Considering a Medical Mission Trip?
A Tennessee dentist thought she was headed for Haiti on a volunteer mission trip, instead she ended up in a Tennessee jail. She was arrested at Nashville International Airport after security discovered five bottles of narcotic painkillers in her luggage. Police were told the medication was intended for patients at a dental clinic in Haiti. Having no official documentation for transporting the narcotics, she was arrested, charged with possession of a controlled substance and intent to deliver, and faced a sentence of between three and six years in jail. This incident is a cautionary tale for practitioners who plan on traveling with medications to foreign countries for medical mission trips. The reality of the situation is that practitioners need to be attuned to not only federal law but also international law when traveling with narcotics in order to avoid serious legal consequences.
Typically, the only way to export or import controlled substances, other than for personal use, is to obtain an import/export license. However, the federal government has carved out an exception precisely for the above scenario. The transport of controlled substances for mission trips requires a special waiver from the U.S. Drug Enforcement Agency (DEA). DEA registered practitioners can request a waiver of federal requirements to legally export controlled substances from the U.S. for use in treatments involving humanitarian mission trips. The waiver is only available to “practitioners who are registered with the DEA as: M.D., D.O., D.D.S, D.M.D, or D.V.M.” Of note, the waiver only applies to the exportation of controlled substances and has no force or effect in foreign countries. As a result, the DEA requires practitioners to also “obtain import authorization from the Competent National Authority of the country of destination prior to entering that country.”
Narcotics aside, practitioners should also be informed about what other types of medicines are restricted from import. There are wide variances in how countries regulate the importation of medicine. Even over-the-counter medications may be prohibited in some countries. For example, the Japanese embassy warns against carrying Sudafed and Vicks inhalers. Practitioners can contact the embassy and consulate of the foreign country to find out what medications are prohibited or restricted.
In sum, there are a few considerations before embarking on an international mission trip: (1) keep in mind that ignorance of the law is not an excuse for noncompliance and can have serious repercussions, (2) research the destination and determine what medicines are restricted or require a necessary permit for government authorization, (3) obtain a letter from the sponsoring agency or from the pharmacy from which the medications were received describing the mission purpose and what the physician is bringing, and (4) make sure you contact PLT in advance of your trip to request consideration for an extension of your professional liability coverage. This list is by no means all-encompassing, but it is a start to preventing unnecessary inconvenience while traveling on a mission trip with medications.