Goat and Soda: NPR

Chris Nickels for NPR
Chris Nickels for NPR

A year and a half into the coronavirus pandemic, we I looked at the medical flight missions, where health professionals from rich countries travel to countries with low resources to set up and run short-term clinics for everything from dental care to cataract surgery. These tasks, which often take a week or two, are seen as both useful and controversial. Criticisms abound: Mobile staff may not understand the type of care required and may not be familiar with the local culture and language. Sometimes untrained staff provide services. There is no follow-up care. There was a lack of respect for healthcare workers in the host country. Recently, a new focus has begun to emerge on training and equipping local medical staff. Then came the epidemic. Travel restrictions have led to widespread flight cancellations. We asked sociologist Judith Lasker, professor emeritus of sociology at Lehigh University and author of the book Hoping to help: The promises and pitfalls of volunteering in global healthHow are these programs going now that the pandemic emergency is over? Here is their evaluation.

about this series

Over the next week, we’ll be taking a look at some of our favourites Goats and soda Stories to see “Whatever Happened to…”

Pre-Covid medical errands

Short-term medical missions have been growing in popularity for decades, and really took off after the turn of the 21st century. “An increasing number of organizations were getting into this work – some church missions often combining Bible study with medical clinics, more university students were joining clubs that linked them to NGOs that ran trips during school holidays, more universities were organizing Universal health programs are sent to undergraduates, medical students, physical therapy students, you name it, says Lasker.

No one knows for sure how many Americans used to go on medical missions — the US Census Bureau stopped asking about it years ago. In her book, which was published before COVID-19, Lasker estimated that at least 200,000 Americans volunteered on medical missions abroad each year.

What did covid do

“Everything stopped all of a sudden. People couldn’t fly. You couldn’t leave the country; you couldn’t go to host countries. People were afraid of being exposed to or spreading COVID-19 if they traveled,” says Lasker.

Some organizations have shifted to shipping equipment and supplies directly to countries. Some have begun to fund local healthcare professionals directly. And some have turned to the virtual platforms, to train local healthcare workers through live online demonstrations.

Mixed picture on whether or not the Missions will return

The number of organizations currently active remains a mystery, as there is no central registry. “It’s still a little early to tell where all this will be resolved numerically,” Lasker says.

There was very little research after that a report By Christopher Dainton of McMaster University in Ontario, Canada, and colleagues. In early 2021, they looked at 359 primary care medical missions in Latin America and the Caribbean that were active in 2015. They found that about a fifth of the organizations no longer existed or had no web presence. Of the 87 respondents, most reported that they are making some of the above changes to be more in line with local needs.

Lasker herself has heard about different scenarios. Some religious groups told them they had not resumed their air missions because of security concerns or because the countries they were visiting were less willing to let them come. Others said they would go back and work as before.

Lasker also heard that funding was down. “People stopped donating to these organizations, and it was a bit difficult to get back to full funding,” she says.

Changing attitudes toward medical missions

She says the coronavirus may have accelerated the reluctance to welcome outside help. “With COVID, poor countries have found that they cannot count on anyone from rich countries to be there for their health needs and especially their Covid needs.” Nor did it help that the richest countries – what some now call the global minority states – had access to all the vaccines.

“There is now a greater desire to say no to strangers,” says Lasker. More locally available health professionals and services, along with a move towards universal health care in some countries, has reduced the need in some places.

“There is now a greater sense of control and power in many of the countries that have hosted mission programmes. They know they can do a lot on their own, and that they don’t have to say yes to anything that someone from outside offers them,” she says.

The future of short-term missions

“I don’t think short-term visits are all terrible and you should never come back,” she says.

“I really need to stress that the vast majority of people involved in these programs are very dedicated, hard-working, and really want to make a difference. But if they decide what society needs without society deciding, they are not achieving as much as they want and perpetuating harmful colonial relationships.”

She says that organizations are starting to take an interest in recently published ethical guidelines, including the Guidelines Broker advertisement that helped compile it. It emphasizes equality in partnerships, sustainability and focus on needs identified by host communities. The declaration has been approved for publication in 2020 by more than 50 organizations around the world, from large international aid coalitions to smaller ones.

Her conclusion: “I think there is a lot of good that can be done, and I would like to see it done better, as part of a mutually sustainable partnership. I would like to see the people in the host countries being the ones to say how things should be done and what they need.” She has hope that what comes back will be better. “There is a lot of activism, collaboration and agency on the part of people in global majority countries now.”

Joan Silbrenner is a freelance journalist and former health policy correspondent for NPR. She has covered global health issues since the HIV outbreak.

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