How we can solve the HEALTH ISSUES for RPCVs

The combined efforts of sick and/or injured RPCVs, Health Justice for Peace Corps Volunteers, and the NPCA continue to collaborate and to advocate for improving access to appropriate medical services, care, and treatment for RPCVs who return from service sick and/or injured. Nancy Tongue (Chile 1980-82) is the Director of Health Justice for Peace Corps Volunteers after having formed the organization due to her continued challenges accessing medical services, care, and treatment. She has recently been joined by Sara Thompson (Burkina Faso 2010-12), to further advocate for improving access to resources for the health, safety, and security of Volunteers in the field and upon returning sick and/or injured. Casey Frazee (South Africa 2009) has also been working to improve Peace Corps and response to victims of sexual assault after having been the survivor of sexual assault while serving in Southern Africa. She organized First Response Action to raise awareness about access to rights and resources for Volunteers who are survivors of physical and sexual assault.

Health and other issues of PCVs have been occurring since day one of the Peace Corps. Now, some progress is being made on these issues, thanks to the work of these individual RPCVs and the NPCA.

Here are Sara’s updates. On behalf of all RPCVs, thank you, Sara.

I wanted to provide an update regarding the coordination of Health Justice for Peace Corps Volunteers (HJPCV) efforts to improve access to healthcare benefits that Peace Corps Volunteers are entitled to upon returning from service sick and/or injured.  We were able to draft and push for legislation to be introduced at the Congressional House, BI-PARTISAN level – YAY!! Exciting news – thanks to Representative Ted Poe (TX) and Representative Joe Kennedy (MA)! We are still waiting on the Senate to finalize drafting and introduce a bill (which shouldn’t differ too much from the House bill).

Therefore, the proposed Peace Corps legislation by the Congressional House is titled, “H.R.2259 – To amend the Peace Corps Act to expand services and benefits for volunteers, and for other purposes.” NOTE: When discussing the bill, do NOT address it as reform. No one wants to talk about “reforming” PC as it puts PC in a bad light. Talk about the bill as “improving PC for its Volunteers” and “ensuring PC has the legislation to further protect and provide for the health, safety, and security for its Volunteers,” or some diplomatic blurb like that. The actual legislation that was introduced is available at this link in the event that you would like to read it:

Main takeaways from the legislation:

1) Allows Volunteers to receive higher disability pay. The current rate puts sick and/or injured Volunteers below poverty level. The increase allows Volunteers to actually make a living of sorts.

2) Mandates that Peace Corps begin distribution of mefloquine in accordance with CDC recommendations (two weeks before heading overseas).** (see note below for more information).

3) Mandates that Peace Corps Medical Officers (PCMOs – Peace Corps doctors) have basic medical qualifications (rather than just being a gynecologist or other specialist without basic practitioner experience).

4) Extends the Sexual Assault Advisory Committee and expands their ability to look into specific cases.

SO – to garner Congressional Support:

House Side

Please contact your Congressional Rep and ask for the following:

1) Support for this legislation – HR 2259 “To amend the Peace Corps Act to expand services and benefits for volunteers and other purposes.”

2) Ask Congressional representative if they would like to co-sponsor the bill. The more co-sponsors there are, the greater the likelihood that the bill will be voted on.

3) Support for any additional bill related to improving the Peace Corps and supporting Volunteers and Volunteer health. (We are hoping to work on legislation for changing Department of Labor (DOL) as actually accessing healthcare and treatment through DOL – FECA remain a challenging issue).

Senate Side

1) Ask your Senator to inquire with Senator Corker’s office regarding the status of the draft legislation.

2) Support for the legislation after it is introduced.

Peace Corps Volunteers should be supported throughout their service and when they return home sick and/or injured. This legislation allows for further support for the health, safety, and security of Volunteers!  

Hope this helps and let me know if you have any questions or would like additional information. You can reach Sara at

**Regarding mefloquine reform:  In the original draft legislation, I had written/proposed banning mefloquine altogether, following the move away from using mefloquine by Department of Defense in 2009. Peace Corps, however, has pushed back and aren’t supportive of beginning mefloquine distribution in the States, in accordance with CDC recommendations. Therefore, Poe’s office compromised and have indicated that PC has to at least be acting in accordance with CDC guidelines. If you would like, you can tell your Congressional rep that you think that mefloquine should be banned. If there is enough outside support and pressure, Peace Corps won’t have any choice but to follow what the public and Congressional reps want them to. Feel free to let your Congressional representative know that mefloquine is the most dangerous, least effective anti-malarial prophylaxis.



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  • Thank you, John, for this important coverage of the Health Care legislation.

    ” Casey Frazee (South Africa 2009) has also been working to improve Peace Corps and response to victims of sexual assault after having been the survivor of sexual assault while serving in Southern Africa. She organized First Response Action to raise awareness about access to rights and resources for Volunteers who are survivors of physical and sexual assault.”

    Casey Frazee and First Response Action lobbied, successfully, to secure the passage of the Kate Puzey Peace Corps Protection Act of 2011. The current introduced legislation will strengthen the provisions of that act and increase Peace Corps ability to extend help to Volunteers after they come home.

    I think it is also important to recognize the incredible support of Kate Puzey’s parents who helped support the original legislation. Now, Sue Castle, Mother of Nick Castle, serving Volunteer who died in China because he received medical care too late, has also worked with Nancy’s team to highlight existing problems and help bring about solutions.

    The Peace Corps community is so fortunate to have these incredible women.

  • We need to add that the new legislation would also improve medical care for ALL serving Volunteers, so that the tragedy of Nick Castle would not happen again.

    • Hi Joanne,

      The current legislation as written will improve the qualifications of the PCMOs as one step in a number of steps that need to be taken by PC to provide for the health, safety, and security of the Volunteer. Unfortunately, not much more could be mandated by Congress for several reasons. Peace Corps still has a very long way to go to be able to respond to the physical and mental health issues of Volunteers in the field, and returning from service sick and injured.


      • Thanks, Sara. I have a comment and some questions:

        The questions first:

        1) What more do you think Congress should mandate that would make a difference?

        2) What do you think are the limits that Congress faces.? This question may just be rephrasing the above.

        This is my comment, and my concern.
        The Peace Corps is a federal agency and its Director and Deputy Director are appointed by the President, There are also some thirty decision making positions that are “Schedule C”, which means they do not come through the civil service system, but can be recommended by the new administration. Prior service as a Peace Corps Volunteer is NOT a requirement for employment with the Peace Corps. So there is a staff superpvising Volunteers that may not be at all familiar with Peace Corps service. Their committment could well be to the agenda of the cuurrent administration.

        Also, Peace Corps Volunteers are not civil service employee nor contract employees. The serving Volunteers do not have the legal protection that civil service employees have or the legal protection that contracts provide. Volunteers serve at the “pleasure of the President” and that authority is delegated down the line to Country Directors and/or other supervisory personnel in the field. Termination is easy.

        Volunteers are private citizens doing public work. I believe that an analysis was done by the NPCA staff was done which pointed out how this fact complicated the way the Department of Labor/Workman’s Compensation dealth with injured RPCVs.

    • Thank you for bringing this to the attention of the Peace Corps Community. Nancy has been working on this for a very long time and has never given up. Sara brings a new perspective to all of this even though she has been working on this for a few years. I bring tragedy -what happened to my son should not happen to another volunteer. What happened to our family in trying to get answers was reprehensible. Yet I work in wanting to see a stronger Peace Corps. Better in service care will reduce prolonged or horrible outcomes for some volunteers. It will take the entire Peace Corps Community to bring about these changes.
      The Peace Corps Mission
      To promote world peace and friendship by fulfilling three goals:
      To help the people of interested countries in meeting their need for trained Volunteers.
      To help promote a better understanding of Americans on the part of the peoples served.
      To help promote a better understanding of other peoples on the part of Americans.

      I’m asking you to support a 4th goal
      To show support and compassion for all volunteers.

  • I am interested in a data bank/blog of health issues of RPCV’s. The purpose would be to identify common issues and provide preventive education to the staff and current volunteers and to assist RPCV’s with info on treatments other RPCV’s are receiving for consideration by their doctor. I served in 68-70. Since returning I have had digestive issues…mild for many years, increasingly troublesome the last 15 and now serious. Am finally getting close to a diagnosis and was told my entomoeba histolytical infection could be a cause. Sure would have been helpful to have heard years before. Perhaps a data base of occurrences and treatments would do this.

    • So far we can’t get anyone to do this formally. We have many in our Health Justice for Peace Corps Volunteers who struggle with gastro-intestinal issues. It would be very helpful to have such a database and to even have Peace Corps identify physicians who have helped returned Peace Corps volunteers with a variety of health issues and then to work to enroll them into the FiECA program so that bills can be covered. We have pushed for this for quite a while, to no avail.
      Nancy Tongue

      • I would like to add, Nancy, how important it is that you and your team are in connect with and provide support for RPCVs with service connected problems. Thank you so much for being there for them, even if you had not gotten all the improvements you have advocated. That kind of support can not be minimized.

        I came home more than 50 years ago. I have medical problems related to excessive ultraviolet
        radiation because when I served excessive exposure to the sun was not identified as potentially cancer-causing, by our “crack medical experts.” (However, the HC women I worked with were very concerned that we did not protect ourselves from the sun.)

        Now, Peace Corps does advise PCVs to protect themselves from sun exposure and also provides sun screen, I believe. My early basal cell carcinoma (I was 28 and in those far off days, I was the youngest with that cancer on the local cancer register) probably saved my life because it identified my high risk for other more serious cancers and an auto-immune disease associated with sun exposure.

        Ironically, I had been treated for what at the time appeared to be a totally unrelated condition. I could not get medical care, stateside, when I came home, sick, and agreed to be a research patient at the National Institutes of Health in Bethesda. I would not want other volunteers to be placed in that position

        I know all about the dangers, now, of mefloquine, thanks to all the great work by Sara Thompson. However, I have recently learned that the anti-malaria drug that we took in the earlier years, chloroquine (Aralan) can suppress the production of estrogen in women. It is used, now, in conjunction with chemotherapy for breast cancer. Who knew?

        I used to say that Peace Corps service had a half-life of 50 years. I was wrong. Peace Corps service leaves an indelible mark on our bodies, as well as our souls, that time can not erase.

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