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Abstract: Two volunteers who have continually dedicated time and effort to the Association for the Advancement of Wound Care (AAWC) and the Global Alliance and World Alliance for Wound and Lymphedema Care (WAWLC) describe perceptions of their life-changing overseas volunteer experiences. Learning and teaching became a two-way enrichment process, as volunteers and local healthcare leaders shared knowledge and practice pearls during lectures and hands-on workshops for managing wounds and lymphedema.

Address correspondence to:
Terry Treadwell, MD, FACS
Medical Director, Institute for Advanced Wound Care
Baptist Medical Center South
2167 Normandie Dr.
Montgomery, AL 36111
Phone: 334-286-3444
Email: tatread@aol.com

     While chronic wounds have become the new global epidemic in under-resourced countries, care for patients suffering with these wounds is lagging behind the current “state of the art.” What is the best way to approach providing evidence-based care for patients with chronic wounds in countries with limited resources? At first glance, one might suggest we could just charge into a country, tell them that they are doing everything wrong, tell them how we do it, and that this is the only way to get good results when treating wounds. Then, smugly return home patting ourselves on the back convinced that we have done a world-class job helping them solve their problems. Later we discover that they are still doing exactly what they were doing prior to our visit. Oh, well…what could we expect from such a backward country? If that is your attitude about helping underserved countries, you are destined for failure before you step on the airplane.

     Under-resourced countries have challenges that we in the United States and other developed countries do not have to consider. Ms. Jan Rice, the wound education coordinator from La Trobe University in Australia, recently reported that the regional referral hospital in Honiara, Solomon Islands did not even have soap for the nurses to wash their hands (Rice J, personal communication, November 2009). We found that having clean water to wash hands and wounds can very well be a luxury. There are reports from Sudan that the bandages of those who have died are washed and reused.¹ There are problems with the lack of trained personnel to care for patients with wounds. Many local physicians view chronic wounds with disinterest and frustration and, when required, treat wounds with outdated and ineffective therapies or just pass the patients on to anyone who will manage the problem.² Obviously, there must be a change of attitude in addition to education.

     What is the best way to interest people in caring for wound patients? How does one effectively provide the necessary information about the importance of wound care? One of the most important concepts is that the existing public health structure in the developing country must be used to spread new information. Everyone, including healthcare workers, public health officials, leaders of the country, and community leaders must understand how good wound care can improve the lives of the people and be aware of the fact that it will be economically advantageous to treat these people and return them to the workplace or at least to a productive, self-reliant life. The new information must be compatible with the social structure into which it is being sent.