Rules of engagement: the principles of underserved global health volunteerism.

d e The day begins at 7:00 AM with a layer of mosquito epellent and boiled coffee in a tin cup. Our medical linic in the small village of Rancho Pedro along the ominican Republic-Haiti border is a small hut comosed of dilapidated wooden planks fastened together nder a thatched reed roof. Patients with a variety of ilments line up daily outside the clinic door in anticpation of seeing a physician, often for the first time. ost patients have been waiting for hours, usually after nduring an overnight mountainous trek from a neighoring Haitian or Dominican village. Many of the medcal problems encountered can be treated effectively ith simple measures of wound debridement, banages, analgesics, or antibiotics; however, some are ore complex with no referral options. The work is ntense but inspiring, rewarding but often frustrating as he limitations of our abilities quickly become apparent. Many such medical programs generate unique peronal experiences for volunteer healthcare providers; owever, we continue to wonder whether any of our fforts have any meaningful and lasting benefit. We ork under the pretense of promoting community auonomy and health sustainability in rural communities ithout access to healthcare, but can any positive diference in community health through the efforts of our olunteer medical teams be noticed? For the local rural