Swedish Physicians Working for International Help Organizations – on New Work Contexts, Knowledge and Reflexivity

What do Swedish physicians experience, teach and learn when they work abroad at international organizations like MSF/Doctors without Borders, the Red Cross, Operation Smile or the United Nations? How do they share their experiences with other medical professionals when they return to the Swedish workplace? My paper is based on an interview study with doctors who have returned to Sweden and it combines theories of knowledge with Pierre Bourdieu's concepts.  I discuss how the physicians reflect on performing their professional role under unusual and at times difficult circumstances, encountering different medical, organisational and local subcultures and gaining and sharing practical and theoretical knowledge. The work abroad is often guided by acute requirements rather than accurate scheme. It puts the well-known, taken-for-granted medical practice into perspective. The Swedish doctors in the study talk about the sometimes tough, but educational adjustment to the new cultural and occupational context. Sometimes, they have to deal with disasters and extreme stress, and there are ethically complex issues when equipment or medicines are perceived as inadequate. In their very reflexive accounts, the doctors appreciate the valuable experience of saving or improving lives, making a difference with small means, as opposed to the overly organized Western medical care, but there are also critical reflections about the long-term benefits of this kind of contribution. The doctors are especially concerned about the post-colonial implications of working in the global south. When they return to a Swedish workplace, their experience is often met with a positive, but rather shallow interest and there is seldom any systematic arrangement for knowledge transfer or utilizing their experiences in the Swedish context. Neither is all knowledge regarded as relevant and valuable in the Swedish/Western medical and organizational reality.