Each year medical providers from wealthy countries participate in short-term medical volunteer work in resource-poor countries. In removing cataracts, repairing cleft palates, or vaccinating children, volunteers focus on the safety and quality of care they deliver. But healthcare services take place in the context of complex social, economic, and political relations. How does providing free care affect the practice of local physicians who charge a fee for their services? Who will provide follow-up care if complications occur after the medical volunteers have left? How does the presence of medical volunteer programs affect government planning for public clinics that serve poor or underserved populations? Are short-term medical programs reaching those who have the least access to care?
We know surprisingly little about how people who receive these services and healthcare providers within these communities perceive these programs and their contribution to health. To begin to understand how one community views the effects of short-term medical volunteer programs, from October 2006 to March 2007, medical students Heidi and Tyler Green from the University of Colorado Denver, working with Dr. Andrew Kestler and me from the Center for Global Health, interviewed 72 individuals in a rural area of Guatemala on the southern shore of Lake Atítlan. They spoke with Guatemalan health care providers and health authorities, foreign medical providers, non-medical personnel working on health projects and a group of parents whose children were treated by a short-term volunteer group.
Participants identified positive aspects of short-term volunteer programs as improved access to free care for the underserved, access to highly-trained specialists and procedures in rural areas, and professional and cultural exchange between foreign and local healthcare providers. The interviews also revealed the complex consequences of short-term medical volunteer work though unforeseen effects on the healthcare system including free care that undermines local providers, disincentives for the government to provide care in areas where short-term volunteer groups operate, and lack of development of primary care systems.
Below is a summary of our key findings. For a complete report of the study please see the article we published in Globalization and Health in 2009: https://www.globalizationandhealth.com/content/5/1/4.
We undertook this study to move the discussion of short-term medical volunteer programs beyond the counting the number of surgeries performed or vaccinations administered or benefits that medical volunteers gain. This preliminary study highlights the need for more intensive, in-depth exploration and analysis of the effects of short-term medical volunteer programs for patients who receive care and for local healthcare providers and systems.