Category Archives: Concept

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.

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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.

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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.

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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)

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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.

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.

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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

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.

Short term volunteer trips abroad: an answer to the challenge of incorporating global health into one’s career?

By Lawrence Loh, MD MPH

Finishing a recent residency rotation in New York City, I had the opportunity to speak with some of the residents there about their plans for the future. All of us final year residents had plans to head back to some combination of clinical work and public health, but those of us with global health aspirations seemed a little bit more cynical about the possibility of pursuing our chosen field. In describing her plans for the future, one of the residents mentioned she would be signing up with Doctors Without Borders (MSF), despite significant debt load and familial obligations. We also talked about the likelihood she would be engaging in work that was not commensurate to her training – starting out from the “very bottom” of the totem pole, as it were.

Her response was one almost of resignation: “Well, that’s just the way it has to be, right? If they want me to pour tea for them, then I’ll do that. Whatever it takes to get your foot in the door.”

Therein lies the great irony for most young professionals pursuing work in global health and development – unless your family is independently wealthy and with the right connections, you’ll spend an immense amount of your personal time and finances to gain mixed experiences that will potentially land you that (often poorly) paying first job in some sort of long-term arrangement for the sake of “getting yourself in the door.” And for many, that’s a dream too far – and many global health aspirants end up throwing in the towel and embracing “reality”, giving up their pursuits abroad for the sake of staying home and paying back their seemingly insurmountable educational debt, and maintaining their certifications and ties that are so critical for ensuring they can do so effectively.

Yet every global health career day you go to, every fair that you visit, the same stories come out. The same unfollowable tales from those who have “made it” (almost a la Hollywood or entrepreneurship) – these folks either had a lucky break, a person who paid them a living wage in pursuing the dreams abroad, or a family that let them do unpaid internship after unpaid internship until they landed that first position. They sold all their worldly possessions and moved to Africa for 10 years, gaining that experience, sacrificing family, earning potential, and time, to succeed in finding a job that filled their passions and skills.

It really shouldn’t be like that.

The current global health workforce set-up and “road map” to success strings along young professionals who may have the skills and passion to succeed, but lack the resources or support to do so. It results in the privileged gaining those posts and those positions, regardless of their abilities or skill set – but simply because they’re the only ones who can pour enough money and time into building those networks and those collaborations. And perhaps this is like “anything else” in life, but moreso in global health does it seem truly like whoever has the money and whoever knows the right people has play.

So where has this paradigm led organizations today?

In a news article published in the Canadian Medical Association Journal (CMAJ) just a year and a half ago, MSF in Canada described their recruitment shortages and the pending crisis in recruiting Canadian physicians.

Médecins sans Frontières seeks for more Canadian physicians

The comments from the MSF recruiter are incredibly interesting. On one hand, the recruiter recognizes that high debt loads, the demands of residency and life in Canada affect the ability of young Canadian physicians to go abroad for more than 1-2 weeks at a time. At the same time, the recruiter goes on to denigrate the work of interested young physicians who can contribute that amount of time, calling them “tourists” and “people who are [only] interested in cross-cultural experiences, in doing a couple missions for their resume […] their primary motivations are not the humanitarian objectives of our organization.”

But in other articles, we know that humanitarian reasons and improvement of work abroad is a reason why many people pursue medical volunteer trips – regardless of how long they are. A survey of Wisconsin residents and medical students found that 82% of students wanted to continue incorporating global health in their future career, with 63% wanting to work with underserved populations abroad:

Needs assessment of Wisconsin primary care residents and faculty regarding interest in global health training

If that doesn’t sound like a disconnect, I don’t know what else there is.

MSF and the rest of the global health community needs to think long and hard about how things are. Taking six to nine months off for young physicians is not something those from less-financially advantaged backgrounds can do, in the face of crushing debt loads, familial obligations, timing, and training requirements. Short-term medical trips represent the only opportunity for these young professionals, ironically so, since despite the enormous financial and personal investments that go into it, such short-term work often represents the “placebo” of global health: both the receiving community and the visitors feeling “good about themselves” without anything ever really changing.

There needs to be a paradigm shift, a challenge, a purpose and improvement of such opportunities. The future of the global health workforce might be how well we as a society adapt to remote technologies, allowing people to be involved for weeks at a time abroad and remotely from home – by leveraging the internet, collaborative models, and shared resources and vision.To stick to the romanticized version of the solo doctor in Africa represents the potential waste of a huge groundswell of passion and talent from young physicians. At the same time, we know short-term work as it stands is also untenable.

It’s time to make these opportunities both accessible and valuable. We see the interest. Let’s figure out  how best to harness it, instead of turning people away – instead of having them just serve tea – and instead of leaving them to languish in “medical tourism” venture after venture. Young professionals have so much more to offer – in fresh eyes, passion, skills, and ability.

As we implement our coordinated model of short-term care, we hope to move the conversation forward in providing at least one innovative way to open those opportunities to those young professionals who want it and are good at it, not merely those who can afford it, while also ultimately benefiting those populations abroad that these short term trips aim to serve.

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

Coordination challenges

By Lawrence Loh, MD MPH

We’ve talked a lot about the value of short-term medical trips and the benefits that the local community, the young professional volunteers, and the organizations themselves could potentially derive from coordinating such efforts. Such coordination is obviously challenging, though; with growing numbers of participants, there are always myriad opinions, ideas, and suggestions that would shape any such model.

Thus far, the biggest barrier faced in implementing a successful coordination model has been structural: a genuine lack of time and effective programs. A proposed website (as described in our previous post) involves significant technical knowledge and programming, as well as up-front aesthetic designs. At present we are in the midst of developing a prototype, but it will obviously need to be piloted by key stakeholders before being put into active service. Making this harder is the general lack of time – as young professionals passionate on the subject, we’re busy doing this off the side of our desks while working our regular day jobs.

Other challenges have been in reaching out and managing the expectations of all the parties involved. We are fortunate that there are so many different teams with differing histories, experiences, skill sets and ideas that are working in the community in question. It challenges us, however, to work with leaders and form consensus, trying to determine a process for what we need to do – how will we standardize protocols? Why have a real-time inventory, and how would we get people to participate? We also work alongside the local leadership to identify gaps and needs that can be fulfilled by projects run by the teams in tandem, and then work with the teams to figure out how best to broadly address these and implement them effectively.

The diversity of opinions and ideas, while valuable, can often times conflict with one another. Different folks have different priorities and different thoughts on the way forward, and of course, the local leadership have their needs and gaps to be met as well. The challenge is in ensuring that everyone feels a valued part of the team – because everyone is – and further to that, ensuring that key aspects of their vision are included in an overarching, shared vision that teams together can take ownership and pride in.

For the most part, though, such challenges are immensely rewarding – the exchange of information and opinions strengthens and galvanizes everyone’s efforts in the common cause. Perhaps the most important aspect of everything is despite the differences, the opportunity to speak and to keep things front of mind is a valuable intangible benefit in keeping everyone involved motivated and committed, eyes on the prize.

In this case, a challenge can be a strength – both in learning how to manage critical relationships, but also, towards improving things by asking the impertinent questions about how best to work together to produce those outcomes that we seek.

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

So what would a website look like?

By Lawrence Loh, MD MPH

In our last post at the beginning of April, we started to talk a bit about what a potential coordination website would look like. Most of what we’ve come up with has been through informal discussion with lots of people – the local community we’re building the site for, the other teams that have significantly longer and diverse experiences participating down there, and what programmers feel is feasible. We’ve settled on a few common elements that are going to form the basis of our product.

The keystone of things will be a centralized calendar and contact database. After all, if we’re going to be working together and coordinating together, at a baseline we should know who everyone is, and where everybody can be reached at. Further to this, this calendar and contact system can one day form the basis for recruitment – trying to find specific young professionals who happen to have a week to come down and join a group for a week – with that group as part of the wider project going on. At the least, this will let everyone know who is who, when someone is heading down, and who to contact that might be on the ground right now or imminently.

Then comes the information sharing. And we had a long think and some very fruitful discussion with the other great people heading down there. From a disease perspective, it comes down to standardizing everything – protocols, program logistics, and information sharing. So we’d look to have team reports, that would be part of a record of what’s been done, but also serve as an information source for upcoming teams. We’d like to see some real-time inventory and tracking of projects that the teams are working on. We’d love to standardize protocols based on best evidence identified by teams (something to do while home and not on the ground there!) as well as experience. And of course, building a wiki of information on cultural customs, what to expect when heading down there, general tips and suggestions – filling into the idea of a virtual library of ideas that will eventually form a valuable knowledge base for anyone doing short or long term work in the community.

Then the biggest part of the interaction – a forum for discussion and communication. Teams can share ideas for new projects, plan how they’re going to go down, set goals, objectives, and indicators for how they’ll measure progress. They can give heads-up to teams heading down after them, or check-in with teams before them to see if there’s something that needs to be followed-up on. A continuous stream of information shared between teams, all on the same side, still individually autonomous, but using technology to push towards the same goal, with the local leadership always at the forefront of making sure things go.

And for those young professionals looking for a shot in, they can join a trip; read up on the locale through the virtual library and ask questions on the forum; source meds in their home community that are identified as in need on the inventory; head down on their trip with their team, and then come home and keep track of what they’ve started and participated in down there virtually until their next trip down in a year, or six months, or whenever.

In today’s busy day and age, it would mean that our valuable week down there becomes something more – it becomes part of solving the puzzle of work down there and turns our investment into something more valuable, part of a mosaic. It’s working together. And in our next post, we’ll talk about how we’ve started discussions with other folks, the general reception, and challenges we’ve faced in the development of our web platform.

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

Coordination of short-term trips: how the locals benefit

By Lawrence Loh, MD MPH

One of the first tangible benefits of an online web platform to coordinate short-term medical trips will be for the local leadership that receives these missions week after week. Often a hospital or a small local organization, these community leaders spend a lot of their energy on telling visiting teams what to bring down, what to expect, and what programs and issues need to be met, in hundreds of emails a day to dozens of teams with questions. On top of that, they coordinate the logistics, food and lodging, and questions that arise from teams that are already down to visit.

The leaders of these already resource strapped organizations are taken away from what they really should be doing: sharing their expert advice on what these short term volunteer trips should be focusing on, and leading their communities, building links between the visitors and their citizens, and understanding exactly what their community’s crucial, long-term needs are. Instead, they field emails and queries and the end result is that most of them serve as merely facilitators, instead of participants, giving a “laissez-faire” attitude to teams where anything and everything goes.

A coordinated web platform crowdsources that day to day information they have to provide. Instead of asking for an update on what’s on the ground, a team coming down and read about the last five teams’ trip reports, and review an up to date tracker in this web community to better understand exactly where the coordinated long-term projects are at. A real-time calendar and inventory allows the teams to plan ahead, thinking on what they need to source and bring. A wiki or forum of discussions and protocols shares trip preparation, trip debriefs, and answers the basic questions that new teams might have about heading down to help.

By doing so, this takes the burden of administrative work off the local leadership, and frees them up to do what they do best: lead. And of course, they could do so by easily being connected into the web platform community themselves.

So how would a website like this work? How are we developing ours? And where are we planning to implement it?
Our next post will begin to answer some of those key questions.

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

Short term volunteer trips: the global health dilemma

By Lawrence Loh, MD MPH

When it comes to short-term volunteerism, young professionals from all stripes are keen to make a difference abroad. Speaking to the issue of global health, which our organization is most familiar with, numerous studies have shown that young health-care professionals in training and recently out of training express an interest in altruistic work abroad with indigent populations. These young physicians, nurses, pharmacists, dentists, allied health and public health professionals today live in a modern world with internet and communications links that bring the worldwide need for their skills into stark focus, with a globally interconnected transport system that opens the doors to these opportunities like no other time in human history.

But at the same time, modern professional training in these fields have saddled many of these young professionals with crushing debts. Training demands and vacation restrictions limit the amount of time they are able to invest in their passions, which in turn keeps them from gaining valuable experience needed to incorporate global health into their career. And often times, despite the sea of plenty, there is a difficulty locating opportunities; most opportunities are not well publicized and often come up by chance, through word of mouth or a fortuitous strike online. Translating these experiences into sustained careers is also challenging, as many entry positions into the global health world often have significant demands for experience and credentials that starting young professionals may not have. At the same time, if all the young professional has had opportunity for is short-term trips (ranging 14-90 days abroad), the global health community tends to look on such experiences with muted disinterest at best, and disdain at worst.

So young health professionals pursuing such dreams to make a difference fall into two categories. The lucky ones, who either strike a scholarship lottery or come from families well off, are able to take gap years and gain the necessary experience abroad, but this in turn delays the completion of their training. Since remuneration and finances are not an issue, it’s just a matter of time, and they invest in it and eventually end up within the very community they are striving to make a difference in.

But for the vast majority of young professionals who want to make a difference, they’re not as fortunate. They may have the passion and skills and desire to help, but with their limited finances and time, they do most of their global health work off the side of their desks. These young professionals invest what limited money and time they have access to, leveraging their lines of credit and their spare vacations, in order to pull together enough short-term experiences that might help them network or land an opportunity. Much like actors trying to “make it”, these youngsters deeply invest in the hopes that they’ll someday land a job that pays them to do what they’re passionate about – about making a difference to the people abroad.

The result is that short-term trips are increasing in popularity, since they are the only option available to real people who have real jobs and can’t afford the time and money it would take to volunteer abroad for years on end. It thus falls to us to figure out how to make these experiences valuable and viable for these young professionals – how to make sure that growing short-term medical trips are beneficial for the communities abroad, for the organizations doing them, and for the young professionals pursuing them.

By coordinating such trips, we can make it easier for the young professional to figure out where the opportunities are. Got a week off in May and there’s six trips going to three different places that need a nurse or doctor? Sold. The website shows the ongoing projects, which the young professional can read up on to prepare for the trip. When they arrive there, they can lend their expertise as planned towards a shared, common effort; and when they return home, they can keep contributing remotely by monitoring the project online, sharing and discussing ideas, and even signing up for a return on another vacation week at a future date. They get to be part of something bigger than just going on a “do good” vacation for a week, and their investment is ultimately maximized.

Of course, the biggest concern with any work abroad is the idea that the community abroad must benefit – being already vulnerable and challenged. Once we link young professionals to the opportunities they seek (and the experience they ultimately need and gain by participating both on-site short term and remotely), we must make sure that the communities abroad also benefit. Our next post will discuss just how they’ll benefit from coordinated short-term volunteer work.

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

Short-term volunteer trips: coordination, collaboration, cooperation

By Lawrence Loh, MD MPH

In our previous entry, we talked a bit about how the short-term volunteer trips are generally felt to be low impact, especially by the global health community. After all, how can anyone accomplish anything in just one week abroad? How can one learn about the local community, overcome cultural and logistical barriers, quickly assess the situation and develop a remedy in just 14 short days? It is this mindset and thinking that has left current short-term efforts ignored by bigger organizations, and tackled by smaller organizations that barely have the resources to actually make things work.

From week to week, at a local level, teams from all over the world visit communities abroad. Uncoordinated efforts result in duplication and wastage. Some teams do things one way; others have other ideas, naturally. Reversals occur and status quo is maintained by well-meaning people. Young professionals are constrained by time and finances to going on these trips, but leave feeling good about what they did – and just remembering a wonderful vacation without being able to follow-up or keep up to date with where their project is going.

Now imagine a properly coordinated locale with a functioning web platform specifically designed to coordinate a string of consecutive weeks. Take every week at a local level, fill it with its own autonomous, hard-working, passionate team – and give the wider volunteer community a common database. A list of protocols, inventory, and a schedule that would let them plan exactly when they’re heading down and read up before they even get there. An online library with a general primer and information that gets updated in real-time.

For the teams, it all starts with the schedule, connecting them with the contact information for the team preceding their visit, who can share with them what is already on the ground there, and what projects are on the go. They get this information ahead of time: needed meds and supplies, progress of shared projects, and ideas for follow-up before they even land on the ground. While they’re there, they link with the other teams abroad to rely on their shared knowledge, and they put in the work towards a long-lasting, effective, sustainable project instead of handing out pills and mismatched charity goods. Then they return home, passing on the cycle by posting their own findings, ideas and thoughts on their trip. They remain connected when they come back and add to the instantly available expertise that teams on the ground rely on. And they work with the local leadership to figure out what projects and plans will work for the local community – and how to get everyone to agree on those common goals.

For the local community, it means improvement and development and a voice. They lead the discussions on the web platform. They engage. They tell what the community needs, and the teams work on meeting that. And the website drives recruitment and programming: engineering projects are able to source engineers for teams heading down by advertising widely and finding someone with a schedule match. Instead of just acute care medicine, teams work to develop health promotion programs or implement basic public health measures that prevent disease instead of providing care that does little to change the underlying factors that made the local citizen sick in the first place.

Ultimately, young professionals also benefit. No more floundering around with a free week and wondering how to make a difference. The web platform allows them to easily access potential opportunities. They can figure out which projects have teams that are heading down to a locale of interest during their one or two weeks of vacation. And because of the bigger goals targeted by these projects, they can get involved in something that is having impact, and still remain as remote participants after their two weeks are done. Any amount of time they can spare is cherished and put towards good, rather than demanding large financial and time sacrifices that they simply cannot afford at the start of their career. You got a free week? Here’s a project – and it’s more than just handing out pills. It’s working to build something bigger than each individual volunteer, each individual team.

That’s the idea of The 53rd week. Individually, a week abroad can only do so much. 52 weeks abroad uncoordinated are just that, 52 weeks. But put them altogether, and something extra, bigger, larger than the individual can collectively occur. Everyone wins – the teams that invest their efforts and money; the young professional looking for valuable, pertinent experience; and most importantly, the local community abroad which benefits from realistic, sustainable, long-term goals over acute, short-term efforts.

Short-term efforts can make a difference. They just have to be part of a bigger picture. And what is that bigger picture? Where does this lead us? What are we looking at?

Our next post will consider the wider phenomenon of who are these people that are going on short term trips, and why they do it.

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