*Co esponding au ho : Balichand Pemashwa .
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion Liscense 4.0.
S eng hening Sho -Te m Medical Mission: Insigh s om Ca ibbean Expe ience
Balichand Pe mashwa 1, 2, 3, *, Gyanp akash Ke wa oo 4, Veda alli Go indan 5, Danika Ng 5 and Julie Edels ein 5
1 Adjunc Assis an P o esso , Depa men o Family Medicine, Campbell School o Os eopa hic Medicine, Lilling on, No h
Ca olina, USA.
2 Hospi alis Medicine, Cape Fea Valley Medical Cen e , Faye e ille, No h Ca olina, USA.
3 Hospi alis Medicine, Fi s Heal h o he Ca olinas, Pinehu s , No h Ca olina, USA.
4 Associa e P o esso o Medicine, Yale New Ha en Heal h, New Ha en, Connec icu , USA.
5 Medical S uden , Campbell School o Os eopa hic Medicine, Lilling on, No h Ca olina, USA.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 23(03), 421-425
Publica ion his o y: Recei ed on 15 Augus 2025; e ised on 20 Sep embe 2025; accep ed on 23 Sep embe 2025
A icle DOI: h ps://doi.o g/10.30574/wjbphs.2025.23.3.0861
Abs ac
Sho - e m medical missions [STMM] emain popula among p o ide s, despi e conce ns abou he limi ed ime spen
ea ing pa ien s and he high cos associa ed wi h hese missions. Many physicians emain mo i a ed o olun ee ,
d i en by he ul illmen o se ing communi ies wi h limi ed access o heal hca e. Pa icipa ing in STMM is o en a
ans o ma i e expe ience o olun ee s, who equen ly epo heigh ened empa hy and a enewed passion o hei
p o ession. STMMs a e gene ally no well-in eg a ed in o he local heal h sec o , las ing om a ew days o a ew weeks.
and encompass a wide ange o se ices, depending on he olun ee s' esou ces, including humani a ian aid, p ima y
ca e ou each, and educa ional p og ams. When hough ully planned, such ini ia i es a e welcomed by hos p o ide s,
os e collegial and communi y pa ne ships, and se e as ga eways o las ing iendships and long- e m collabo a ions.
Fo hese e o s o esul in success ul and sus ainable pa ne ships, i is essen ial o cen e he p io i ies o hos
coun ies. One p oposed s a egy is o hos coun ies o implemen a egis a ion sys em o ack and align incoming
o eign medical eams wi h ongoing heal hca e ini ia i es.
Keywo ds: Sho -Te m Medical Missions; Con inuing Medical Educa ion; Collabo a ion; Cul u al Sensi i i y; Heal h
Ca e; Capaci y Building
1. In oduc ion
Fo many heal hca e p o essionals om low- and middle-income coun ies (LMICs) who ha e buil ca ee s in highe -
income na ions, gi ing back o hei home communi ies is mo e han a p o essional endea o —i is a hea el
commi men . STMM ips o e a ga eway o olun ee ing, connec ing wi h colleagues in de eloping coun ies. The
dilemma many olun ee s ace is how o con inue helping when hei nex isi may be a yea away. Many olun ee s
a e mo i a ed by s ong cul u al and amilial ies o a pa icula egion. They a e encou aged o assis a e di ec
obse ing gaps in heal hca e and discussion wi h local colleagues, who ha e iden i ied a eas whe e olun ee s possess
he necessa y skills and capabili ies o make a meaning ul con ibu ion. STMM emains a popula op ion among US
p o ide s, wi h mo e han 16% o US doc o s pa icipa ing in medical missions annually. Be ween 2004 and 2012,
app oxima ely 800,000 o 1,100,000 US indi iduals olun ee ed in e na ionally, including on mission ips d i en by a
desi e o assis unde se ed popula ions [1]. A signi ican amoun o ime and esou ces ha e been spen on STMM,
wi h he US leading he e o , equi alen o 5,800 physician ull- ime equi alen s, and an es ima ed $3.7 billion in
esou ces is in es ed annually [2]. Mo e s uc u ed guidelines ha e become a ailable o aid in planning o an e ec i e
mission [3]. In a 2012 e iew o medical mission publica ions spanning 25 yea s, Ma iniuk e al. ound ha heal hca e
p o essionals o en econnec ed wi h he co e mo i a ions ha led hem o pu sue a ca ee in medicine, iewed he
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 23(03), 421-425
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ans e o skills and knowledge o local coun e pa s as a undamen al aspec o hei ole, and we e gene ally
welcomed by communi ies ha exp essed hope and an icipa ion o u u e isi s [4]. Medical missions a e deeply
sa is ying and ewa ding o he p o ide s and olun ee s [5]. Volun ee p esence can lead o he es ablishmen o a
p o essional connec ion wi h he hos coun y, he eby cul i a ing meaning ul ela ionships, es ablishing ne wo ks, and
c ea ing educa ional oppo uni ies ha ex end beyond sho - e m elie . They a e also c i icized o se e al easons,
including he limi ed ime alloca ed o ca e and he lack o ollow-up and moni o ing o ensu e long- e m posi i e
ou comes. A lack o unde s anding and espec o local cus oms, language, medica ions, and belie s can lead o
misunde s andings and po en ially ha m ul p ac ices, as hese a e o en un egula ed and poo ly in eg a ed in o he
egional heal hca e sys em [6].
Success ul missions comp ise mul iple essen ial componen s. I is c ucial o a oid a i ing wi h p econcei ed
assump ions abou he necessi y o ex e nal expe ise; ins ead, olun ee s should emain open o local solu ions and
o e suppo whe e i is genuinely needed. Key concep s o inco po a e include:
• Mu uali y— ecognizing, espec ing, and in eg a ing local p o ide s and hei expe ise in o he eam o
op imize pa ien ou comes; and
• Con inui y—ensu ing ollow-up ca e o pa ien s and main aining sus ained ela ionships wi h local
p o ide s, olun ee s, and hos o ganiza ions o allow o ongoing collabo a ion and eedback.
2. Ma e ial and Me hod
The i s wo au ho s, B.P. and A.K., ha e pa icipa ed in nume ous medical mission ips o he Ca ibbean due o cul u al
and amily connec ions. We e lec on some o ou expe iences o communi y engagemen , hanks o he es ablished
ela ionships, and o e ecommenda ions o planning a mission ip. The o e a ching goal o hese e o s is o suppo
local p o ide s by add essing esou ce limi a ions h ough educa ional ini ia i es, in e -o ganiza ional collabo a ion,
he p o ision o specialized equipmen , and he ans e o clinical skills - ul ima ely con ibu ing o he s eng hening
o he local heal h sys em wi hou c ea ing a s a e o dependency.
Au ho A.K. is dedica ed o ad ancing gas oen e ology educa ion and cance p e en ion, pa icula ly on colon cance
awa eness in he Ca ibbean. The incidence o colon cance is ising wo ldwide in he younge popula ion, including he
Ca ibbean egion [7 ]. Howe e , he Ca ibbean egion lacks he same le el o heal h esou ces and ained specialis s o
ackle his p oblem. By conduc ing a se ies o medical missions and collabo a ing wi h local p o ide s in Jamaica, he
sha es knowledge eely and p o ide essen ial endoscopic equipmen and each echnical skills o pe o m endoscopic
p ocedu es - add essing a na ional heal h conce n while os e ing capaci y building.
Du ing he COVID-19 pandemic, Ca ibbean coun ies aced a c i ical educa ion gap due o he dis up ion o in-pe son
educa ional ac i i ies due o qua an ine es ic ions. In esponse, he p ima y au ho , BP, in collabo a ion wi h US and
Ca ibbean o ganiza ions, c ea ed he In e nal Medicine Lea ning Collabo a i e Lec u e Se ies (IMLC), a ee online
lec u e se ies o p o ide educa ional suppo o Ca ibbean physicians du ing his unp eceden ed ime [8]. No ably,
80.84% o local physicians gained new medical knowledge ha led o p ac ice changes.
In 2023, he Guyana Ch onicle highligh ed he ala mingly high p e alence o hype ension in Guyana, a ec ing 24.5%
o men and 21.5% o women [9]. This widesp ead issue con ibu es o nume ous heal h complica ions, including
ca dio ascula diseases, s okes, and ea ly enal ailu e. A collabo a ion wi h he local Ro a y Club led o a ee
educa ional campaign aimed a add essing his na ional heal h conce n. Educa ion ma e ials in he o m o an elec onic
pos e we e dis ibu ed ee o cos , le e aging he widesp ead a ailabili y o Wha sApp, o empowe indi iduals wi h
he knowledge o manage and mi iga e hype ension e ec i ely.
2.1. Medical S uden Pe spec i e
Medical missions a e now in eg a ed in o many medical school o a ions, enabling s uden s o gain o e seas expe ience
in cul u al awa eness and wo king in unde se ed a eas, as well as exposu e o global heal h [4]. Co-au ho DN, a
second-yea medical s uden a Campbell School o Os eopa hic Medicine (CUSOM), Lilling on, No h Ca olina, who
pa icipa ed in he i s o e seas medical mission in 2023, joined he school’s annual ip o he Dominican Republic.
He mo i a ion o engaging in a medical mission s emmed om a desi e o p o ide ee medical ca e and explo e
medicine in a di e en cul u al con ex . The expe ience p o ed o be an in aluable lesson in wo king wi hin a esou ce-
limi ed se ing. Howe e , se e al challenges eme ged du ing he mission. Limi ed esou ces became a p essing conce n
as he supplies b ough along quickly deple ed. Ano he signi ican issue was he language ba ie . Despi e being in a
Spanish-speaking coun y, he popula ion se ed p ima ily spoke Hai ian C eole. Communica ion elied on un ained
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 23(03), 421-425
423
in e p e e s, esul ing in a complex ansla ion be ween English, Spanish, and Hai ian C eole. This aised conce ns abou
miscommunica ion, pa ien con iden iali y, and p i acy iola ions. Las ly, he sho du a ion o he mission made ollow-
up ca e nea ly impossible, lea ing a gap in con inui y o ca e.
3. Resul s and Discussion
While hese expe iences can be ewa ding, olun ee ing o p o ide heal h ca e o he unde se ed comes wi h se ious
esponsibili y. The e a e many c i icisms o sho - e m medical missions, and I ecommend ha olun ee s ead and
educa e hemsel es, ecognizing hei s eng hs and limi a ions is essen ial.
A book ha I ha e ound e y help ul is “Hoping o Help- The p omise and pi alls o global heal h olun ee ing” by
Judi h Laske [14]. The Au ho examined he h ee p incipal playe s in STMM — he Volun ee s, Pa ien s, and Hos
coun ies — and analyzed mul iple ac o s, including mo i es, bene i s, impac , and cos s.
The pi alls ha he medical s uden s encoun e a e no unique and a e equen ly obse ed when p ope planning and
inpu om he hos coun y a e lacking. Volun ee s o en ace cul u al and linguis ic ba ie s, limi ed ime wi h pa ien s
wi hou ollow-up ca e, sho e m medica ion dispensing, which can po en ially ha m pa ien s. Local p o ide s
welcome collabo a ion wi h o eign colleagues, as hey can o e immedia e assis ance, ans e knowledge, skills, and
equipmen . Howe e , hey ecommend ha mo e educa ion and capaci y building a e needed, ocusing on cul u ally
ele an and educa ional p ojec s ha bene i he hos coun ies [15,16]. Medical missions should complemen and
collabo a e wi h local heal hca e sys ems, a he han eplace hem, by ocusing on p e en ion h ough he in eg a ion
o hei skills in o exis ing na ional p ojec s. This app oach should be sensi i e o language and cul u al ba ie s, as well
as awa e o local heal h egula ions [17].
O ganizing medical missions in ol es signi ican ime, esou ces, and expenses. A eam o app oxima ely 20 olun ee s,
in ou conse a i e es ima e, can incu cos s exceeding USD 30,000, including ai a e, accommoda ion, ood,
anspo a ion, supplies, and dona ions when a elling o he Dominican Republic om he Uni ed S a es.
App oxima ely 60% o he budge is alloca ed owa ds ai a e and ho el expenses, which do no bene i he hos coun y.
Helping does no always equi e in-pe son ac i i y, ollowing he ini ial isi and needs assessmen , ongoing inancial
and ma e ial suppo can be p o ided o es ablished heal h p ojec s, making he e o mo e cos -e ec i e and
sus ainable. Howe e , in-pe son collabo a ion wi h hos coun y p o ide s o e s addi ional bene i s, including a
pe sonal en iching expe ience o local cul u e and heal h p ac ices, os e ing collegial ela ionships, iden i ying gaps in
heal hca e whe e we can assis , heigh ening empa hy, and a enewed passion o medical wo k [18,19]. The desi e o
many olun ee s o connec pe sonally and con ibu e di ec ly o hose in need is a d i ing o ce behind hei decision
o olun ee hei skills, ime, and inances, based on ou expe ience.
A signi ican limi a ion o STMM is ha hey a e conduc ed du ing he olun ee aca ion ime, which may no align wi h
he schedule o he pa ien and hos coun ies. STMMs a e expensi e and ime-consuming o o ganize p ope ly. Based
on ou expe ience, we o e ecommenda ions o planning an e icien medical mission ip, summa ized using he
ac onym H.E.L.P.
3.1. Humili y
Be humble and know you limi a ions. I you can' do i a home, you should no do i o e seas.
Main ain he same s anda ds o p o essionalism du ing o e seas medical missions as you would in you daily p ac ice
[3]. Sho - e m missions, as he name implies, a e b ie isi s, ypically las ing one o a ew weeks. I akes ime o
unde s and he local heal hca e sec o , i s limi a ions, and he app oaches ha a e e ec i e in he egional con ex .
Fo eign olun ee s a e o use his ini ial isi o iden i y gaps in educa ion and heal hca e, and lea n how hey can assis ,
inco po a ing local cul u e and knowledge in o hei e o s.
3.2. Educa e
Educa ional p ojec s a e widely welcomed and a e one o he mos e ec i e ways o make a las ing commi men ha
con inues beyond he li e o he mission [8,11]. They a e inexpensi e o ini ia e and can be easily main ained using eely
a ailable ideo echnology o maximize e ec i eness. C ea e educa ional lye s ha inco po a e local language and
cul u e, his ma e ial can be easily sha ed on social media, eaching a la ge segmen o he popula ion.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 23(03), 421-425
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3.3. Leade ship
O ganizing a o eign medical mission equi es ca e ul planning, including ec ui ing olun ee s, secu ing necessa y
esou ces and inancial suppo , ob aining pe missions, and pa ne ing wi h a eliable hos o ganiza ion and local
collabo a o s. Assign eam leads and es ablish clea agenda o add ess any issues ha may a ise du ing he mission.
Clea ly sha ing you mission’s goals wi h he hos o ganiza ion os e s collabo a ion as well as open discussion o
po en ial con lic s.
No all assis ance is bene icial—ca e ully assess olun ee skills o ensu e hey a e con ex ually app op ia e. A
signi ican po ion o he eam o en consis s o nonmedical pe sonnel who should no be p o iding medical ca e.
3.4. Planning
Success ul o e seas medical missions equi e a s ong hos pa ne , which is some imes he mos complex piece o he
planning puzzle. A eliable local hos p o ides in o ma ion on heal hca e gaps, conduc s a needs assessmen ,
ecommends o ganiza ions and p o ide s o collabo a e wi h, and o e s a ange o logis ical suppo , including secu ing
anspo a ion, ob aining a pe mission le e , and guidance on accessing cos -e ec i e local medica ions. Collabo a ion
wi h he local medical socie ies and ci ic o ganiza ions, such as he Lions and Ro a y Clubs, is in aluable [12]. These
o ganiza ions ha e membe s who a e o en p o essionals, o e ing an oppo uni y o ne wo k. They a e o en awa e o
educa ion and disease gaps needing o be add essed, aligning wi h na ional heal h s a egies and p o iding
oppo uni ies o suppo and in eg a ion.
I is essen ial o ob ain pe mission om he local Heal h Depa men o conduc he mission and include local p o ide s
in he ea men eam as hey a e amilia wi h locally a ailable medica ions, which a e o en mo e a o dable and be e
unde s ood by bo h p o ide s and pa ien s. In ol ing local p o ide s helps add ess he lack o ollow-up ca e, a
equen c i icism o sho - e m medical missions. Feedback om local p o ide s plays a pi o al ole in planning ollow-
up missions; hei engagemen o en leads o imp o ed heal h ou comes and inc eased medica ion adhe ence [13].
4. Conclusion
Hos communi ies welcome o e seas mission ips as hey se e as ga eways o las ing iendships, communi y
engagemen , and assis ing wi h heal hca e gaps, whe e meaning ul con ibu ions can be made. Al hough medical
missions equi e signi ican inancial and logis ical in es men s, hey con inue o a ac physicians who ind pe sonal
ul illmen in his wo k. Fo a success ul and sus ained ela ionship, i is essen ial o os e mu uali y by inco po a ing
he p io i ies o hos coun ies and implemen ing p ojec s ha a e cul u ally and linguis ically app op ia e. Con inui y
o ca e emains a c i ical a ea ha equi es imp o emen , wi h collabo a ion be ween o eign medical eams and local
p o ide s p esen ing a iable solu ion.
Fo eign medical eams should ob ain pe mission, adhe e o local egula ions, help based on iden i ied needs o
maximize bene i s, and a oid os e ing dependency. One p oposed s a egy is o hos coun ies o implemen a
egis a ion sys em o ack and align incoming o eign medical eams wi h ongoing heal hca e ini ia i es. Such a sys em
would enhance coo dina ion, ensu e ha isi ing eams con ibu e meaning ully o exis ing e o s, acili a e objec i e
assessmen o hei impac , and p omo e sus ainable heal h ou comes.
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
No con lic o in e es o be disclosed.
Re e ences
[1] T acey P, Raja a nam E, Va ughese J, e al. Guidelines o Sho -Te m Medical Missions: Pe spec i es om Hos
Coun ies. Global Heal h. 2022;18(1):19. doi:10.1186/s12992-022-00815-7
[2] Cald on PH, Impens A, Pa lo a M, G oo W. Economic assessmen o US physician pa icipa ion in sho - e m
medical missions. Glob Heal h. 2016;12(1):45. doi:10.1186/s12992-016-0183-7
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 23(03), 421-425
425
[3] S anda ds o Medical Mission Pa ne ships and P ac ices (Sending and Hos O ganiza ions). Published online
Oc obe 2019. h ps://www.pqmd.o g/wp-con en /uploads/2021/SMMPP/#/
[4] Ma iniuk ALC, Manoucheh ian M, Negin JA, Zwi AB. B ain Gains: a li e a u e e iew o medical missions o low
and middle-income coun ies. BMC Heal h Se Res. 2012;12:134. doi:10.1186/1472-6963-12-134
[5] Cough an AJ, Me ell SB, Pineda C, Scea s LA, Yang GP, Mo is AM. Local and Visi ing Physician Pe spec i es on
Sho -Te m Su gical Missions in Gua emala: A Quali a i e S udy. Ann Su g. 2021;273(3):606-612.
doi:10.1097/SLA.0000000000003292
[6] T an Y, Ja e J, Ga dne S, Fe nando J, Milli on M, Hong L. Long-Te m Impac o In e p o essional Medical
Mission Se ice T ips in Sie a Leone. F on Med (Lausanne). 2021;8:742406. doi:10.3389/ med 2021.742406
[7] Plumme JM, Leake PA, Fe on-Boo he D, e al. Colo ec al cance su i al in Jamaica. Ann Med Su g (Lond).
2016;6:26-29.
[8] Pe mashwa B, Mang u J, Yu E, Spence KM, Goble K, Singhal M. An In e nal Medicine Lea ning Collabo a i e
Facili a ing a Vi ual Con inuing Medical Educa ion P og am in Guyana and he Wide Ca ibbean Du ing he
COVID-19 Pandemic. Cu eus. 2024;16(3):e56972. doi:10.7759/cu eus 56972
[9] Guyana is among se e al Ca ibbean coun ies wi h wo ying hype ension a es. Guyana Ch onicle. Published
May 13, 2023. Accessed June 23, 2025. h ps://guyanach onicle.com/2023/05/13/guyana-among-se e al-
ca ibbean-coun ies-wi h-wo ying-hype ension- a es/
[10] Ame ican Hea Associa ion. High blood p essu e. Published 2025. Accessed June 23, 2025.
h ps://www.hea .o g/en/heal h- opics/high-blood-p essu e
[11] Wa son SM, Fe illo H. E ec i eness o Sho - e m Medical Missions on Ch onic Disease in Unde se ed
Communi ies. Wes J Nu s Res. 2021;43(4):323-329. doi:10.1177/0193945920944809
[12] Fak o KL, Payán DD, Rami ez AJ, May FP. Impac and Sus ainabili y o Fo eign Medical Aid: A Quali a i e S udy
wi h Hondu an Heal hca e P o ide s. Ann Glob Heal h. 2023;89(1):17. doi:10.5334/aogh 3995
[13] Bae C, Naik N, Misak M, e al. Assessmen o Local Heal h Wo ke A i udes owa d In e na ional Medical
Volun ee s in Low- and Middle-income Coun ies: A Global Su ey. J Epidemiol Glob Heal h. 2020;10(3):230-235.
doi:10.2991/jegh.k.200605.001
[14] Laske JN. Hoping o Help: The P omises and Pi alls o Global Heal h Volun ee ing. 1s ed. Co nell Uni e si y
P ess, 2016. h p://www.js o .o g/s able/10.7591/j.c 20d88hs
[15] Man ey EE, Doh D, Laske JN, e al. Ghanaian iews o sho - e m medical missions: The p os, he cons, and he
possibili ies o imp o emen . Global Heal h. 2021;17(1):115. doi:10.1186/s12992-021-00741-0
[16] Con empla ion in Ac ion: Lessons om Medical Mission Wo k. Geo ge own Uni e si y School o Nu sing.
Published Ma ch 6, 2019. Accessed June 23, 2025. h ps://online.nu sing.geo ge own.edu/blog/humani a ian-
nu sing/
[17] Bes P ac ices o Medical Missions. MedicalMissions.com. Published June 24, 2024. Accessed June 23, 2025.
h ps://www.medicalmissions.com/ esou ces/78580/medical-missions-bes -p ac ices
[18] A e Medical Mission T ips Wo h I ? Medical Aid. Published Decembe 12, 2022. Accessed June 23, 2025.
h ps://medicalaid.o g/a e-medical-mission- ips-wo h-i /
[19] Jansen M. 5 P os and 5 Cons o Medical Mission T ips: One P e-Med’s View. A lan is. Published Oc obe 13, 2021.
Accessed June 23, 2025. h ps://joina lan is.com/blog/p os-and-cons-o -medical-mission- ips/
