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2.2 What sort of scenarios might I consider?
'Generalist' in a smaller rural Hospital
Busy hospitals (often the old Mission Hospital), with up to 250 beds, now run by Government, Christian Agencies or the local church or a mixture of all three. Usually staffed and managed by nationals. A broad range of experience in General Medicine, A&E, Paediatrics, O&G, General Surgery and Community Health (such as is gained in training for General Practice) is needed to fill such a role. As one missionary medic put it 'The key personal needs are the core skills of good clinical examination and judgement and basic practical surgical skills with lots of prayerful enthusiasm'. Posts usually need to be financed by the applicant. Some hospitals may be prepared to take more 'junior' doctors for shorter periods in a supervised role – a possibility for a gap year before starting as an ST?

See www.healthserve.org/pages/pages.asp?page=subsection&id=4 for links to such hospitals

'Specialist' in a Tertiary Referral, University Hospital or Medical School
This could be a Government or Christian post (e.g. Ludhiana or Vellore in India and KCMC in Tanzania). Their need is usually for accredited specialists or senior trainees who are able to teach students and residents while providing some service provision. A postgraduate specialist qualification (eg MRCS, MRCP, MRCOG) and some years of experience at registrar level will be essential. In teaching hospitals a sub-specialty skill maybe required. Relationships established may well bear fruit through longer term bilateral commitments after your return to the UK. Such institutions may be accredited by Royal Colleges in the UK for specialist training – see article below

See careerfocus.bmj.com/cgi/content/full/330/7485/46

Community Health and Development Work
Such work will inevitably be related to major national or regional programmes in villages or city slums, administered by an NGO, FBO or Government agency. Field work may entail a lot of travelling. The need is usually for doctors with postgraduate training in Public Health along with experience directly related to the needs of resource poor countries. Community Health Global Network is a useful resource for this area of work.

See www.communityhealthglobal.net/

Virtually all work in resource poor countries will entail involvement in community health projects and, if your training is deficient in this area, you are well advised to do something about it before you go.

Disaster Relief
Doctors in all specialities, of at least registrar grade, and preferably with some experience of working abroad, are often needed, at short notice, to serve in refugee communities, drought-stricken areas, war or disaster zones. Tear Fund, British Red Cross, Merlin, Oxfam, or Medecins sans Frontieres each keep a register of such doctors. (see Appendix 6 for contact addresses)

Refugee Camps, Rehabilitation Centres and Prisons
All need healthcare workers with a variety of professional skills

HIV/AIDS and Palliative Care
With an estimated 40 million HIV cases and 90% of them living in resource poor countries, there is a need for healthcare professionals experienced in every aspect of HIV/AIDS and in palliative care. Those who can co-ordinate and oversee health education and home-care teams of trained nurses and paramedics. Palliative care is lacking in many LDCs and there is a desperate need for trainers and those who can oversee such developments.

Mildmay International is a useful resource - www.mildmay.org.uk/IntServiceDevelopment.html

Locum support
Locums are always needed. Those who are flexible and willing to cover all eventualities are worth their weight in gold. The time needed may vary from a few weeks to several months.

See www.healthserve.org/overseas_opportunites/ for such needs and register for email alerts.

Mercy Ships, Surgical Camps, Mobile clinics
Bring healthcare to remote areas where there are limited facilities or opportunities for the local people to reach a health centre. Your input can save and change lives.

You can find agency details at http://www.healthserve.org/pages/

And don't forget

a) It's not just the medicine that matters
There will be innumerable opportunities to encourage local Christians (healthcare professionals and others) and to get involved in local church activities or church planting. It may be possible to catalyse the launch of a Bible study group; start a work amongst student; help set up a new CMF group or revitalise a flagging one. It is hard to overestimate the value of sharing your wisdom and Christian experience with local colleagues. It is also important to go with a humble and teachable spirit being willing to learn and grow together in your spiritual lives (Romans 1:11,12). You are only there for a short while but your input will bear much fruit in the longer term - especially if you are able to develop an ongoing relationship that will be a means of encouragement and spiritual motivation for them to stay put and serve rather than move on to a place where life is more comfortable.

b) It's a mistake to think that cross-cultural mission is confined to working abroad
Massive migration in recent decades has led to large ethnic minority groups in many Western cities. Whether it's West Africans in Paris, Guatemalans in New York or Bengalis in London, the health needs relative to those of indigenous populations are huge. Such immigrants, who may originally have been refugees, are often disadvantaged in terms of language, culture and their access to healthcare. Healthcare professionals who have worked in their home country, and who know something of their language and culture, can be a tremendous asset.


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Acknowledgements My thanks to Chris Lavy, Eldryd Parry, Ian Spillman and Nick Wooding, all of whom have worked overseas and have a continuing involvement, for their helpful comments and advice. First edition 1994 - Entitled ‘A Medical Missions Handbook’ by Peter Saunders. Second Edition 1998 (updated April 2000) Third Edition September 2003 - by Peter Armon Fourth Edition 2007 – renamed ‘Working Abroad’ - totally revised & rewritten by Peter Armon All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the CMF. Christian Medical Fellowship 6 Marshalsea Road London SE1 1HL Tel. 020 7234 9660 Fax 020 7234 9661 Websites:www.cmf.org.uk and www.healthserve.org Christian Medical Fellowship is a registered charity No. 1039823 DISCLAIMER While seeking to be accurate in all the details contained in this document, CMF cannot be held responsible for the information contained in this booklet. The reader should double check the information for him/herself