Helping out overseas as an EMS person is an idea that appeals to many of us. The draw includes both a feeling of satisfaction with giving back and the excitement of something new. The challenge, however, is finding opportunities that are relevant to the EMS clinician and that match well with what we are looking to get out of the experience. So that’s what we’re going to discuss – how the EMS provider gets into this scene and how he or she finds opportunities that both offer value and that match our unique skill set.
Medical volunteerism, as the general field is known, is mostly designed with the non-EMS clinician in mind. Opportunities abound for physicians and nurses and many others in between, but not so much for medics and EMTs. Of those opportunities that are available to EMS providers, most preferentially recruit ALS folks, due to capabilities and scope of practice. This makes it a bit difficult for EMTs to get in on things, but it’s still possible, and we’ll discuss some specific opportunities in just a moment. The general idea here is that it can be tough to find opportunities and the search may require a bit of both persistence and patience.
Another consideration is that the work itself may be quite different from the normal day to day grind of an EMS service. While there are ways to volunteer running calls on a truck and responding to emergencies, these opportunities are quite rare. More often than not the focus is on primary care or education. If these are unfamiliar, it can be intimidating for the EMS provider to step into this new space. And while that’s completely understandable, it is definitely manageable, as long as the overseeing organization provides support and guidance to help navigate that gap in experience. This brings us to our next topic of discussion: choosing the right group.
Just as not all EMS agencies are the same, in terms of support offered to providers and quality of care delivered in the field, neither are NGOs (non-governmental organizations) and charities that recruit medical volunteers. Some are great and some aren’t. An NGO may offer different projects or opportunities, some of which are great, and some of which aren’t. It can feel a bit overwhelming to try and sift through the many options, but that’s what we’re here to help with. One way to work through this process of finding an opportunity is to consider a few questions: What are we looking for? What sort of experience does the group have with EMS clinicians? What are the hurdles involved? We’ll talk about each of these in turn.
The first consideration is to reflect on what we hope to get out of the experience. If it’s exposure to something new and different, many opportunities may fit the bill. If, however, the goal is clinical exposure in the EMS field, that may be more difficult to come by. Other motivating factors might be to practice or learn a specific language, to use the opportunity as a gateway to a specific part of the world we’ve always wanted to visit, or simply to try something new and get out of our comfort zone a bit. Whatever the case may be, have those goals in mind and be sure to make sure the experience aligns with them.
Next is to look into what history a group or organization has with other EMS volunteers. This isn’t to say that an absence of such history means an opportunity isn’t worth pursuing, rather a question to clarify whether or not a path for someone in our role has been established or not. If so, we can easily determine whether we like that path and want to keep moving forward with it. If not, however, we may have to establish the path via a dialogue with the organization about scope of practice and skill set, legal considerations, and/or personal comfort in working outside of the traditional EMS arena. And then if we like a given path, whether forged by others in the past or in the makings via our own effort, we can carry that conversation forward.
Sidenote on this idea: EMS practice and the associated labels for healthcare providers vary widely around the world, so keep in mind that not all opportunities for “medics” apply to US-certified paramedics or EMTs. Likewise, not all international organizations will be familiar with details regarding scope of practice for various levels of providers. These sorts of things are a bit easier to navigate if a given group has experience working with EMS providers (from the US or other countries), but that shouldn’t be considered a prerequisite – just ask clarifying questions and make sure that expectations are clear ahead of time.
The last thing on our short list of questions when considering volunteer opportunities is what steps are involved in getting on board with a group. Many outfits require an application and/or online training, but those sorts of things tend to be fairly manageable. Other obstacles, which may be more difficult to navigate, include immunizations, prophylactic medications (mainly against malaria), visas, etc. The big hold up for many of these pursuits is money. It’s not uncommon for organizations to charge a fee to volunteer with them, plus it’s expensive to travel to many of the places where these groups work. That may or may not be a gamechanger, but it’s good to know up front what expenses to expect from something like this so that we can make a well-informed decision on it all.
As an example, let’s work through these considerations for an organization with which we have extensive experience. Global Response Management (GRM) is a non-profit that provides medical care around the world. They started in Mosul, Iraq in 2014 treating trauma casualties as other organizations pulled out of the region due to safety concerns. They currently have ongoing projects in Mexico along both the US and Guatemalan borders and actively recruit volunteers, both clinical and non-clinical, to help provide care to immigrants. They also respond to situations that arise internationally and are working to develop a system for rapidly deploying teams on short notice.
First consideration is to think about what we’d hope to get out of working with a group like this. The care they provide is largely clinic-based and focused on primary care, so if ambulance runs are what we’re looking for, this probably isn’t the best bet. If, however, you’re an EMS person looking to develop skills in the primary care setting, this may be a good fit. And if you know or want to learn Spanish, the ongoing projects they have in Mexico might be perfect.
Next is to consider prior experience with EMS providers. GRM has utilized EMS folks from the very beginning. In fact, many of their founding members were, and are, EMS people. This means they know exactly what we, as clinicians in this field, are capable of and trained to do. Additionally, this includes both EMTs and paramedics – they have availability for all. So even though the work itself may not fall into the standard EMS transport mold, there is a great deal of institutional experience in this area.
Lastly are the hurdles. GRM does require a bit of online training prior to deployment, but it’s relevant to the work they do. The process goes pretty quick and they have regular opportunities for volunteers, particularly at their Mexico projects. One more thing to mention is that GRM doesn’t require volunteers to pay to lend a hand – if you can agree to get there, they’ll put you to work.
As another example, there’s an organization called Raleigh International out of the UK that utilizes clinicians to provide medical support for volunteers on projects in the developing world. Raleigh takes young adults to different places around the world on “expeditions” that involve three phases: a community project focused on WaSH concepts, an environmental project geared towards natural resource management and an adventure leadership project that is essentially a backcountry trip of sorts to develop skills in leadership and resiliency; each one roughly three weeks long and the whole expedition is about three months in length.
The role of the medical provider in these expeditions is to provide medical support for the volunteers during various activities and while at project sites, not necessarily to care for people in the host country. Medical providers also function as project leads and, therefore, fill a sort of dual role. In addition, the medics (their generic term for docs, nurses and/ or paramedics) organize first aid training at the start of the expedition, field calls from non-medical project leads about cases that come up on sites, and staff a clinic during business hours when volunteers are at a field base in between phases of the expedition.
Just as before, if a 911-style experience is what you’re looking for, this probably isn’t the best opportunity. The medic side of the Raleigh experience is more of an add-on, with the focus on the projects themselves and helping volunteers get the most out of it (back to the dual-role idea we just mentioned). It’s also largely focused on intercultural exchange: volunteers are from both the UK and the host country, with some from the UK entering into the opportunity by way of scholarship programs. All that said, emergencies do come up, and that’s why they staff medics on these expeditions.
Moving on to experience with EMS clinicians: Raleigh does advertise medic positions for paramedics, but they are a UK-based program and the paramedic role across the pond is not 100% equivalent to what it is in the US. That said, it’s not an insurmountable hurdle and they have taken US paramedics (or at least one of us…) on projects in the past. We can’t speak to the AEMT/ EMT-I role, but it’d be worth an ask – especially for those with remote experience.
Just as before, the final consideration is the hurdles involved. The biggest one to mention is that Raleigh typically has a fee associated with its opportunities. This money goes to offset costs of the expedition and funds projects, but it can be a barrier to entry. That said, they do offer support for and actively encourage fundraising to offset this expense. Another thing to mention is that being a UK-based organization makes access to opportunities before and after an expedition difficult for those of us in the US. This also means that you’ll likely have to interview and work through the vetting process remotely via video chats. On that same note, Raleigh does a commendable job of maintaining a sense of community for those planning to and having participated in their opportunities, but nearly all of the associated social events, activities and opportunities take place in the UK. Which is totally understandable, just something to be aware of when getting involved from the US.
In light of those two in-depth examples, we’ll also mention a few other groups in passing without getting into the same level of detail – that’s on you if any of them seems like an opportunity you’d like to pursue. HERO Client Rescue in Haiti takes EMS providers of all levels to work on ambulances; if ambulance runs are what you’re looking for, this might be the ticket. Also in Haiti, Haiti Air Ambulance utilizes volunteer clinicians from HEMS programs in the US and Canada to augment their internal staffing. The opportunities are a bit more limited, but it’s an awesome rotor-wing experience if you have the time to make it happen. Team Rubicon also offers opportunities for EMS clinicians – these folks do all kinds of projects both domestically and internationally, all sort of focused on disaster/humanitarian response; some of which involve medical components.
Lastly, there are many organizations around the world that don’t have formal systems for recruiting volunteers that are, in fact, very much in need of motivated people willing to lend a hand. Don’t be afraid to reach out and initiate a dialogue. If you then decide that you can create and experience a new opportunity, do it. Make it happen, do good work, enjoy the ride, maybe even learn something new, and then reach out and let us know all about it when you make it back home!
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