Getting beyond ‘voluntourism’

Thinking of joining an overseas humanitarian medical mission? The first question to ask yourself is: “Who am I doing this for?” said Barry Pakes, global health lead, Temerty faculty of medicine, University of Toronto. “You may want to experience other cultures and see new things. That’s OK, as long as you’re thinking about it in an appropriate way and it’s somewhat secondary to the motivation of wanting to use your skills to do something good to help those in need,” Dr. Pakes said. “Many people in the humanitarian world are not running toward something but running away from something in their lives. That’s a motivation you want to avoid.” A fine line So, once you decide your motivations are sound, how can you make sure a humanitarian organization you are considering is doing good work? Much has been written about the fine line between beneficial work and “voluntourism,” which can do more harm than good. From a 2017 article in Tropical Diseases, Travel Medicine and Vaccines: “It has been argued that much of international medical volunteering is done for the wrong reasons, in that local people serve as a means to meet volunteers’ needs, or for the right reasons but ignorance and ill-preparedness harm the intended beneficiaries, often without volunteers’ grasp of the damage caused.” Would-be volunteers also have to make sure they are joining an organization that is not just out to take advantage of their good intentions. “The first thing to find out is how much money are you expected to contribute? It should not be a large sum,” said Dr. Myron Semkuley, a retired Calgary family physician and co-founder of Medical Mercy Canada. “For example, we ask for a small donation to cover some of our organization’s expenses and for you to pay for your own travel.” A trusty doctor who has done it Owen Campbell, human resources manager at Doctors Without Borders/Médecins Sans Frontières Canada, recommends speaking to someone you trust who has worked with the organization about their experience. “And if it looks too good to be true, it often is. Do your research,” Campbell said. “The most important thing with any global health project is, who are their partners on the ground? You can’t just parachute into a country and start doing medical work. “Even countries going through a difficult situation have a ministry of health. They have a legal framework. So if an organization has no information on who they work with and how it is formalized, that’s a red flag for me. There are a lot of organizations doing great work, but you have to do your homework. There are organizations that do more harm than good.” For example, a World Journal of Surgery article outlines The Seven Sins of Humanitarian Medicine, which include, “failing to match technology to local needs,” “failing to have a followup plan,” “allowing politics, training, or other distracting goals to trump service” (even though the mission is represented as service oriented), failures in organizational cooperation, and “doing the right thing for the wrong reason.” To avoid being involved with these sins, Dr. Pakes recommends getting answers to questions such as: How long has the organization been doing work in a country? Are they replacing health services that are otherwise offered by the government or others? Do they have a team there all the time or are they there infrequently? What does the population think about what they are doing? “A large organization that has no partnerships or is moving around to a lot of different places may have had to move because the communities haven’t responded or been positively disposed to what those organizations are doing,” Dr. Pakes said. He also warns against working with organizations that go abroad with a mission to “save” a community. “Some will focus on the health aspect and others will try to save their souls. There are a lot of ethical issues related to that.” Perpetuating white saviour complex? Indeed, many criticisms of voluntourism centre around perpetuating the white saviour complex, where volunteers from wealthy countries travel to rescue the poor. “Research an organization’s mission and values and make sure they are things you identify with. Google to see if there have been issues with the organization. Do they have ulterior motives?” Dr. Pakes said. Many academic institutions are forming partnerships with institutions in other countries and Dr. Pakes suggests searching these out. “There is often a higher standard or a different level of accountability when organizations have partnered with academic institutions. So that would be a green flag.” Dr. Pakes also says it is important to have training in global health and an understanding of it. “Practising in other countries is profoundly different than practising in Canada,” he says. “Not only because of different health systems and the different resources that are available, but the different epidemiology of diseases and the different ways in which you work.” A local life While a degree or course in global health is best, Dr. Pakes recommends at least choosing an organization that delivers pre-trip training. He also suggests doing research on websites such as the Institute for Health Metrics and Evaluation, to learn the profile of a country. “You can see what illnesses they are seeing and the basics of epidemiology and demographics. For example, if you’re going to an agricultural community, you can expect to see farm injuries or pesticide toxicity,” he said. Dr. Semkuley says you must also be willing to fit in with the people in the community you will be working in. “That means you try to live with them as much as possible—eat their food, learn their language, learn their culture. We’re not trying to change people, we are trying to help them improve their own life,” he said. “We focus on health and medical care, but we also provide education and help them see how they can improve their health facilities and train them so they can carry on the work.” Elaine Semkuley, a retired pharmacist and co-founder of Medical Mercy Canada, adds that it is important to listen to the local community. “Get it to one-on-one. Go for a walk with just one person and listen to them. You have to really listen,” she said. “It’s amazing what we have learned over the years. It has made a lot of difference in the way we operate.” Campbell says doing humanitarian work can take an emotional toll. “But it’s also rewarding,” he said. “You’re helping people and using your skills. You learn from people who aren’t able to rely on expensive diagnostic tools and you learn how to practise medicine in a lower resource setting. So, you can rely on new skills and build up new skills. You come back invigorated.”

Getting beyond ‘voluntourism’

Register for free access or login.

Related Topics