The Promises and Pitfalls of Global Health Volunteering is
the subtitle of an interesting book which examines the
issue of doing good. HOPING TO HELP is organised into
sections. First, who actually sponsors medical missions?
Second, who are the volunteers? Third, the host communities
and fourth, how to best organise the aid to gain maximum
advantage for everyone. If this sounds like something you
want to know about or get involved in, Judith Lasker has
written a practical guide.
Experiences from Haiti, Ecuador, Ghana and Niger are
shared. We don't think of medical aid missions as having
research assistants along or professorship candidates, but
if someone goes along who is not immersed in the
exhausting, emotionally demanding work of providing hands-
on aid all day, this extra person is well placed to line up
translators and observe. We are told that the
international volunteer community is huge, and from America
alone one million people gave their efforts during 2007.
Not everyone appreciates this work, adds Judith Lasker. In
2013 a Somalian blogger wrote a sneering piece about
idealistic well-off people trying to atone for a colonial
past. This was countered by a Guardian journalist who
praised the beneficial impact of voluntary workers with
NGOs (non government organisations) particularly, rather
than profit-making companies. I would add that if bright,
energetic people risk their own health by travelling to a
disaster zone to distribute medical or practical aid, why
should anyone care about their motives?
Many volunteer trips last two weeks - this is the vacation
time people can take from work. Continual change means
there may be no continuity of aid or preparation; the best
programmes work with local agents to organise doctor visits
ahead of time. Incoming volunteers may be poorly prepared
for the situation or culture and applicant screening may be
basic. Poor record keeping and analysis can mean that no
records of the successes are available even in the best
outcome examples. So the practices of the groups have been
analysed by Judith Lasker in order that she can recommend
good measures and warn of the many pitfalls.
I found the accounts fascinating. For instance we are told
that groups travel to build homes and orphanages in poor
lands or after an earthquake; yet if there is one thing
these communities don't lack it is manual labour. From
reading about Disaster Capitalism, I've seen that outside
companies arrive, mop up aid money to build communications
or basic housing, and leave without having employed locals.
Judith Lasker says a father expressed the hope that the
experience would teach his son to be a charitable person.
But some young volunteers were concerned that their
presence served the aid organisation rather than locals. As
a social scientist, she asks the challenging questions. One
NGO staff member informed her that volunteers were secretly
not expected to do a good job; their purpose was to pay for
the trip and be tapped for funds again in the future. A
trip Judith Lasker took to Haiti included two people sent
specifically to prepare PR material for the group.
Judith Lasker says the world's poorest countries have seen
a sharp decline in public services due to war, famine or
foreign debt. Volunteer doctors and bridge builders save
them having to borrow more from the World Bank, which might
be wasted to corruption anyway. But if these countries
cared to address corruption they would be able to afford
more than the reported one nurse per 60 inpatients. So in a
sense, the volunteers prolong the corruption. Governments
now prefer to hand money to NGOs than to a perceived
corrupt dictator. The burden of disease is being fought by
outside medical aid, vaccination and education programmes,
which should help the populace. Surgeons who travel each
year to carry out many operations and train local
physicians make a significant impact. A group established
to tackle a specific health issue may address no other
health issues, fragmenting care; some of these work well
with mobile general clinics.
People have much better access to information through the
internet and want to make a difference; students in
particular. Volunteering looks good on a CV. Immigrant
families want to help their home country. Some long-
established NGOs are seen as bureaucratic and slow to
update, so small groups self-organise. Safety of the
volunteers is hugely important. But faith-based
organisations may have to work carefully where missionaries
are forbidden. One missionary woman quoted told a
conference "It's all about Jesus first, medicine second."
So motives clearly vary. The helpers themselves report
stress from factors like heat, exhaustion, stomach trouble,
cockroaches, lack of needed equipment and seeing death.
Staff in Haiti spoke praise of good volunteers, willing to
work hard at anything, but also described high maintenance
people who distracted staff rather than helped.
Judith Lasker has asked open-ended questions of many
individuals and organisations, and compiled the results.
She has also been there, done that, seen some of the
outcomes. I found HOPING TO HELP an excellent and inspiring
read. Also something of a warning against being blindly
idealistic.
Overseas volunteering has exploded in numbers and interest
in
the last couple of decades. Every year, hundreds of
thousands
of people travel from wealthier to poorer countries to
participate in short-term volunteer programs focused on
health
services. Churches, universities, nonprofit service
organizations, profit-making "voluntourism" companies,
hospitals, and large corporations all sponsor brief
missions.
Hoping to Help is the first book to offer a comprehensive
assessment of global health volunteering, based on research
into how it currently operates, its benefits and drawbacks,
and how it might be organized to contribute most
effectively.
Given the enormous human and economic investment in these
activities, it is essential to know more about them and to
understand the advantages and disadvantages for host
communities.
Most people assume that poor communities benefit from the
goodwill and skills of the volunteers. Volunteer trips are
widely advertised as a means to “give back” and “make a
difference.” In contrast, some claim that health
volunteering
is a new form of colonialism, designed to benefit the
volunteers more than the host communities. Others focus on
unethical practices and potential harm to the presumed
“beneficiaries.” Judith N. Lasker evaluates these opposing
positions and relies on extensive research—interviews with
host country staff members, sponsor organization leaders,
and
volunteers, a national survey of sponsors, and participant
observation—to identify best and worst practices. She adds
to
the debate a focus on the benefits to the sponsoring
organizations, benefits that can contribute to practices
that
are inconsistent with what host country staff identify as
most
likely to be useful for them and even with what may enhance
the experience for volunteers. Hoping to Help illuminates
the
activities and goals of sponsoring organizations and
compares
dominant practices to the preferences of host country staff
and to nine principles for most effective volunteer trips.
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