In May INMED posed the question, “Are short-term medical missions (STMM) effective?” and also raised related issues of ethics and cultural relevance. Responses from you the readers were plentiful and absorbing.
You said that we should recognize both the pros and cons of such service:
Advantages for our mission hospital are: Coverage for staff vacations, teaching our personnel new skills, giving us fresh perspectives, and providing of a service, like eye and hearing care, that we’re not able to. There are disadvantages, too: The logistics of visitors can be draining (transportation, housing, interpreters) and they may raise expectations of our community for extra services that we can’t sustain. – Nancy Cutherell, RN, Bach Christian Hospital, Asia
STMM are great for the participants, bring them face-to-face with the plagues of deep poverty. Short-term volunteers become prayer partners, sometimes become longer-term workers, and help publicize our work so that others become supporters. They are also less likely to engage in quickie solutions to complex, multifaceted problems like the issues surrounding sexuality. – Jean Young, MD, Saboba Medical Center, Ghana
You also recommended that the emphasis of most STMM change from provision of episodic care toward contributing to sustainable solutions:
STMM should focus on those most at risk: women and children under five, and on programs most likely to result in permanent change: home gardens for family sustenance, growth monitoring for low-weight children, women’s education, non-profit small loans for business startup, support for exclusive breast feeding. – Nicholas Cunningham, MD Dr PH, Columbia University
Add value. Don’t just come to do what the national staff is already doing. Train, mentor, encourage. Serve – but moreover build capacity. The most useful thing you will do is to train a local resident to continue providing a skill long after you have left. – Ian Chadwell, Partnership Program Manager, International Nepal Fellowship
Such emphasis on sustainability is an integral part of the INMED International Medicine & Public Health Courses offered year round. Many respondents resonated with the importance of developing and sustaining partnerships with host communities and institutions:
To make a real change and contribution STMMs should be a part of an ongoing program to support particular hosts. Groups cannot visit a different location every year and expect to make a real change. We advocate providing continuity and expertise. In short, we should focus our efforts. – Doyle Word, CEO, Madaktari Africa
If the leaders have a long-term vision, and each short-term team is only one part of that vision, then longer-term results can be achieved. To make this a reality requires being in partnership with an indigenous, local host in the community being served. In this context we help equip and encourage them, for in the long run lasting results are only achieved when the indigenous partners take the initiative to provide the long-term benefits themselves. – William Walker, COO, His Healing Hands
What does healthy partnership with host nationals look like? Such partnership embodies the virtues of respect, humility, and deference toward others. In this context, we can inquire, “What can I do to assist at your facility?” “What special services do your people need?” “What subjects can I help to teach?” and perhaps most profoundly, “What can you teach me to better serve your people?”