The American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) recognizes that many of its members voluntarily engage in global humanitarian outreach efforts that provide humanitarian relief in crises, patient care in low resource areas, and healthcare provider education around the world. The AAO-HNS advocates that the primary objective of global humanitarian outreach efforts be the ultimate development of sustainable, autonomous healthcare within the local healthcare environment. Patient care activities within global humanitarian outreach efforts should be undertaken with local healthcare professional stakeholder input and participation in order to maximize patient care outcomes as well as educational opportunities for visiting and host healthcare teams.
Patient safety remains the top priority in patient care in low resource environments, and patients should be afforded the highest possible quality of care, with input from local healthcare providers regarding limitations in resources and cultural considerations which may impact patient care. Volunteer healthcare providers’ engagement in patient care should be consistent with their skills, credentials, and practice in their normal working environment, as well as in accordance with the laws of the host country. With consistent and thoughtful collaboration between visiting and host physicians and other healthcare providers, a successful global humanitarian outreach effort ideally should eventually eliminate the necessity of its own existence.
References:
1. Butler M, Drum E, Evans FM, et al. Guidelines and checklists for short-term missions in global pediatric surgery: Recommendations from the American Academy of Pediatrics Delivery of Surgical Care Global Health Subcommittee, American Pediatric Surgical Association Global Pediatric Surgery Committee, Society for Pediatric Anesthesia Committee on International Education and Service, and American Pediatric Surgical Nurses Association, Inc. Global Health Special Interest Group. J Pediatr Surg. 2018 Apr;53(4):828-836. DOI: 10.1016/j.jpedsurg.2017.11.037.
2. DeCamp M, Lehmann L, Jaeel P, et al. Ethical obligations regarding short-term global health clinical experiences: an American College of Physicians position paper. Ann Intern Med. 2018; 168:651-657. DOI:10.7326/M17-3361
3. Lasker JN, Aldrink M, Balasubramaniam R, et al. Guidelines for responsible short-term global health activities: developing common principles. Global Health. 2018 Feb 7;14(1):18. DOI:10.1186/s12992-018-0330-4
4. Short-term medical mission trips: Recommendations for practice. Catholic Health Association of the United States. 2015. Available at: https://www.chausa.org
5. Medical outreach: Best practices study. AmeriCares. 2013. Available at: https://medicaloutreach.americares.org/globalassets/_mo/resources/07_bestpractices/americares-medoutreachpracticesstudy-lit-review-final.pdf
6. Fagan J, Aswani J, Otiti J, et al. Educational workshops with graduates of the University of Cape Town Karl Storz Head and Neck Surgery Fellowship Program: a model for collaboration in outreach to developing countries. Springerplus. 2016 Sep 23;5(1):1652.
7. Fagan J, Zafereo M, Aswani J, et al. Head and neck surgical subspecialty training in Africa: Sustainable models to improve cancer care in developing countries. Head Neck. 2017 Mar;39(3):605-611.
8. Mulwafu W, Fagan JJ, Mukara KB, Ibekwe TS. ENT Outreach in Africa: Rules of Engagement. OTO Open. 2018 May 22;2(2).
Adopted 1/14/2020
Important Disclaimer Notice (Updated 7/31/14)
Position statements are approved by the American Academy of Otolaryngology—Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position statements are not intended to and should not be treated as legal, medical, or business advice.
