When the ibuprofen runs out, what can a patient with terrible back pain do?
After a stroke leaves her partially paralyzed, how can a rural farmer still manage to go out to the fields every day and feed her family?
In resource-limited settings, physiotherapy or occupational therapy can take on a whole new meaning in patients getting better outcomes. An anti-inflammatory can help with back pain, and driving instead of walking can relieve the travel difficulty for a farmer in a more developed area, but in remote rural regions the knowledge and empowerment given by a physiotherapist or occupational therapist can change lives forever.
Helping a patient learn how to walk again, or teaching techniques for a family to communicate with a stroke victim who has lost speech, or helping regain flexibility after an injury, or teaching safe lifting techniques….knowledge is power, and knowledge that allows patients to take control of their own recovery can lead to amazing results. We have seen patients stand again after being trapped in a wheelchair for years, we have seen people crippled by pain walk without agony, and we have seen people who have lost the power of speech find a way to tell their family what they need.
From our point of view, physiotherapists and occupational therapists have a significant role to play in all of our work and we wish we had a lot more of them as volunteers!
It is an extraordinary clinical opportunity to encounter many conditions with clinical signs more advanced than would be common in more developed areas, as well as many unusual tropical conditions. Even more interesting is the extremely contextual approach to every ailment that must be considered—for example, our data shows that on average, our patients drink about 1.5-3 cups of water per day…in tropical heat. Dehydration is ubiquitous and affects many presenting conditions. However, a patient might die of dehydration because you advised them to drink more water but they drank impure water and got diarrheal disease. Here, you must look at the patient in the context of their entire environmental, mental, physical, social, economic, and cultural context when designing management approaches.
Here, physiotherapists’ and occupational therapists’ creativity and ingenuity are tested. They must design and implement effective interventions without the fancy equipment and facilities they may be used to, and do a lot of education to help our patients gain a better understanding of how they can continue to develop their own techniques to go on improving even long after the therapist has returned to their home country.
From mid January until mid-December, we typically run two weekly clinical schedules—there are weeks where on Monday we do new volunteer training and work in the government nursing home we support (called an ‘Asilo’) we support, and deploy for single-day clinics to two different remote communities on Tuesday and Wednesday. We revisit the nursing home, handle our clinical data and re-pack our mobile pharmacy on Thursdays, and on Friday a small team revisits both communities to do follow up while the rest of the team works on other projects. Depending on the community size, typical patient loads per clinic day run from about 40 to 130 patients.
The Asilo nursing home is of especial relevance to our therapy volunteers. The vast majority of patients there have either severe physical or mental handicaps (or both), and it is here that therapists can often offer far more lasting help than our doctors.
During our second type of weekly schedule, we do new volunteer training and nursing home work on Monday, and deploy on ‘multiday’ clinics Tuesday-Friday to particularly remote villages, bringing hammocks and mosquito nets to live in the target community during the multiday. These clinics offer the unique opportunity to be a welcome guest in a Ngabe village and get to know your patients outside of clinic.
During clinical days, bilingual physiotherapists or occupational Therapists may also scribe for providers or translate in clinic, assist providers in consults, ultrasounds, house calls or procedures, or may staff the pharmacy station, administration station, or clinic intake stations to check vitals, take basic histories and conduct health screening for anemia, diabetes or other conditions. Normally any patient with chronic pain, a speech or hearing deficit, a movement disorder or other handicap, or any issue with activities of daily living will be referred for a physiotherapy or occupational therapy consult. To help ensure that the advice you give is practical, Floating Doctors staff will offer explanations and context for everything we encounter. Therapists may also engage the children in the village school and help teach stretching, safe lifting, or other preventative methods to preserve mobility and physical health. Participants will gain invaluable experience as well as learning the contextual approach to solutions that are practical to the surrounding resource limitations.
During clinical deployments, therapists often conduct their activities in patients’ homes, giving a unique opportunity to be a welcome guest in many indigenous homes and spending a lot of time interacting with whole families. You may make assessments and craft care plans that involve four or more generations of family members to help a patient!
Years of working closely with the indigenous Ngäbe-Buglé communities in our network has forged a relationship of trust and cooperation giving our volunteers a unique access to a very different culture. Our goal for our volunteers is that their experience will be transformative, not only encouraging global thinking and a deeper understanding and appreciation of other cultures and environments, but also reinforcing the value of service not only for others but for ourselves. It is never long until the cultural differences become lost in all the ways it is clear we are the same. This is an opportunity to reach out across vast gulfs of experience, culture, geography, socioeconomic status, education, and other factors and make real connections based on our shared humanity that transcend all of those differences
When we travel and experience new things, it changes us—but when we combine real service to others with our travel, it adds a new dimension to our trip. We find that we do not take a journey; the journey takes us instead. These are trips that are not just fun, or entertaining, or a great learning experience—these are the experiences that stay with us forever, that help us define who we are, and that no one can ever take away from us.
Where You Will Be Staying:
Volunteers and staff stay at the Floating Doctors base on Isla San Cristobal, a 10-minute boat ride from the town of Bocas del Toro on Isla Colon. Our headquarters is an off-the-grid remote facility located on a mangrove island, relying on solar power, rain catchment and filtration, and biotreatment of waste. Participants sleep in our 9-room bunkhouse dormitory or in small casitas, and deploy from our base to our target communities. Our leadership and facilities staff work very hard to keep our volunteers comfortable and well-fed, but please remember that these are accommodations built and maintained with much struggle against an unforgiving environment—far more comfortable than camping, but not the Ritz! Our headquarters is a working medical support base built for the purpose of delivering health care to remote jungle communities. There is not air conditioning, but electric fans and mosquito nets are provided for every bed. Our kitchen is run by a team of women and men from the neighboring village of Valle Escondido and they are justifiably proud of the meals they prepare for us.
We ask that participants be adaptable and enjoy the adventure of living off the grid, and the sight of glowing bioluminescence at night, the occasional visiting sloth, or flocks of parrots returning home overhead at the end of the day. The mangroves and the jungle are beautiful, especially at night, and swimming or snorkeling off the dock in the warm clear tropical water is a great way to cool off at the end of a day out in the field.
Accommodations every night, and all meals from Sunday night to Friday night will be provided. Cooking facilities are available for volunteers and staff staying on base for a quiet weekend to prepare their own food; often volunteers and staff stay at hostels in Bocas town Friday and/or Saturday night to enjoy Bocas’ night life). There is access to Wi-Fi, showers and other basic amenities. All program-related transportation is provided, as well as regular scheduled water shuttle service twice daily between Bocas town on Isla Colon and the Floating Doctors headquarters.
What you will need to apply:
We have an online application (link below) where you can fill out your information, desired dates, emergency contact info, etc. To submit the online application, you will also need to have several documents ready: AND THEY MUST BE NAMED AND FORMATTED CORRECTLY:
Naming format for uploaded documents is: Lastname_Firstname_Document
Example: A Resume for John Smith should be named “Smith_John_Resume”
DOCUMENTS MUST BE IN PDF FORMAT
Because our goal is not only providing health services locally, but also to affect health systems in the home countries of our volunteers through tropical and clinical exposure and mentoring, our volunteer selection process is very open compared to most volunteer organizations. We accept volunteers at many skill levels from bilingual veteran mission doctors to non-Spanish speaking students interested in an immersion experience. We normally have capacity throughout the year to accept people when they would like to come, although we strongly urge you to submit your application several months in advance, especially during our high season (May-July).
APPLICATIONS CANNOT BE SAVED AND FINISHED LATER, SO HAVE EVERYTHING READY WHEN YOU APPLY. YOU WILL NEED THE FOLLOWING DOCUMENTS (IN PDF FORMAT!) TO SUBMIT YOUR APPLICATION:
- (All): One COLOR copy of your passport photo page
- (All): One copy of your resume
- (Licensed dentists/dental nurses/techs only): One copy of license
- (Licensed dentists/dental nurses/techs only): One copy of diploma
- (Students only): One COLOR copy of your school identification
- (Students only): One letter of intent outlining what you feel you would give to a program such as ours as well as what you hope to take away from the experience
- (Students only): Two letters of recommendation
How long is a volunteer commitment?
We accept volunteers for varying lengths of time, from as short as one week to over a year.
Do I have to be able to speak Spanish?
No. It is highly desirable to speak Spanish, not only to function more effectively in our clinic, but also to deepen your experience interacting with our target population. We try to maintain at least 50% ratio of Spanish-speakers on our team of volunteers and leaders, and we may occasionally cap our volunteer numbers if there are not enough bilingual volunteers. We usually pair a non-Spanish-speaking volunteer with a translator or bilingual volunteer, or assign them to clinic roles that do not require Spanish.
Do I have to be a doctor to volunteer?
No. We accept Volunteers of almost all ages and backgrounds besides medical workers, because we believe that there is no talent or skill that cannot be expressed in a way that is of service to others.
Are there any costs involved?
Yes. We require a participation contribution from each volunteer that allows us to provide accommodations, meals, and all travel for our clinical and service deployments on site. Additionally, our volunteer contributions fund medications for our pharmacy, emergency and advanced care for patients, equipment repair and purchase, and almost all our other operational costs for maintaining a remote rural health care service providing help for over 10,000 patients annually.
There is a $100 deposit that is required for us to process your application and confirm your volunteer stay. Please submit payment at the time of application submission.
We rarely turn down volunteer applicants and if so we will refund your deposit. Our application process is not a competitive process and is meant to coordinate applicants so we have the right distribution of specialties, training ability, and language ability on our team at a given time, so your $100 deposit is not at risk of being forfeited.
The volunteer contribution is the backbone of our operational support–in addition to covering the costs of your accommodations and meals, they put fuel in our boats, medicine in our bags, and help cover the cost of the emergency or advanced care we get for our patients. We prefer that non-volunteer donations go towards building infrastructure and capacity, and we pride ourselves on managing almost all operational costs through our volunteer program.
Our leadership work very hard to provide a safe and rewarding experience for our volunteers and high-quality health services for our patients. Our Volunteer contribution fees are quite low compared to locally available hotel and food charges; your contribution covers your accommodations, excellent meals, and all costs associated with our teams deploying to the field. As Dr. George LaBrot always says, ‘It’s the most affordable way I know to have a life-changing experience.’ Here are our current contribution rates:
- $650 for one week of stay +$100 application fee ($750 total)
- $600 per week for two weeks of stay +$100 application fee ($1,300 total)
- $550 per week for 3 weeks of stay (or longer) +$100 application fee ($1,750 for 3 weeks, $550 each additional week
Please note that full payment is not required to complete your online application; only the $100 application fee is required at the time of signing up.
Will I actually spend most of my time doing service work, or will I see one patient and spend the rest of my time lounging around?
You will work very hard, with lots of clinical exposure and many, many opportunities to be of service. There will be ample time off at the weekends for leisure and exploring all the fun things the region has to offer, but if you are looking for somewhere you can work for one day and spend the rest of your time lying on the beach with a piña colada, and then home bragging about your medical mission trip, you are on the wrong organization’s website. If you are looking to work hard and make a real difference, you have come to the right place!
When should I apply?
Right now, of course! ☺