Last week on The Stream on Al Jazeera English, hosts Femi Oke and Malika Bilal questioned whether global health volunteerism is a help or a hindrance in countries like Kenya and Tanzania. The World Health Organization says volunteers provide 40 percent of the health services in Sub-Saharan Africa, but a survey by the Center for Medical Missions found one in five of its volunteer doctors had been sued over work they had done in the field.
Dr Jessica Evert, executive director at Child Family Health International, told her own harrowing story of being a medical volunteer in Kenya as a first-year student. A week into her experience, she was asked to perform a lumbar puncture, where she had to take fluid from a seven-year-old’s spine through a needle, without anesthetic.“I didn’t get the lumbar puncture; it delayed the diagnosis for the child; and it also injured him significantly, while a local physician – who was licensed and had done many of these and could probably have got it right away with a lot less pain for the child – sat next to me.”
The Stream showed a number of social media clips of similar stories, from American quarterback Tim Tebow helping perform circumcisions in The Philippines, to a volunteer talking about delivering babies unsupervised in Tanzania, to a volunteer posting pictures of herself on Instagram suturing a head laceration in Vietnam with the hashtag #idkwhatimdoing.
Noelle Sullivan, assistant professor of Global Health Studies and Anthropology at Northwestern University in America, has been studying medical volunteers in Tanzania. “You get anybody from a secondary school student all the way up to full practitioners… But the vast majority of these people that I’ve been watching in Tanzania for several years don’t actually have a lot of medical qualifications. Many of them have none and yet they are performing procedures on patients.”
Dr. Evert says the conditions are there for a “perfect storm,” as “tens of thousands of students want to go to med school but they will never even get into an interview.” With medical schools asking for “clinical experience,” many prospective students believe medical volunteering overseas will help get them be accepted to study. Hospitals are also being incentivized to take part through payments for hosting volunteers.
But Dr. Evert warns that the irony is that this kind of experience is actually teaching volunteers a number of wrong messages, from patient safety to social justice. “There is a disconnect here between what students are seeing and doing and what we want to nurture in them,” she says.
Similarly, Sullivan warns that the actual benefits of volunteering are limited. “They’re not necessarily learning skills that are relevant in their region. The drugs are called different names and the procedures are done differently based on the country and the medical culture, etc.”
Dr. Evert says it’s also important to factor in the opportunity cost. Pointing to the large sums of money spent on helping volunteers travel across the globe, she says, “If you took that money you could pay a salary for one to two years, depending on where you are, or put a nurse through nursing school.”
Daniel Motunga, a Kenyan healthcare professional, is more positive. He believes “there is a role for medical volunteers in developing countries” as they often “come in with a lot of resources.” But he adds, “You have to draw a line so people who are touching patients do actually know what they’re doing and the lives of patients aren’t at risk.” He says Kenya now requires volunteers to be properly licensed.
In a video comment, Pipple Biddle, a former medical volunteer, went further. “If a voluntourist wouldn’t be able to do something in their home country, they shouldn’t be doing it in a developing country. There are no ethical choices to be made by volunteers other than to get themselves out of positions that require training and expertise, whether it’s taking someone’s blood, helping in a surgical room, or any other volunteer position inside or outside of medical volunteering that you would not want a novice doing to you, you should not be doing to anybody else.”