I'm an anaesthetist and volunteer for blindness prevention charity Orbis. We operate the Flying Eye Hospital, which is a teaching facility with both a lecture and operating theatre on board. Through my experiences, I have discovered that my approach to work within the UK is changing. The NHS is, after all, a teaching organisation and volunteering is very much a two way learning curve.
We all want to feel like we are doing something to help others; this is why many of us became doctors. It's easy within the NHS to become caught up in the administrative tasks & processes and become disconnected from delivering care to patients. In the environment of working as a volunteer, care is much more immediate, with more time dedicated to clinical work and time with the patient.
In the UK, we largely treat people with problems that are relatively minor in comparison to what we see when volunteering abroad. Moreover, in remote areas, even minor health complications can be life threatening. Being able to help someone so ill is immensely satisfying. You have changed their life.
The patients we treat are quite remarkable too. So stoical. They are patient and calm and grateful for the service in whatever form it takes, whether it's through Orbis or what is normally there. It's something you still see in the NHS from time to time. Usually from the elderly, who probably still appreciate the NHS for what it truly is.
It goes without saying that volunteering is challenging. But all clinicians like to be challenged and to remind themselves of their ability to work well within difficult environments, with less. It proves to us just what can be achieved with basic facilities. You are required to use your knowledge, judgement and skills relying on your well-honed instincts, because it's not feasible to request a complicated test.
Practising with major limitations requires us to find alternative solutions that are sensible and safe when operating. Equipment may be broken or poorly maintained, but we find a way. I have a great deal of respect for the people I work with abroad. Their dedication, initiative and ingenuity is immense, and it requires us to be the same.
I was once tasked with teaching an anaesthetist in Zambia, the sub-Tenon's technique. This is undertaken with a metal cannula, which in the UK costs pounds. I needed to find a more cost effective alternative. My colleague suggested that I try using the sheath of an intravenous cannula. These are cheap (a matter of pence) and easily obtained throughout the world so I adopted this technique and I now use it for all of my work in the UK too. It offers a clear cost-saving but, furthermore, I note it to be far less traumatic to the eye and more comfortable for the patient. This is no doubt just one of many processes doctors have developed though volunteering abroad.
I have found that volunteering brings with it a new sense of appreciation for the processes and working environment we have here in the UK. We are stringent in our approach to infection control and sterilisation. We operate under the WHO surgery checklist, which, at Orbis, we implement in every hospital we work in.
In most of the hospitals I have volunteered at, there is a very hierarchical approach. There are so few doctors; they are almost treated as gods, which is not to their benefit. At home we are all are encouraged to challenge situations to prevent a poor outcome. We recognise the benefit of bringing everyone together.
Volunteering is very hard work, but you return feeling refreshed by the experience. You scrutinise the way in which you work, looking for areas of inefficiency or waste. We should always ask the question, can we simplify? It's not always about the equipment and drugs you use but the way you do things. It's surprising how much you can learn from the way people do things elsewhere. Volunteering has been such an important experience for me. It's an important experience for the NHS too. We know it's not perfect, but the NHS is vital and we can all make a difference.