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CMAJ. Oct 23, 2007; 177(9): 1020–1021.
PMCID: PMC2025615

Getting involved: donating time, money and expertise to global health

It's the smiles that Dr. David Ponka remembers most. In the midst of poverty, disease and civil strife, the Ottawa-based family physician can't get over the resilience of the people he saw last year in Chad while on a 4-month stint providing critical medical aid to internally displaced persons.

“It was a place that really affected me deeply,” says Ponka of his sojourn in the desert as a volunteer for Doctors Without Borders. His patients had been forced to flee their homes, with little or nothing, to escape the violence spilling over from neighbouring Sudan. “Just to be dealing with human life on such an elemental level is really, on the one hand, thought provoking but, on the other hand, uplifting,” he says. “The thing that struck me the most was how people were able to survive despite all the atrocities. These people were still able to try to lead normal lives. You still saw smiles in the market. That's what impressed me the most.”

Like Ponka, many Canadian health care professionals and medical students have responded to the urgent need for assistance in such poverty-stricken regions around the world. But with the ongoing ravages of HIV/AIDS, malaria, more drug-resistant forms of tuberculosis and other diseases that afflict impoverished countries, the demand keeps rising. And while the world has become more aware of the health issues plaguing these nations, and the interest in global health has escalated, the extent of participation in administering humanitarian medical relief hasn't kept pace. “It's not been a dramatic increase in the assistance and activity [and] involvement of medical doctors in Canada and internationally,” says Dr. Bill Hanlon, a family physician from Cochrane, Alta., and founder of the Basic Health International Foundation.

Hanlon, who has been volunteering in difficult-to-reach, high-altitude communities, such as Tibet, for the last 20 years, adds that time shouldn't be considered a barrier to involvement, given that some international organizations can accommodate short-term commitments on the order of a few weeks. “It's a great opportunity to recharge,” says Hanlon, adding that working in challenging conditions, with limited resources, provides physicians a real opportunity to hone their primary clinical skills.

It also instills perspective, Ponka says. “We have a skewed perception of what the true global killers are. Yes, cancer is important everywhere and heart disease is important everywhere. Things like malaria, tuberculosis, HIV/AIDS … those are the true global killers, and we lose sight of that and we lose our sense of priority sometimes.”

Volunteering abroad, though, isn't the only way to support international health care relief efforts or create more awareness about the correlation between ill health and poverty. There isn't an organization that would reject a cash donation, and there's always need for assistance in fundraising, public-awareness and organizational campaigns aimed at alleviating conditions in the developing world. “A lot can be done on the ground here, without actually going anywhere beyond your community,” says Hanlon. “I believe that there's a very strong, large group of committed doctors out there.”

Listed below (alphabetically) are some of the Canadian organizations seeking overseas volunteers from the medical community. Unless otherwise specified, travel and accommodation costs are covered. (If we've missed your organization, please contact ac.amc@ordnoK.enyaW).

Canadian Africa Community Health Alliance: Undertakes medical missions in Benin, Gabon and Tanzania with small teams of health care professionals, including doctors, nurses, pharmacists, dentists and surgeons. In partnership with African organizations, provides free medical consultations, minor surgeries and medications to remote rural communities. HIV/AIDS treatment, prevention and care are the primary focus in Tanzania. Missions last 2–3 weeks, but longer placements can be arranged for those interested in spending sabbaticals overseas. Provides fundraising assistance to cover travel and accommodation costs and welcomes donations of medical supplies. Website: www.cacha.ca; email: ac.awattou@ahcac.

Canadian Public Health Association: Undertakes capacity-building initiatives in low-and middle-income countries with counterparts and health ministries in those nations, as well as international agencies such as the World Health Organization, Pan American Health Organization and UNICEF. The general approach is to provide direct technical assistance to strengthen the capacity of partners to design, deliver and evaluate their public health services. Now involved in more than 20 countries, the association typically relies on local health professionals but does occasionally deploy technical advisors and experts off a volunteer roster that it maintains. Website: www.cpha.ca; email: ac.ahpc@rotceridphg.

Canadian Relief Foundation: Brantford-based organization, with chapters in British Columbia and Saskatchewan, that establishes Disaster Assistance Response teams, comprised of paramedics, physicians and nurses, to help countries cope with the fallout from such natural calamities as earthquakes and floods. They also selectively undertake public health projects such as community water wells and longer-term initiatives like creating orphanages. Travel is not covered, but charitable tax receipts are issued for such expenditures. Website: www.canadianrelief.ca; tel: 877 832-0172.

Canadian Society for International Health: Works with public health ministries and associations in low-and middle-income countries to promote capacity building in public health services. Currently managing bilateral projects, jointly funded by the Canadian International Development Agency, in Guyana, Ukraine and the Balkans. Teams of Canadian medical consultants, including doctors, nurses, laboratory experts and epidemiologists, provide training and mentoring, as well as technical assistance for policy development. Website: www.csih.org; email: gro.hisc@hisc.

Global Medic: The Toronto-based operational arm of the David McAntony Gibson Foundation coordinates rapid-response teams to help developing nations handle natural or man-made disasters. Missions typically involve the provision of emergency medical aid such as establishing field hospitals, search and rescue operations, or installation of water-filtration systems. Teams comprised of paramedics, doctors, nurses, firefighters, police officers, engineers and skilled tradesmen are usually sent abroad for 10–14 days. Website: www.dmgf.org; email: gro.fgmd@ocnaibopacm

Médecins du Monde Canada: Now working in Haiti, Malawi and Zimbabwe on projects aimed at reducing the impact of HIV/AIDS, providing vaccinations for children, improving the health of women and children and promoting better reproductive health. Activities include emergency medical assistance in disaster areas, rehabilitation efforts to restore health care infrastructure, development initiatives to establish sustainable and accessible health services, and local projects to assist marginalized populations in need. Volunteer commitments can range from a few weeks to a year. Expenses are covered and a small living allowance is provided. Website: www.medecinsdumonde.ca; email: ac.ednomudsnicedem@tnemeturcer

Médecins Sans Frontières: The gold standard of humanitarian medical organizations and winner of the 1999 Nobel Peace Prize for its pioneering efforts. Now operating in more than 80 countries, Doctors Without Borders is involved in a variety of medical-aid efforts, including emergency relief for populations suffering as a result of war, disease outbreak, and natural or man-made disasters; primary health care for refugees and displaced persons; and long-term missions to rehabilitate health services and help local communities establish self-sufficient health infrastructure. More than 2500 volunteers worldwide. Missions typically last 9 months to 1 year, although emergency relief initiatives may be shorter. Online volunteer applications available at: www.msf.ca.

VSO Canada: Active in more than 30 countries in Africa, Asia and the South Pacific, the organization works with local counterparts to deliver health and social services to communities, including prevention programs, and care for orphans, AIDS patients and other vulnerable groups. About 30-40 medical professionals participate annually in placements ranging from 6 weeks to 2 years. Website: www.vsocan.org; email: gro.nacosv@yriuqni.

In addition to the nondenominational organizations above, there are a number of faith-based missions and organizations across Canada that rely on volunteers to help staff their overseas projects. Those include HOPE International Development Agency (www.hope-international.com), Volunteer International Christian Service (www.volunteerinternational.ca), and World Vision (www.worldvision.ca).

Medical students/residents

There are also several organizations that help to place volunteer medical students and residents. Those include:

Canadian Federation of Medical Students: Operate an International Health Program aimed at providing students with the resources, training and opportunities to develop global health leadership skills. The federation also participates in the International Health Mentorship Program, which matches medical students with leaders in international development in a variety of local projects and national campaigns focusing on such themes as public health, reproductive health and HIV/AIDS, human rights and equity. Supports involvement in International Federation of Medical Students' Associations conferences. Website: www.cfms.org.

Residents Without Borders: Established by residents at the University of Toronto, the group supports discussion groups and fundraising events aimed at promoting global health and skills development. Currently developing a global health curriculum for residents. Can link residents with clinical and research opportunities abroad through a database of electives. Website: www.pgme.utoronto.ca/international/Residents_Without_Borders.htm; email: ac.otnorotu@bwrtu.

Uniterra: An international cooperation program run jointly by the Centre for International Studies and Cooperation and the World University Service of Canada, the group now operates development projects in 13 countries, including ones focused on health, nutrition and HIV/AIDS. Volunteer postings range from 2 weeks to 2 years. Website: www.uniterra.org.

Helping in Canada

Several organizations are constantly seeking volunteers and other forms of aid, to assist in advocacy or domestic relief programs within Canada but do not send physicians or health care professionals abroad. Those include:

Canadian Physicians for Aid and Relief: Now involved in the provision of health care programs in Ethiopia, Malawi, Uganda and Tanzania in such thematic areas as sexual and reproductive health education, HIV/AIDS prevention and care, child health and nutrition, skills training for traditional birth attendants, and improving the capacity of health facilities to provide emergency, obstetric and comprehensive care. Study tours, lasting several weeks, are available to physicians who wish to visit agency projects. Website: www.cpar.ca; email: ac.rapc@inawhdawhc.

Canadian Red Cross: Volunteer opportunities are confined to Canada, as the agency only deploys internationally designated, and specially trained, delegates on overseas commitments. Details on obtaining delegate status are available at their website: www.redcross.ca.

Physicians for Global Survival (Canada): An advocacy group, the physician-led organization strives to raise awareness of, and find solutions for, such issues as nuclear disarmament, war prevention and social justice. Promotes the participation of medical students in international conferences and Peace Through Health projects. Website: www.pgs.ca; email: ac.bew@sgp. — Lisa Bryden, Ottawa


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