I am not sure if I understand this:
They have a poor family in a poor country and a mother with a medical emergency.
Why would this require ongoing large loans ? Your friend is getting first world wage to pay off third world medical costs so this should not be gargantuan. This would be more understandable if the mother came to the US and had to have medical treatment at US costs without health insurance or something.
But it is hard to make sense of if she is getting treatment in the low medical cost country. Is it possible the money is going to mother’s emergency plus maybe supporting the rest of the family and a few debts here and there and maybe a real estate venture or drugs or booze or gambling and something else ?
Lol, no. Evidently I did a horrible job explaining things. There is no requirement for ongoing large loans. There is a need for one loan. After the medical emergency, the fellow needs to send more money back home than they can currently do with their fellowship salary. That can be solved by either getting one loan here and paying off the loan back home, or moving to a hospitalist position with a higher paycheck.
I'm a born cynic when it comes to requests for money from overseas. Almost a decade in the military and many years OCONUS has left me rather jaded in that regard. I've seen some things, man.

Secondly, I never said they came from a third world country.

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