Dr. Jeannie Beauchamp, left, performs dental work on a patient during her visit to Haiti last week. The doctor faces three to six years in jail for trying to take medication out of the country without the proper documents.
Clarksville dentist Karyl Jean Beauchamp thought she was going to Haiti on April 18 to volunteer at a free clinic. Instead, she ended up in a Tennessee jail.
What started as a mission of mercy turned into a legal nightmare when Beauchamp was arrested at Nashville International Airport after more than 150 prescription pain pills were found in her luggage. She told police the narcotics were intended for patients at a dental clinic in Haiti.
But she had no official documents allowing her to take the medicine out of the country. So Beauchamp was charged with possession of a controlled substance with intent to deliver. Federal law has prohibited taking narcotics out of the country without permission since the 1970s.
“There’s no dispute that she was doing this for humanitarian purposes,” her attorney, David Raybin, said. “I just don’t see that any laws were broken.”
Beauchamp’s legal woes reflect a new reality facing doctors doing medical mission work. Tightened airport security has made it harder to take medication overseas. And poor countries are keeping a closer eye on volunteer doctors. Medical missionaries used to work with little oversight, but today doctors often have to carry copies of their licenses and board certifications, and face strict limits on what kinds of medicines they can take into a foreign country.
All this is happening when churches are embracing a do-it-yourself approach to missions, organizing trips on their own instead of working through experts. In some cases, they’re finding out what they don’t know can hurt them.
Joseph Smith, director of operations for Nashville-based Healing Hands International, which provides medical supplies for humanitarian work, says doctors have to follow strict rules when taking medications overseas.
While doctors can take antibiotics, over-the-counter painkillers and other medications with little hassle, narcotics require special permission from the U.S. Drug Enforcement Agency.
Smith also tells doctors not to take leftover prescription medicines. Those drugs can be out of date and sometimes their quality is suspect.
About a decade ago, Healing Hands received a truckload of donated ibuprofen that was about to expire. The charity had the drugs re-tested and got new expiration dates for the drugs, but patients overseas were not convinced.
“They peeled off the new labels, saw the old expiration date and said, ‘Are you trying to kill us?” he said. “Sometimes, we mean well, but can do more harm than good.”
Sam Molind, head of Global Health Outreach for the Bristol, Tenn.-based Christian Medical and Dental Association, said his group created a series of best practices for medical missionaries after organizing mission trips for the past 12 years. His group sends out about 700 doctors a year.
His practices include registering all doctors on mission trips with the ministries of health in the countries where they volunteer, collecting each doctor’s credentials, including copies of their medical licenses and resumes.
His group also discourages treating the patients and then leaving with no follow-up plan in place.
“That’s what we call we call guerrilla medicine,” he said. “It’s not safe. It’s not effective. It’s not prudent, because at some point people will get hurt.”
Instead, Molind’s group works with local doctors and established hospitals in the developing world. Their doctors often consult with the local doctors to do follow-up treatment.
Some avoid trouble
Even though Beauchamp was charged, other doctors have traveled overseas with medicine without encountering any trouble.
Chris Sizemore, an ob-gyn from Franklin, has been on previous mission trips to Guatemala, Ghana and Haiti. He did emergency care after the earthquake in January. Because he knew he’d be doing surgery, Sizemore tossed a bottle of 4,000 Vicodin into his bags.
Nobody asked questions about the painkillers, he said.
“I’ve always heard that if you have your license with you, and you keep the medicine in the original container, you will be OK,” he said. “It’s one of those ask for forgiveness, not permission, situations.”
But that approach can get doctors in trouble, said Barbara Bookholdt, an official with Drug Enforcement Agency’s office of Diversion Control.
Being a doctor offers no protection when it comes to transporting narcotics, she said, which is governed by federal law and international treaty.
That’s why Bookholdt’s office provides medical mission waivers to doctors. Doctors complete a form, list the medications they want to bring and the mission work they’ll be doing. Once her office does a background check, making sure the doctor’s DEA registration is in order, they issue a waiver letter the doctor can show to customs in the United States and overseas.
Usually, the process takes about a month. In a crisis, it can take two hours.
Since Jan. 12, the DEA has issued 170 letters to mission groups, working round the clock in the early days.
“In some cases, the doctors were on the tarmac, and we e-mailed them a letter,” she said.
The waiver letter application for Haiti is on the DEA website and has about a 48-hour turnaround.
Bookholdt’s office says they want to help doctors doing humanitarian work, but they can’t ignore the law. And doctors who do will face the consequences, especially if they get arrested overseas.
“Some countries are not very forgiving,” she said.
Jail time is possible
Raybin believes Beauchamp will be vindicated. She owns Clarksville Pediatric Dentistry and has a long history of charitable service. She has been to Haiti many times to volunteer through Immaculate Conception Catholic Church’s regular medical mission trips and the Nashville-based Visitation Hospital Foundation.
She has no criminal record.
After posting a $2,000 bail, Beauchamp was allowed to go to Haiti, to continue her mission work. But she’s due in court May 10 to face the criminal charges, and if convicted, she faces three to six years in jail.
“Dr. Beauchamp has been to Haiti multiple times at her own expenses,” Raybin said.
On a previous trip, the clinic ran out of pain medication and that’s why she was taking the pills in April.
“When the drugs ran out, they were pulling teeth without anesthesia,” Raybin said. “No one wants to see that happen.”