For some, March means spring break, but for others it’s the season for medical mission trips. These short-term trips are usually to countries in the developing world, and when compared to one another, they almost always read like step-wise instructions.
Step 1: Privileged person goes to a developing country.
Step 2: They spend a week or two in said country.
Step 3: They come back with pictures and “life-changing” memories.
Step 4: They urge others to go on said trip and help said people.
While I’m generalizing, this idea of voluntourism — the act of both volunteering and touring a new place at the same time — has exploded into the mainstream in recent years. Embarking on a voluntourism mission has pretty much become a rite of passage among college students and 20-somethings. Maybe the hearts of these volunteers are in the right place, but the issue is that these short-term service trips are creating more problems than they are solving.
They’re usually spun as culture exchanges or a short-term study of another culture — and they absolutely are. In a way, everyone on a medical mission is an ethnographer. However, as ethnographers, we are taught that by simply inserting ourselves into a community, we are changing the narrative. That’s a significant privilege. To bear witness to and be a part of some other community’s narrative is something that should not be taken lightly.
At the very least, the goal should be to not make the trajectory of that narrative worse. Having worked in a global health capacity long-term in resource poor areas, I know that time is perpetually against us. After years, we still may not feel like we’ve made enough headway on an initiative or project. It’s hard work. It’s often demoralizing, frustrating, and burn-out is paramount. It’s not work that brings instant gratification or even a sense of accomplishment at times. The lure of sampling a country for one week, while providing a short-term service may sound appealing, but it’s more often than not sustainable, ethical, or beneficial. Here’s why.
The photography taken on these trips is completely unprofessional and often dehumanizing.
We’ve all seen the “life-changing” Facebook profile picture of a smiling, college-aged student surrounded by a cluster of small brown and black children. Some people have even gone so far as to include these photos on their dating app profiles. Especially on medical service trips, photography becomes a professionalism issue. At a US institution, photographing patients or even just the inside of a medical facility is not something that is ever tolerated. And yet, it seems to be completely acceptable when volunteering somewhere else. When we take these pictures in the “exotic locations” of our missions, we risk dehumanizing people and reducing them to objects whose photos can be coopted for our own use.
In addition, representation matters.
When Slumdog Millionaire came out, I spent the better part of a year telling people: 1. No, you don’t need to go to India to help the “slum kids.” 2. Not all of India is so “colorful” or looks like the one location that was used to film Slumdog. And 3. White tears were not going to make tangible differences in the infrastructure needed to provide social services to these impoverished communities.
When I traveled to Bogota, Colombia this past spring on vacation, I was particularly struck by a pretty politically-charged graffiti tour I went on. My guide, a Colombian-born, American-raised 20-something, said he did this tour not only because of his background in street art, but because he hoped that Western tourists would go back to their respective homes and tell others that Colombia was more than the stereotypes of cocaine, Pablo Escobar, kidnapping, and crime. The way we directly or indirectly portray a community and its people through pictures, writing, or how we speak, communicates our experiences there. It’s crucial to pay attention to these things in a socio-political context.
These trips promote this idea of “us vs. them.”
By sustaining trips that send students to countries that have historically been classified as the “third world,” we continue to create a dichotomy between us vs. them. We reinforce ideas that countries in the developing world need to be saved by a White, western influence. By going to “serve,” we continue to propagate a colonial mindset between Western countries and the rest of the world.
It costs a lot of money to get just one volunteer to where they want to go.
The cost is often in the thousands of dollars, so it’s pretty common for volunteers to raise money for their ticket. The money fundraised and spent on getting one single person on a volunterouism trip, could instead go toward building a sustainable infrastructure, and/or training community members to perform the same tasks that these Western volunteers would. Sending an unqualified millennial, who doesn’t have a tangible skill set, just doesn’t make any sense. Finding local workers is not only financially practical, it also promotes a sense of longevity that volunteers on a mission trip just don’t have.
Despite the hundreds of articles, research, and think pieces that argue against voluntourism and medical mission trips, they will undoubtedly continue. We can, however, take steps toward making them more helpful to the communities they serve. Here’s what every quality voluntourism organization should do.
1. Create a strict photo policy that does not allow pictures to be taken in a medical setting or of local communities/individuals without their permission.
Pictures of patients should never be posted on social media for any reason. I don’t walk into the hospital at my medical school and take pictures of the patients I speak with. This should always be the protocol, regardless of what country you’re in.
2. Create and implement a mini-ethnographic course.
A course like this would allow people to better interact with the communities they are going to be working with, prior to the trip. Partner with a Department of Anthropology, Sociology, or Global Health to bring to focus the cultural, social, and political climates of a community. Personally, I believe if you’ve never had a basic ethnography or anthropology class on methods or culture of the place you are going, I don’t think you should be able to go on a mission trip to that place. The necessity of knowing the cultural, political, social, and economic climate of a community is essential, especially on a short-term trip.
3. Reevaluate community and institutional needs at timely intervals along with community partnerships.
4. Use trained medical interpreters from community for all patient interactions.
If there aren’t any medical interpreters in the community, train some.
5. Use an ethical code that is at least similar to the one implemented in your home country.
This includes reflecting on what medical procedures someone with minimal skills should be doing, how we interact with patients, and how we bring back our experiences in the forms of pictures. Often in global health work, the idea of “anything is better than something” permeates. And granted, there are resource-limited areas where the same Western standards of care cannot be made. However, professional ethics should never be sacrificed, they always matter.
Providing services, experiencing a different culture, or being exposed to a new language is a wonderful opportunity. However, medical mission trips are not really a two-way streak in terms of global development and sustainability. And in many ways, these trips create a false sense of service and work that is not beneficial to the communities they target. If providing a service in a community different from your own is the end goal, you don’t have to leave the country. Global health can start at home.