them fairly and show respect.”

The 53rd Week is working to become an organization respected in La Romana and worldwide for providing sustainable solutions for the poor there and increasing access to basic needs and health care.  We know that providing for people’s health is an essential way to provide them with an opportunity to escape poverty.

“Poverty and ill-health are inseparable.  In 127 case studies in Voices of the Poor which examine why families have fallen into poverty, ill-health emerges as the single most common trigger for the downward slide.”

Thank you for following our blog and working with The 53rd Week to help us develop effective short-term volunteer models that might allow young professionals to lend their efforts towards tackling ill-health and poverty in La Romana and the wider world.

Dr. Christine Thorne is a resident physician in California.

Feel free to read the original document where all these quotations are taken from:
World Health Organization and World Bank, January 2002: Dying for Change

Getting closer

By Lawrence Loh, MD MPH

While the blog may have fallen silent for the past few weeks, the team at The 53rd Week continues to work on optimizing the outcomes of short-term medical (and volunteer) trips abroad. During the recent American Public Health Association conference in San Francisco, I had the opportunity to meet with a number of young professionals who all expressed an interest in doing work abroad, while presenting research with some colleagues, a paper that examined barriers to physician participation in global heath careers, and another that categorized potential global health areas of practice by physician specialty.

In all our discussions, it did strike me that many young, interested global health professionals are facing the same time and financial crunch that we’ve being describing. Thus, even though they knew it was “wrong”, many did travel abroad on short-term trips. Many still had questions as to the value of what they were doing, and on learning about our paradigm, expressed interest and hope that things would work out.

At the same time, leaders of the global health field expressed the same dismissive view towards short-term trips. One even told me that his goal was to get as *few* people going abroad as possible – and that instead, he would rather have everyone learn about global health issues at home, in their medical school curriculum or at the hospital, without forging out beyond. Yet this faculty himself participates in work abroad, and goes abroad quite commonly.

My simple question, therefore: why him, and why not us? For the longest time that people have decided to ignore the growth in interest of short-term medical trips and volunteer work abroad, the question I have is – why? I believe most of us in the West live in a society that doesn’t just value charity and altruism, but also respects the right of people to decide what they want to spend their time on and how they are best able to do that. Given the challenges and opportunities that young professionals face today, those who want to build on that charity and altruism abroad will undoubtedly choose to participate in short-term medical trips.

As we’ve said before, in their current form, such trips are a detriment to the community. But we need to stop ignoring it. If people are going to go abroad, if they are going to exercise their fundamental right to put their desire to help in a trip abroad, we need to support that, improve it, maximize benefits, and minimize harms.

In all, it was a fulfilling meeting. There is certainly a growing divide, though, between the younger generation of global health professionals that are living the new paradigm, and the older generation who remain unconvinced of the potential that lies in optimizing such short-term opportunities.


In other news, planning for our upcoming trip to the Dominican Republic is going smoothly. We have a team of 21 people from all over the United States and Canada who will be joining us over the New Year’s break in La Romana. Much as we try to push ideas upstream, our team will provide the usual clinical care, but also has identified a few projects to tackle, including:

  • Needs assessment to be placed on the newly built website platform;
  • Medical Spanish phrasebook;
  • Cost-benefit analysis for short-term medical trips as well as alternatives (improved trips, for example)
  • Curriculum of training for local residents and interns to be fulfilled by visiting medical teams

Our multidisciplinary team is keen on seeing sustainable, longer-term outcomes to fuel our development model.

We hope to allow interested young professionals to participate at a reduce cost through fundraising. Any support is greatly appreciated. Our goal is to raise $5000 to help worthy candidates learn more about a collaborative short-term model and work to improve the outcomes related to the short-term volunteer paradigm and phenomenon.

For more information on how to donate, visit us here. Any amount is appreciated.

Lawrence Loh is Chief Medical Officer of The 53rd Week.

Symposium: a step in the right direction

By Lawrence Loh, MD MPH

This is a blog entry coming live to you from a beautiful fall evening in Boston. I just arrived here and am getting ready to head out to the University of Massachusetts Medical School in Worcester, Mass. tomorrow to participate in a symposium focused on bringing together all those different teams that work in La Romana. It’s not the first time that such an effort to gather everyone together has come through before, and indeed, there are some key players who are unable to make it for reasons of time or distance. But that said, there is reason to be optimistic this time that we’re going to start a bit more of a routine this time around.

Most of the people spearheading the effort thus far represent the younger generation in La Romana – medical students, residents, and recently graduated physicians who are indeed keen to make a difference. Together with the wisdom of the older members attending tomorrow, they will become more invigorated to see the efforts through despite grueling schedules and training requirements. That a symposium is happening at all is a sign that this effort is at least on the radar for all involved.

There are defined collaborative topics at hand on in the agenda. Some of these include sharing educational materials, discussing previous collaborative efforts (such as a project to contribute to ongoing consistent hypertensive therapy), and ideas for future meetings. We’re also grateful to have a website to offer to the group and to see what sort of feedback we get. The potential for real solid groundwork to be laid towards ongoing efforts is even more exciting than the certain knowledge exchange that will happen.

Indeed, other linkages have already started forming between groups, as we work with our UMass partners on developing a protocol to do a chart review and determine what disease burden is addressed by the short term trips. We’re hoping the website will at least get the approval of our partners tomorrow and be able to move forward in implementing it on a go-forward basis. Things are definitely afoot.

At the same time, we’re also branching out and bringing our collaborative message to the world. Dr. Henry Lin, one of our officers, led a well-received discussion at the Talk Change conference at McMaster University a couple of weeks ago. I myself have brought this message informally to the World Medical Association’s meeting in Bangkok and will be bringing it more formally (through research with co-investigators on global health careers and workforce issues) to the American Public Health Association Meeting in San Francisco. If you’re attending, stop in, say hi, learn about the research we’re doing with our partners:

Finally, we’re thrilled by the number of volunteers who have signed on with us recently, both for work at home as well as for the upcoming trip. There’s just so much that’s been on the go, which is why the blog posts have fallen a bit to the wayside. If you are able to donate, please visit http://www.crowdrise.com/53rdweek – and for those who need a proper tax receipt, email lawrence.loh@53rdweek.org for a different set of instructions.

Together, we can make a difference. The key being “together.”

Lawrence Loh is Chief Medical Officer of The 53rd Week.


Incorporation and logo: pieces coming together

This week has been a turning point in the development of The 53rd Week as an organization – after months of waiting, we finally received word that the New York State Department of State had officially recognized The 53rd Week as an incorporated domestic non-profit organization. As such, we’re now able to officially state that we are working within the boundaries of a non-profit organization, and are able to take the next steps in the process which include filing for tax-exempt status with the Internal Revenue Service, holding our first meeting and preparing the materials that will define our organizational activities (finalizing the officer list, budgets, by-laws, and the like) and eventually using this to drum up some financial and human resource support. All very exciting!

Visit our official listing on the New York Corporation and Business Entity Database.

This week also saw us gratefully receive our new logo from a partner organization of ours, the Marketers of Baruch! This was certainly the fun part of the week. We unveil it below:

The logo itself speaks to our mission and concept. On the idea of building week on week, you’ll note that the 5 is held together in three parts, which would be otherwise single dashes or lines but brought together form a coherent whole. The different colour of the plus sign reflects its role (coordination, adding two parts together) as being the difference between being individual shapes and being part of a bigger picture with more noticeable results.

In that way, the plus reflects our belief that we can build more sustainable outcomes by coordinating disparate efforts (adding team on team towards a larger goal.) This allows us to improve and maximize the short-term volunteer trip paradigm, allowing young parties to donate what precious time and money they do have to a cause that actually has an impact. The plus also doubles as a hospital cross, as homage to our founding interest in short-term medical trips – though theoretically, global development work could likely use short-term volunteer contributions from other professionals and even multidisciplinary teams in order to solve the harder problems.

Finally, the identical stylistic curves of the 5 and 3 represent uniformity of purpose and goals – while the tops of the numbers remain different, there is still a common element to each number. In that same sense, while individual short-term volunteer groups retain their autonomy, there is much to be gained by aligning our efforts towards long-lasting, locally-led global health outcomes, and all the benefits accorded to the volunteers, the participating institutions, and the local population abroad that we’ve talked about before.

These are exciting times, and we look forward to sharing more with you as our organization continues to grow and solidify our concept to bring about a better return on investment from the numerous short term volunteer trips abroad that take place worldwide each and every single year.

Stay tuned.

And about our partners who came up with this fantastic logo, taken from their Facebook site:

“Marketers of Baruch aims to seek individuals who are interested in the fields of marketing and advertising in order to create a network of students to interact, learn, and better themselves as professionals.With these goals in mind, we aim to help students in these fields develop the skills needed through serving both Baruch College and the local community, as well as through participating in national and international competitions. As members of the Baruch community, we believe it is important not only to develop ourselves, but develop our community as a whole.”

To learn more about the Marketers of Baruch, and the great work they’re doing, be (ad)venturous; visit and like their Facebook page.

The power of potential

By Lawrence Loh, MD MPH

As our planning has begun for another trip down to La Romana this December, I am excited about the possibility and potential that is being demonstrated just by the people we’ve approached to volunteer and the communications we’ve had with other teams that have just been working down there recently. In every aspect of the trip, there is potential for improvement that drives the work of our long-time volunteers, as well as those who are joining us for the very first time – either in the community, or in the global health arena.

For those very first-time volunteers, the idea of delivering aid and making a difference appeals to them – it is, after all, the primary motivation for people to strike out of their comfort zone. They want to help. From my part, as one of the leaders taking them down there, I want to make sure that their experience is positive in the ways it needs to be positive. While we cannot guarantee it will be comfortable or luxurious (at all), I want to guarantee at the least their safety and security, so that they can take the opportunity to immerse themselves in a culture dissimilar from their own and learn about how they as an outsider can work with locals to make a difference. I also want to guarantee that their work is truly meaningful, part of a larger, broader time horizon, with the understanding that differences that may not be noticed now could certainly take months or years to come around – and that we’ll do our best to use technology and communications to learn about them when they do. The goal is to make the experience so positive and useful that they are willing to volunteer their energy and efforts to a future short term trip here or elsewhere.

For those more experienced volunteers coming to La Romana for the first time, I usually try to figure out their motivations from switching from other efforts. That usually helps to determine what needs to be done to fully tap their potential on the trip. Many bring fresh eyes from other communities abroad, or even from their own volunteer experiences here at home. They are filled with good ideas, alternatives, and suggestions from myriad ways of making a positive difference. In that sense, they represent a challenge to the inertia of trip after trip to La Romana; they represent potential improvements to the logistical, programmatic, and overall choices that we make. For them, they have a proven volunteer history and perhaps see La Romana as a chance to develop their skills further. That drive and interest represents untapped potential as well; depending on what they are looking to improve, they might easily drive a project that our team has interest in getting done, or bring their own ideas to the fore.

Finally, for those of our volunteers returning to La Romana, our potential is in the connections we make with the local community, the team, and the work there. We represent familiar faces to the local leadership – relationships based on years of trust and help, of commitment, and of a desire to do good. In that sense, the potential is limitless – in terms of working with the local leadership to identify priorities for our team, and deciding how to best use the team’s potential to achieve local goals – while keeping a longer-term view together through coordinating with the teams to follow us down. For returning volunteers, the potential lies in their existing relationships and understanding of the terrain – and having that drive the base work of the team, allowing other volunteers joining to learn and apply themselves as part of an ongoing understanding between the returning volunteers and the local leadership.

While we’ve just sent out the first e-mail, I am also struck by the potential that surrounds the team unit. We have proposed meetings and teleconferences coming up with other teams that work in La Romana. We’ve publicized our dates down with many of the other team leaders. We’re committed to working with other teams and the local leadership to figure out solutions for the hard questions that are faced there. In that greater picture, we see the transformative potential and opportunity in building week upon week.

Within each week, you have the newbies, the new-to-locale, and the old folks building on each other’s potential. In the synergy of each of those weekly groups, the idea of a wider community of groups committed towards longer-term solutions using collaborative tools widens. Now it no longer has to happen in a week – now, a new volunteer can join a team due to head out in eight weeks, and receive motivational thoughts and role discussion with teams that are already on the ground there (in addition to their own team as they plan through the site and through meetings.) Similarly, those who may not have been down for a few years but remain a source of information can stay remotely involved in helping new recruits and old folks with their wisdom.

In many ways, the idea of coordinating short term groups, each with their own volunteer categories as described above, perhaps represents an even greater potential to make a difference in both the local community, as well as for visiting participants, that we have only really begun to touch upon.

Dr. Lawrence Loh is Chief Medical Officer of The 53rd Week, and a physician in Toronto, Ontario, Canada.