# Austere medicine outside of the military



## aflasa (Nov 17, 2019)

I thought it would be cool to get a conversation going about far-forward medicine outside of a strictly military environment.

I'm curious about what kinds of opportunities are out there to provide healthcare support outside of a traditional hospital setting. I've seen some really great organizations like GSMSG and NYCMedics, and I'm wondering if there's anything else or other organizations like this?

What do you all think of NGO austere medicine in general? From what it seems to me, it varies greatly depending on the security of the host nation, organization/company you're with, etc. I think it would be pretty awesome to provide humanitarian aid to those who need it most while practicing a form of medicine not traditionally seen outside of SOF.

I heard an interview with the founder of GSMSG where he said that a lot of the bigger, more well known humanitarian aid groups basically dump off some medical supplies with the locals and say "good luck." He also said that humanitarian groups sometimes have a bias against taking on prior military, something about wanting to "seem neutral in a conflict." I thought that was pretty screwed up if true, and a huge waste of talent.

Finding a starting point for this type of medicine seems difficult, a lot of these organizations want "3-4 years of austere medical experience in an international capacity," or something along these lines before even applying. Of course, having time with JMAU, SOST, or an FST would fit this perfectly, but a lot of civilian docs somehow link up with these organizations as well.

There's no money in it, of course, so I have to imagine a lot of healthcare professionals wouldn't even consider joining a volunteer group with a mission set like this.

Kind of thinking out loud here, was just wondering if anyone had some perspective or unique experiences with this type of stuff.


----------



## SOSTCRNA (Nov 18, 2019)

Many people do volunteer mission work through churches etc, there are also the NGO type teams as you mentioned.  Samaritan's Purse is one example of an organization that brings surgical care to places like Iraq and Syria.  I think it is fine if you want to do that sort of thing but remember this.  If you get rolled up by bad guys while trying to save the world, a whole lot of good guys might have to risk their lives coming to save your ass.


----------



## Devildoc (Nov 18, 2019)

The best thing about austere medicine in 3rd world countries: license?  What license?  You do what you need to do that the doc, any doc, is comfortable with you doing. 

What my esteemed colleague @SOSTCRNA said is true:  you pays your money, you takes your chances.  Most religious NGOs and charity groups don't go anywhere super dangerous, but enough are on the fringe that things can go sideways quickly.

Finding an organization that does ongoing, paid austere medicine is challenging.  The few that do get experienced people.  If you don't get your experience in the military, then start out by volunteering.


----------



## aflasa (Nov 18, 2019)

SOSTCRNA said:


> Many people do volunteer mission work through churches etc, there are also the NGO type teams as you mentioned.  Samaritan's Purse is one example of an organization that brings surgical care to places like Iraq and Syria.  I think it is fine if you want to do that sort of thing but remember this.  If you get rolled up by bad guys while trying to save the world, a whole lot of good guys might have to risk their lives coming to save your ass.


You're right, there's a fine line between asset and liability for a lot of these groups. GSMSG is cool because they give tactical training to everyone on their teams and make a point to take on former SOF personnel. They seem to make a point of being able to defend themselves.


----------



## aflasa (Nov 18, 2019)

Devildoc said:


> The best thing about austere medicine in 3rd world countries: license?  What license?  You do what you need to do that the doc, any doc, is comfortable with you doing.
> 
> What my esteemed colleague @SOSTCRNA said is true:  you pays your money, you takes your chances.  Most religious NGOs and charity groups don't go anywhere super dangerous, but enough are on the fringe that things can go sideways quickly.
> 
> Finding an organization that does ongoing, paid austere medicine is challenging.  The few that do get experienced people.  If you don't get your experience in the military, then start out by volunteering.


Definitely in my experience there's a correlation between being "far-forward" and increased scope of practice. Austere paid medical employment is a dream job for me personally. A lot of NGO's seem to have a wide enough mission set to keep their members pretty well occupied though (in addition to their normal employment). I'm personally leaning away from any kind of religious group for this stuff. The few groups I know of don't have any official religious affiliation or capacity, actually.


----------



## Devildoc (Nov 18, 2019)

aflasa said:


> Definitely in my experience there's a correlation between being "far-forward" and increased scope of practice. Austere paid medical employment is a dream job for me personally. A lot of NGO's seem to have a wide enough mission set to keep their members pretty well occupied though (in addition to their normal employment). I'm personally leaning away from any kind of religious group for this stuff. The few groups I know of don't have any official religious affiliation or capacity, actually.



Don't let the "religious groups" thing fool you.  A lot of medical providers who do medical missions don't belong to 'that' group; some see it as a public service.  It's also a foot in the door, and you meet people downrange who can often open doors.


----------



## aflasa (Nov 18, 2019)

Devildoc said:


> Don't let the "religious groups" thing fool you.  A lot of medical providers who do medical missions don't belong to 'that' group; some see it as a public service.  It's also a foot in the door, and you meet people downrange who can often open doors.


Interesting, I'll give those groups another look then. I greatly appreciate the insight.


----------



## x SF med (Nov 18, 2019)

aflasa said:


> You're right, there's a fine line between asset and liability for a lot of these groups. GSMSG is cool because they give tactical training to everyone on their teams and make a point to take on former SOF personnel. They seem to make a point of being able to defend themselves.



The issue there is that as a member of an NGO, you are not subject to the protections of the US Government...  you shoot, or get shot and you are at the whim of the people you're with or the BGs attacking you.   Just sayin'.


----------



## Stretcher Jockey (Nov 18, 2019)

While I was at SOMA this year, I attended a brief from a company that does austere medicine in forward locations. They were in Mosul during the offensive that took place and the entire presentation was essentially them talking about what x SF Med is saying. They talked a lot about their difficulties integrating with the US military in the region and the local defense forces. Not only that, but their specific lack of protection on any side of the conflict, both legally and physical. While it was eye opening, its seems supremely sketchy to run into a forward deployed location without any established support lines during a massive conflict. 

As a side note, the slideshow SOSTCRNA linked was one of the main presentations during the conference and was thoroughly fascinating. Thanks for sharing that!

Some other companies you could look into would be Team 5 or boots on the ground. Don't have personal experience with them, but the work they seem to be doing is right about what you're asking about.


----------



## MosulMedic (Jan 24, 2020)

Just noticed this thread so apologies for showing up late to the party.

If one possesses a skill set in medicine there is a myriad of opportunities in austere environments.
Some of my take home points regarding doing such work:
1. Experience, Experience, Experience!!
2. Be comfortable being uncomfortable!!
3. Know with 100% certainty what your getting into!!
4. Did I mention Experience?!
5. Do your due diligence vetting such organizations.
6. Although military experience, especially real world, downrange experience is invaluable, many, almost all want no Rambo types so tighten up your social media pics, posts etc before submitting any request or resume.

If you are co-located with a foreign military I highly, highly suggest having/possessing humility, ability to listen more and talk less, no need to boost of prior experiences, lofty resume because damn skippy when the SHTF your actions will speak volumes.

My personal feelings, at the end of the day when it’s you and your maker meeting eye to eye, what is most important in life? Tangible items are fleeting but experiences and friendships last a life time. Following your calling


----------



## MosulMedic (Jan 24, 2020)

Devildoc said:


> Don't let the "religious groups" thing fool you.  A lot of medical providers who do medical missions don't belong to 'that' group; some see it as a public service.  It's also a foot in the door, and you meet people downrange who can often open doors.


Never shy away from an opportunity at experience. Restarting and totally agreeing that it’s a foot in the door moreover you’ll be able to make contacts for future opportunities.


----------



## aflasa (Apr 19, 2020)

Looks like I’ll be heading abroad later this year with an NGO. Really looking forward to it; hopefully this will help me narrow down what I want to do with my life now that I’m out.


----------



## MosulMedic (May 10, 2020)

Curious, what NGO did you get with? Apologies if I’m reading your last sentence incorrectly but what you choose to do with your life should be a paying gig. Then when hot spots arise link up with an NGO.


----------

