Medical Missions

[Wishing4MD]

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Hey everyone! This might be a silly question, because I know it must look amazing, but I still want other people to opinionate. How good does a Medical Mission look on the application? Thanks in advance! 🙂

 

[Frazier]

Hey everyone! This might be a silly question, because I know it must look amazing, but I still want other people to opinionate. How good does a Medical Mission look on the application? Thanks in advance! 🙂

It looks like something that is done by enough people to not make it that amazing to do anymore.

If you don't mind spending the money, go ahead. If it is funded -- definitely go on the free vacation. 🙂

 

[apumic]

haha.... not as "AMAZING" as you might think. They're quite common. Go for the experience and to serve others, not for some wishful thinking-esque "boost" to your application (b/c it truly would be wishful thinking).

 

[LizzyM]

Hey everyone! This might be a silly question, because I know it must look amazing, but I still want other people to opinionate. How good does a Medical Mission look on the application? Thanks in advance! 🙂

It doesnt look good. It looks like tourism. In fact, it is worse than tourism because it usually involves handouts which undermine the development of self-sufficiency. At least tourists buy things and stimulate the economy.

Do we have no people in need of assistance here? The fact that you performed a procedure that requires a license to perform in the US will not impress us.

Good thread here:http://forums.studentdoctor.net/showthread.php?t=587185&page=2

starting at post 34 is best.

 

[krs881]

For all those thinking about medical mission trips -- not just the OP -- this is a really fantastic thread on the subject that discusses not what a medical mission trip will do for your resume, but what it does for the patients, communities and countries visited.

http://forums.studentdoctor.net/showthread.php?t=587185

This thread was linked to by LizzyM in another thread about medical trips (it's over a year old) and I couldn't stop reading it once I started. Many points of view are expressed and important questions raised. Try to get to the second page if you can, where the conversation takes a new turn.

 

[necoli]

... it usually involves handouts which undermine the development of self-sufficiency...

Wow. Good arguement against supporting charity. 😱

 

[krs881]

oops, we were responding at the same time. I'm glad to know you continue to post that thread LizzyM. I have even sent it to people outside of SDN who are asking similar questions, because there are not a lot of forums addressing them.

Another good resource for health professions students is the Global Health Education Consortium. I was at their annual meeting this year, and it brought together a lot of faculty, NGOs, govt/ministry of health officials, and students thinking about these very issues. There website has a lot of information, links and resources.

 

[LizzyM]

Wow. Good arguement against supporting charity. 😱

Read the other thread. Start at 34... you'll see what we mean. There are right ways and wrong ways to help the needy.

For example, farmers in Haiti have less market for their goods if those who would otherwise be buying their products are filling their bellies with free food being donated by well meaning Americans. (At this point, not in the days immediately after the earthquake) Now the farmer can't make a living on the farm so why should he farm? He might as well go to the city, try to find work there, and eat some of that free food.

 

[sedaniel]

It doesnt look good. It looks like tourism. In fact, it is worse than tourism because it usually involves handouts which undermine the development of self-sufficiency. At least tourists buy things and stimulate the economy.

Do we have no people in need of assistance here? The fact that you performed a procedure that requires a license to perform in the US will not impress us.

Good thread here:http://forums.studentdoctor.net/showthread.php?t=587185&page=2

starting at post 34 is best.

I don't really agree with this, I think it depends on the group that you go with and how the trip is set up. I went with 4 surgeons for a week to a rural town in Honduras where their hospital is not normally staffed with surgeons and we did whatever procedures needed to be done for the whole week. People down there literally wait for months for the team (they go down once or twice a year I think, I've only been once so far) because there simply isn't anyone in the area to do those operations. So I think that our trip was really helpful to the community. It was also organized privately by one of the surgeons. We each had to pay for our plane ride down there, and then we stayed on site in a bunkroom in the hospital and ate meals with their regular staff.

All in all, it was an amazing experience for me, but I do think it depends on how your trip is set up because I've heard from friends that the trips they went on were not nearly as good of an experience as mine.

 

[LizzyM]

I don't really agree with this, I think it depends on the group that you go with and how the trip is set up. I went with 4 surgeons for a week to a rural town in Honduras <snip>.

Interesting thesis on the ethics of these trips to Honduras:

http://etd.library.pitt.edu/ETD/available/etd-07262009-200714/unrestricted/Bradke.pdf

 

[necoli]

I have had the pleasure of reading that thread. I agree with the ideas shared in it, in that an improperly run medical mission can be counterproductive. My concern with your post, is that it comes off (at least to me) as cruel. It reminded me of Ebeneezer Scrooge and his perspective on the "population surplus".

Even when your comments are draped in the context of the aforementioned thread, your comments make me discouraged. Your post reveals what the adcom is to think when she sees that a student participated in a medical mission- this applicant is incapable of deciphering productive from unproductive, helpful from unhelpful. What makes this disheartening, is that you will not be familiar with the details of the trip, and, in all likelihood, not bother to research what actually occurred on the medical mission. So a student who particpated in a medical mission is now judged based on the duration rather than the quality of the trip.

Back to medical missions; I am organizing a medical mission to go to Mexico. I will be there for a summer, and will be working with educators and trash picker-uppers to create opportunities for a missionary couple to interact with people. It will have a decidedly religious slant. I think that for a medical mission of this type, a religious theme is perfect, rather than an ambiguously altruistic "I want to help people not be deathly ill".

Research and thorough knowledge of the area, and it's needs, are critical to a successful medical mission. In this way I hope that the "handouts" I provide will not "undermine their development of self-sufficiency", but provide a needed boost to the local children's education, teach the adults profitable trades, and to give people the opportunity to receive quality healthcare, even if it is for a limited period of time.

Will all the nuances of the trip get passed on to adcoms when I send in my applications? No; I have not even effectively communicated them on this forum! With your post in mind LizzyM, I realize that adcoms won't take the medical mission half as seriously as I did. Ergo I would be a fool to play this experience up in my application.

As to your second post, you are merely exemplifying the effect of inadequate research of the area, not to be confused with the ineffectiveness of medical missions in general. Of course, there isn't going to be a perfectly planned trip that works out perfectly, but does that mean that we shouldn't try?

A good medical mission should have:
1. A good reason- why Mexico? Because, based on my research, the medical mission will be an effective use of our resources in terms of saving souls.

2. A clearly defined plan on achieving these goals. Doing pap smears all day long would not be the most efficient means of achieving our goals. Education + Workforce Training, coupled with quality medical attention/advising, can help to open doors to create long term relationships with people, that can then be used to promote spiritual growth and so forth.

All this rambling to say that medical missions can be helpful. Have pre-meds exploited them as a means to look unique? Sure. Should adcoms become jaded and assume that all students who participated in a mission of <X length are frauds? No. Each student is different, and I want to encourage adcoms to thoroughly examine each student, without attempting to stereotype the student.

Knowledge is power. Adcoms and applicants alike should not go to an interview powerless.

I am tired of writing.

 

[LizzyM]

It may not be available online right now but do try to find a hard copy of
Collaterals an essay by M. Allison Arwady, MD, MPH that appeared in JAMA. 2010;303(22):2229-2230. It reflects on being a resident on a rotation in a hospital in Africa. One snippet:

Mulago Hospital is always contrasted with a US hospital that seems increasingly utopian with each missing blood test, unavailable antibiotic, and dying patient. Visiting physicians underscore the "otherness" of the non-US system, partly to process experiences, partly to reassure that ineffectual flailings at disease can be blamed, at least in part, on the resources at hand. It is a hollow reassurance, but a common source of comfort. There is an unspoken assumption in the United States that US physicians go "to help Uganda." But young US-trained physicians are less proficient at bedside procedures and physical examination skills than Uganda-trained physicians and are less accustomed to working with minimal supervision. In general, US physicians don't speak the language, have little first-hand knowledge of major tropical diseases, and often spend a lot of emotional energy getting through each day. We want to be of use, we want to learn, we want to treat this woman with SVC syndrome and the wards full of patients even sicker than she is, but we are not adept at making things happen in a system that is opaque to outsiders.

 

[LuciusVorenus]

I don't even understand why Medical Missions exist. Why do you need to make it a religious thing at all?

 

[Narmerguy]

It's always been interesting to me that it seems that whenever this topic comes up its customary 3-4 times a semester/summer, the vast majority of those in favor are those that have gone or are planning to go, and those that are against it (usually equally strongly so) are those that have not gone and have no intention of going.

Though the latter group makes sense (why would you go on something you don't support?), it should be noted that one could have gone on one of these trips and later felt it is a poor decision (which I have never seen). Similarly, I have very very rarely seen the situation where someone that hasn't been able to go on one of these trips still feels that it's a great opportunity and a productive use of one's time, which one might expect...simply because there are likely people that can't afford it that would still like to. However, this group is either extremely small or relatively soft spoken.

Just some observations of mine over the past 3 years. I've seen this trend many many many times.

 

[SweetRain]

If it helps, I have a friend who went to one of the Central American countries. He paid about $2000 for a ten-day trip 😱
Later when he came back he told me how life-changing it was, how he wants to do another one before he graduates, and basically how amazing this experience was.
When he showed me the pictures from the trip, they were mostly pictures taken on the beautiful beaches, a night at a local bar, and some famous tourist sites. He did have some pictures of him and others in scrubs at a local clinic they volunteered at but they didn't really do anything but hand out pills.

It's your money to spend if you want to, but I don't see why anyone would go there for ten days once a year and make the local people become more dependent on foreign sources. If you are truly interested in making their lives better, you should join the peace corps (or anything long term with a legitimate supporting organization) and work on community development or health education.
My volunteer coordinator was with the Peace Corps before and she worked on preventive medicine (eating healthy, washing hands etc) while some other members worked on local farming.

In the end, it's your decision to make but make the right decision.

 

[PreMedder]

If it helps, I have a friend who went to one of the Central American countries. He paid about $2000 for a ten-day trip 😱
Later when he came back he told me how life-changing it was, how he wants to do another one before he graduates, and basically how amazing this experience was.
When he showed me the pictures from the trip, they were mostly pictures taken on the beautiful beaches, a night at a local bar, and some famous tourist sites. He did have some pictures of him and others in scrubs at a local clinic they volunteered at but they didn't really do anything but hand out pills.

It's your money to spend if you want to, but I don't see why anyone would go there for ten days once a year and make the local people become more dependent on foreign sources. If you are truly interested in making their lives better, you should join the peace corps (or anything long term with a legitimate supporting organization) and work on community development or health education.
My volunteer coordinator was with the Peace Corps before and she worked on preventive medicine (eating healthy, washing hands etc) while some other members worked on local farming.

In the end, it's your decision to make but make the right decision.

Yes, your anecdote applies to every mission/brigade/trip that every student goes on. 👍

 

[Narmerguy]

Yes, your anecdote applies to every mission/brigade/trip that every student goes on. 👍

That doesn't make it any less instructive. There's no real data on this so all anyone ever gives is a collection of anecdotes they've interacted with.

 

[NickNaylor]

I was going to go on a medical missions trip this summer. But then I found out the price tag was $3,600 for two weeks.

No thanks.

 

[CapnCrunch]

I was going to go on a medical missions trip this summer. But then I found out the price tag was $3,600 for two weeks.

No thanks.

Wow. I'm amazed how much these programs cost and how exactly it's justified... I went on a non-religious program that totaled to about $4,500 for 3 months to India (and I still thought that was a lot). This included living, breakfast and dinner, and transportation. Though, I wouldn't consider it a "medical mission". Anything that has been privatized is going to face ridiculously high costs.

 

[NickNaylor]

Wow. I'm amazed how much these programs cost and how exactly it's justified... I went on a non-religious program that totaled to about $4,500 for 3 months to India (and I still thought that was a lot). This included living, breakfast and dinner, and transportation. Though, I wouldn't consider it a "medical mission". Anything that has been privatized is going to face ridiculously high costs.

That was actually through my school. It was to Kenya, so admittedly most of the cost was in airfare. But still - too expensive for just two weeks.

 

[skierbum]

I would like to volunteer for a year between going to either med or pa school. I have done lots of hours of hospital volunteering, but have always wanted to travel and volunteer. I think it would give me a different perspective than the affluent suburban hospital where I volunteer.

How would I fit this with applying? When would I take the mcat or gre? I know this is a couple years off, but I want to get a general idea. One year, either abroad or in the us, would provide me with the experience that I have wanted for a while. Between a year volunteering or a year studying abroad, which would be better? My neighbor did a year in Cambodia and Thailland and felt really rewarded. Is it even possible to go from undergrad to a volunteer year straight to med school? Or would I lose another year after volunteering for applying?

 

[Perrotfish]

Wow. I'm amazed how much these programs cost and how exactly it's justified... I went on a non-religious program that totaled to about $4,500 for 3 months to India (and I still thought that was a lot). This included living, breakfast and dinner, and transportation. Though, I wouldn't consider it a "medical mission". Anything that has been privatized is going to face ridiculously high costs.

I think the justification is that the cash is your contribution to the mission. You're not qualified to do anything yet, and the last thing the third world needs is more people to do manuel labor, so most of what you're giving in exchange for your changed perspective and resume enhancement is the money that buys the manpower and materials that gets the work done.

The challenge, of course, is verifying that that's where the money actually goes.

 

[ryguy4810]

Absolutely absolutely correct.

Sadly medical missions do more to create a warm cuddly feeling on the part of the volunteer than do any real good in poor populations. It encourages a culture of expecting handouts from developed countries rather than encouraging countries to properly care for their own people. Yes, you may work hard for a couple days, diagnose a couple respiratory infections, hand out some pre-natal vitamins. But when you leave, the economy takes a hit and these programs aren't as well funded, the people that previously depended on these services don't know where to turn, because in-country care never developed.

Spoken as a currently serving peace corps volunteer who has never served in a medical mission.

 

[Bojangles85]

Not to be selfish, but there are A LOT of places in the United States that needs volunteers as well. It may not be as "fun" as going to a foreign country, but the need still exist.

 

[pkpHawks87]

I went on one such trip and it was woven heavily into my personal statement and interview process. Surprise surprise, I got in. I dont understand the bad stigma behind these trips on this forum. More often than not I encountered physicians in my shadowing experience who regularly took trips of this nature. People on here freak out about the cost and paying out of pocket to go on what is dubbed a "voluntourism" trip. Well, heres a solution: raise the money yourself. Thats exactly what I did and any extra over the cost of the trip I donated to the on-site project manager. It worked out great. I would go back and do it again in a second.

 

[krs881]

I don't even understand why Medical Missions exist. Why do you need to make it a religious thing at all?

The use of the word “mission” doesn’t imply that there is necessarily a religious affiliation, motivation or activity. The terms “medical brigade” and “medical mission” are often used for short-term medical work in poor countries.

 

[LizzyM]

I went on one such trip and it was woven heavily into my personal statement and interview process. Surprise surprise, I got in. I dont understand the bad stigma behind these trips on this forum. More often than not I encountered physicians in my shadowing experience who regularly took trips of this nature. People on here freak out about the cost and paying out of pocket to go on what is dubbed a "voluntourism" trip. Well, heres a solution: raise the money yourself. Thats exactly what I did and any extra over the cost of the trip I donated to the on-site project manager. It worked out great. I would go back and do it again in a second.

Stating that these trips are not, in the long run (and sometimes in the short run), beneficial to the people who are recipients of services, does not mean that applicants who participate in such trips will not be admitted to medical school.

Sure, some physicians make trips abroad to "help". The circumstances vary (many physicians went to Haiti after the earthquake as part of organized efforts to respond to the emergency) and the benefits vary. However, the physicians have knowledge, skills and ability! They have medical licenses! What they can do if far different than what a college grad or college student can do. Even then, as pointed out in the recent essay "Collaterals" (cited above), the US-trained physician is far less efficient than local counterparts.

 

[cfx]

You're obviously going to get two answers, here: the one from those who have gone on one and want to defend it, and the one from everyone else.

Premeds on "medical missions" seem like a dime a dozen. I have not done one, nor will I ever, because of all of the reasons others have expressed already. The whole idea really turns me off 🙄.

I'm sure you can donate the several thousand dollars and it will probably go much further toward helping people than anything you can "do" on these trips.

 

[LizzyM]

You're obviously going to get two answers, here: the one from those who have gone on one and want to defend it, and the one from everyone else.

Premeds on "medical missions" seem like a dime a dozen. I have not done one, nor will I ever, because of all of the reasons others have expressed already. The whole idea really turns me off 🙄.

I'm sure you can donate the several thousand dollars and it will probably go much further toward helping people than anything you can "do" on these trips.

Hear, hear.

Doctors without Borders is a stand-up organizations that does a great deal to treat patients and train local physicians.

 

[krs881]

For those really interested or considering a medical mission, I would again strongly suggest reading the thread linked to previously, as a lot of these same issues are fleshed out there.

It's always been interesting to me that it seems that whenever this topic comes up its customary 3-4 times a semester/summer, the vast majority of those in favor are those that have gone or are planning to go, and those that are against it (usually equally strongly so) are those that have not gone and have no intention of going. [...] Similarly, I have very very rarely seen the situation where someone that hasn't been able to go on one of these trips still feels that it's a great opportunity and a productive use of one's time.

Those who think medical missions are good ideas but haven't been on one probably don't have much to say about it on SDN &#8211; those with strong and extreme opinions tend to pipe up more in any forum. Most of the people I know or have seen post on SDN threads who question the effectiveness and/or ethics of medical missions are those who have spent significant time in "medical mission" receiving countries. I haven't been following these threads on SDN for all that long, but I think these people (and their concerns) can be differentiated from those that express personal concerns of costs or preference to work in U.S. communities, etc. This has nothing to do with "5 years abroad is better than 1 yr is better than 3 months is better than 10 days" but rather, comes from the nuanced perspectives gained over significant time in the country in question -- politics, government, culture, medicine, health systems, beliefs, development (the list goes on) -- and north-south and intercultural dynamics more generally (or west-rest or developed-developing, whatever binary terminology one prefers, as long as we are forcing ourselves into a binary nomenclature). These perspectives most often come after living long-term in a poorer "medical mission" receiving country, though it is certainly possible to question medical missions on these grounds without that experience, it just appears to be less common. This is also not to say that all Americans or Canadians or rich westerners living long-term in poor countries share these views. I think most importantly, after long-term stays and developing such perspectives, one of the strongest impression that one comes away with is, often, how much one still has to learn about said country. The perspectives gained, questioning of self and world, and recognition of how little you know, are among the reasons I think spending time outside of your country can be a highly rewarding and "life changing" experience &#8211; the value is NOT necessarily in directly "helping the poor" or "doing something is better than nothing" or "gaining experience" but rather in the long-term impact in your life and how that influences what you do and how you go about doing it. But such experiences should not be sought at the expense of the health of the countries visited.

Your post reveals what the adcom is to think when she sees that a student participated in a medical mission- this applicant is incapable of deciphering productive from unproductive, helpful from unhelpful. What makes this disheartening, is that you will not be familiar with the details of the trip, and, in all likelihood, not bother to research what actually occurred on the medical mission.

Given the only scant attention medical missions have been given in the literature, I wonder how many ADCOMMs would think poorly of any and all medical missions? Perhaps someone could comment on this, as I am just speaking from what I have observed among the general health care sector--as another poster mentioned, lots of MDs, nurses and others go on such trips--but ADCOMMs are regular people too! Many might have concerns about appropriate supervision/activities for students and pre-departure preparation, as these are issues that are beginning to be more thoroughly discussed and addressed in medical schools and in the literature, but I wonder if a blanket disapproval of all medical mission trips is common? I think it'd be useful to hear from some more ADCOMMs about this here. If an applicant is concerned about these issues and believes that their health-related activity in a developing country (short term mission or other type) was particularly well designed and executed and addressed the ethical issues at question here, then they could mention these details in the EC description. Certainly some groups, such as Shoulder to Shoulder, have been cited often as examples of better models.

I think the justification is that the cash is your contribution to the mission. [...] most of what you're giving in exchange for your changed perspective and resume enhancement is the money that buys the manpower and materials that gets the work done. The challenge, of course, is verifying that that's where the money actually goes.

It would be great if this were the case. Even if the money goes to the right place, as Perrotfish rightly questions, these schemes set up dependency that in my opinion is far worse than the same questions one might have about welfare programs in developed countries, because the communities served are far more vulnerable, marginalized, and have less agency and resources to wield on their own behalf. (see post #59 and beyond of the above thread for much more eloquent discussions of this). But all things being equal (which they most certainly are not) and if dependency is not created (jury is out for any particular trip given the lack of program evaluation and long-term research), the inefficiency of this form of resource delivery is breathtaking. Number crunching alone won't answer this &#8211; I think an important point of this entire discussion of medical missions is that healthcare in any society, much less in extreme poverty in a society foreign to us, is far more complex than we can imagine. But to give a crude example: the cost of airfare for one person on a medical mission could probably pay for a full-time physician in a rural health center for 2-5 months in most places. This is just a math game, plenty of other non-monetary factors play into staffing that health center, but there are certainly plenty of great organizations that can use that cash to the benefit of the public health somewhere. To give another example of inefficiency, donated supplies are more often than not (so I am told by those that work in this field) not worth the energy and admin costs of getting them through customs (this obviously varies a lot by country), then to where they need to go (transportation networks are not what one would expect in rich countries), and properly utilized. This is the case when, for instance, meds are close to expiring, donated supplies have no basis in actual needs or capacity for utilization, involve equipment that cannot be maintained or supplies that cannot be obtained in country, etc. Most Ministries of Health do not have the resources to keep tabs on the dozens of foreign medical groups/supplies that arrive weekly, although some do try. In a pediatric hospital where I work there is an entire room packed floor to ceiling with brand-new-in-the-box donated toys. Fisher Price play kitchen for children whose mothers cook over wood fires in dirt-floor homes and wash their clothes in the river; blond-haired blue-eyed dolls for dark-skinned children. Periodically they are given away and I'm sure a lot of the kids appreciate them greatly and have fun playing with them. A lot of families of patients in this same hospital barely scraped together the money to travel to the city, rely on a locally-funded charity shelter for accommodations and food, and can't afford medications that are prescribed while hospitalized let alone when they go home. These children, whose imaginations and creativity have developed playing with whatever odds and ends they found around the house instead of talking dolls or board games, probably could use a lot of things before a fisher price kitchen set. I digress (and am probably preaching to the choir on this last point).

For the many visiting medical groups that are more careful about the donations they bring, all the other issues mentioned in the thesis linked to by LizzyM as well as the thread linked to above become factors that in my opinion make few such trips worth the while, or even ethically defensible. When I first started researching medical missions I was surprised by the lack of published research on these trips, and am very glad to see the level of reflection that is going on in the SDN community and on medical school campuses, and to be part of it.

(posted by someone who has lived in a latin american country for 3 years working in public health research and capacity building and is confronted every day with the fact that she does not have very many answers)

 

[morning]

Read the other thread. Start at 34... you'll see what we mean. There are right ways and wrong ways to help the needy.

For example, farmers in Haiti have less market for their goods if those who would otherwise be buying their products are filling their bellies with free food being donated by well meaning Americans. (At this point, not in the days immediately after the earthquake) Now the farmer can't make a living on the farm so why should he farm? He might as well go to the city, try to find work there, and eat some of that free food.

Yes, the people of Haiti, who are so starving they eat mud mixed with sugar, need less food because it will spur farmers to try to work the ENTIRELY deforested and eroded landscape that only makes the hurricanes more devastating due to ensuing floods and landslides. People have not been "filling their bellies" with free food. We haven't even come close to ending global malnourishment yet.

http://www.guardian.co.uk/world/2008/jul/29/food.internationalaidanddevelopment

Haiti, btw, is barely farmable. Your argument might work in some other country (but not a lot of them - most of the poorest countries receiving food are also severely screwed up environmentally - Nigeria suffers leaking oil the size of the Gulf spill every single year, Chad and middle Africa are also suffering leeched soils, lack of water, and desertification, etc etc) but Haiti is one of the worst of the lot. Without major investment in technology and education there are not going to be very many successful farmers on that part of the island. Just withdrawing food and international support and hoping that will spur a miraculous reinvention of the economy is a pipe dream. They still need help and support.

And what of refugee camps? Are they going to turn into farms any time soon? I doubt the refugee camps around Goma are going to disperse any time soon.

I don't think that entails a "medical mission", which I agree are really rather meaningless, but your comment wasn't really about medical missions.

 

[Rickybobby]

Medical Mission = application padding. Do something in your community that you care about.

 

[LizzyM]

Yes, the people of Haiti, who are so starving they eat mud mixed with sugar, need less food because it will spur farmers to try to work the ENTIRELY deforested and eroded landscape that only makes the hurricanes more devastating due to ensuing floods and landslides. People have not been "filling their bellies" with free food. We haven't even come close to ending global malnourishment yet.

http://www.guardian.co.uk/world/2008/jul/29/food.internationalaidanddevelopment

Haiti, btw, is barely farmable. Your argument might work in some other country (but not a lot of them - most of the poorest countries receiving food are also severely screwed up environmentally - Nigeria suffers leaking oil the size of the Gulf spill every single year, Chad and middle Africa are also suffering leeched soils, lack of water, and desertification, etc etc) but Haiti is one of the worst of the lot. Without major investment in technology and education there are not going to be very many successful farmers on that part of the island. Just withdrawing food and international support and hoping that will spur a miraculous reinvention of the economy is a pipe dream. They still need help and support.

And what of refugee camps? Are they going to turn into farms any time soon? I doubt the refugee camps around Goma are going to disperse any time soon.

I don't think that entails a "medical mission", which I agree are really rather meaningless, but your comment wasn't really about medical missions.

Food aid hurts Haiti's farmers

http://www1.voanews.com/english/news/americas/Food-Aid-Hurts-Haitis-Farmers--92405389.html

 

[Longshanks]

http://www.amazon.com/Dead-Aid-Working-Better-Africa/dp/0374139563

 

[morning]

Food aid hurts Haiti's farmers

http://www1.voanews.com/english/news/americas/Food-Aid-Hurts-Haitis-Farmers--92405389.html

Do you have any comment on it besides someone else's opinion article? Or did you read my own article and not put two and two together?

This season, farmer Charles Surfoad is storing his rice rather than selling it. He says food aid from the earthquake relief effort produced a glut that pushed down prices. If he sells now, he says he'll lose money.


Vendors of other foods who have increased prices have been left with unsold stock. In the Policard slum, a jumble of broken concrete clinging to a mountainside, the Ducasse family tripled the price of its fritters because of surging flour prices. "Our sales have fallen by half," said Jean Ducasse, 49, poking at his tray of shrivelled wares.


Do you have any comment on the fact that these people were eating cakes made out of mud and spare condiments before the earthquake?

Got any comment on what happens to the refugee camps of the world if food aid were to disappear?

Food aid to the absolute poorest countries - Haiti, Sudan, etc - is not about depressing the economy, it's about saving lives that would certainly otherwise fail. Food aid to countries that are developing, albeit slowly, is a tougher situation. Aid dependency is a real issue but it's way more complicated than you make it out to be. Aid sent to a corrupt country with a crappy political system rarely makes it exactly where it needs to be and always has unintended consequences. Aid sent to a country that is developing and is not in dire need of it can do damage to the country's farmers - but probably not as much as our artificial trade system. Do you support the free trade movement? What about abolishing debt to heavily indebted countries?

There are countries who are currently set up to do much more with the aid they get than most countries. Sending support to a country like Rwanda, which is extremely poor but currently fairly well run (not endorsing Paul Kagame, per se, because he's been very bad for his neighbors, but he has done quite a bit for Rwanda) pays dividends. A country that saw one of the worst genocides in history only 15 years ago has cut its poverty rate at an almost unbelievable speed since then, and they didn't do that without food aid and other international help. But if you look just over the border in the DR Congo, it's an absolute mess. Part of that country would certainly benefit from less aid and more hands on the ground...but the Lake Kivu region is BEGGING for food aid and many people simply would not survive without it.

You can't just make a blanket statement about how food aid is damaging. You have to look at each country or even regions within each country individually and understand the complexities within them.

And there are some countries where agriculture is probably never going to develop at the rate you seem to believe it will. You have Sudan fighting Egypt hard for control of the Nile. Water tensions are rising everywhere. Droughts cripple agriculture in countries. Floods cripple them elsewhere. Situations arise.

 

[LizzyM]

Do you have any comment on it besides someone else's opinion article? Or did you read my own article and not put two and two together?
Do you have any comment on the fact that these people were eating cakes made out of mud and spare condiments before the earthquake?
<snip>

That was a news article. One of the opinions expressed was that of the President of Haiti:

Whether impression or fact, Haitian President Rene Preval raised the issue when he came to Washington last month. He said food aid was indispensible right after the earthquake. But, "If we continue to send food and water from abroad," he said, "it will compete with national production of Haiti and with Haitian trade."

If you read the article about "mud" you will see mention of the consumption of these products for pregnant women because they contain minerals such as calcium. I suspect that the people who are making and selling these items might be "making a market" in a behavior called "pica" which is not unheard of in the US as well and can include items such as laundry starch.

And thanks longshanks for bringing the Dead Aid book to my attention. I'm going to put that on my reading list.

 

[Longshanks]

And thanks longshanks for bringing the Dead Aid book to my attention. I'm going to put that on my reading list.

You're welcome. Its on my list to read as well. Came out last year, but the local book store didn't have it. They just published a paperback last month, so I'll be planning on picking it up soon. I saw the author give an interview on TV once and it seemed interesting to hear another perspective.

 

[Shagalabagala]

Do you have any comment on it besides someone else's opinion article? Or did you read my own article and not put two and two together?

This season, farmer Charles Surfoad is storing his rice rather than selling it. He says food aid from the earthquake relief effort produced a glut that pushed down prices. If he sells now, he says he'll lose money.


Vendors of other foods who have increased prices have been left with unsold stock. In the Policard slum, a jumble of broken concrete clinging to a mountainside, the Ducasse family tripled the price of its fritters because of surging flour prices. "Our sales have fallen by half," said Jean Ducasse, 49, poking at his tray of shrivelled wares.


Do you have any comment on the fact that these people were eating cakes made out of mud and spare condiments before the earthquake?

Got any comment on what happens to the refugee camps of the world if food aid were to disappear?

Food aid to the absolute poorest countries - Haiti, Sudan, etc - is not about depressing the economy, it's about saving lives that would certainly otherwise fail. Food aid to countries that are developing, albeit slowly, is a tougher situation. Aid dependency is a real issue but it's way more complicated than you make it out to be. Aid sent to a corrupt country with a crappy political system rarely makes it exactly where it needs to be and always has unintended consequences. Aid sent to a country that is developing and is not in dire need of it can do damage to the country's farmers - but probably not as much as our artificial trade system. Do you support the free trade movement? What about abolishing debt to heavily indebted countries?

There are countries who are currently set up to do much more with the aid they get than most countries. Sending support to a country like Rwanda, which is extremely poor but currently fairly well run (not endorsing Paul Kagame, per se, because he's been very bad for his neighbors, but he has done quite a bit for Rwanda) pays dividends. A country that saw one of the worst genocides in history only 15 years ago has cut its poverty rate at an almost unbelievable speed since then, and they didn't do that without food aid and other international help. But if you look just over the border in the DR Congo, it's an absolute mess. Part of that country would certainly benefit from less aid and more hands on the ground...but the Lake Kivu region is BEGGING for food aid and many people simply would not survive without it.

You can't just make a blanket statement about how food aid is damaging. You have to look at each country or even regions within each country individually and understand the complexities within them.

And there are some countries where agriculture is probably never going to develop at the rate you seem to believe it will. You have Sudan fighting Egypt hard for control of the Nile. Water tensions are rising everywhere. Droughts cripple agriculture in countries. Floods cripple them elsewhere. Situations arise.

It's a balance. I was in Haiti for a week in February, and the past three weeks in May, and I can tell you that the general sentiment in tent cities is that literally, "everybody would die" if food aid were to subside. At the same time, I fully believe that Haiti needs it's own farmers need help producing more food, and receiving less aid, but this isn't going to happen overnight.

The US needs to stop subsidizing the overstock rice and corn that has been dropped in Port-Au-Prince for the past 40 years, and rural farmers need help combating the erosion. Haiti is NOT, as somebody said, "unfarmable." It's one of the most fertile pieces of land in the world, with the most fresh groundwater of any caribbean nation. It's also got 9.9 billion pledged to it's development. There is incredible potential - but you're right. Everything has to be done on a case by case basis.

 

[Narmerguy]

I went on one such trip and it was woven heavily into my personal statement and interview process. Surprise surprise, I got in. I dont understand the bad stigma behind these trips on this forum. More often than not I encountered physicians in my shadowing experience who regularly took trips of this nature. People on here freak out about the cost and paying out of pocket to go on what is dubbed a "voluntourism" trip. Well, heres a solution: raise the money yourself. Thats exactly what I did and any extra over the cost of the trip I donated to the on-site project manager. It worked out great. I would go back and do it again in a second.

I don't understand, are you suggesting that your trip didn't stop you from getting in? It's very possible that you got in despite the negative connotations an adcom may have associated with the trip.

On the other hand, I'm not sure I understand what some of you that are against foreign aid are suggesting? Are you suggesting one shouldn't aspire to actually help people in other countries but rather write a check? Is that the proposed solution, throwing money at the problem? I can certainly understand the frustration of those with no skills going and basically "lending a hand" for thousands of dollars. However, for those with skills to offer (skills which are paid for in other countries), why not attempt to offer this to other countries?

It's one of the most fertile pieces of land in the world, with the most fresh groundwater of any caribbean nation.

Really? You sure about that?

Source: Haiti Agriculture, Information about Agriculture in Haiti http://www.nationsencyclopedia.com/economies/Americas/Haiti-AGRICULTURE.html#ixzz0rUlIiK2L

Declining soil fertility, natural disasters, and cheap imports from abroad have all contributed to agriculture's decline. It is calculated that only one-third of Haiti's land is arable, but nearer one-half is under cultivation, adding to deforestation and soil erosion. The land is often too mountainous to produce sufficient yields while, in the more fertile valleys, disputes over land ownership have often led to violence. Technology is largely lacking.

The main export crop is coffee, but it contributed less than 6 percent of earnings in 1999. Many small-scale coffee farmers have switched to food crops because of high taxes and exorbitant percentages demanded by the middlemen who buy the coffee from the peasants to sell on the international market. Other small export crops include mangos and essential oils for the cosmetics and pharmaceutical industries in the United States. Subsistence farming is also in decline, hit by an influx of rice and wheat, some of it smuggled in from the Dominican Republic and some sent to the country as humanitarian aid. Most of what is produced by small farmers is consumed or sold locally, but Haiti's main imports continue to be basic foodstuffs.

Source😛romoting and advancing sustainable rural development in Haiti, http://www.piphaiti.org/overview_of_haiti2.html

Intensive production is limited mostly to the fertile Artibonite Valley, yet the majority of rural population has access only to the hillsides for subsistence agriculture of maize, beans, cassava, and fruit. As a result, most hillsides are visibly eroded, and according to USAID, a third of all land is severely degraded (White and Jickling, 1995). Gully erosion is endemic, particularly along rural footpaths and roads (Wahab et al., 1986), seriously compromising both soil fertility and infrastructure

The existence of a few fertile patches (which are largely unreachable to the majority of the population) does not justify considering it one of the most fertile nations in the world. Indeed, it may not be as bad as some portrayed, but let's not get carried away...

 

[lemoretired]

some interesting readings to consider...

 

[krs881]

A lot of good books on all sides of the aid debate have come out recently, including Dead Aid. I've been reading some recently and that's next on my list. I think they also give us some frameworks in which to see medical brigades and medical aid.

- White Man's Burden (William Easterly)
- Bottom Billion (Paul Collier)
- The End of Poverty (Jeff Sachs)

If you have just a passing interest, I think these are all books that it's worthwhile to read just the first or maybe first/last chapters to get an idea of where the authors stand and their contributions to "development" ... i.e. an afternoon browsing at barnes & noble...

For anyone who's read White Man's Burden: I am reading it now and have been thinking that his discussion of "planners" (big aid from rich countries, big interventions implemented from rich countries) and "searchers" (smaller scale, innovation, more local) can help us think about medical brigades and developed world healthcare assistance in the developing world. It appears to me that medical brigades make a lot of the mistakes of planners, although of course on a much smaller scale in most cases. But the fact that it's smaller scale gives them a great opportunity to change relatively easily, and start working more like searchers. I think that if they worked more like searchers, some medical brigades could be a lot more useful, efficient, and ethical. Some groups are already working like this, Shoulder to Shoulder comes to mind, although I have only passing knowledge of them.

 

[astrocreep96]

I did a medical mission trip - it was great fun. The group I went with gave "scholarships" in exchange for XXX number of volunteer hours completed in your local community, so it was motivation to volunteer in your community as well as abroad.

It was operated through a local Rotarian chapter - a core group in the US works with a local group in the other country to identify a village in need, and then that village hosts the US group for about 5 years. They provide immediate medical and dental care for the time in country, but also help out to establish long term facilities, stock supplies, and usually train local teachers or nurses. They also provide money and supplies for construction, there was a microenterprise program designed to help establish some form of industry (usually through money and supplies), buying books to stock schools, etc.

I think there was a positive impact on the area, I learned a little from it, saw things that I wouldn't see otherwise, etc. Personally, I'm wary of people that dismiss trips like these with such broad strokes - I think they can be a great opportunity.

 

[Nibby]

Honestly, I think that the experience of a medical trip is completely based on the individual. For me, my medical trips have given me a perspective on healthcare in developing nations and also gave me exposure to some illnesses that we don't see much in the US. I did a 1 week trip in belize that was your typical medical mission. Set up shop in random locations, did basic physicals and bp, glucose, etc, and was a great way to practice basic skills as a first year. I definitely don't think it was anything that sets me apart on a CV, but interacting and using spanish made the trip worthwhile to me as a student. The stuff we did is all stuff that I do in the clinics back at my medical school, but one still gets a completely different perspective on cultural differences. Belize uses a lot of alternative medicine and the amount of worms and rashes is completely different from my local clinics.

My other trip was 2 weeks working at a hospital and rural clinic in India. The rural clinic was similar to belize, so I focused on the hospital, but was able to see a completely different approach to medicine. The hospital we were at had very little resources and it was common to just amputate for everything. We got to do some stuff that medical students in the USA don't do until 3rd year, but obviously that doesn't make a difference when you are applying after 3rd year and everyone has done those same procedures. The difference however was in the triage in the ER, the emotional aspect of most of the patients not being able to afford $100 procedures and dying as a result. The fact that so many people don't go to the hospital until its too late and are showing symptoms of advanced AIDS or cancers. We saw a lot of rheumatic heart disease that is pretty rare in the USA. I also spent time in radiation oncology and their techniques were so low resource and primitive to anything we have here that it really gives you an idea of how physicians work in other countries. To me, it was humbling to see that these physicians do the best with what they have and try to help to the best of their ability.

I think if you are going on a medical mission for personal growth, then go, if you are going only for a CV boost, then you probably won't get much out of it.

 

[dani6706]

I am interested in going a medical mission for at least one month because I want to combine traveling and helping. I've read all the opinions and am still interested. However I'm having trouble finding a good place to go or program to join. I'm not sure where to begin. I don't want to go through one of those huge organizations, but maybe volunteer in a smaller clinic, but I'm not sure where to find information. Does anyone have information or websites or contacts that could help me?

 

[music2doc]

I am interested in going a medical mission for at least one month because I want to combine traveling and helping. I've read all the opinions and am still interested. However I'm having trouble finding a good place to go or program to join. I'm not sure where to begin. I don't want to go through one of those huge organizations, but maybe volunteer in a smaller clinic, but I'm not sure where to find information. Does anyone have information or websites or contacts that could help me?

Your request here is extremely broad....

What skills do you have to offer?

What do you hope to do?

What do you hope to get out of the experience?

What parts of the world are you interested in?


And, drumroll, the most important question:

Why can you not do these things at home?

 

[Itsame]

Two cents:

Imagine you come home one day and find that your mother is feeling under the weather. You take her to the local clinic, only to find that you are not going to be treated by a doctor, nurse, or trained CHW familiar with your community. Instead your mom is going to be looked after by that guy who sits two rows in front of you during organic chemistry - you know, the one who plays angry birds all class?

If you do decided to go on one of these medical mission trips (and I know there is little I can say to talk those of you who really want to go out of going), please sit down before you leave and create some boundaries for yourself. Consider your personal skill set.

If you have no training/licensing, promise yourself that you will not preform any procedure on someone that you wouldn't feel comfortable having the angry birds guy preform on your mother.

Once you get there, it is probably going to be really easy to do some things that you would NEVER be allowed to do in the US without proper training or licensing. Just because it's super easy (and probably super cool) does not mean that it's right.

I'm not trying to make any blanket statement about angry birds or whatever, but just remember that you will be working with REAL people who will be trusting you literally with their lives. Don't abuse that trust by letting them think you are something you're not.

It's a fine line - make sure you know where it is at all times.

 

[mipp0]

It doesnt look good. It looks like tourism. In fact, it is worse than tourism because it usually involves handouts which undermine the development of self-sufficiency. At least tourists buy things and stimulate the economy.

Do we have no people in need of assistance here? The fact that you performed a procedure that requires a license to perform in the US will not impress us.

Good thread here:http://forums.studentdoctor.net/showthread.php?t=587185&page=2

starting at post 34 is best.

LizzyM is the best. I love her posts...

 

[kkuhn]

Different people will view it differently. To some, it'll look like tourism and/or naivete. Which is quite fair. But to someone else, it'll look like someone who wants to make a difference in the world (even if they don't necessarily know the best way to do it yet.) That is, if the rest of your application supports that -- if you don't have any other volunteering, that... doesn't look great.

"Voluntourism" has a lot wrong with it, but it can inspire someone to go down a path where they'll help a lot more people. My life has been very much changed by the mission trips I have been on (though none have been medical). Someone could easily say they were a waste of time, but they weren't to me, or the people I served there. Of course, now I've revealed the source of my bias. 😉

IMO, foreign medical missions do not necessarily need to be sustainable. SOME do, of course. But they're just two different kinds of missions -- both necessary to treat the "disease" of poor healthcare infrastructure. One treats the "symptoms," treating those individuals who are dying right now, and wouldn't benefit from a large systemic change, even if it happened right now. More sustainability-focused missions treat the "underlying disease". Both should be addressed, and I don't think it's fair to write off unsustainable medical missions as entirely worthless. If you life was saved during one of them, would you still think they were a waste of time/resources?

Bottom line: people have opinions; you'll never please everyone. Reflect, listen to advice, and do what you think is right.

 

[candav]

I doubt it looks bad, considering the number of applicants who have had such international experiences at the places I've interviewed at. I've been on several international "missions", although I would never call them that. Although my work did involve things like education, health programming, and assisting in clinics, I still find something very arrogant and almost colonialist in undergraduates heading to a foreign country, to which they've never been and often don't speak the language, with the notion of "helping" them. I think it's fantastic that people want to do so, but most of us don't have the tools for that yet. Rather, I'd suggest looking at these experiences as opportunities to learn, grow and expand your worldview.

 

[kkuhn]

I still find something very arrogant and almost colonialist in undergraduates heading to a foreign country, to which they've never been and often don't speak the language, with the notion of "helping" them. I think it's fantastic that people want to do so, but most of us don't have the tools for that yet. Rather, I'd suggest looking at these experiences as opportunities to learn, grow and expand your worldview.

Yes, there is something arrogant about that -- which is why it's important to go in with the realization that they may very well do more for you than you do for them. Service is not a one-way street; it's a relationship, a chance for two very different worlds to meet and try to understand each other.

The attitudes of individuals on the trips don't negate the value of the trips themselves. (Though some trip organizers may encourage that attitude more than others.)