August 6, 2014 held a shocking surprise for all involved in working with medical students in countries other than their own, on elective rotations or volunteer assignments: 2 such students from Newcastle University, England, were stabbed to death in Kuchin, Malaysia in the early morning hours after an argument with local people in a tea house. http://www.bbc.com/news/uk-28678420
What makes this even more tragic is that the young gentlemen were at the end of a 6 week rotation, ready to go home with all their newly acquired knowledge, both professional and cultural.
We, at Medicorps extend our heartfelt condolences to the families and friends of both young men, as well as to Newcastle University. We have hosted a number of medical and dental students from that fine institution in Cambodia, fortunately without any adverse events. Not knowing particular details of the incident we cannot lay blame on anyone other than the brutal perpetrators.
Does this mean that we should stop now sending young health-care providers to developing countries? Wouldn't that be the way to avoid any harm to such promising young students?
From our viewpoint we have to answer with an emphatic NO! Medical students as well as residents and young doctors need to be exposed to health-care in poorer countries, learn about other cultures and strengthen their competence to function in, at times, alien environments. The accomplishment of having succeeded in non-familiar locations will be a milestone in a doctors development for all times to come, let alone the professional enrichment and emotional growth with enhanced empathy and compassion.
We need to have care givers who understand the mechanics of disease and suffering in the less privileged parts of this world. We need doctors who can function without the benefit of high technology. We need medical personnel who can diagnose tropical diseases in returning travelers before it is too late. Volunteering overseas is not a one way road to help destitute populations, more than anything is means learning and growing.
So, how do we prevent such senseless loss of life, or any injury or calamity to medical students such as Neil Dalton and Aidan Brunger? At Medicorps we have hosted visiting medical trainees for more than 30 years without any adverse events. In all honesty we must admit that there is no guaranty that calamities may never happen, such as is possible in their home town, but there are some ways to reduce the risk considerably:
- We send out pre-departure instructions geared for particular countries
- We give a verbal instruction and indoctrination on cultural sensitivities at the time of arrival
- We provide local guides and companions available 24/7
- We choose safe and convenient lodging for our medical volunteers
- We give specific warnings about the use of alcohol, about confrontations and nightlife in general.
It's impossible to restrict 22 year old students to the hospital or their place of assignment. They want to enjoy their stay in often beautiful and charming countries. They want to make new friends and see new sites. We want them to have fun, but we warn them about abuse of liberty, especially late at night and in unsavory locations.
What could these English students have done differently? I only can mention generalities not having been there. We always advise our students not to go out late at night in somewhat rough parts of town. We especially warn them to moderate their alcohol intake and stay away from arguments. It's always better to quietly walk out, be polite and let the other person be right. If there is any sense of incipient danger, call your coordinator or the authorities.
In conclusion we sincerely hope that this may be the last serious incident, but realistically we must say that accidents and violence can happen in any place at any time, at home or abroad. We will always strive to make our elective rotation program better and safer all the time. We want medial student and nurses to work with us in Cambodia or anywhere in the world where we have a program. We want them to become better doctors, dentists and just more compassionate and informed human beings. Neil and Aidan were very likely on the way to become such people, only to be cut down senselessly. Our heart goes out to them.
Gunther Hintz, M.D., Medicorps