This case introduced the idea of personal safety for trainees during short-term training experiences abroad. In many cases, a global training experience abroad can be risky for trainees, simply because of the nature of the local environment. Complex ethical issues arise when considering how safety standards can differ in local contexts; how much risk a trainee can safely assume; and how best to minimize this risk in balance with the overall goals of the collaboration.
It is impossible to provide a framework to cover all possible personal safety risks for trainees. However three general themes emerge from considering this scenario:
- Trainees should be alert to the possible safety risks they may encounter during a short-term experience abroad – such as the risk of multi-drug resistant TB Ben encountered. In addition, sending and host institutions, as well as sponsors, share the responsibility for informing and preparing trainees for these risks.
- All involved with short-term training experiences – trainees, sending and host institutions, and sponsors – also share the responsibility for helping minimize personal safety risks. Determining how to do so, and what measures to take, is likely to be determined on a case-by-base basis by those in a collaborative partnership, just as Ben discussed his N95 masks with his advisors.
- Even with advanced preparation and planning, safety risks and incidents, like Ben’s, might still occur. Sending institutions, host institutions, and sponsors have the responsibility to ensure plans are in place if and when these happen.
Understanding these three themes can help all those involved with short-term training programs abroad help ensure a safe and productive training experience.
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Additional Resources
Under universal precautions all patients are considered to be possible carriers of blood-borne pathogens. Guidelines recommend wearing gloves when collecting or handling blood and other bodily fluids contaminated with blood, wearing face shields when there is danger of blood splashing on mucous membranes, and disposing of all needles and sharp objects in puncture-resistant containers.
Universal precautions were designed for doctors, nurses, patients, and health care support workers who are required to come into contact with patients or bodily fluids. This includes staff and others who might not come into direct contact with patients.
For more information:
- Centers for Disease Control and Prevention. Perspectives in Disease Prevention and Health Promotion Update: Universal Precautions for Prevention of Transmission of Human Immunodeficiency Virus, Hepatitis B Virus, and Other Bloodborne Pathogens in Health-Care Settings. MMWR(1988; 37(24) 377-388.
- Panlilio, A. et al. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Post-exposure Prophylaxis. MMWR 54: 1-17 (2005).
- Kortepeter MG, et al. Health Care Workers and Researchers Traveling to Developing-World Clinical Settings; Disease Transmission Risk and Mitigation. CID 2010; 51 (11):1298-1305
