Volunteers in Mongolia

by Tsogt

Limited contributions by Healthcare and Medical Volunteers in Mongolia

By, Ana-Maria Udrica
September 1, 2008 · ULAANBAATAR, Mongolia

There are two categories of foreign healthcare and medical volunteers in Mongolia: those who are certified doctors or medical professionals, and those who are either currently in medical school or considering the profession for their futures. Regardless of qualifications, both are limited as to how much they can contribute and gain through their services.

According to Dr. S. Abai, a neurosurgeon at the Schastin Clinic III, medical volunteering in Mongolia is not very common and mainly occurs in the form of disaster relief or Red Cross efforts to help the poor. Based on his experiences, qualified foreign volunteers only come to the Schastin Clinic about ten times a year, usually in teams or through projects such as the “Heart Saving Project” from Japan. Out of these volunteers, 50 percent work in cardiology and the remaining 50 percent is split between other health-care departments.

Some volunteers bring books, supplies or equipment. These can be useful, but the costs are high for both volunteers and patients. Sometimes, as seen from the MRI equipment that has been provided at the Second State Hospital, the cost of utilization is too high for patients to gain benefits.

As a result, most volunteers come to teach through practice or talks. Dr. Abai is keen to welcome many more such volunteers as he believes that much can be learned from their efforts which are very helpful. However, since medical and healthcare systems vary from country to country overseas, he admits that it can be a challenge and sometimes impossible to practically apply what they have learned because they don’t have either the proper drugs or equipment.

This was evidenced by an epilepsy case which Korean volunteers came to discuss treating by performing surgery or providing more advanced medication. Although the Mongolian doctors gained useful information, they inquired mainly about alternatives because they do not have the necessary technology and/or special medication and are still only capable of managing the syndrome with basic anti-epileptic drugs.

Thus, due to Mongolia’s limited capabilities, qualified volunteers often end up making contributions that are too advanced for the medical system.

The opposite is true for non-qualified volunteers. Such volunteers are either in medical school, fulfilling their medical school elective period, or considering the field for their futures. In the absence of a degree, most, like Tiffany Chiu, hope to “Gain more exposure in a developing country than back home.” Such expectations are sometimes not met, with volunteers ending up spending days merely observing whilst following doctors around. This can become extremely repetitive and tedious, but even shadowing has its benefits.


For example, in addition to witnessing surgeries and finding that cell phones are permitted, Tiffany noticed that her hospital has no general elevators for those in wheelchairs. She also noticed that families serve in the role of nurses at eastern hospitals and was surprised to see patients walk in with their own scans and X-Rays because such important documents are safely stored in western hospital files.

Other non-qualified volunteers such as, Sevil Khatibi, are paired with doctors capable of communicating in English and can thus engage in discussions in addition to shadowing. Most of their discourse revolves around current medical issues that need improvement.

Sevil, sat down with Dvree, a pediatric specialist trainee and outlined the leading problems facing Mongolia’s healthcare system. First, there is the lack of incentive for people to become doctors as a result of low pay, no medical school financial aid, and a mandatory two-year un-paid post graduation internship. Next, there is the need for specialized equipment and training on its use. Lastly, public health education about common diseases, smoking, diet and allergies is desperately needed, they agreed.

Contrary to the above, not all observations are negative. Volunteers are impressed by the cleanliness of the hospitals and how knowledgeable the doctors are despite the three languages used in medical school, with text books being in Russian, current research in English and assignments in Mongolian.

Most, like Nina Wiebking, “Admire how much they can do with so little.”

“Doctors are constantly improvising. In the west, if one thing is missing, doctors and nurses are stuck. Here, if they don’t have something, they go back to the basics and find a way to finish the procedure,” Sevil explains. Although the freedom to improvise and their ability to work around situations are commendable, these would not be allowed in the west where standard operating procedures must be followed to avoid medical malpractice.

Despite these drawbacks volunteers did gain exposure to Mongolia’s hospitals, but “I don’t feel like I am actually volunteering,” says Tiffany. This is because, while these non-qualified volunteers walk away with an experience, they are not able to contribute much more than discussion and help to bring such issues to the forefront.

However, even within these limitations, one thing is certain - healthcare and medicine is better with all of these volunteers than without them. Whilst they may not always gain much, they bring knowledge, technology and an exchange of cultural ideas, the effects of which are either instantly seen through the curing of patients by qualified volunteers, or will be seen in time as technology improves or doctors find themselves referring back to what they once heard from an unqualified volunteer.