In 2024, I joined a medical mission trip across East Africa with my spiritual community. Our guiding principle was simple: “Love all, serve all.” The goal was selfless service: providing free medical care to anyone who needed it. Roughly sixty of us traveled together, physicians, pharmacists, nurses, and support staff, moving across rural sites to set up temporary medical camps.
We saw hundreds of patients in environments that shifted constantly: church centers, private hospitals during a physician strike in Kenya, partially constructed facilities without basic infrastructure, and school grounds. Each day was intense and exhausting. But what stayed with me most was not the volume of patients or the logistics of care delivery. It was the emotional disconnect I experienced throughout the trip, and continue to reflect on now.
I cried on the first day.
Not because I didn’t want to be there, and not because I didn’t believe in what we were trying to accomplish. I cried because I could already feel the gap between intention and capacity, between what we hoped to offer and what the system could realistically sustain once we left.
My desire to practice medicine in a global context actually started when I was a teenager watching an episode of The Oprah Winfrey Show. Dr. Catherine Hamlin, an OB/GYN who founded a fistula hospital in Ethiopia, became my hero. Her work, and the women she served, stayed with me. She started a hospital in Addis Ababa and built a community of volunteers that included former patients. That moment quietly shaped my path toward OB/GYN and a long-held dream of serving women in Africa.
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So when I finally arrived on this mission trip, it was the fulfillment of a dream I had carried for years. And yet, the reality was more complex. We moved through Uganda, Kenya, and Tanzania, each setting presenting its own version of urgency and resource limitation.
In Kampala, we worked out of a Sathya Sai Baba center, where something unexpected happened. Individuals who initially came as patients gradually became volunteers and mentors, helping us navigate language barriers, organizing patient flow, and grounding the work in the local context. They even slept in cars to remain on site and support the work.
In Kenya, we set up in a private hospital during a time when local physicians were on strike. The level of unmet need was overwhelming. The demand far exceeded what we could safely address with short bursts of care.
In Tanzania, we worked in a hospital still under construction, without running water at times and without reliable infrastructure. We adapted constantly, improvising solutions minute by minute.
And throughout all of it, I kept noticing something I did not expect: the women.
The women I met were strong, intelligent, resilient, and deeply grounded. Many young female patients were already mothers, sometimes in their mid-teens. I routinely started asking, “How many children do you have?” Only once did someone pause and gently respond, “I’m still studying.” That moment stayed with me. It reminded me how much I take for granted: the education, the opportunities, the resources that shaped my life and allowed me to become an OB/GYN.
The local community left a deep impression on me. They were not passive recipients of care; they were essential partners. They taught me how to slow down, how to listen differently, how to manage frustration, and how to remain present in conditions that were far from ideal. In many ways, they modeled what sustainable care actually looks like.
The more I observed, the more I questioned the assumptions I had brought with me. Much of what we offered was rooted in clinical frameworks developed in high-resource settings. I began to wonder how often those frameworks truly translated into meaningful, long-term impact in places where follow-up is uncertain.
Even simple clinical decisions, such as minor surgical procedures, felt ethically complex in that environment. When procedures like lipoma removals were performed, I found myself thinking not only about the operation itself, but what happens afterward. Who removes sutures if they are non-absorbable? Who manages complications? Who sees these patients in a week or two, when we are no longer there?
The intention is always to help, but I found myself returning to the first principle of medicine: First, do no harm. The experience left me holding two truths at once: There is undeniable value in showing up where care is scarce, and short-term medical missions do not always create sustainable, lasting impact.
One of the most sobering realizations for me was how brief our presence truly is in a patient’s life. For us, the encounter is a proud memory of service we carry home. For the patient, it is their health, their body, their lived reality long after we have left.
We often do not see what happens next. We do not always know if a wound healed, if a complication developed, if follow-up care was accessible, or if an intervention ultimately helped or unintentionally complicated someone’s course. And that uncertainty carries weight.
It made me ask difficult questions. In our urgency to help, are we fully accounting for the consequences of our absence? Are we certain that what we do, in compressed time and limited continuity, serves the patient’s long-term well-being? Or are we sometimes comforted more by the act of giving care than by the ability to understand its outcomes?
I don’t ask these questions from a place of judgment, but from a place of responsibility. Because the truth is, we leave, but patients do not have that option. They live with whatever we set in motion.
I don’t leave this experience believing we should stop going. I leave believing we must go differently. Not to briefly deliver care and leave, but to build with the communities we serve, alongside local clinicians and volunteers who understand the landscape far better than we do. In both Dr. Catherine Hamlin’s hospital and during our trip, I witnessed patients becoming volunteers, stepping into care roles with remarkable commitment and purpose. It made something clear: Local communities are deeply capable of driving change, but resources and infrastructure are often lacking. The question is whether we are truly supporting and strengthening that capacity.
I argue that we should be building with that energy, not around it. Strengthening what already exists. Creating space for local ownership to grow. Staying long enough, or returning often enough, so that what is started does not disappear the moment we board a plane.
Perhaps the real measure of loving all and serving all is not what we accomplish while we are there, but what continues after we are gone.
Priya Panneerselvam is an obstetrician-gynecologist.
