Main Themes	Sub-themes	Codes
General perceptions of volunteer teams	Expressed desirable trait	1.1 Cooperation/coordination
		1.2 Appropriate skillset/credentials
		1.3 Knowledge exchange
		1.4 High standards of care
		1.5 Kindness
		1.6 Asks questions
		1.7 Organized/prepared
		1.8 Speaks Creole
	Expressed undesirable traits	1.9 Disrespect staff/ hospital rules
		1.10 Culturally insensitive
		1.11 Incompetent/unprepared
Perceptions of the effects of the volunteer teams on healthcare systems	How teams affect hospital/healthcare system positively	2.1 Training programs improve local capacity
		2.2 Prestige to hospital
		2.3 Improves access to surgery for poor
		2.4 Promotes culture of quality
		2.5 Attracts more patients
	How teams affect hospital/healthcare system negatively	2.6 Strains hospital resources
		2.7 Complicates fee structure
		2.8 Impacts patient safety
		2.9 Creates commotion
		2.10 Patient follow-up difficulties
		2.11 Undermines relationships between patients & local staff
Perceptions of the effects of the volunteer teams on local healthcare workers	Professional impact on local team	3.0 Increases stress → more preparation and follow-up; multitask roles; language barrier/miscommunication; increased patient load & responsibility
		3.1 Longer workday
		3.2 Increased knowledge and skills
		3.3 Stimulated professionally
		3.4 Opportunity for international travel to conferences
	Economic impact on local team	3.5 Lost wages/transportation costs
		3.6 Improved livelihood with gained skills
	Social impact on local team	3.7 Build friendships/cultural awareness
		3.8 Improved self-esteem
		3.9 Positive work environment
		3.10 Mistrust of translators
	Spiritual impact on local team	3.11 Life change for patient/staff
		3.12 Forms self-identity/value
		3.13 “Increases blessing count”
		3.14 Feels good to help own people
Future recommendations	Before mission	4.0 Inform coordinator of team’s surgical specialties
		4.1 Pack all needed supplies
		4.2 Prepare lectures
		4.3 Do not include expired medications
		4.4 Create transparent hospital/patient fund
		4.5 Invite local doctors to attend conference and training
	During mission	4.6 Fair allocation of supplies
		4.7 Fewer volunteers in OR
		4.8 More training less surgery
		4.9 Promote integration of local staff into training and education
		4.10 Patient education (BP and diabetes)
		4.11 Identification badges
		4.12 More translators
		4.13 “If you don’t do it in the States, don’t do it here.”
		4.14 Daily briefings
		4.15 Universal symbols for medication instructions
	After mission	4.16 Continue communication
		4.17 Plan return
		4.18 Consider long-term partnership
		4.19 Develop mission evaluation forms