Prescription for Travel

Framed along with the medical diploma and the other parchments of pro fessional achievement on the wall of Dr. Alan R. Grain's Washington, D.C., office hangs a reminder of a recent six-week vacation. It is no mounted marlin or spread of ten-point antlers-only another certificate. "Nay chung-nhan," it begins, which is Vietnamese for "This is to certify," and goes on to let it be known with gold seal and red ribbon that Dr. Grain served this spring as a visiting orthopedic surgeon at the crowded, understaffed Cho-Ray Hospital in Saigon.

Without Pay. Such a working vacation is hardly the relaxing change of scenery a doctor might order for a patient, but Dr. Grain and a small but dedicated number of U.S. physicians are choosing the prescription for themselves. Through a program coordinated by MEDICO, the CARE-affiliated international medical cooperation agency co-founded by the late Dr. Tom Dooley, the doctors volunteer to spend a month practicing their specialties in out-of-the-way places in Africa, Latin America and the Far East. They usually pay their own way and always work without pay. At local clinics and hospitals, they train native doctors in modern medical techniques and treat patients who crowd in from hundreds of miles away.

Since 1959, when the first "vacationer" went to Jordan for a month, at least 175 U.S. doctors have offered their services in a dozen countries. During a 40-day visit to Jordan, a surgeon examined 635 patients, performed 69 operations on almost every affliction known to orthopedics. In Hong Kong, three prominent eye surgeons performed a series of delicate corneal transplants. When Algeria gained its independence last July, fewer than 200 doctors were left to care for 11 million people, many suffering from epidemic diseases and war injuries. MEDICO rushed in emergency teams of doctors and nurses; now eight one-month doctors are on duty in Algiers. The volunteer system, says Dr. Peter D. Coman-duras, co-founder and now chief of MEDICO, demonstrates that "a great deal can be done with very little money in bringing the latest in medical science to underdeveloped countries."

Weary but Ready. On Dr. Grain's trip, except for a two-day excursion into neighboring Cambodia, he had no time for sightseeing. He was kept busy day after day at the hospital. There were two native orthopedic surgeons to train and a ward teeming with patients, many of them mangled victims of Viet Nam's guerrilla war. The cases, Dr. Grain says, were fairly routine-muscle and nerve operations, bone grafts and other reconstructive procedures. But not the conditions. Flypaper hung over the operating table, amebic dysentery was rampant, and blood for transfusions was in short supply. The thousand-bed hospital was so crowded that sometimes two beds were pushed together to accommodate three or four patients. Americans in Saigon quipped that "semiprivate at Cho-Ray means two in a bed."

Like many vacationers, the doctors' return weary but enthusiastic. Several volunteers have made more than one trip. Dr. Grain says that it will take him four months to recover financially and to catch up on his case load back home, but he is all ready to pack his instruments and go again. "They're setting up a program in Afghanistan," he says. "I'd like to go there."

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