A variety of volunteer anesthesia opportunities for Certified Registered Nurse Anesthetists (CRNAs) and student nurse anesthetists are available in foreign countries. Opportunities include providing patient care services and/or teaching. Sponsoring organizations may be strictly humanitarian or may have significant religious emphasis.
When CRNAs or student nurse anesthetists consider volunteering overseas, they often have many questions. Below are frequently asked questions about how to prepare, what to expect, and where to get additional information. For more information and current travel warnings, refer to the U.S. Department of State website at http://travel.state.gov .
1. Do I need a passport?
Yes, for entry into many countries a passport is required, and it is strongly recommended that you have a passport for all countries. Even for those countries that do not require U.S. citizens to have a passport to enter, a passport or birth certificate may be needed to return to the United States. You also should leave a copy of the face sheet of your passport with someone at home in case you will need a replacement.
2. Is a visa necessary?
Many people overlook the necessity of a visa; however the lack of a visa can result in denial of entry into a foreign country. Before leaving the United States, check this requirement well in advance, as obtaining a visa may take several weeks. The sponsoring agency should know, but if you are unsure call the country's embassy. It’s a good idea to check in with the U.S. Embassy or Consulate on your arrival. This makes your presence and whereabouts known in case it is necessary for a consular officer to contact you in an emergency.
3. Can I carry prescription drugs and medical devices?
All drugs should be marked with a prescription label and carried in the original container. You should consult with the sponsoring agency concerning the transportation of any drugs or supplies if you plan to personally transport drugs and medical devices. A letter from the sponsoring agency stating the purpose of your trip and that you will be carrying medical supplies should help you through most customs inspections. In general, it is easier to take supplies into the country where you will be working than to bring them back into the United States. Whenever possible, one should not stop for visiting purposes en route, as transporting medical supplies through one country to another can be complicated. Sightseeing is easier done on the return trip.
4. Do I need a nursing license?
You need a valid and current U.S. registered nursing license and the appropriate advanced practitioner credential if issued in the state of licensure. Also, you should have evidence of certification or recertification as a CRNA. Most volunteer agencies will ask you for this information. The country that you are going to may or may not ask you for such information; however, it is a good idea to have a copy with you should you be asked for it by the local authorities.
5. What health precautions are necessary?
Universal precautions should be practiced in all healthcare settings. Other precautions will vary depending on your destination. For example, malaria prophylaxis is recommended if malaria is endemic to the region. The Centers for Disease Control and Prevention (CDC) hotline number for malaria prevention is 770-488-7788; the CDC website is www.cdc.gov . A gamma globulin shot to protect against infectious hepatitis is recommended in the week before leaving. Tetanus, polio, and measles boosters also should be current. Yellow fever, cholera, and other vaccinations may be required. If you consult with a travel clinic or an infectious disease physician before you go, make sure it is understood that you will be working as a healthcare provider, not just going as a tourist.
6. What about sanitation?
In general, sanitation is not up to the standards found in the United States. Many restroom facilities do not have toilet paper or places to wash afterward. You might want to carry your own toilet paper and packaged towelets. Do not drink water from the faucets or fountains unless you are positive that the water is safe. Use bottled water for drinking and brushing your teeth. It is not a good idea, for example, to brush your teeth in the shower. Be careful of eating foods that are not cooked, such as lettuce salads, unless you know that the foods were cleaned with bottled water. It is not impolite to gently inquire about such things, and, in fact, often your hosts will tell you before you ask.
7. What anesthesia equipment should I take?
You must assume the simplest of anesthesia equipment will be awaiting you at your destination. Ask an anesthesia provider who has preceded you to the area for recommendations. Often a battery-powered pulse oximeter with spare batteries is useful. Your own laryngoscope and a simple drawover vaporizer also are useful in some countries.
8. Will oxygen be available for anesthesia?
In a few countries the oxygen supply may be severely limited or even nonexistent. Again, contact someone who has preceded you.
9. Who pays for the expenses?
The payment of expenses varies with the sponsoring group. Usually, the provider pays for all travel expenses and frequently lodging expenses as well. Some groups have funds for supplies, others do not. The provider should make certain that all expense issues are understood before departing.
10. What can I deduct from my taxes?
Expenses incurred that are direct and documentable can be deducted from the provider's income tax. Allowable expenses include travel, lodging and medical supplies if not reimbursed. Lost income or the value of the services provided cannot be deducted from your income tax. Sightseeing or personal travel may affect deductibility. Specific questions should be directed to your accountant or the U.S. Internal Revenue Service before departure.
11. Who makes the arrangements?
The sponsoring agency usually makes all the “in country” arrangements. Most agencies also will make the travel arrangements so volunteers can enter the country together. Entering a foreign country as a group is generally helpful, especially if customs problems arise.
12. Where can I find out about specific opportunities?
Please contact any of the organizations listed on our Volunteer Organizations page. Also keep an eye on the Volunteer Overview and Opportunities page.
The Council for Public Interest in Anesthesia (CPIA) provides this brochure for informational purposes only. It makes no endorsement, representation, warranty, or assurance as to the timeliness, accuracy, or completeness of the information contained herein. All volunteers should make their own investigation of any organization they choose to work for and the safety of any area they are going to visit. In no event shall the CPIA or the American Association of Nurse Anesthetists be liable to anyone for any damages or injury whatsoever resulting from use of this information.
Council for Public Interest in Anesthesia