Medical Director for Eye Care

Central Asia / Medical / Health / 2+ years / Job ID: 1535

A non-profit organization where expatriate professionals serve in partnership with local staff to build capacity in the sectors of health and development working together in hope for the welfare of the people of the country.

S/He will coordinate and contribute to training of ophthalmologic residents senior doctors nurses and ophthalmic technicians maintaining contact with international eye care professionals associations and institutions. S/He will supervise senior doctors in medical accuracy and proficiency confidentiality and copyright issues. S/He will contribute to annual evaluations of program outcomes propose strategies to improve the quality and efficiency of the programme and participate in developing evaluation tools to measure the impact and outcomes of activities. S/He will liaise with government health officials and contribute to the development of countrywide eye care policies and services.

S/He will be an ophthalmologist (or senior medical professional) with experience/interest in training. S/He will have fluent written and spoken English and good documentation management and communication skills. S/He will need to be able to work methodically and effectively without direct supervision. S/He will need to have an ability to speak or willingness to learn the local language.

Ophthalmologist

Central Asia / Medical / Health / 1-11 months / Job ID: 1536

A non-profit organization where expatriate professionals serve in partnership with local staff to build capacity in the sectors of health and development working together in hope for the welfare of the people of the country.

This person will assist in the continued development and implementation of the existing programme for ophthalmic physicians and residents in training in eye hospital sites. S/He will assist the project staff to maintain high standards of ophthalmic care both in regard to clinical and surgical practices and procedures in outpatient clinic wards and operating theatre. S/He will progress the doctors professional development training and accreditation program through supervision direction and discipline of medical staff. S/He will give advice on purchases personnel procedures and administrative issues as needed.

S/He is an accredited ophthalmologist a highly motivated independent worker and thinker who is still a team player a self-starter able to teach theory and demonstrate clinical/surgical principals/procedures. S/He is a people person with good relational and communication skills who is able to encourage and motivate others. S/He is able to work in cooperation with and learn from national staff/authorities as well as expatriates from various cultural and professional backgrounds.

Optometrist

Central Asia / Medical / Health / 1-11 months / Job ID: 1537

A non-profit organization where expatriate professionals serve in partnership with local staff to build capacity in the sectors of health and development working together in hope for the welfare of the people of the country.

This person will assist in the continued development and implementation of the existing programme for ophthalmic technicians and in eye hospital sites. S/He will assist the project staff to maintain high standards of ophthalmic care in regard to clinical practices and procedures in outpatient clinics. S/He will progress the technicians professional development training and accreditation program through supervision direction and discipline of medical staff. S/He will give advice on purchases personnel procedures and administrative issues as needed.

S/He is an accredited optometrist a highly motivated independent worker and thinker who is still a team player a self-starter able to teach theory and demonstrate clinical principals/procedures. S/He is a people person with good relational and communication skills who is able to encourage and motivate others. S/He is able to work in cooperation with and learn from national staff/authorities as well as expatriates from various cultural and professional backgrounds. S/He is able to follow through likes a challenge has good organizational skills. S/He is willing to work in live in and travel to underdeveloped areas of the country.

The gift of a voice

Speech therapy is largely unheard of in Cambodia. Currently there are no speech therapists in the country who were trained at a Cambodian university. For the last 18 months, I have worked as Program Manager in a locally-run organisation working to grow speech therapy in Cambodia. We have a vision for a Cambodian university-qualified speech therapy profession that is able to provide high quality, culturally-relevant services to the estimated 600,000 Cambodians with communication or swallowing difficulties.

Establishing a new profession is a pretty daunting task! Curriculum writing, development strategy, clinical research and advocacy work all require connections and expertise beyond our little team of seven Cambodian staff and three foreign therapists. For a university course to be relevant to this context we need to document research and experience of using speech therapy strategies here. The purpose of this is to evaluate what approaches to speech therapy work in Cambodian culture and in the Khmer language, rather than simply transplanting models of practice from Western countries.

Cambodia has a long history of foreign therapists working in isolation for a few months or years, each investing in their small area but with little connection to government systems and no overall coordination. One of the first tasks for our organisation was to partner with others to establish the Cambodian Speech Therapy Network, with an aim to share resources and learning, and to be an orientation point for future speech therapists coming into the country.

Another early task was to establish a speech therapy clinic as a social enterprise. Two years in, our private clinic is booked out and needs more staff than we can find. This clinic brings opportunities to document therapy in Cambodia. Furthermore, also critical to ongoing success, the clinic helps to raise awareness and builds advocacy platforms with influential Cambodians whose families have benefited from therapy.

Currently, many children with disabilities are not in school even though by law and by government policy children with special needs are allowed to attend. Last year we designed and implemented a pilot project to coach rural primary and preschool teachers in their inclusion of children with communication difficulties within government schools. Beginning with disability-accessible schools from the government’s special education department, our staff worked to train the teachers in skills and knowledge that assists them in using teaching methods that helps all children learn. Presenting our results to the government was a tangible example of how speech therapy could help Cambodians. We ended the year with a formal partnership agreement with the Ministry of Education and had some very pleasing discussions with the University of Health Sciences as they plan a bachelor course in speech therapy to start in 2020.

Building on our national staff’s connections in the national disability and health sector, I’ve been able to bring my experience from 12 years of living and working in Cambodian poor communities along with my grassroots involvement in community-based disability rehabilitation work and establishment of community preschools and homework clubs. As a cross-cultural worker with longer-term experience, I’ve helped our local and foreign team members to understand each other better. In addition to my professional expertise in speech therapy, I’ve also drawn on Interserve’s values of partnership, servant leadership and valuing local expertise as together we grow our organisational culture and strategy.

While it’s not part of the employment criteria, it has been a surprise and encouragement to see how many staff members in the speech therapy project share the Christian faith. For the Christians within our staff it’s been easy to see God’s hand guiding our planning and his provision of resources and partnerships. It is such a joy to together celebrate God’s blessing, lament the injustice we encounter and advocate for systems that allow access to services for the poorest and most marginalised.

Ruth lives with her family in Cambodia. She works with a local NGO working to grow a Cambodian speech therapy profession.

A different way of doing medicine

I was only fourteen when I decided I was going to become a medical missionary. I assumed I would be going to Africa – back then I thought all missionaries went to Africa.

But I was surprised to learn that female medical personnel were most needed in Muslim countries, where women must see a female professional and sometimes died when there were no women doctors to attend them.

So I ended up doing a medical student placement in South Asia. It was in a compound with high fences and armed guards. Women were not allowed outside the compound alone, and we had to cover every part of our body including our head. I remember old rusty beds, surgical gloves hanging out to dry after use, hot sweet tea and lots of kids with thin mums.

I started to think about wholistic health and doing medicine in a different way after I witnessed a nurse stomping a baby’s bottle under her foot. Her strange action made sense after I learned that bottle-feeding contributed to the illness of babies there. Big multinational companies sold their milk formulas cheaply and promoted bottlefeeding as the way of the West. However, many poor village women watered down the formula to make it last longer, depriving their babies of the nutrition necessary for growth. The lack of clean water and difficulty to sterilise bottles frequently led to infection and diarrhoea, then dehydration and death.

My brief time there taught me so much. I learnt the importance of preventative and community medicine. I learnt that even though curative hospital care was exhilarating and necessary, for me prevention is better than cure. I began to understand that people’s health is more than physical, and that it is bound to their poverty, education level, status, economic means, gender and religious beliefs. In short, I had begun to understand about wholism.

Another turning point in my Christian journey came when I had the opportunity to go on an evangelistic ward round. The hospital evangelist shared the gospel with patients’ relatives, who stayed to care for the patient. I thought it was great that the gospel was shared, but I was uncomfortable with the division for me: because of time constraints doctors mostly dealt with the physical and evangelists dealt with the spiritual. I didn’t want to restrict myself to being a doctor; I wanted to be a doctor sharing Christ and to teach from the Word of God. This was a good fit for the way God made me.

So I began full-time theological study while working part-time as a GP and completing my training. I was able to reflect on the interaction of the physical, emotional and spiritual. We are complex beings and being healthy is a complicated business.

When I applied to join Interserve, I was willing to go where I was most needed. That turned out to be Central Asia, where the church had grown exponentially since the fall of the Soviet Union, but leaders were young in years and young in faith. I quickly caught the vision of impacting communities in a wholistic and grassroots way, where they could be empowered to recognise and solve their problems with local resources. Our community development lessons covered many topics, such as physical health, income generation, agriculture, emotional issues and moral values like honesty and forgiveness.

Most of the communities we worked with knew we were followers of Jesus, and in time, through interaction, they developed a more positive understanding of Christianity. We did this work not as a means to evangelise or plant churches, but because it is good in itself and demonstrates the love of Jesus. In many places around the world, however, the natural consequence of such wholistic community development is that, over time, new communities of faith begin.

These early lessons have shaped my work as an Interserve Partner for the last 22 years. When there is harmony between people and God (the spiritual dimension), among people (the social dimension), within the person (the emotional dimension) and between people and their environment (the physical dimension), we have wholistic health. As Christians we work to show that Jesus is Lord of all and has reconciled all things in heaven and earth to Himself (Colossians 1:15-20). That’s wholism.

Lyn is Interserve’s Regional Director for East Asia and South Pacific. She lives in Australia with her family.

Listening with respect

I see myself more as a Jack-of-all-trades than a specialist. I spent more of my working life raising children than in my profession of medicine, returning to family practice and then counselling as they grew up.

In my new country, I work in ‘support’. I do not run any projects myself. ‘Support’ for me may mean collating clinical data, making cushions, dolls and straps for disability work, applying for grant funding, updating health training materials, training locals in counselling and offering child development and parenting support. There is no ‘ordinary week’ for me. Some work is fun, some engaging and exciting, some frankly boring but necessary.

There are highs and lows. Here is one low from the start of my work: I was finally going to do something useful and I was excited! After a year of cultural and language learning, I was going to assist a local NGO with health promotion and a women’s shelter. I had carefully prepared my first training presentation and I arrived twenty minutes early, ready to set up and start on time. The room was in use, so I waited. With five minutes to go, I showed my face at the window. When it was time to start, I knocked on the door. A colleague came out. She said that the person before me was still talking. I waited for forty-five minutes. The team then came out and asked me to give my presentation another day, as now they did not have time for my training!

We now live in a relationship-based culture, not a time and task-based culture. I knew ‘flexibility’ was important for living and working here. I just didn’t know how flexible. Your duty is the person in front of you and other commitments go on hold until they leave. I have learned to call the day before I run training, and to schedule sessions at the start of the day so it starts approximately on time. That is, after the mandatory relationship-building cup of tea and chat.

I have continued to work with the same wonderful ladies for the last five years. They sat patiently while I attempted to teach in a new language. It was a relief to all of us when they offered to allow me to train in English, with one of them translating. They always encourage me and tell me how much they value me, which makes it hard to get good feedback for improvement! I think it took three years before my health training took root. I think it also took about that amount of time before they really trusted me.

Here are some of the highs:

I was asked to work as a counsellor in a medical clinic. It is always challenging seeing people in very difficult circumstances when you are unlikely to see them again. What could I really do? I was very humbled when lady after lady shared their experiences of difficulties with husband or children. They entered sad and left smiling. What had I done? There was really no advice I could give them, no change in their circumstances. It was simply important to them that both I and my Christian translator listened and valued them. I encouraged them. So many of these ladies only get abuse and blame. To be listened to with respect and cared for was a new experience for them.

The ladies running the women’s shelter asked for training to help the children who had escaped abusive situations with their mothers. I explained that although the children will probably later need counselling, the first and most important thing is to provide them with a safe and nurturing environment, provide good food and clothing and to cater for their educational needs. I also gave them training on basic child development and parenting skills. They were very grateful and said they found this training helpful even in their own families. They also realised that their work was just as important as what professionals did.

Nothing happens by chance. God uses all our experiences, and I am grateful for everything he is doing through my retirement!

Marian and her husband are doctors, serving long-term in a remote part of Central Asia.

Names have been changed

QA with a Doctor

Celeste is a doctor living and working in Asia.

What led you to pursue a profession in medicine?
I never had a ‘noble’ intention to do medicine. I did well at school, and it was a practical profession. I always wanted to serve people and medicine provides that. A lot of people might have thought about saving the world, but for me, it was just a good profession and I had the ability to get there.

How did you sense God calling you into cross-cultural mission?
I struggled with this. Did I really hear God asking me to mission? Some people have dreams. But I think God also works through how your brain works. So for me it was open opportunities. Having everything line up: time, ability to go, the desire to go. I find that if I respond to one thing, God will lead me to the next thing. You don’t suddenly arrive there. You just need to have the willingness first to see mission as a possibility.

You have a heart for your patients, but also for your professional colleagues.
We can serve our patients well if our hearts and our brains and our values are all connected. There is only so much that we can do for one patient, but if we can have an influence on the healthcare provider, how much more we can serve the patients over and above what we can do by ourselves.

If we hold the value of being God’s created ones, then it is reflected in how we treat patients. To be able to look after your colleagues – it changes how they see themselves and the value a patient has in their eyes.

How can you share Jesus’ love when there are professional boundaries to what you can say?
I don’t think that is any different whether you are in my country or in Australia. It is more a change in your thinking – to be Christ-like in the workplace. People read you and watch you. The dignity and kindness that you give to a person speaks volumes. As much as we have to open our mouths, the Holy Spirit is working in their hearts. I am seeing that more and more.

People will ask “Why are you so different to the other doctors?” As we grow in faith, something has to change about us. There is a time and place for you to speak and a time and place when you show Christ through what you do. He will be the one who provides an opportunity to talk about it.

Names have been changed.

Therapist (Physio/Occupation.)

South Asia / Medical / Health / 1-11 months, 12-23 months, 2+ years, Consultant, Elective / Job ID: 1463

This is a development project situated in a rural area. It has a training school for midwives nurses and community workers a community development work a research hub an English-speaking school up to age 16 and a 150-bed hospital (with obstetric gynaecology surgical medical and paediatric departments). There is also a Rehab department for children where mainly children with cerebral palsy are seen but also other children with disabilities. There is a clubfoot program and assistive devices are produced on location.

The project is seeking a physiotherapist or occupational therapist who can support the rehab team with training and with the management of patients with needs outside of the normal problems.

Physiotherapist or Occupational Therapist. Some clinical experience is preferred

Physio/Occupational Therapist

Central Asia / Medical / Health / 1-11 months, 12-23 months / Job ID: 1121

This NGO is committed to helping disabled children with a focus on children with autism.

A physiotherapist or occupational therapist is wanted to design and run rehab programs for children with disabilities.

The applicant should have suitable qualifications and some experience in physiotherapy / occupational therapy is desirable.

Medical professionals

Central Asia / Medical / Health / 1-11 months, 12-23 months, 2+ years / Job ID: 1236

The vision of this non-profit organisation is to create outstanding medical education programmes that will radically improve the quality of healthcare in the country. This is done through organizing master classes lectures and hands-on training.

There is a need for medical specialists in different areas. The main role will be involvement in training and mentoring local professionals in local hospitals clinics or medical universities. Besides medical training there are opportunities to teach medical English in local hospitals and clinics.

The organisation is looking for medical professionals with at least five years work experience and at least a Masters degree. Applicants should have the desire to pass on their knowledge and skills to local professionals. There is a need for: doctors orthopedic surgeons neurologists pediatricians and nurses (especially specializing in wound care).