Worldwide inequalities in the availability and quality of health care means that international demand for medical and health professionals is enormous.
When we think about international work in health and medicine, we often envision field workers delivering primary care in conflict or disaster zones. But emergency humanitarian aid is just one of many areas in which health and medical professionals can play an important role abroad.
Humanitarian aid and disaster relief falls within the much larger field of global public health. In its broadest terms, work in global health aims to address health issues that affect whole populations, transcend national boundaries and are most effectively tackled through coordinated international cooperation.
Worldwide inequalities in the quality and availability of healthcare mean that in many parts of the world, the need for medical and health professionals is enormous. It’s estimated that to address current global health needs, an additional four million health workers are required.
Who works in international health and medicine?
Health and medical work can be divided broadly into clinical and non-clinical roles. The clinical sphere involves direct patient care—think of a field nurse in the Democratic Republic of the Congo or a surgeon working in a private hospital in Qatar. But it can also involve training programs, capacity building or research.
In the non-clinical sphere, the focus of the work is on disease prevention and on education that aims to promote healthy behaviours. The work requires clinical professionals (physicians and nurses for example) but also non-clinicians with expertise in disciplines like biostatistics, behavioural and health science, epidemiology, health services administration and environmental health.
There are opportunities internationally in both the clinical and non-clinical spheres in a wide variety of roles, from work in the private sector, to global health initiatives and programs, to humanitarian aid missions.
Humanitarian Relief
Emergency humanitarian relief situations typically call for a range of both clinical and non-clinical professionals throughout the various stages of the crisis—from first response to longer-term support.
Early on in an emergency situation, highly skilled and very experienced practitioners are sought to assist overwhelmed local health and medical professionals. Surgeons, anaesthetists and medical professionals with experience in emergency medicine will be needed. Mental health professionals may be called upon as well. Disease outbreaks also require the expertise of public health professionals, who work to determine the source and extent of an outbreak, the effectiveness of interventions, and who may also support community education programs, monitoring and screening to prevent further spread of disease.
Médecins Sans Frontiéres' (MSF’s) “Who We Need” list illustrates the broad range of medical and other professionals required for humanitarian missions.
As a crisis is brought under control, the focus may shift from emergency medicine to rehabilitation and rebuilding the capacity of the local healthcare system. Allied health professionals like physiotherapists, occupational therapists and psychologists may be called upon.
Global Health
There is much ongoing work being done worldwide to address healthcare challenges and inequalities, predominantly in low- and middle-income countries. Overseas assignments can sometimes involve clinical care—acting as an extra pair of hands or filling in where there are staff shortages, or bringing specialist skills where they are lacking. But, in recent years, the trend is toward helping local healthcare systems strengthen their own capacity to manage health issues in their communities. It is more likely that healthcare professionals will be recruited for roles that involve teaching, knowledge transfer, advocacy, research, or as consultants and advisors.
There are a variety of organizations working in the area of global health that employ a broad range of both clinical and non-clinical professions. They include:
Non-governmental organizations (NGOs): NGOs can range from small, community-based organizations to large international organizations. Requirements vary widely—from frontline clinical roles in crisis environments with organizations like MSF or Merlin, to positions with organizations like Skillshare International or VSO, where work has more of a public health and international development focus.
Governments and multilateral organizations: Multilateral organizations like the World Bank or the World Health Organization (WHO) generally channel development and relief funds from donor nations to recipient nations' governments or to NGOs. Positions with these organizations are often high-level and are usually far removed from field work: allocating funds, managing contracts, monitoring etc. Competition for these positions is fierce and it's unlikely that working with any of these agencies will be your first, or even second job in global health.
Academic and research organizations: These organizations research and inform health policy and may engage in advocacy and educational activities. It’s not uncommon for academics and research institute staff to also work as consultants on global health projects.
Consultancies: Health and medical consultancies generally work project-to-project, for government agencies, multilateral organizations and sometimes NGOs. They prepare bids, assemble teams of experts to implement projects, manage budgets and report to their clients.
Foundations: A foundation makes grants to other organizations and institutions for charitable purposes. The Bill and Melinda Gates Foundation and the Aga Khan Foundation are two well-known examples involved with global health. Many foundations of this sort have work opportunities for professionals with expertise and experience in public health and administrative roles.
Locum Tenens positions: For qualified health professionals, there are also many opportunities to work in a hospital or clinic in another country, either as a long-term position or doing locum tenens placements. Finding work in this capacity largely involves contacting a reputable recruiting company or locum tenens agency to help you line up suitable placements.
What kind of skills and experience are required?
Gaining the requisite medical, allied health, or public health professional education and qualifications is just the beginning of a path toward an international career. There are many other skills and competencies you will have to develop in order to be truly effective in the field.
For example, to work on the medical side of a humanitarian aid mission, some agencies require a minimum of two years’ experience in your field as well as experience living and working in a different cultural and geographic setting.
Owen Campbell, a Human Resources Manager with MSF says, “prior experience in leadership positions, training, coaching and supervisory positions is important." He emphasizes that actual experience volunteering or working in low resource settings outside the Global North, or previous humanitarian work is highly valued. “We have a baseline requirement that all applicants need to have two to three months experience in a developing country."
Richard Zereik, who spent a decade in Operations with MSF says, “[relief] agencies are now recognizing the importance of soft skills when working overseas, either in the short- or long-term: how do you deal with stress? Are you a team player and how do you tolerate others? How do you deal with ambiguity?”
Beyond the often stressful, sometimes dangerous conditions of a humanitarian relief mission, there are many international opportunities in more stable environments. Dr. William Cherniak is a physician, and the Executive Director and Cofounder of Bridge to Health Medical and Dental, a Canadian humanitarian organization working in East Africa. When he works in Uganda, he says he does practice medicine but adds, "my main role is to organize the teams, organize logistics, and ensure the health camps are functioning."
Dr. Rohit Ramchandani, an adjunct assistant professor at University of Waterloo’s School of Public Health & Health Systems and the CEO of Antara Global Health Advisors, says much of his work involves connecting networks and teams of experts in order to solve public health challenges. Ramchandani says that research design skills, data collection, scientific and persuasive writing, public speaking and presentation skills are vital. “More and more, you'll need to be able to speak the language of multiple sectors,” he says.
Dr. Raywat Deonandan, an epidemiologist, global health researcher and Assistant Professor in the Faculty of Health Sciences at the University of Ottawa offers this advice: Take the time to learn about the world, through newspapers, books and cultural engagement. He recommends improving the basic skills sets of your profession, improving your communication and analysis skills, writing and publishing on topics relevant to international health wherever possible, and attending relevant conferences and events to meet people engaging in similar work.
Want to know what it's really like to work internationally in the healthcare and medical sectors? Visit Careers for Globetrotters and get the lowdown from professionals who are working internationally in a range of careers, from public health to paramedicine.