Medical Mission Trips

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I remember a sermon I heard from a missionary from a Carribean island. Along with "pray for us" and "donate money to help us do our work" he said, "Come visit our island. Tourism is our major industry and our people depend on people like you for their livelihoods."

You can give a man a fish, or you can pay him to: catch a fish, cook it for you and clean up after you've eaten it.

How would you have known about this if you were not abroad LizzyM? I wonder because I would just like to give my 2 cents: that while a completely agree that going abroad to do a mission is for the volunteer more much more than the community, the volunteer can then catapult that knowledge for something much greater. For example, what if the man told you that there was recently a large cholera outbreak in the surrounding region where there were 4 large refugee camps. This knowledge could then be used to create connections between people from across the world to create a monetary fund of some kind. How would you have known about the need? TV commercials and brochures only do so much.....

on that note, i have always thought that the admissions process is a learning experience in itself. For example, Adcoms want people who have volunteered, have clinical experience, and do research. I think alot of people assume that these are things that the students should inherently be interested in and if they are not then they are simply hoops to jump through. I would completely disagree, and say that they are experiences that adcoms believe can teach the student about empathy(volunteer), the US healthcare system (Clinical experience), and the scientific process (research).

now, lets assume i am correct in that logic. what happens then if a person goes abroad to volunteer in a clinical setting rather than in the united states? i believe the lessons in empathy becomes magnified, since there is so much more of an emotional impact when going through culture shock. Understanding one's role as a service provider to those seeking it becomes a much stronger lesson to the volunteer abroad student than the guy who drives down to the local shelter. Should it be the case that abroad experiences have more of an impact? absolutely not! Poverty is poverty no matter where it is. Is it the case? of course! We're human beings!

Thus, i wonder whats wrong with viewing global volunteer missions as "clinical experiences that provide a much stronger emotional impact to derive lessons from" rather than "this man/woman probably thinks theyre ghandi. They must be semidelusional."

Also, i wonder sometimes about the need to destroy the desire of pre-meds to save the world. Of course its not realistic and thus thinking provides little for the world because real life planning is lost...but heres something to think about (http://psyphz.psych.wisc.edu/web/News/Meditation_Alters_Brain_WSJ_11-04.htm)

"In a striking difference between novices and monks, the latter showed a dramatic increase in high-frequency brain activity called gamma waves during compassion meditation. Thought to be the signature of neuronal activity that knits together far-flung brain circuits, gamma waves underlie higher mental activity such as consciousness. The novice meditators "showed a slight increase in gamma activity, but most monks showed extremely large increases of a sort that has never been reported before in the neuroscience literature," says Prof. Davidson, suggesting that mental training can bring the brain to a greater level of consciousness.
Using the brain scan called functional magnetic resonance imaging, the scientists pinpointed regions that were active during compassion meditation. In almost every case, the enhanced activity was greater in the monks' brains than the novices'. Activity in the left prefrontal cortex (the seat of positive emotions such as happiness) swamped activity in the right prefrontal (site of negative emotions and anxiety), something never before seen from purely mental activity. A sprawling circuit that switches on at the sight of suffering also showed greater activity in the monks. So did regions responsible for planned movement, as if the monks' brains were itching to go to the aid of those in distress.
"It feels like a total readiness to act, to help," recalled Mr. Ricard.
The study will be published next week in Proceedings of the National Academy of Sciences. "We can't rule out the possibility that there was a pre-existing difference in brain function between monks and novices," says Prof. Davidson, "but the fact that monks with the most hours of meditation showed the greatest brain changes gives us confidence that the changes are actually produced by mental training."
That opens up the tantalizing possibility that the brain, like the rest of the body, can be altered intentionally. Just as aerobics sculpt the muscles, so mental training sculpts the gray matter in ways scientists are only beginning to fathom."

I believe wanting to change the world is the first step to doing so. The next is then trying to complete those intentions. 100,000 people will fail. One might succeed....AND THATS ALL YOU NEED TO JUSTIFY THE FAILURE OF 100,000 PEOPLE!!!! life will do plenty to destroy people's dreams of making a profound impact. Adcoms should not be a source of that, but a cultivator. Its a responsibility of those older and more experienced to define reality for those younger and less experienced than themselves. I believe that not doing so is just irresponsible.

Lets take a hypothetical situation...How would you feel if a mentor consistently told a child how horrible the world was, how he or she should just give up on life, how people just die anyways. Is the world horrible? in alot of ways, it is. Does everybody die? yes! But these are realities are ignored to create effective human beings. This is probably a situation that falls into that catagory. Let the pre-meds dream of changing the world. One might actually succeed. :D

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How would you have known about this if you were not abroad LizzyM? I wonder because I would just like to give my 2 cents: that while a completely agree that going abroad to do a mission is for the volunteer more much more than the community, the volunteer can then catapult that knowledge for something much greater. For example, what if the man told you that there was recently a large cholera outbreak in the surrounding region where there were 4 large refugee camps. This knowledge could then be used to create connections between people from across the world to create a monetary fund of some kind. How would you have known about the need? TV commercials and brochures only do so much.....

on that note, i have always thought that the admissions process is a learning experience in itself. For example, Adcoms want people who have volunteered, have clinical experience, and do research. I think alot of people assume that these are things that the students should inherently be interested in and if they are not then they are simply hoops to jump through. I would completely disagree, and say that they are experiences that adcoms believe can teach the student about empathy(volunteer), the US healthcare system (Clinical experience), and the scientific process (research).

now, lets assume i am correct in that logic. what happens then if a person goes abroad to volunteer in a clinical setting rather than in the united states? i believe the lessons in empathy becomes magnified, since there is so much more of an emotional impact when going through culture shock. Understanding one's role as a service provider to those seeking it becomes a much stronger lesson to the volunteer abroad student than the guy who drives down to the local shelter. Should it be the case that abroad experiences have more of an impact? absolutely not! Poverty is poverty no matter where it is. Is it the case? of course! We're human beings!

Thus, i wonder whats wrong with viewing global volunteer missions as "clinical experiences that provide a much stronger emotional impact to derive lessons from" rather than "this man/woman probably thinks theyre ghandi. They must be semidelusional."

Also, i wonder sometimes about the need to destroy the desire of pre-meds to save the world. Of course its not realistic and thus thinking provides little for the world because real life planning is lost...but heres something to think about (http://psyphz.psych.wisc.edu/web/News/Meditation_Alters_Brain_WSJ_11-04.htm)

"In a striking difference between novices and monks, the latter showed a dramatic increase in high-frequency brain activity called gamma waves during compassion meditation. Thought to be the signature of neuronal activity that knits together far-flung brain circuits, gamma waves underlie higher mental activity such as consciousness. The novice meditators "showed a slight increase in gamma activity, but most monks showed extremely large increases of a sort that has never been reported before in the neuroscience literature," says Prof. Davidson, suggesting that mental training can bring the brain to a greater level of consciousness.
Using the brain scan called functional magnetic resonance imaging, the scientists pinpointed regions that were active during compassion meditation. In almost every case, the enhanced activity was greater in the monks' brains than the novices'. Activity in the left prefrontal cortex (the seat of positive emotions such as happiness) swamped activity in the right prefrontal (site of negative emotions and anxiety), something never before seen from purely mental activity. A sprawling circuit that switches on at the sight of suffering also showed greater activity in the monks. So did regions responsible for planned movement, as if the monks' brains were itching to go to the aid of those in distress.
"It feels like a total readiness to act, to help," recalled Mr. Ricard.
The study will be published next week in Proceedings of the National Academy of Sciences. "We can't rule out the possibility that there was a pre-existing difference in brain function between monks and novices," says Prof. Davidson, "but the fact that monks with the most hours of meditation showed the greatest brain changes gives us confidence that the changes are actually produced by mental training."
That opens up the tantalizing possibility that the brain, like the rest of the body, can be altered intentionally. Just as aerobics sculpt the muscles, so mental training sculpts the gray matter in ways scientists are only beginning to fathom."

I believe wanting to change the world is the first step to doing so. The next is then trying to complete those intentions. 100,000 people will fail. One might succeed....AND THATS ALL YOU NEED TO JUSTIFY THE FAILURE OF 100,000 PEOPLE!!!! life will do plenty to destroy people's dreams of making a profound impact. Adcoms should not be a source of that, but a cultivator. Its a responsibility of those older and more experienced to define reality for those younger and less experienced than themselves. I believe that not doing so is just irresponsible.

Lets take a hypothetical situation...How would you feel if a mentor consistently told a child how horrible the world was, how he or she should just give up on life, how people just die anyways. Is the world horrible? in alot of ways, it is. Does everybody die? yes! But these are realities are ignored to create effective human beings. This is probably a situation that falls into that catagory. Let the pre-meds dream of changing the world. One might actually succeed. :D

Wow. this thread is amazing. your comments are amazing, and just what the "typical" premed needs to hear.

I think our dear friend LizzyM is getting a tad cynical in her old age. Not all med school applicants have done the things that they list on their app just to have things to list on their app.

My (mere) 4 months in Southeast Asia, living with a family in a rural area and working in a small hospital, shadowing doctors all day, and teaching English to doctors and nurses at night, was nothing short of life-altering. Rather than "padding" my application, it motivated me to come home, finish my prereqs and apply to medical school -- a process that took 3 years.

I chose a medical school (and it chose me) because of my desire to serve overseas as a doctor. This "little trip" changed my life and career.
 
Wow. this thread is amazing. your comments are amazing, and just what the "typical" premed needs to hear.

I think our dear friend LizzyM is getting a tad cynical in her old age. Not all med school applicants have done the things that they list on their app just to have things to list on their app.

My (mere) 4 months in Southeast Asia, living with a family in a rural area and working in a small hospital, shadowing doctors all day, and teaching English to doctors and nurses at night, was nothing short of life-altering. Rather than "padding" my application, it motivated me to come home, finish my prereqs and apply to medical school -- a process that took 3 years.

I chose a medical school (and it chose me) because of my desire to serve overseas as a doctor. This "little trip" changed my life and career.

Four months is fine. What I find objectionable are the trips that are < 2 weeks. Some are only 10 nights- or less- if you subtract off the time spent in a plane. That may be life altering but they don't make you a better applicant than someone who stayed home and worked to earn money for school or cared for a disabled or aged relative so the usual caregiver could take a break. Multiple globe trotting trips are often a measure of socio-economic status more than anything else.
 
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Four months is fine. What I find objectionable are the trips that are < 2 weeks. Some are only 10 nights- or less- if you subtract off the time spent in a plane. That may be life altering but they don't make you a better applicant than someone who stayed home and worked to earn money for school or cared for a disabled or aged relative so the usual caregiver could take a break. Multiple globe trotting trips are often a measure of socio-economic status more than anything else.

completely agree. (and i may now put LizzyM back on the pedestal where she belongs.)
 
I don't think anyone is trying to destroy pre-med ideals but just bring a dose of reality to them. My travels took me from an idealist to an "realist idealist." I've come to see the limitations of brief mission trips. It doesn't take more than a few minutes to make a positive impact on the life of another person but to making a lasting change on a society you need more than a few weeks. I have no doubt I have helped many individuals but have I made a great impact in the societies I've visited even after 3 months? The answer is no. However, we are in the "selfish" (for lack of a better word) stage of our lives-we are learning the skills we need to make some sort of grand impact in the future. Perhaps I'll never make the impact I desire but I will have helped out countless individuals and that's not so bad.

I do disagree with the point that multiple globe trotting trips means you come from a wealthy family... I worked 3 jobs at times to pay for my trips (both as a volunteer and a "mere" tourist).
 
I do disagree with the point that multiple globe trotting trips means you come from a wealthy family... I worked 3 jobs at times to pay for my trips (both as a volunteer and a "mere" tourist).

Same here. I've been to over 15 countries, but it's not because I am rich or my family is rich. I've taken out loans to study abroad, and the summer before my study abraod trip, I worked fulltime and saved up money to travel to other countries while I was in Spain. For Rwanda, I applied for funding to help me get over there, and once again, I was able to travel to other countries b/c I had saved up some money while working during grad school. For Thailand, I go because my work pays for it. Every other trip I've done has been about budgeting, saving money, and giving up other fun things (eatting out, going to bars/clubs, shopping, etc) so that I would have the money to travel abroad. And generally the most expensive thing is the plane ticket. Once that's paid for, staying in hostels is very cheap. It's all about how you budget.

I've also met many people who worked fulltime for 3+ years, saving their money, and then selling their houses, so that they could travel throughout Africa for a year.

I plan on going to India this summer to volunteer, and luckily I will have enough frequent flyer miles from my trips to Thailand that I will be able to use them for a free roundtrip to India. Without that, this upcoming trip would not be doable for me this year.

Yah being rich is one way to be a globe trotter, but it's not the only way.
 
Everyone is talking about what they could potentially get out of these short term medical mission trips abroad without really considering the effects on the communities they are "helping." I am currently writing my master thesis on this very topic and while it is true that the pre-med student stands to benefit quite a bit from these excursions, the community rarely receives a sufficient benefit in return and is sometimes even harmed.

Can you imagine if your medical care was provided by foreigners, three weeks a year (if you are lucky), with no follow up care and little to no continuity? Since students are gaining perspective, a meaningful life experience and a resume builder, they should be doing something better in return. If they can't, they shouldn't go. Medical missions in general are a sub par way to provide health care. The better than nothing argument is bullshi*t and people have done better (such as adopting communities and staffing them year round as Shoulder to Shoulder has done).

If the experience gets someone involved and interested in global health as a lifes work, then it can be argued that these communities will eventually receive a large benefit in return. Such as my trip to Honduras sparking my interest in global health and my thesis project. However I know there are better ways to experience global health, with more respectable programs, that can have the same effect.

Feeling like you made a huge difference after going on one of these trips is a farse, and it is notions like this that perpetuate this model. Do more and be better. Pay attention to what you are giving and not just what you are experiencing. Your life altering experience is not worth compromising someone else health care. At least be informed.

There are over 70 different, uncoordinated mission trips that travel each year to Honduras alone.
 
It's nice to see other pre-meds with a genuine interest in international medicine and realistic views about what gets accomplished on short term visits.
 
Everyone is talking about what they could potentially get out of these short term medical mission trips abroad without really considering the effects on the communities they are "helping." I am currently writing my master thesis on this very topic and while it is true that the pre-med student stands to benefit quite a bit from these excursions, the community rarely receives a sufficient benefit in return and is sometimes even harmed.

Can you imagine if your medical care was provided by foreigners, three weeks a year (if you are lucky), with no follow up care and little to no continuity? Since students are gaining perspective, a meaningful life experience and a resume builder, they should be doing something better in return. If they can't, they shouldn't go. Medical missions in general are a sub par way to provide health care. The better than nothing argument is bullshi*t and people have done better (such as adopting communities and staffing them year round as Shoulder to Shoulder has done).

If the experience gets someone involved and interested in global health as a lifes work, then it can be argued that these communities will eventually receive a large benefit in return. Such as my trip to Honduras sparking my interest in global health and my thesis project. However I know there are better ways to experience global health, with more respectable programs, that can have the same effect.

Feeling like you made a huge difference after going on one of these trips is a farse, and it is notions like this that perpetuate this model. Do more and be better. Pay attention to what you are giving and not just what you are experiencing. Your life altering experience is not worth compromising someone else health care. At least be informed.

There are over 70 different, uncoordinated mission trips that travel each year to Honduras alone.

I would like to borrow a term commonly heard and invert it for use in this current conversation. PreMedical Tourism is this phenomenon of volunteer groups (premeds, medical students, physicians, etc, most not speaking a lick of the native tongue) going abroad for less than a year and doing 'hit and run' style medical mission trips in developing countries where they typically dispense a huge amount of medications and supplies in addition to seeing patients and performing surgeries without much prior coordination from domestic health authorities or any plans for much continuity of care. Typically results in surgeon's patting themselves on the back and telling heartbreaking stories about the poverty and destitution at socialite charity dinners, and premeds talking about how they held malnourished babies in personal statements and interviews but with the developing country in question no better off save for a few corrected cleft palates and village health workers (or just villagers) with tons of expired medication with no idea how to prescribe it.

I agree wholeheartedly with CarlyMD that many of the posts above have neglected to take into account the point of view of the patients in these developing countries, and have instead focused on whether or not the STUDENTS are gaining experience or 'making a difference', which is the common attitude of people participating in premedical tourism with seemingly altruistic intent, but really their own interests in mind. I am especially appalled by the story of the volunteer in Africa assisting on surgeries and operating on babies. The desire of premeds to jump straight into practicing medicine is so strong it seems that it frequently overshadows the needs of the people they are 'helping'. There is a reason premeds aren't allowed to do these things in the US: its a matter of ethical conduct and maintaining a high standard of care. If it's clearly not okay in the US, why is it okay abroad? How come we don't hold ourselves to the same ethical standards of conduct in medicine once we leave our own borders? These are particularly vulnerable populations of patients in developing countries, aren't they entitled to the same standard of care that we offer in the US? Just because they come from a developing country doesn't mean they aren't human, same as any of us, and just because there's no enforced health ethics guidelines in these countries doesn't make it okay for you to get your rocks off practicing h&ps, drawing blood, handing out meds, doing brain surgeries, or delivering babies.

Dumping a bunch of medical supplies and medicines in a country and then bouncing doesn't constitute making a difference no matter how badly the need is for them there if there is no system in place to ensure that these supplies are properly distributed and doled out to patients. Correcting a bunch cleft palates is great, but without the proper infrastructure in place to provide postoperative care after you leave may be doing more damage than good, and without providing the domestic physicians and surgeons with the proper training and equipment to do these procedures on their own your just creating a dependency situation that doesn't really impact the long term development of a country's medical capabilities. Finally, doing any sort of medical work in another country without working with the country's own health authorities (no matter how messed up you may think the health system is there) is NOT a sustainable strategy for health relief because when you leave (or whatever charity or NGO you're working through loses funding and falls apart) a developing country's health workers are all they have left, and by providing health services instead of empowering the health workers there full time to improve the quality of care, you are directly undermining the growth of these fragile health care systems. And, of course, from a utilitarian stand point, the money and resources spent by mission teams going abroad will ALWAYS go a lot further as a simple lump sum donation.

I'm not trying to completely discourage international health work, because it is true that if you approach the right way and work with the right people, and/or if it does develop into your life's work you can make a long lasting difference like Paul Farmer. So, if you have a genuine interest in the experience beyond adding another bullet to your CV, having something to talk about, or because all the other premeds at your college are doing it, by all means, but with the right motivations and practices in mind. ALWAYS keep the patients' best interests at heart, and don't ride in on your white horse ready to save the day, but look towards collaborating with domestic health providers to create sustainable improvements in the quality of health over the long term.

All this international aid work is being done with the right motivations in mind, but there needs to be a shift in thinking about how we approach the problem. Why is it that even with over 400 NGOs and non-profit organizations in a small country like Nicaragua, it still remains one of the poorest and destitute nations in all of Latin America. If you are really interested in international medicine and development, after your done reading Mountains Beyond Mountains (which most bleeding heart premedical tourists sleep with under their pillow at night) pick up The White Man's Burden by William Easterly, then read The Bottom Billion by Paul Collier.
 
So if you cannot give "everything" you should give "nothing." I do not buy it.

This attitude is used by people on both ends of the humanitarian spectrum and, in both cases, it is self-serving.

Those who do nothing criticize those who go overseas for a few months. (Translation: i did nothing and i am better than you. you are an ugly american.)

Those who go overseas for 3 years criticize those who go overseas for a few months. (Translation: i did more than you. you are an ugly american.)

Both are equally ridiculous.
 
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The point docontheroc is making (I think) is that these countries are using these unstructured programs as a crutch instead of developing their own systems. The countries I have visited have had little governmental structure or support (ie Ecuador has had something like 8 presidents in the last 6 years, the eastern part of Bolivia is trying to declare its independence, etc). There is so much corruption and the turnaround is so high no one can get anything of any consequence done. These things cannot be changed overnight~many people that I have spoken with, have no faith in the government (why would they?) and thus any time something goes wrong they're ready to bring in someone else. These are structural problems that cannot be corrected in a few weeks or months or even by someone outside of government. In my experiences, some of the larger, more structured programs do benefit the societies at least at a grassroots level more than they do harm because they're aimed at education and publich health (ie the Peace Corps in Bolivia does really good work, at least until they were pulled out because of the civil uprisings). Even many of the locally-run organizations are able to do amazing things. However, there are a great number of foreign-run organizations that drop volunteers in a country for a couple of weeks with little or no preparation. Generally, they have no idea what they're doing and have no understanding of the local culture (this takes months if not years depending on where you're going). I didn't go on my trips to pad my app but because I wanted the opportunity to help some people less fortunate than me and I love traveling. Despite praises from family in friends for having gone on these trips I never once felt like I gave the people much in return for the life-changing lessons they taught me (few relating to medicine). Thus, I've decided not to do another short-term trip but to stick to cultural tourism if I've got a few weeks to spare. I am not saying you should do nothing but there are better, more beneficial ways to spend your time and still get the cultural and educational experiences. The money goes directly to the people (assuming you use local guides) and goes to bettering the lives of everyone. To attract tourists the government hires cops to make the streets safer and technological advances (especially medical) become more commonplace so the tourists feel safe and secure. I've always been welcome as a tourist because the local people know how beneficial tourism is to their economy. Many see tourism as a way to better their society and ultimately their lives.
 
So if you cannot give "everything" you should give "nothing." I do not buy it.

This attitude is used by people on both ends of the humanitarian spectrum and, in both cases, it is self-serving.

Those who do nothing criticize those who go overseas for a few months. (Translation: i did nothing and i am better than you. you are an ugly american.)

Those who go overseas for 3 years criticize those who go overseas for a few months. (Translation: i did more than you. you are an ugly american.)

Both are equally ridiculous.

Maybe I was a bit misleading with my criticisms, but I did not mean to make an ultimatums on the subject. I just think there are so many more dimensions to this issue that many of the premeds who go on this trips do not stop to consider. My personal belief is that if you are going to do something, do it RIGHT, and inconvenience is not an excuse for going abroad and meddling in foreign areas simply because you want to feel like your 'making a difference' or because people in these countries aren't getting any care anyway, so they should be eternally thankful for whatever second rate help you can provide. The assumption also shouldn't make made that just because these people don't have much they want (or need) your help. No one is begging for premeds to go to their countries to see patients anyway.

I should also mention that I am guilty as charged for taking part in premedical tourism myself, and after having been there, experienced the situation first hand, and spoken to many people who are on the frontlines of medical care in these developing countries, I realized what a huge mess foreign aid can turn out to be. (so I'm not trying to take a 'holier than thou' stance as you implied, the criticism isn't self serving, it's REAL) I'm taking more of a sustainable approach to my international health work now, and am doing it the best way I know how: working with an in-country NGO and domestic health authorities to supplement their efforts in whatever way I am CAPABLE and QUALIFIED to help. Finally, I have nothing against tourism in the general sense, it goes a long way infusing local economies with much needed capital. As long as it isn't the only vehicle relied upon for development I think it can be a very helpful building block for many countries.
 
The point docontheroc is making (I think) is that these countries are using these unstructured programs as a crutch instead of developing their own systems.

. . .there are a great number of foreign-run organizations that drop volunteers in a country for a couple of weeks with little or no preparation. Generally, they have no idea what they're doing and have no understanding of the local culture (this takes months if not years depending on where you're going).

Completely agree with these two statements.

The focus of foreign aid shouldn't be to do the work or dump supplies/medications, but to teach natives to problem solve, develop systems, function within those systems and help them to procure supplies themselves. The buzzword for this in development is "capacity building."

It's extremely hard to build or reinforce capacities in 2 weeks with no cultural knowledge or language skills.
 
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I went on a 2 week trip to Nicaragua that appears to be what most people here are criticizing. You say that we should try to help them build a more sustainable healthcare system, but pre-meds are certainly less equipped to do that than the "meaningless" care we provide them for the short time we are there.

I can't see how anyone can criticize people doing only what's within their knowledge to do. You go and do your best for the people there with the knowledge and resources you have and you leave. I can't think of a single person there wasn't completely thankful.

In order for trips like this to provide a "crutch" they have to be able to survive completely on our care, which for my mission group is not possible. We give basic meds, which come down to things that improve quality of life, but are by no means life saving. Therefore I think the crutch argument is not valid.

What my trip did was provide them things that pre-meds are perfectly capable of giving, things like advil, iron supplements, cold meds. Someone said early that the money used to go abroad could be better used donated to another program.

I couldn't disagree more. By going there you expose a group of students to the hardships people outside of the United States face. Even if just 1 or 2 of these kids devote something to international medicine after one of the trips, I think the trip was worth it. If you haven't been on one of these trips, I don't think you realize the impact that it has on you. Sure some people realize that international medicine isn't for them, and maybe for those people the trip turns into a line on their CV. But for a few, it turns into a lifetime passion, and to me that makes the trips worth it.
 
I went on a 2 week trip to Nicaragua that appears to be what most people here are criticizing. You say that we should try to help them build a more sustainable healthcare system, but pre-meds are certainly less equipped to do that than the "meaningless" care we provide them for the short time we are there.

I can't see how anyone can criticize people doing only what's within their knowledge to do. You go and do your best for the people there with the knowledge and resources you have and you leave. I can't think of a single person there wasn't completely thankful.

In order for trips like this to provide a "crutch" they have to be able to survive completely on our care, which for my mission group is not possible. We give basic meds, which come down to things that improve quality of life, but are by no means life saving. Therefore I think the crutch argument is not valid.

What my trip did was provide them things that pre-meds are perfectly capable of giving, things like advil, iron supplements, cold meds. Someone said early that the money used to go abroad could be better used donated to another program.

I couldn't disagree more. By going there you expose a group of students to the hardships people outside of the United States face. Even if just 1 or 2 of these kids devote something to international medicine after one of the trips, I think the trip was worth it. If you haven't been on one of these trips, I don't think you realize the impact that it has on you. Sure some people realize that international medicine isn't for them, and maybe for those people the trip turns into a line on their CV. But for a few, it turns into a lifetime passion, and to me that makes the trips worth it.

Once you set the precedent of giving supplies, treatment, etc without expecting payment or contribution, it makes all further work that's done in that community difficult. Of course people are grateful for free stuff, who isn't?

What you might not understand is that it's creating an uphill battle for future projects that aim to mobilize community resources to solve problems. "Why do we have to contribute something now when all the other folks that come in give us stuff for free? We'd rather just wait for one of those "nice" people to come around again." It creates a culture of dependency, and it has little to do with whether or not the gifts are crutial for survival. You see it as help, but you're not there for the aftermath.

Also, how many wells, buildings, equipment, etc have been given because it's what we think a community needs? A lot. How many of these lie in disrepair because the community was never a part of the process, had no sense of ownership, and doesn't have any idea how to maintain their "gifts"? A good amount, I'd guess.

Many of my Peace Corps colleagues and I had to work against the lingering effects of these strategies. In the past, this was the common way that development was done, but it did little to develop anything.

EDIT: If you really want to get involved in international volunteering, I'd look for an aid organization that doesn't have projects based on doling out free infrastructure, stuff, and services, but rather focuses on skills development/educational efforts/or even research. There are many of these out there. You might not get to save any "DABs" and will most likely have to stay more than 2 weeks but it will be much more beneficial to the populations involved.
 
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I went on a 2 week trip to Nicaragua that appears to be what most people here are criticizing. You say that we should try to help them build a more sustainable healthcare system, but pre-meds are certainly less equipped to do that than the "meaningless" care we provide them for the short time we are there.

I can't see how anyone can criticize people doing only what's within their knowledge to do. You go and do your best for the people there with the knowledge and resources you have and you leave. I can't think of a single person there wasn't completely thankful.

In order for trips like this to provide a "crutch" they have to be able to survive completely on our care, which for my mission group is not possible. We give basic meds, which come down to things that improve quality of life, but are by no means life saving. Therefore I think the crutch argument is not valid.

What my trip did was provide them things that pre-meds are perfectly capable of giving, things like advil, iron supplements, cold meds. Someone said early that the money used to go abroad could be better used donated to another program.

I couldn't disagree more. By going there you expose a group of students to the hardships people outside of the United States face. Even if just 1 or 2 of these kids devote something to international medicine after one of the trips, I think the trip was worth it. If you haven't been on one of these trips, I don't think you realize the impact that it has on you. Sure some people realize that international medicine isn't for them, and maybe for those people the trip turns into a line on their CV. But for a few, it turns into a lifetime passion, and to me that makes the trips worth it.

The trips are worth it to whom? My trip to Mexico renewed my interest in medicine, made me buckle down and start studying for the mcat, and start working harder to bring up my gpa. What about the people I "helped" in Mexico? They're still in the same situation they were in before. My point is that people cannot really make a huge difference in the lives of these people in a short period because they're not capable of undertaking the government inefficiencies and bureaucratic mess seen in most of these countries. Yes, I am dedicated to international medicine because of my trip but my head isn't in the clouds thinking I did anything worthwhile for the people I encountered. I hope to work internationally one day but until I can make a legitimate commitment I'm staying stateside with my medical practice. Yeah you can see the incredible hardships faced each and every day by the people living in these countries but you can also get the same idea by merely walking down the street. Most people doing these trips need to get off their high horse and realize that yes their intentions are good but perhaps they are causing more harm than good. People are capable of learning to help themselves but they need a chance to figure it out. We need to focus more on educating local people how to work within their system instead of hading out advil because we won't always be there to do so. For example, I imagine volunteer tourism is going to decline this year because of the economy~what are these people to do that rely on these types of programs for healthcare? We can't possibly take care of the entire world but we can help them learn how to take care of themselves.

So what can we do at this point? There isn't much we can do to help out foreign countries outside of advocacy or traveling to stimulate local economies. Whilst stateside we need to focus on learning medicine, speaking foreign languages, and if there's time volunteering (you could teach English as a second language~I teach a basic class and it's the highlight of my week, help out at a refugee camp, or perhaps volunteer at a medical clinic specific for foreign patients~there's a free clinic for Spanish-speaking patients around here. Ask college professors if they know of places you could provide assistance locally). Sometimes you just have to be patient and wait until you have the capacity to do something the right way.
 
What you might not understand is that it's creating an uphill battle for future projects that aim to mobilize community resources to solve problems. "Why do we have to contribute something now when all the other folks that come in give us stuff for free? We'd rather just wait for one of those "nice" people to come around again." It creates a culture of dependency, and it has little to do with whether or not the gifts are crutial for survival. You see it as help, but you're not there for the aftermath.

I may not have made my argument clear, or I could be just plain wrong. I understand that providing anything for free starts a culture of dependency. This is the standard argument against any kind of welfare. I don't, however, think that its a reason not to provide anything.

We weren't completely naive when we came back from our trip, and certainly saw the benefits of providing something sustainable to the people in Nicaragua. You could draw the culture of dependency argument of providing something sustainable for them as well. Are they ever going to improve things for themselves, or are they just going to wait for those "nice" people to come back and help them again? You can always use this argument against providing anything for someone.

Parenting could be a good parallel. Although I'm not a parent myself, it seems clear that you have to put your kids in a position to make their own decisions and develop themselves. Providing them with resources and help along the way is definitely necessary to their growing. You can look at the countries being helped as children(although I wish there was a less derogatory word, they are certainly not as helpless as children). I think the pre-med mission trips simply provide some helpful resources, much like a parent does for a child. It is obviously out of the scope of pre-med mission trips to provide sustainable resources, much less helping them develop better medical infrastructure. I think other, more capable organizations should help these countries develop themselves.

My problem with your argument could be caused by my own experience. We were a group of eleven students, providing very little for the people. We provided so little, and the mission trips only happen 3 separate 2 week periods during the year, that I can't honestly see it building any kind of cultural dependence.
 
The trips are worth it to whom? My trip to Mexico renewed my interest in medicine, made me buckle down and start studying for the mcat, and start working harder to bring up my gpa. What about the people I "helped" in Mexico? They're still in the same situation they were in before. My point is that people cannot really make a huge difference in the lives of these people in a short period because they're not capable of undertaking the government inefficiencies and bureaucratic mess seen in most of these countries.

Yes, I am dedicated to international medicine because of my trip but my head isn't in the clouds thinking I did anything worthwhile for the people I encountered. I hope to work internationally one day but until I can make a legitimate commitment I'm staying stateside with my medical practice.

You're right, the people from your Mexico are immediately in the same situation. Look at a hypothetical situation though. By you being there you have the chance to go back and tell people your story and mobilize people/resources to better provide a more sustainable resource for them. Without your trip, which many are deeming meaningless, the people that you visited may not have hope for a better future.


I'm sure you managed to do something for the people there in the short term. I always thought that handful of advil i could give someone atleast could take pain away for a day. I think the long term benefits of these trips are like you said, it made you interested in international medicine. Without building this interest in young doctors, we won't ever be able to make the impact on countries developing health infrastructure.

Don't look so much at the immediate impact, because as you pointed out it's not that great. I think the trips are great in the fact that they get people involved in international care. We're not ready for taking on the problems these countries have right now, but by seeing that they exist, it certainly prepares us for helping out later.

Idk if you already said all this about the long term, but after typing it I don't feel like deleting it.
 
Don't look so much at the immediate impact, because as you pointed out it's not that great. I think the trips are great in the fact that they get people involved in international care. We're not ready for taking on the problems these countries have right now, but by seeing that they exist, it certainly prepares us for helping out later.

Instead of focusing on the long term impact on your own life, look at the long-term impact of short-term mission trips on these communities (hope that makes sense). Using your analogy of parenting, what kind of parents give their children things without teaching the importance of work ethic or teaching them how to survive in the world? Prolonging the inevitable isn’t a viable solution.

Our welfare system is a complete mess because it does not provide any relevant training to get people back on their feet. Instead, it gives them enough to buy food and pay a little rent but most people must work 2-3 jobs minimum wage jobs to pay for other expenses. Often the kids grow up without much parental support or encouragement leading them to drop out of school and the vicious cycle repeats itself. I’m not saying we should stop helping the less fortunate; I’m merely advocating a more progressive way of doing things. Instead of sending people a monthly check we need to find them decent paying jobs, get them educated, and help them help themselves. Even then, some will be left behind. It’s not something I’ve completely accepted but sometimes people just don’t want to change. You can’t make them use their resources wisely or stay in school but you can provide the option. Not to mention it reinforces the idea of the grand benefactor coming on a white horse to save the poor, dim-witted natives.

These things are fixed overnight and you need community support. Many grassroots organizations, at least in South America, have come a long way in promoting community health and advocacy. They are working for the long haul and in my experience do a lot of great things for the community. However, until the governments in these countries get their act together (something we probably can’t fix) there won’t be any change of consequence. If you’re going to do an outreach trip, these are the types of organizations to look for and not the American organizations. However, they’re harder to find as most are not online.

I applaud your desire to help the less fortunate but anything worth doing is worth doing the right way!
 
This has turned into such an interesting and dynamic conversation. I think that both sides have very legitimate points! I believe one of the reasons why pre-meds may be interested in these short-term international programs is just to get their foot in the door. Many international positions require previous experience working or volunteering abroad. Therefore some people who do not have the ability to do PC may opt for these shorter trips instead.

...All this international aid work is being done with the right motivations in mind, but there needs to be a shift in thinking about how we approach the problem. Why is it that even with over 400 NGOs and non-profit organizations in a small country like Nicaragua, it still remains one of the poorest and destitute nations in all of Latin America...

This is why monitoring and evaluation is becoming a hot thing in global health and development. Previously, so many NGOs and orgs, such as UN, WHO, CDC, and CARE have had programs running in countries that they assumed were "successful" just because they worked in the U.S. For example, there was a program by one organization (won't mention the name) where they were using sex education among women as a method for decreasing the spread of STDs and HIV. However, women were treated as 2nd class citizens in this particular country they didn't have the power to ask their husbands to use condoms. Condoms had a stigma and if women wanted to use them, then it was assumed that they were ****** or infected with an STD. Although so many organizations are working in Africa and so much funding has gone to fight HIV, the disease still remains a huge problem in Africa. Part of this reason is that there needs to be more evaluation of the effects of prevention methods and current programs.
 
To add to my post above, there also needs to be more coordination and partnerships, among NGOs. So many NGOs are doing the same things in the same areas, but are not communicating their strategies for development or lessons learned from the implementation of their programs. Even worse, there is still too much "politics" and egos among people in these organizations. In addition, I think we need to be careful of ever describing these countries as "children." It is so easy to feel superior as a foreigner, especially when your skin color gives you certain priviledges that locals don't have. I'm not saying anyone here is guilty of this; however, it's easy for this to go to your head, and I've seen people with the best intentions get a superiority complex (even though it oftens comes off subtle). I had one guy in East Africa tell me and my friends that he was so happy that us white people (I was considered white there even though I'm not, which was another culture shock) were there to help them b/c white people are so smart and advanced. :eek:

This is the kind of dependency I believe people are talking about. Locals begin to see Westerners as walking ATM machines, and no longer view themselves as competent in making change or developing new ideas.

One thing I noticed in Africa is the amount of classism and racism that foreigners have towards locals (and this is not just about white vs. black in U.S.-terms b/c race changes depending on which country you're living in). It's subtle, but it's shockingly there. I also had friends in Latin America noticed this. Unfortunately, no one (not any schools nor organizations) discuss any of this in their orientations since there's so much stigma and shame associated with these topics. It's actually quite sickening.

I still believe that people should go abraod if they can, but there definitely needs to be more training in cultural sensitivity before anyone leaves.
 
You guys should check out Global Medical Brigades. go to globalbrigades.org. They are a relatively cheap group well established in the coutnries that they work (medical is mainly in Honduras) and they work at all aspects in the rural villages (water, business solutions, public health, education etc.) to make sure their programs are sustainable. As medical students/pre-meds, you will be taking vitals, histories, shadowing/interpreting for docs and dispensing/explaining prescribed medications to patients (you will get trained in this). If you have other training you can be as involved as your training allows. Medical missions really are amazing if you go on the right one.
Good luck!
 
wise words


If anyone is interested in volunteering at mother teresa's, this is a pretty good description of how to go about doing it. It is EXTREMELY informal. You can show up out of the blue at the mother house for one of the info sessions and start volunteering later that week.
http://www.lonelyplanet.com/travelstories/article/volunteeringinkolkata_1207/interest/volunteer

Off topic, but I have such a love-hate love affair with lonely planet. I absolutely love the guidebooks (especially the regional Shoestring ones) because they give enough info, but leave it open enough that I can get off-track and generate my own adventure. But at the same time when I'm walking up the street and see someone carrying the book like it's a lifeline, I just want to rip the book out of the person's hand and throw it into the street.

Back on topic, your experience sounds super interesting. I might look that up when my friend and I stumble over to India at some point.
 
This is an excellent speech given by Ivan Illich to a group of young Americans who wanted to go and volunteer in Mexico. Although it's a bit outdated, it encompasses what a lot of people have been saying on this thread. It makes you think. http://www.swaraj.org/illich_hell.htm

That said, I volunteered/lived in Southeast Asia for two years and it was the best decision I've made. All at once it was amazing, challenging, thought provoking, frustrating, fulfilling, and many many other adj. I went because I love traveling, experiencing new cultures, learning languages, and basically being thrown out of my element. I've lived in many different areas of the U.S. and in Australia and I decided that I wanted something completely different. And I got it. I went after my graduating from college and it helped me refocus why I wanted to be in medicine and what exactly I wanted to accomplish with an M.D. degree. If you're interested... http://www.viaprograms.org (they have summer and long term programs. and generally more affordable than other international programs)

Of course I think people should volunteer in their own neighborhoods. But, I also think that if you have an opportunity to go abroad then you should. Too many americans are sheltered from this increasingly global society. And as long as you're not an "ugly american" and you're respectful...you're showing people in countries that hate americans that American people are not necessarily the American gov't.

Where in Southeast Asia? Southeast Asian studies was one of my college majors, then I spent a 5 months backpacking, and now I work here! It really is my favorite region.
 
I've gone on medical missions trips to Mexico, Ecuador, and Honduras. They were all incredible experiences and I would do another one in a heartbeat. You learn a ton, you see things you'll never see in the USA, and they can be life-changing experiences in a very personal way. I hope you'll have the opportunity.
 
Hey everyone! anyone out there heard of Mercy and Truth medical missions? I want to go on a trip with them this summer but I don't know how to check their legitimacy. Any wisdom? Thanks! :)
 
My Opportunity:

So the neurosurgeon I am doing research with/shadowing this summer had a few years ago gone to Tanzania and opened up a neurosurgery clinic there, because apparently there were only like 3 neurosurgeons in the entire country. Now he opened up this clinic not just to do procedure, but to make a large impact on there. He ended up teaching one man how to do surgeries, who was not even a doctor, and this individual has now done more than 100 cases.

I have an opportunity to go volunteer there, for just a few weeks. However, this is not an official medical mission trip, my costs will be payed for by a scholarship I got from school and these guys are not just leading to a Tanzania dependent of the American neurosurgeons but rather creating a Tanzania who has enough local neurosurgeons. I feel like the impact and benefit of this clinic is far greater than many of the clinics every has been bashing.

Now, obviously, as a premed, I still will only have so much responsibility and will probably not be able to do much at all, and I do not know what exactly I will be able to do there. Chances are that I might be more involved in the actual process of surgery, especially considering some of those individuals performing successful brain surgeries now are not even doctors. However, I will not deny that this will be more of an impact to me than others.

What do you all think about this?
 
Hi all,

As to short-term medical missions, I'm not qualified to say because I've never been on one. Right now, my husband and I and our four children are preparing to begin long-term missions in 2 years, when he's done with his Masters. I'm on this forum because I'm trying to figure out what would be the best medical preparation for me to help while there (MSc - PH? Midwife? Nurse? - PM me if you have any advice!!! Oh - I already have a BS in Zoology, BA Global Studies, and we're looking right now at southern Africa (AIDS) or Papua).
However, I have done two short term international trips and I've lived in Singapore a total of 5 years. One short term trip was to a language school in Costa Rica when 16, one was with my church to visit our sister church in Honduras.
If anyone is considering international missions, medical missions specifically, then I would suggest the absolute BEST thing to do is go overseas. I know there's been a big debate over just being a tourist or giving out bandaids. I think there's a third way. Go with a church or a parachurch. There are lots of short-term opportunities, if you really want to "do" something, but I found the best experience was on the sister church trip. We lived with local believers, fellowshipped every day and night together, occasionally helped out when and where we could and even got some eco-tourism in when we joined the church for a beach trip. :) At the end of two weeks, I hadn't seen much except the super poor neighborhood we'd lived in, but I was rich - rich in friends (20 people saying goodbye at the airport!), rich in love and more understanding of the culture, rich in ways the "eco-tourists" who had come as consumers just couldn't have had.

I don't want to start a whole new debate on "building service" vacations or anything, I just wanted to mention the possibility since the point seemed to be getting lost in the general discussion. Also, I'd like to mention the language aspect. I had spent 5 years studying Spanish and could barely speak a word. One month of living in Costa Rica fixed that (the school was a nice reminder but not really necessary for me). So if someone is really thinking about possible international careers, study the language at home but plan on immersing yourself when time and finances permit.

Just my two cents...:D Make that $.0195 because we're in Canada! :p
 
I am spending a year in a remote area of Africa where I basically created my own program. They are so low on doctors that the first day I was assisting with surgery. Now I'm usually the only person at the table besides the doctor. I do minor proceedures solo, deliver babies, and help bring docs from overseas to help. Pre-med students can make a huge difference if they're willing to really go out on the line. However, I'm also careful not to take on more than I can handle. (I refuse to do c-sections myself, though they want me to, etc.) Before you blast me, if I wasn't there, the doctor would be doing the surgeries with no assistance... and an extra set of hands certainly helps.

By the way, if there are any doctors who can give time, we'd love to see you in Sumbawanga!

Is this program still functioning? I know your post was from a long time ago, but I am definitely interested in lending a hand and I know a few other people too who would like to join in!
 
Refuse to do c-sections as a pre-med, like that's some incredible show of will and ethical acumen... are you effing kidding me.
 
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