Clinical guidelines for medical volunteers: “There are no evidence based guidelines”

August 21, 2016 | Christopher Dainton

This week, I presented on clinical guidelines for medical volunteers at the American Public Health Association conference in Chicago, followed shortly after by a very similar presentation at the Canadian Conference on Global Health in Montreal.

We concluded (based on a review of the literature) that there are really no good published clinical guidelines being used by NGOs operating medical service trips and medical missions in Latin America. Many thanks to collaborators Lawrence Loh, Henry Lin, and 53rd Week.

Why do medical service trips and global health experiences need clinical guidelines?

International volunteers may be relying on unproven assumptions. In particular, they may apply familiar Western guidelines and practice patterns to settings where they may not be a good fit. Similarly, they may simply rely on the subjective experiences of veteran colleagues on our teams.

Getting patients to healthcare key clinical guidelines challenge

However, medical practice in a low resource setting in Latin America is distinct from practice in the developed world. Cultural and language barriers may make it more difficult to procure information during an assessment.

Even more important, epidemiology and disease patterns are distinct. Local and regional guidelines and practices should clearly be taken into account, as well as local availability of common medications. Simply handing out the medications that were donated to volunteers back at home is of little use if patients have no way to refill them.

Developing clinical guidelines for medical volunteers

Creating useful practice guidelines for medical service trips and international volunteer projects is no easy task. Like all guidelines projects, it requires collaboration from multiple stakeholders, from local clinicians to Western NGOs. Furthermore, it requires the merging of evidence based recommendations from both international guidelines and local field research. Our published methods article discusses one possible approach to developing guidelines.

Our journey begins with collecting clinical protocols from the hundreds of volunteer sending organizations listed on this site. Understanding current practice is a key first step to understanding how medical volunteers can improve.

Check back here to follow our progress on the guidelines project.




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