Medical missions should remember sustainability

It’s hard to believe that spring break ended less than a week ago. From alternative breaks at Navajo Nation in Utah to brigades all the way in Honduras, many students committed their seven days to humanitarian causes. These experiences bring a slew of benefits, but there’s always the risk of doing more harm than good in terms of sustainability. It’s an issue that’s especially prevalent when it comes to university programs that send pre-health students abroad for one-week trips.

Medical volunteering has recently greatly expanded, with more than 500 medical organizations in the United States and more than 6,000 short-term missions, according to a 2011 Global Health paper. At a glance, it’s not hard to see the benefits of these trips — at least when it comes to the students.

For a week, students experience life beyond the sheltered bubble of college where they can’t enjoy the everyday luxuries of heat, running water, electricity and — God forbid — Wi-Fi. Often located in developing countries, these brigades allow students to foster cultural appreciation and sensitivity, essential qualities in developing empathy. And while most pre-med students haven’t received enough medical training to perform procedures, there’s more than enough to do to run a makeshift health center, from setting up tents to escorting patients.

There’s a downside, however. As a paper published by the journal Globalization and Health put it, the issues regarding “voluntourists” include “using vulnerable people in developing countries to practice clinical skills, enhance resumes, and provide opportunities for travel to far-away and exotic places.”

More often than not, these trips also serve to add another bulletpoint to the resume.

“There is such pressure for students to have these experiences to get into medical or public health schools that short-term programs are springing up all over the place,” Melissa Melby, assistant professor of anthropology at the University of Delaware, told NPR. Such a trend is dangerous because it marks a shift of focus. It becomes more about how the trip can help the student make a difference rather than how it can ultimately help others. In fact, according to a recent survey by the AAMC, of 13,682 matriculating medical students in 2015, 36.3 percent participated in international mission trips. This high number could suggest that international missions may be an increasing tacit expectation for admissions.

Another issue is that some students are so eager to serve that they often overstep boundaries. In a 2008 paper in the Journal of Medical Ethics, a medical student who embarked on a mission trip to Mexico recalled, “While I was seeing patients by myself, other first-year medical students were performing surgeries in the other clinics and later bragging about it.” Practicing without a license is prohibited in the United States — why should the standard of care and ethical conduct be any different when we leave our borders?

And then there’s long-term sustainability. While students often help many individuals, the root of the issue remains untouched. Deep-seated problems, from inefficiencies in infrastructure to bureaucratic instability, are difficult to solve, especially for groups operating from outside the country.

While a systemic overhaul is often not within reach, perhaps involving the local community can help ensure sustainability. The approach would be not only on treating patients, but on education and public health as well. After all, if the aid were based entirely on foreign aid, a culture of dependency will inevitably follow. Continuity is crucial to ensure lasting impact is made.

Still, on the bright side, groups that do make sustainability a priority are emerging. For instance, there’s Shoulder to Shoulder, an NGO that has served the rural communities of Honduras for 26 years and employs over 150 local staff members. Dennis Clements, a professor of pediatrics and global health at Duke University, told NPR about a program he designed that educates students in a 12-week training course on not only global health, but also the area’s history, religion and cultural practices before letting them take off.

With more established efforts, one-week trips will be able to support causes that make a lasting impact. In turn, as motivations become more centered on helping communities rather than gaining experience alone, efforts to tend to our own backyard will increase. Amid all this traveling frenzy, we often leave our own communities in the dust, neighborhoods that could use the same help that we’re shuttling off to places abroad. After all, getting out of our comfort zones and helping others doesn’t always require a passport.

Valerie Yu is a senior majoring in English literature and biological sciences. She is also the blogs editor of the Daily Trojan. Her column, “Heart of the Matter,” runs  every other Thursday.