Effective purpose in transnational humanitarian healthcare providers


  • Donna J. Perry, PhD, RN




global health, humanitarian, international deployment, staff education, effective purpose


Objective: To advance knowledge regarding the education and support needs of staff deployed to international settings from a US academic medical center (AMC).
Design: A qualitative approach rooted in phenomenology called, Transcendental Method for Research with Human Subjects was used. A flexible interview guide was used to guide participants into self-reflection about the decision to participate in global healthcare, educational preparation, field experiences, and return.
Setting: The study was conducted at a US AMC.
Participants: Sample size was 15 and included nurses, physicians, and therapists who had participated in disaster and/or developmental humanitarian global health deployments. Purposive sampling with a maximum variation approach was used along with snowball sampling. Sample size was determined by reaching horizonal understanding of participants.
Main outcome measures: The study sought to elicit and analyze responses from participants in an open-ended manner.
Results: Analysis revealed the following seven themes: a) the yearning to relieve suffering, b) getting ready, c) making a difference, d) bad things happening to wonderful people, e) challenging and sustaining factors, f) dialectical alienation, and g) knowing what really matters. The concept of “effective purpose” emerged from interpretation of these themes.
Conclusions: Most participants found their experiences to be beneficial and meaningful but faced challenges in the field. Knowledge and skills varied among providers. Education and support are critical for healthcare professionals who engage in transnational healthcare. Recommendations for staff preparation are provided.

Author Biography

Donna J. Perry, PhD, RN

Assistant Professor, Graduate School of Nursing, University of Massachusetts Worcester, Worcester, Massachusetts; Nurse Scientist, The Yvonne L. Munn Center for Nursing Research, The Institute for Patient Care, Massachusetts General Hospital, Boston, Massachusetts.


Jaffer AK, Campo RE, Gaski G, et al.: An academic center’s delivery of care after the Haitian earthquake. Ann Intern Med. 2010; 153(4): 262-265.

Crocker JT, Huang GC: Reflections on Haiti: The role of hospitalists in disaster response. J Hosp Med. 2011; 6(2): 105-107.

Kerry VB, Ndung’u T,Walensky RP, et al.: Managing the demand for global health education. PLoS Med. 2011; 8: e1001118.

Eckhert NL: Getting the most out of medical students’ global health experiences. Ann Fam Med. 2006; 4(suppl 1): S38-S39.

Drain PK, Holmes KK, Skeff KM, et al.: Global health training and international clinical rotations during residency: Current status, needs, and opportunities. Acad Med. 2009; 84(3): 320-325.

Thorne S: Global consciousness in nursing: An ethnographic study of nurses with an international perspective. J Nurs Educ. 1997; 36(9): 437-442.

Kirkham SR, Van Hofwegen L, Harwood CH: Narratives of social justice: Learning in innovative clinical settings. Int J Nurs Educ Scholarsh. 2005; 2(1); ISN 1548-923X, DOI: 10.2202/1548-923X. 1166.

Gupta AR,Wells CK, Horwitz RI, et al.: The international health program: The fifteen-year experience with Yale University’s Internal Medicine Residency Program. Am J Trop Med Hyg. 1999; 61(6): 1019-1023.

Bentley R, Ellison KJ: Increasing cultural competence in nursing through international service-learning experiences. Nurse Educ. 2007; 32(5): 207-211.

Curling P, Simmons KB: Stress and staff support strategies for international aid work. Intervention. 2010; 8(2): 93-105.

Fullerton CS, Ursano RJ,Wang L: Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. Am J Psychiatry. 2004; 161(8): 1370-1376.

Armagan E, Engindeniz Z, Onder Devay A, et al.: Frequency of post-traumatic stress disorder among relief force workers after the tsunami in Asia: Do rescuers become victims? Prehosp Disaster Med. 2006; 21(3): 168-172.

Walsh DS: Interventions to reduce psychosocial disturbance following humanitarian relief efforts involving natural disasters: An integrative review. Int J Nurs Pract. 2009; 15: 231-240.

Benjamin E, Bassily-Marcus AM, Babu E, et al.: Principles and practice of disaster relief: Lessons from Haiti. Mt Sinai J Med. 2011; 78: 306-318.

Crump JA, Sugarman J: Ethical considerations for short-term experiences by trainees in global health. JAMA. 2008; 300(12): 1456-1458.

Kene M, Pack ME, Greenough PG, et al.: The professionalization of humanitarian health assistance: Report of a survey on what humanitarian health workers tell us. Prehosp Disaster Med. 2009; 24(suppl 2): s210-s216.

Harvard Humanitarian Initiative and Dartmouth Medical School: 2007 Humanitarian Health Conference: Final Report. 2007. Available at http://hhi.harvard.edu/publications/hhi-program-publications. Accessed March 20, 2008.

Harvard Humanitarian Initiative: 2009 Humanitarian Action Summit: Exploring the Edges of Humanitarian Health: Summit Proceedings and Policy Compendium. 2009. Available at http://hhi.harvard.edu/publications/hhi-program-publications. Accessed April 26, 2011.

Walker P, Russ C: Professionalizing the Humanitarian Sector: A Scoping Study. Commissioned by ELRHA; Enhancing Learning & Research for Humanitarian Assistance. April 2010. Available at http://www.elrha.org/uploads/Professionalising_the_humanitarian_sector.pdf. Accessed April 26, 2011.

Perry DJ: Transcendental Method for Research with Human Subjects: A transformative phenomenology for the human sciences. Field Methods. 2013; 25(3): 262-282.

Lonergan B: Insight: A study of human understanding In Crowe FE, Doran RM (eds.): Collected Works of Bernard Lonergan. vol 3. 5th ed.Toronto: University of Toronto Press, 1957/2000.

Lonergan BJF: Method in Theology. Toronto: University of Toronto Press, 1972/2003.

Perry DJ: Catholic supporters of same gender marriage: A case study of human dignity in a multicultural society. Lewiston,NY:The Edwin Mellen Press, 2008.

Patton MQ: Designing qualitative studies. In Qualitative Research & Evaluation Methods. 3rd ed. Sage: Thousand Oaks, 2001: 209-257.

Lonergan B: Horizon, history, philosophy. In McShane PJ (ed.): Collected Works of Bernard Lonergan, Phenomenology and Logic:The Boston College Lectures on Mathematical Logic and Existentialism. Toronto: University of Toronto Press, 2001: 298-317.

Neuman WL. Social Research Methods: Qualitative and Quantitative Approaches. 5th ed. Boston: Allyn and Bacon, 2003.

Creswell JW. Qualitative Inquiry and Research Design: Choosing Among Five Traditions. Thousand Oaks, CA: Sage, 1998.

Davies D, Dodd J: Qualitative research and the question of rigor. Qual Health Res. 2002; 12(2): 279-289.

Perry DJ: The Israeli-Palestinian Peace Movement: Combatants for Peace. New York: Palgrave Macmillan, 2011.



How to Cite

Perry, PhD, RN, D. J. “Effective Purpose in Transnational Humanitarian Healthcare Providers”. American Journal of Disaster Medicine, vol. 8, no. 3, July 2013, pp. 157-68, doi:10.5055/ajdm.2013.0123.