VOLUN-TOURISM Some do it to get into heaven, s…
VOLUN-TOURISM Some do it to get into heaven, some to get into medical school. Some do it because everyone else is doing it. Whatever the motivation, the number of health care volunteers heading from developed to developing countries has soared recently. The reasons to applaud are self-evident: The old epidemics are compounded by the new ones, and the health-related fallout of wars and natural disasters never ends. If both skilled and unskilled labor can help, then surely those who provide such labor should do good, feel good and learn much. Not necessarily, critics say. Some concur instead with a Somali blogger who in 2013 said that the developing world has become a place for young adults from developed countries to “pay” for being lucky enough to be born in a wealthy country. Indeed, as sociologist Judith Lasker watched groups of American and Canadian volunteers in matching T-shirts surging through the Port-au-Prince airport two years after Haiti’s disastrous 2010 earthquake, she was reminded of “the weekly Saturday turnover at American vacation resorts.” Dr. Lasker, a professor at Lehigh University, asks: “Do volunteers help or hurt?” she asks. “In what ways?” It turns out these questions cannot be answered very precisely. Still, anyone thinking about a volunteer stint is likely to be interested in Dr. Lasker’s results. Tens of thousands of religious and secular institutions send hundreds of thousands of health volunteers from the United States into the world, generating close to an estimated $1 billion worth of unpaid labor. Volunteers include experienced medical professionals and individuals who can provide only manual labor; between these extremes of competence are the students in the health professions, among whom global volunteering has become immensely popular. Dr. Lasker presents data from a few hundred programs, gleaned from several surveys, dozens of interviews, and some brief trips of her own. (She did not look at large organizations like Doctors Without Borders, which are organized differently and generally do not use unpaid volunteers.) Most of the programs she considers sponsor volunteer assignments that last just weeks rather than months, despite almost universal agreement among hosting communities that longer stays are much more helpful. The hosts generally have fairly simple expectations: Volunteers should do as they are asked, know enough about their destination not to violate local norms (“Women in shorts!” grumbled one African social worker), and understand that dirt, dust and discomfort are part of the experience. However, students may take advantage of the circumstances to attempt tasks well beyond their expertise. Experienced professionals may adhere to standards of practice that are irrelevant in poor countries. Unskilled volunteers who do not speak the language may monopolize local personnel with their interpreting needs while providing little value in return. Problems may lie with the structure of a program rather than the personnel. One set of volunteers may not be told what the previous group had been doing and not be able to leave suggestions for the next group. Medications may run out. Surgery may be performed with insufficient provisions for postoperative care. Nor are the benefits to the volunteers themselves clear. Do they learn the true meaning of charity? Do they become more educated global citizens? A few studies on the long-term effects of short-term good works are ongoing. In the meantime, “there is little evidence that short-term volunteer trips produce the kinds of transformational changes that are often promised,” Dr. Lasker finds. She winds up cautiously endorsing short-term volunteer work, provided the volunteer chooses carefully among programs and behaves responsibly while at work. Still, she suggests that returning volunteers be “humble” when it comes to claiming they have made a difference, either for others or for themselves.