On a Medical Mission

Medical mission trips are service-learning opportunities that are, for many PA students, formative.

Shea Dempsey, MPAS, PA-C, has participated in Shenandoah University’s mission trips as both a student and faculty member. “Going reminds us of why we do what we do,” he said.

The logistics of arranging a mission trip are numerous and complex, so many programs choose to work with a partner organization to take care of details like transportation, food, lodging, and translators.

Shenandoah, found in Winchester, Virginia, has been taking students to Nicaragua for the past nine years. Though they work with a U.S. travel agent to arrange flights, they team up with local organization El Ayudante to coordinate in-country plans, including where they’ll be practicing each day. “We work in local clinics, we work with the school systems. A school may close for the day so we can host a clinic, or we may be in someone’s kitchen or a community center,” Dempsey said.

Faculty at Wagner College on Staten Island opted to organize their trips to Belize and Guatemala themselves. Program Director Nora Lowy, PhD, MPA, PA-C, wrote to doctors and nurses in rural areas who then put her in touch with chiefs of indigenous villages, which she visited during scouting trips. In Guatemala, she found herself in the remote highlands where access to health care is difficult.

“I met with people in the community and said, ‘What should we be doing?’” Lowy recalled.

As she developed the itineraries, Lowy thought the trips should include a fun activity, like cave tubing, to give students a break. “As the students got there and the week progressed, they would come to me and say, ‘You know, we can skip that. We just want to go see another village,’” said Lowy. “That really brings a tear to my eye.”

Carrie Beebout, MPAS, PA-C, from St. Francis University in Loretto, Pennsylvania, has noticed similar reactions from those who participate in their trips to Jamaica and the Dominican Republic. “I have never heard a student complain about the experience despite the long hours and hardships endured,” she said.

Beebout added that the medical mission trip gives students an entire week to practice “hands-on” medicine under the supervision of their instructors. “The supply of patients is virtually unlimited, with ages ranging from newborn to geriatric, and the complaints varied,” she said.

Shenandoah’s program includes students from other health care professions, including pharmacy, occupational therapy, and physical therapy. “The feedback I hear [from students] is that this is one of the only places where they are able to immediately consult with other disciplines,” Dempsey said. “We never have that closeness in the U.S.”

While students are overseen by faculty members, many experience more autonomy than they’ve had previously.

For Rick Leon, a Wagner student who’s participated in several of the program’s trips, “It was the first time we were making our own decisions,” he said. “For me, that was a strong point of realization of how my mindset would process information.”

Creating Long-Term Change

An important part of any mission trip is collecting medication prior to departure. Shenandoah holds an over-the-counter medicine drive every year, which is sponsored by the school pharmacy. They also raise money by selling locally grown Nicaraguan coffee and holding an annual fundraising gala.

Wagner, too, relies on fundraising and donations. They recently spent seemingly endless hours packing supplies for both the Guatemala and Belize trips. Even still, the stock quickly diminishes once a program is treating patients. “It’s a challenge to reach everyone that you want to reach,” Lowy said.

The program may want to give a year’s worth of vitamins to each patient, for example, but it’s impossible to provide that for 1,400 people.

“It doesn’t do a lot of good to bring somebody medicine for a month if they’re going to need it for the rest of their lives,” Dempsey said. “Figuring out what we can do to truly be sustainable to them is something we talk about quite often.”

Despite those constraints and challenges, Lowy said they’ve seen real change in the communities they visit each year. On her most recent trip to Belize, she saw a patient who had been extremely malnourished the previous year. “She runs up to me and says, ‘You’re back! I’ve been healthy for a year!’ That made everything worth it to me,” Lowy said. “All the mosquito bites were worth it for that moment.”

The percentage of students that participate in mission trips varies widely by program, but for Wagner, it’s recently become 100 percent. They’ve found internal funding — cost will no longer prevent interested students from participating.

What’s more, they’ve developed a progression for their one-week mission trips. Wagner is a three-year program: first-year students visit England to learn about socialized medicine, second-years travel to Belize, and third-years practice in Guatemala. “There is a progression,” Leon explained. “Each trip prepares you for the following trip.”

If a particular experience made an impression on a student, they then have the opportunity to return for an international rotation.

Our mission trips are a big draw for our program — attracting civic minded individuals,” said Lowy. “Every one of our students is looking to make a difference and is happy to get involved in meaningful outreach work.”

Developing a Mission Trip

For programs looking to establish their own medical mission trips, there are many specifics to evaluate, including safety, visas, and policies on bringing medical equipment and medications into the country.

The amount of travel time is also important. “The number one challenge is to go to an area of the world that has a significant need but can be reached affordably and in a timely fashion,” Beebout said. “If too much time is spent in travel, or everyone is exhausted when they arrive, care provided will be impacted.”

Though the list of things to consider is long, Dempsey said that shouldn’t dissuade programs from developing their own mission trips. “It may look overwhelming, but the experience is nothing you can replicate in the States,” he emphasized, adding, “Our students are talking about it all year long.”

In the works: Later this summer, we’ll be profiling international rotations.