Mission possible: A brief how-to guide on medical missions

Lisa Marie Piwoszkin, DO, became an expert at taking blood pressure before she even started medical school. She did so by taking a medical mission to the Dominican Republic.

“My medical knowledge at that point was fairly limited,” said Dr. Piwoszkin, who is now a pediatrician in Oak Lawn, Ill. “But on that mission, I probably did 1,000 blood pressure measurements.”

The chance to hone your medical chops is just one reason Dr. Piwoszkin suggests osteopathic medical students consider medical mission trips. Dr. Piwoszkin, who also traveled to Guatemala during her residency and completed a spiritual mission in Haiti as a medical student, said her journeys broadened her horizons and built her character. At the Student Osteopathic Medical Association’s spring convention in Washington, D.C., in early March, she offered advice to students interested in medical missions.

To find opportunities, students can inquire about international rotations at their schools, Dr. Piwoszkin noted. And you don’t have to be especially spiritual to participate in a medical mission organized by a church group if you keep an open mind, Dr. Piwoszkin said. Students can also check out DOCARE International’s missions to Guatemala, Nicaragua and other countries.

Finances

Once students find a trip to go on, they’ll have to figure out how to pay for it. For her travels in Central America, Dr. Piwoszkin said the flights cost about $1,000 while her living expenses for a one- to two-week trip were about $250. Dr. Piwoszkin financed her missions by appealing to loved ones and others for donations.

“What I’ve done for every single one of my missions is send out contribution letters to family, to friends and to local businesses saying something like, ‘Hi, I’m a medical student. I have this excellent opportunity to experience the practice of medicine, and I’d really appreciate any help that you could contribute,’ ” Dr. Piwoszkin said.

Dr. Piwoszkin said she sent 30 to 50 letters before each mission.

While students work out the finances of the trip, they’ll want to make sure they have passports and are vaccinated. Then they’ll be ready to carefully choose what to pack in their bags.

For her trips, Dr. Piwoszkin had a carry-on and two checked bags—one with her own clothes, and another with donations for patients. If students plan a trip far enough in advance, they can elicit donations such as clothes, socks and toiletry items for patients, Dr. Piwoszkin noted. Count on the mission’s organizers providing you with donations to pack.

“Your second bag, [the group’s organizers are] going to stuff full of things that they want to take there—soap and shampoos, medical supplies and so on,” she said.

What to expect

When embarking on a mission trip, Dr. Piwoszkin suggested students abandon expectations about what they’ll be able to achieve and what the conditions will be like. They should understand that they won’t be able to help some patients as much as they would like—or in some cases, at all.

“You’ll see two extremes,” she said. “One is super severe pathology because people don’t have access to a clinic.”

She recalled the 9-year-old boy with severe scoliosis who came to her clinic in the Dominican Republic. Such patients can be referred to a clinic in a bigger city, but students should realize that many patients typically don’t have the resources to travel far and pay for the treatment.

At the other extreme, students will also see simple conditions that are preventable.

“That’s the most frustrating part,” Dr. Piwoszkin says.

Although their caregiving is sometimes limited, students can make a big difference by talking to patients about good health habits—even something as simple as using clean water.

“The biggest thing that you can contribute is good education,” she said. “Talk to patients about clean water. Tell them what they need to do with it and why it’s important. You can make a solid impact there.”

A unique asset DOs bring on medical missions is osteopathic manipulative treatment, Dr. Piwoszkin notes. This is especially beneficial because the clinics are often short on medication and other supplies.

Attendee Houston D. Lui, OMS II, said he appreciated Dr. Piwoszkin’s practical advice.

“It’s really helpful to understand what to expect when you’re going out internationally,” said Lui, who attends the Des Moines (Iowa) University College of Osteopathic Medicine. “Dr. Piwoszkin gave really good helpful hints about passports, vaccinations and donations. These are things you might not think about if you’ve never been on a medical mission trip.”

Lui, who has done humanitarian work in Rwanda, advises similar-minded students to learn about the culture of their destination before the trip.

“People know you’re not going to know everything, but they love seeing you care about their culture by saying a few phrases in their language,” he said.