After working with some of the largest international medical NGOs in the world, both Doctors Without Borders/Medicines Sans Frontieres (MSF) and the International Committee of the Red Cross (ICRC), I frequently get asked “how can I get involved?”. Often those questions come from trainees who one day dream of taking part in humanitarian work without knowing the path. Through this post I’d like to share with you some of what I’ve learned along the way.
The difference between humanitarian work and development work
Generally speaking, humanitarian work differs from development work. Humanitarian work tends to be short term with the priority being the immediate relief of suffering caused by disasters, war or political crises. Development work aims for longer term change, focusing on systemic issues, such as education or poverty alleviation. For the most part, the largest medical NGOs (i.e. MSF – Doctors Without Borders and the ICRC – International Committee of the Red Cross) work in the humanitarian space.
What many don’t realize is that applying to work for a humanitarian organization like MSF is not as easy as you think. The large humanitarian organizations are recruiting doctors from all over the planet and when they’re seeking specific applicants, they are looking for both specific qualifications and characteristics.
A quick primer on Doctors Without Borders (MSF)
A quick primer on MSF specifically. For emergency medicine-trained physicians, MSF typically requires a 6 month minimum commitment for a first-time assignment. Most applicants have had significant global health experience before applying and once accepted, recruits are placed in a pool and offered specific assignments. Physicians don’t often have much say in the type of project that is offered, but there is no obligation to accept any assignment. Practice in the field can be quite varied, often requiring an extension of practice into other fields of general medical care such as pediatrics and internal medicine. MSF has a strictly humanitarian focus and assignments often take place in challenging regions affected by conflict. It can be both exhilarating and exhausting, and often a combination of both.
If after reading this you’re still interested in participating, here are a few key ways to prepare.
Motivation for global EM humanitarian work
Firstly, before even looking into finding an organization, I’d suggest contemplating your personal motivation for doing humanitarian work. Spend some time reflecting and thinking about what draws you to global health. From my personal experience, motivations that are more externally focussed – (i.e. it looks good/fun, people will think highly of me, I like the challenge) generally will not give you the reward you’re looking for. People who are drawn to the work for authentic reasons, ( i.e. the genuine desire to make a difference) tend to thrive when the work becomes challenging – which it inevitably will.
Personal skills required for global EM humanitarian work
While it might be difficult to know exactly how you would behave in a new and sometimes extreme setting, it might be worthwhile to reflect on how you respond or have responded to new and challenging situations.
How well do you work under stress? How about extreme stress?
How good are you at getting along with others? Working in a team?
How good are you at dealing with uncertainty?
Can you rapidly adjust to new and different situations?
Have you ever lived or worked overseas?
Can you live in lower resource conditions for extended periods?
How will you cope with isolation? Death?
People who adapt easily to a variety of situations, can be flexible with a variety of medical roles, have good interpersonal skills, and can cope with less than perfect living conditions will thrive more easily in the field. Luckily, many of the skills inherent in Emergency Medicine physicians translate well to field work (see our previous posts).
Global health experience for humanitarian work
Have you had experience working or living in a developing context? While this is a prerequisite, it’s also important for an applicant to know personally how they would cope in a lower resource setting. For instance, while working in South Sudan, I slept in a tent, it was forty degrees Celsius regularly and I lived within a very small compound, fenced within a refugee camp that was literally hundreds of miles from anything. While this is an extreme example, you should be aware of how much exposure to different foods, cultures, ways of living and of course, medical scenarios you’ve had. There are ways to prepare for this of course. Firstly, travel and see the world, and note if you’re attracted to some of its more remote corners (from a “Western” perspective). There are plenty of opportunities to get involved in smaller global health projects first to see if working within a larger organization is something you’d like to try.
Education for humanitarian work
What do you know about the practice of medicine in the location you’re planning on working? It took just a few days on a volunteer medical mission to Tanzania to realize how little I knew about the medicine of the tropics. Schistosomiasis? Leishmaniasis? Disseminated tuberculosis? The diseases and practice patterns are going to be significantly different from what we’ve seen and learned about in North America.
I believe that it’s imperative to have some preparatory education so that you can be most effective in the places you’re planning to work. There are many global health-related courses, from days to week-long prep courses, to diplomas and masters degrees in Tropical Medicine. I was fortunate enough to complete a Diploma of Tropical Medicine, aka the DMT&H. This was a three month course offered in London, England which provided a strong background in the medicine of the tropics. I found it an extremely interesting and valuable course that gave me the fundamental knowledge base that allowed me to work in new settings. Many similar courses exist, a few of which are listed below.
Time/Flexibility in humanitarian work
Perhaps the most challenging and often most misunderstood component of working in the international humanitarian space is the time commitment involved. For a first mission with MSF, the minimum time commitment is six months, sometimes longer, and it is similar with the ICRC. With more experience, occasionally shorter missions are available, but one must be prepared to commit to this time span. On top of this, those six months must be somewhat flexible. This means that it’s not only six months where one is free, but when the availability arises. This means that one might need to leave on short notice or have a flexible leaving date. When I went to South Sudan, I was given one week’s notice and had to arrange work plans, VISAs, and find a sublet for my home. As a result, one often finds two common age peaks in humanitarian workers. The first peak is between 25-35 years of age and the second, 55-65 years of age. Of course, there are workers of all ages and everyone is welcome to apply.
Working in the humanitarian space has been the most challenging and rewarding work of my career. Even if this doesn’t sound feasible at this stage of your life, don’t fret. There are many ways to get involved in global health that don’t involve working in the humanitarian space. And people often get involved at different stages of their lives and careers.
I hope this quick primer helps to give you a more realistic perspective on how best to personally prepare for humanitarian field work. If you have more questions, please feel free to reach out to me personally. firstname.lastname@example.org
Some International NGOs
MSF/Doctors Without Borders: www.msf.ca
International Committee of the Red Cross: www.icrc.org
International Rescue Committee: help.rescue.org
Care international: www.care-international.org
Mercy Ships: www.mercyships.org
Partners in Health: www.pihcanada.org
Selected tropical medicine courses
DTMH (Diploma in Tropical Medicine)
Gorgas Course – Lima, Peru – 9 weeks: https://www.uab.edu/medicine/gorgas/diploma-course-menu
Liverpool School of Tropical Medicine – Liverpool, England – 3 months: https://www.lstmed.ac.uk/dtmh
London School of Tropical Medicine – London, England – 3 months: https://www.lshtm.ac.uk/study/courses/short-courses/DTMH
CTropMed (Certificate of Knowledge in Tropical Medicine and Travellers’ Health)
Navpreet Sahsi MD, DTMH. Navpreet has extensive experience working in some of the world’s most challenging contexts with the world’s largest humanitarian organizations. He has worked with MSF/Doctors Without Borders in Ad Dhale, Yemen, in an active conflict zone, and in Bentiu, South Sudan in an UNHCR IDP camp. He has also worked with the International Committee of the Red Cross in Cox’s Bazar, Bangladesh. Other projects have taken him to Addis Ababa, Ethiopia; Kathmandu, Nepal; and Moshi, Tanzania. Navpreet holds a Diploma of Tropical Medicine from the London School of Tropical Medicine and Hygiene and is a member of Global Health Emergency Medicine (GHEM) at the University of Toronto. His work has been featured on the NPR podcast Embedded and he has spoken publicly for MSF’s Forced From Home US tour. He has travelled to over 60 countries and counting.