'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. Often 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 useful for such a role. One missionary medic put it: 'The key personal needs are the core skills of good clinical examination and judgement and basic practical skills with lots of prayerful enthusiasm'.
• Posts usually need to be financed by the applicant. Some hospitals may be prepared to take less experienced doctors for shorter periods in a supervised role – a possibility for a year away after foundation programme, or as Out of Programme Experience (OOPE) during specialty training (see 3.3)

'Specialist' in a tertiary referral hospital or medical school

• This could be a government or Christian institution (eg 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 may be required.
• Relationships established may bear fruit after your return to the UK, either through the development of Health Links (see above – THET) or through on-going mentoring and support of the colleagues with whom you worked abroad.

Community Health and Development work

• Often related to national or regional programmes in villages or city slums.
• May be administered by a government agency, a non-governmental organisation (NGO), faith-based organisation (FBO).
• Field work may entail a lot of travelling.
• The need is usually for doctors with 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.

Disaster relief

Doctors in all specialties, of at least registrar grade and preferably with some experience of working abroad are needed, sometimes at short notice, to serve in war or disaster zones and refugee communities. Medair, Tear Fund, British Red Cross, Merlin, RedR, Oxfam and Medecins sans Frontieres each keep a register of such doctors (seeAppendix 6 for contact addresses).

HIV/AIDS and palliative care

With an estimated 33 million people living with HIV and 90% of them living in resource poor countries, there is a need for healthcare professionals experienced in every aspect of HIV care and in palliative care. Those who can co-ordinate health educationprogrammes and and oversee home-care teams of nurses and volunteers are vital. Palliative care is lacking in many LDCs and there is a desperate need for trainers and those who can initiate and support new developments.

Useful resources are;
Mildmay International www.mildmay.org/default.aspx
African Palliative Care Association (APCA) www.apca.org.ug/

Locum support

Locums for doctors working abroad long-term 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.

CMF advertises these needs at www.cmf.org.uk/international/jobs.asp

Mercy Ships, surgical camps, mobile clinics

Bring healthcare to remote areas where there are limited opportunities for the local people to reach a health centre. Your input can save and change lives. You can find agency details at www.cmf.org.uk/international/hsp.asp

And don't forget…

• 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 church activities or church planting. It may be possible to begin a Bible study group; start a work amongst students; 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 may only be there for a short while but your input may 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 and serve rather than to move to places where life is more comfortable.

• 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 the 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.