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8. When you arrive
Be -attitudes

• Go with a Christ-like servant attitude - humble and teachable
• Be flexible
• Be quick to listen and slow to speak
• Be patient
• Don't be judgemental and criticise.
• Take time to assess the situation and don't try and change things too quickly.

Remember that if change is needed then to be effective it will require others seeing the need, agreeing the solution and owning the work necessary to bring it to pass. Sometimes the change needed may be in yourself and especially your attitudes.

Short termers can be a great stimulus and joy to longer-term colleagues who may have very little spare time or energy. Accept leadership and advice from nationals who, although possibly significantly less qualified than you are, will have considerably more local knowledge and experience than you will ever achieve. Remember that you are part of a team.

Seize every opportunity

To continue your medical education. Initiate or attend clinical meetings even if this means undertaking difficult journeys to centres where you can meet other colleagues. Keep accurate personal records of interesting and unusual cases. Teach and train others - an essential part of your work. Look for opportunities to impart your knowledge and skills in an appropriate practical way so that you leave something lasting and sustainable behind you.

There may be a local medical journal which you can contribute to. Publish case reports, accurate descriptions of diseases and locally relevant management protocols that will be use to others. You are more likely to make an original contribution to the literature abroad than at home! Talking with specialists in the UK before leaving may be useful in producing ideas for research that you can carry out while abroad.

Keep records and a journal

Note down your initial impressions and take photos of your surroundings early in your stay before everything becomes too familiar. Record interesting medical cases on camera. They could become useful teaching aids in the future. However, always be sensitive to local culture and seek advice and permission before taking out your camera.

Written consent from patients for the taking and then use of medical photographs should be obtained. It is helpful to include the statement that the photo may be used for medical teaching purposes and this might involve including it on a CD or a website if this is a possibility. CMF are interested in appropriate contributions to include on future editions of the Developing Health CD.

See GMC guidelines at www.gmc-uk.org/guidance/current/library/making_audiovisual.asp

Beware of burnout

You are highly likely to be drawn into a variety of non-clinical roles. These may include strategic planning, interviewing potential workers, discipline (and discipling) of fellow workers, financial management, report writing, new building planning, pastoral care of colleagues and Bible teaching. Beware of taking on too much. There is such a thing as 'burnout'. You are not superhuman and you must learn to be able to say 'no'.

Go intending to develop friendships. It may be that more good could come from these relationships than specifically medical projects.


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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