Physician Leadership and Healthcare Relief: Mission of International Medical Corps

Mike Sacopulos:
Ms. Traub, can you tell us a little bit about International Medical Corps' history and mission?

Margaret Traub:
Sure. International Medical Corp began its first mission in 1984 in Afghanistan during the Soviet occupation and what we found is that medical professionals, doctors, and nurses particularly, were being targeted inside the country. What we realized is you really can't bring enough volunteers into a country to help solve medical and health crises due to war. And really, the only way to have a long-term and sustainable impact was to train.

So we focused on starting up training programs for medics, and then those people could go to their communities and treat 80-90% of what they were seeing in the war zone. So that model essentially was expanded to Africa and Asia and the Middle East over the many years, and so we have over those years provided medical relief and healthcare and training in 80 countries. Today, we're in 30 of those countries, including Ukraine, Syria, Yemen, Afghanistan. As you mentioned, Congo, Nigeria, and places like that. And we focus on going to the places that are hardest hit and reaching communities that are not being reached so that when there is a crisis, say in Ukraine, while we are in Poland, there are a lot of groups in Poland, so we want to try and also go to those areas that are not receiving services.

Mike Sacopulos:
What are the ways in which International Medical Corp assists?

Margaret Traub:
We view health as the comprehensive portrait of health. So that means the physical health and mental health of people, particularly in crisis areas, and really in general mental health is often kind of neglected or ignored. And so, we provide primary healthcare services, tertiary care, wound care in conflict zones, vaccinations. We have been doing large-scale vaccination programs during COVID, as well as prevention and treatment programs for COVID-19 in 30 countries, including in the United States. We provide maternal healthcare, water sanitation hygiene because obviously, clean water is pivotal to good health. Nutrition services, and then also something we're seeing a lot in Ukraine is the beginnings of issues around gender violence and protection. Women and children are fleeing the country, often without men, because the men have to stay behind and fight. Women and children are alone, do not have their resources and support systems, and they're on the move and on the run. And so, they are extremely vulnerable. So, we also provide services to help people who are extra vulnerable and need protection.

Mike Sacopulos:
Does your organization partner with other organizations?

Margaret Traub:
In any crisis that we respond, unless we are the only group operating in the area, and usually it's in conjunction with the Ministry of Health of the local government and the Red Cross, but in these large scale disasters like the Haiti earthquake, like Ukraine, there is organizing what's called a cluster of the NGOs, the non-governmental organizations that are responding, and we organize through the Red Cross, Red Cross, and UN agencies so that everyone is not stepping on each other toes so that we're efficient so that we're reaching people who need to be reached, so that we're not leaving gaps, we're not duplicating our work, and we're providing services that are needed, not services that are not needed. So, that means that while we might be focused on health, another group might be focused on education, and another might be focused on shelter. We coordinate and talk about what are those needs and how can we divvy up the work.

Mike Sacopulos:
Recently, we've all been focused upon the situation in Ukraine. Please describe the public health situation in Ukraine from International Medical Corps' perspective.

Margaret Traub:
Well, sadly it's so catastrophic. Parts of Ukraine in the south, particularly places like Mariupol, Mykolaiv, Poltava, places like that, are seeing catastrophic losses. We have staff that has worked in Mariupol, and we are still trying to determine where they are and if they're okay. Hospitals, as you know, and schools have been targeted, and while we have numbers of casualties and deaths, we are quite certain that the numbers are much, much higher. People in these areas have run out of water. They don't have electricity. They don't have food. They don't have shelter. All of the basics are gone. And they are on the run or sheltering in place, and it's very hard to have communication with them.

It's also hard to get any supplies in, so establishing a humanitarian corridor through which we can safely send supplies, or get people out, has been nearly impossible. The frontline of the conflict has spread, and so they're all over the country now, moving south, north, and now to the west. So, these are areas where infrastructure has been devastated, including health infrastructure, where actual clinics and hospitals have been targeted.

Mike Sacopulos:
Is it ever too dangerous for your organization to be in a country? I mean, do you ever have to make the call to pull people out because it's just not safe?

Margaret Traub:
Absolutely. And there have been places in this conflict where we have had to pull to a safer area and move our staff, so this is a constant security assessment that we do. Ukraine is not the only place where this has happened. We work in Syria and Yemen and Afghanistan and other places that have seen years and years and years of conflict, and where we have been working for many years, since the beginning of these conflicts. So, absolutely. And keeping our staff safe is our primary objective while they work to deliver care. But it's a constant struggle.

Mike Sacopulos:
You mentioned other locations that you're in. Do your staff up in areas where the refugees are headed? I'm thinking of Poland or Moldova.

Margaret Traub:
Right. So, we are currently active in Poland and Romania, and Moldova. Those are the countries that are seeing the largest refugee flows. Moldova is a smaller country with less internal capacity, so the large numbers are even harder on a country like that. So, we're working with the Ministry of Health there to determine, especially because there are fewer NGOs there, is there more we can be doing there. So, we are surging our staff and scaling up in the entire region. Before this latest escalation of hostilities, we were working inside Ukraine since 2014, and have continued to work throughout this conflict. So, we have had a very long-term presence there, working inside Ukraine, and so this is a continuation, but at the same time, we're scaling up, sending in staff from our existing networks around the world to come in and help and in a variety of expertise from again, water sanitation hygiene, to mental health, to medical doctors and nurses, logisticians. It runs the gamut, so we are staffing up very quickly.

Mike Sacopulos:
Is it fair to say that the type of resources you need varies depending upon what's going on in the country, conflict versus large refugee population?

Margaret Traub:
Absolutely. I think if it's an active conflict zone, you're going to see a lot of need for trauma and wound care, but frequently, when people are on the run, they don't have their medicines with them. They don't have their diabetes medication, or for the regular things, over the long term, children are no longer getting their vaccines and babies are still being born. Thousands of babies have been born during this conflict. The needs of women and children and pregnant women go on. So, when we were looking at say COVID, the needs might be respiratory needs or prevention and treatment of COVID. But in a war zone, the needs are different.

Again, there's a lack of clean water, so you have diarrheal diseases and those kinds of outbreaks. It can be a wide range of needs, but again, primary healthcare is a major one.

Mike Sacopulos:
If a physician wants to become involved, what would be the first two or three things he or she should do to be evaluated if they are a good candidate for this type of work?

Margaret Traub:
Absolutely. We are always looking for great folks to work with our organization. We have large existing networks, both through the unions as well as the academic institutions and the hospital networks in the United States and the UK. I would say going to our website and uploading your information and looking at some of the openings. In an emergency, we're actively recruiting and those are posted on our website. Follow our social media. You can sign up for newsletters on our website and internationalmedicalcorps.org, and our social media, Facebook, Twitter, and Instagram. So, those are good ways to kind of stay informed, share information with others. For large hospital groups, post information so that your colleagues are aware.

We're always still soliciting donations so people can give on our website. Those are the best ways. We have a lot of gifting, pharmaceutical and medical companies that we partner with, all of the major names, and they provide donated supplies, which is fantastic. So, we don't need so many kinds of donations of masks and PPE and that kind of thing. We get those from some of the larger companies. A great way people can help, who want to volunteer, is to go on our website.

Mike Sacopulos:
Does International Medical Corps accept assistance from residents or fellows, people in training?

Margaret Traub:
We have in the past in certain instances if people are doing a fellowship or residency. During COVID, as you know, staffing was a huge issue for hospitals around the country, and so we too ended up not needing to because it came in waves. We were able to deploy people from one part of the country to the other part of the country. So, when we were serving New York and Chicago and Detroit, we were taking volunteers from California and Texas, and then when it switched, we were able to bring people from New York and the east coast over to the west. So, it worked out, but yes. In some instances, we do use residents and fellows.

Mike Sacopulos:
What about the young physician program? Do you offer anything for young physicians?

Margaret Traub:
I don't know if we have anything for young physicians because these are resource-poor environments and conflict zones that are very complex. So, we generally like people who have a little bit of experience, either with a kind of massive trauma, emergency department experience, or have international experience. So, because these environments are difficult, we generally like people with a little bit more experience.

Mike Sacopulos:
Margaret, if in our audience today there is a retired physician who wants to help, what are the criteria? Do you have physical fitness requirements for individuals?

Margaret Traub:
It's not like it's the Marine Corps, where you have to keep a certain weight and be able to bench…whatever. It is a difficult environment so I guess I would say first and foremost, a sense of ease, a sense of your abilities, and honesty with yourself about what you can do. Frequently, the work requires driving long distances on bad roads, or where roads are out and bridges are out, and you're hoofing it into a remote area. We generally say you should be able to carry three days of supplies to sustain yourself on your own, on your back. If you're going into an area, say when I was in the Philippines after Typhoon Haiyan, these are areas where there wasn't clean water, where bridges and roads were out, and you had to get on your feet and go packing into a far community.

So being able to sustain yourself and being nimble and not requiring a lot of infrastructure around you. For an anesthesiologist, you're not going to have ultrasounds, and you're not going to have a lot of the equipment, so being able to be nimble and light on your feet is important.

Mike Sacopulos:
What, if any, are the professional liability concerns for physicians assisting patients through International Medical Corps?

Margaret Traub:
Well, I don't want to get over my skis, because I'm not a legal expert, but when you sign on to volunteer with International Medical Corps, you’re part of a humanitarian organization and you are signing onto our code of conduct and our policies with regard to the treatment of local populations and we have approval from local governments, except in certain instances, and we aren't usually bringing in volunteers to those places. But we have approval from the local government to being our work, and so those are done under our auspices.

Mike Sacopulos:
If a listener wanted to support the work of International Medical Corps, doing so via state planning or legacy planning, where should he or she go to look for information about that?

Margaret Traub:
We do encourage that. We have a development department who can work with them or their foundation or their advisor on setting up estate planning and requests and being able to give or give in honor of someone. So, we have all of that, and the person can certainly get in touch with me, and I can direct them to the right individual. But we have a department, a resource development department, that handles that.

Mike Sacopulos:
And as we wrap up our time together, I'm interested to know beyond individuals, how can health facilities or health systems assist International Medical Corps in its mission?

Margaret Traub:
I think it's always good to have existing partnerships set up before an emergency happens, so make those connections if there's a health facility. Over my many years, I've worked with health facilities to arrange partnerships at the outset or memorandum of understanding, where we're going to work together. We've done this in the past with health systems in the United States, the SEIU is one of them, the Nurse's Association, where we have these agreements in place. And then when we can go out to them and say, "We need 10 nurses who have emergency room experience or trauma care experience, and they need to be able to deploy in five days. They need to be able to speak French," or whatever it is. And these networks are great at saying, "Okay, here's whom we have." And we train them in advance, and so all that is set up. And it then becomes turnkey when an emergency happens.

Mike Sacopulos:
And do you ever have health systems or organizations that provide matching funds for donations made by their employees or staff?

Margaret Traub:
We do. Absolutely. So, if staff is giving, we encourage the staff to notify their employer, or for the employer to be aware so that they can match. But we do that through many, many companies. We have about 100 corporate partners, including hospitals associations that match their employee's giving.

Mike Sacopulos:
This is a fabulous organization, doing tremendous work. On a personal note, you're headed to the Ukraine region, are you not?

Margaret Traub:
Probably this week, yes. Still working out the dates.

Mike Sacopulos:
Well, thank you, not only to the International Medical Corps for its tremendous humanitarian work, but thank you also to you for all your service and great work. Please be safe.

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Margaret Traub is Head of Global Initiatives for International Medical Corps, the Los Angeles-based humanitarian organization that since 1984 has delivered more than $3.9 billion in healthcare relief and training in conflict and disaster zones in 80 countries. As a member of International Medical Corps’ Emergency Response Team, Traub travels extensively to field programs around the world - including to Syria, Lebanon, the Democratic Republic of Congo, the Philippines, South Sudan, Nigeria, and Haiti – to assist and to advocate for those affected by crisis. Prior to joining International Medical Corps in 2005, Traub spent 17 years in print and broadcast journalism. From 2000 to 2004, she was an Executive Producer at CNN, overseeing show coverage of the wars in Iraq and Afghanistan, the September 11th terrorist attacks, and the 2000 presidential election.