How Health Volunteers Overseas Works

Local health care providers at the Jigme Dorji Wangchuck National Referral Hospital in Thimphu, Bhutan.
Local health care providers at the Jigme Dorji Wangchuck National Referral Hospital in Thimphu, Bhutan.
Photo courtesy Jim Matiko

In December 1984, the Journal of the American Medical Association (JAMA) published an article by an Oregon-based doctor named Ralph Crenshaw. In the article, titled "Doctors Across the Sea," Dr. Crenshaw implored his colleagues in the United States to consider how they could "make a substantial difference in medical care throughout the world" by sharing their knowledge with physicians in other countries [source: JAMA]. At the time, neither the U.S. government nor American doctors were known to have a strong interest in international medical education. Aspiring foreign medical students wanted to be educated and trained in the United States, but immigration laws were strict because of fears that the American-trained doctors would stay -- and possibly outnumber American-born doctors -- rather than returning to their home countries.

Many developing countries don't have the funds or facilities to train enough indigenous doctors, which often results in a huge doctor-to-patient ratio and means that many people go without any kind of treatment. In 2006, for example, Africa had a shortage of 1 million health care providers [source: HVOUSA]. And while charities exist to provide medical aid during disasters or times of war, finding ongoing care can still be a problem. So Crenshaw was proposing something unique: Instead of just spending their time in developing countries treating patients, doctors could train local medical personnel. Often, patients -- and foreign governments -- can be suspicious of American doctors. Indigenous doctors could better meet the needs of the local population.


This concept of "give a man a fish, he'll eat for a day; teach a man to fish, he'll eat for a lifetime" was the impetus for the 1986 creation of Health Volunteers Overseas (HVO), a nonprofit, privately funded organization of doctors, dentists, nurses, surgeons and physical therapists. Prior to the founding of HVO, Orthopedics Overseas, a group of orthopedic surgeons, had formed in 1959 to train doctors in countries such as the Dominican Republic and Honduras. Crenshaw stated that they had "trained enough physicians in Indonesia for the local medical school to now have an independent orthopedic surgery department" [source: JAMA]. Orthopedics Overseas served as a model for HVO and now functions as one of the organization's 13 different divisions.

In this article, we'll learn about HVO's mission and organization, who participates, and what it's like to be a volunteer.

Health Volunteers Overseas Basics

A child clutches his health profile outside the Queen Elizabeth Central Hospital in Blantyre, Malawi. Although Malawi has a population of more than 10 million, there are less than 300 doctors.
A child clutches his health profile outside the Queen Elizabeth Central Hospital in Blantyre, Malawi. Although Malawi has a population of more than 10 million, there are less than 300 doctors.
Photo courtesy Jim Matiko

HVO is "a private non-profit organization dedicated to improving the availability and quality of health care in developing countries through the training and education of local health care providers" [source: HVOUSA]. Although HVO was founded and is headquartered in Washington, D.C., it isn't a government organization. Only about 7 percent of HVO's funding comes from the government; the rest comes from companies, professional associations, foundations and private individuals.

The HVO's Board of Directors are unpaid volunteers who focus on the organization's mission, policies and finances. An executive director, who reports to the Board of Directors, oversees a staff of 14 people and has a budget of about $8 million. More than 98 percent of this budget is spent on HVO's programs -- the rest goes to pay administration, fund raising and membership costs.


The organization stresses the importance of being sensitive to local cultures and customs as well as cooperating with the government and organizations of the host country. Volunteers shouldn't expect conditions and procedures used by local medical professionals to be just like those in the United States. Just as Dr. Crenshaw suggested in his 1984 article, HVO volunteers are expected to use locally available technology and supplies as much as possible so that the medical professionals they train can sustain the programs and practices they have established. If volunteers see a need for donated supplies or equipment, it has to be able to work for the area. For example, equipment requiring electricity wouldn't be very helpful in an area where electrical service isn't reliable.

Training has to be realistic and tailored for the specific needs of the local population.This means that volunteers must know about the most common health problems in the area.They're also expected to emphasize prevention and the importance of continuing education among medical professionals. HVO wants the local medical professionals to be able to train others as well, which can greatly increase the impact of its programs. The organization encourages both new and existing medical professionals to stay in their home countries and help fill the critical needs of their fellow citizens.

Volunteers with HVO have worked in 25 different developing countries located in Africa, the Caribbean, Eastern Europe, Latin America, Oceania, East Asia and South Asia. Each year, an average of 400 medical professionals volunteer their time, and there are about 1500 new volunteers.

Next, we'll look at the divisions these volunteers serve under and the professional associations that sponsor the HVO.

Health Volunteers Overseas Divisions and Programs

A Bhutanese child with a cast on his arm in the orthopedic ward at the Jigme Dorji Wangchuck National Referral Hospital in Thimphu, Bhutan. The HVO operates several programs at the hospital.
A Bhutanese child with a cast on his arm in the orthopedic ward at the Jigme Dorji Wangchuck National Referral Hospital in Thimphu, Bhutan. The HVO operates several programs at the hospital.
Photo courtesy Jim Matiko

Volunteers with HVO serve in more than 60 programs in one of 13 different divisions:

  • Anesthesia
  • Burn management
  • Dentistry
  • Dermatology
  • Hand surgery
  • Internal medicine
  • Nurse anesthesia
  • Nursing
  • Oral and maxillofacial surgery
  • Orthopedics
  • Pediatrics
  • Physical therapy
  • Wound management

Divisions operate independently in a lot of ways; their programs vary greatly depending on the individual needs of the people in the area and the technological capacity. Each division also has a steering committee, which decides where the greatest need lies for the type of medical education and training that its volunteers can provide. They then design a program along with local organizations. Each program has a volunteer director, who is responsible for the screening and oversight of its volunteers.


Divisions are also sponsored by one or more professional medical associations, of which volunteers are members. For example, the Dentistry Overseas division is sponsored by the American Dental Association, while the American Society for Surgery of the Hand sponsors the Hand Surgery Overseas division. Since there are more programs than we have space to discuss in detail, let's take a close look at a specific program within the Pediatrics Overseas division.

Sponsored by the American Academy of Pediatrics, Pediatrics Overseas has programs in Cambodia, Honduras, Malawi, St. Lucia and Uganda. The program in Uganda -- the first pediatric program launched by the HVO -- began in 1995 when HVO reached an agreement with Ugandan officials. This was the culmination of three years of work by the Pediatrics Overseas Steering Committee, whose members were appointed by the American Academy of Pediatrics.

The program recruits pediatricians to work with faculty in the Department of Paediatrics and Child Health at Makerere University and Mulago Hospital in Kampala.

Pediatric volunteers in this program lecture and train both undergraduate and post-graduate students as well as go on rounds and develop various training modules with their Ugandan counterparts. Pediatricians with subspecialties such as cardiology, neonatalogy and nutrition also work intensively with their counterparts to strengthen these programs.

Now that you know a bit about the HVO's programs, we'll discuss the basics of volunteering with the HVO in the next section.

Volunteering with HVO

As we mentioned in the last section, volunteers with the HVO are members of their medical professional associations. The HVO has a Program Department that works to recruit volunteers and place them within the program that suits their skills and interests. Once a volunteer is placed, the HVO provides training and makes arrangements. Each program's director provides specific information about things such as local customs, housing and current health conditions in the area.

HVO volunteers are highly experienced, licensed professionals who are active in private practice, a hospital practice or a university setting in either the United States or Canada. Retirees also volunteer. Volunteers need to be patient, highly adaptable, flexible and open-minded. Most programs require volunteers to stay for one month, although some are as little as two weeks and others can last up to six months. Each program may have specific requirements for volunteers in addition to the basic requirements. For example, the Physical Therapy Overseas program in Bhutan is a four-month-long program and requires licensed physical therapists with more than five years of experience.


In order to become a volunteer, professionals are encouraged to first join HVO and pay annual dues. These vary depending on the profession; doctors and dentists have a larger suggested amount, while nurses, allied health care professionals and students can donate less. There is then a volunteer profile form, which requires references, educational information and an explanation of why you want to become a volunteer. Volunteer profiles are valid for three years.

After submitting the form, potential volunteers are contacted by HVO recruiters to discuss locations. Then a program director contacts volunteers for further assessment and checks their references. Once a volunteer is improved for an assignment, he works with the recruiter to finalize the details and receives a packet of orientation materials and resources. He is also encouraged to speak with previous volunteers and do his own research so that they are fully prepared.

Volunteers can often bring their spouses and families along with them. In many cases, these family members can also volunteer. It just depends on the specific program. However, volunteers must keep in mind that they are responsible for getting to and from the program site. Some sites provide room, board and daily transportation, while volunteers are responsible for providing their own in other cases. Because the HVO is a nonprofit, most of the expenses incurred by volunteers are tax-deductible.

Past HVO volunteers often describe their experience as a two-way street -- they often feel that it's just as much of a learning experience for them as it is for the people they work with at the site. Not only have they done their part to improve the health of the local population, they've also contributed to improving medical education around the world.

For more on volunteering, try the articles on the next page.

Related HowStuffWorks Articles


  • Health Volunteers Overseas
  • Coughlin, Richard R. "Orthopaedics Overseas celebrates 50 years of service." American Academy of Orthopaedic Surgeons NOW. May 2009.
  • Crenshaw, Ralph. "Doctors Across the Sea." Journal of the American Medical Association. December 14, 1984. Volume 252, Issue 22.
  • Direct Relief International
  • HVOUSA: About Us
  • HVOUSA: Program Areas
  • HVOUSA: Volunteer Toolkit
  • InterAction
  • International Health Volunteers
  • Lalani, Amina. "An MD Travels with...Health Volunteers Overseas to Uganda." Doctor's Review: Medicine on the Movie. February 2006.
  • Monsiavis, Daniel. "Journey to Maldova: Working with Health Volunteers Overseas." El Paso Magazine. December 11 2008.
  • Saldinger, Martha. "War-weary Ugandans need pediatric volunteers." AAP News. September 1995. Volume 11, issue 9.