By Abdi Ali
Published August 3, 2016
A first-year medical student volunteering in Kenya is asked to perform a lumbar puncture to get fluid from a seven-year-old’s spine through a needle without any anesthesia as a licensed and experienced local physician sits next to her. Unable to get it done, the diagnosis for the child is inordinately delayed.
This incident, taken from The Stream, a social media community with its own daily TV show on presented by Femi Oke and Malika Bilal on Al Jazeera English, questions whether global health volunteerism is a help or a hindrance in countries like Kenya and Tanzania.
The Stream shows several social media clips, from US American quarterback Tim Tebow helping perform circumcisions in The Philippines, to a volunteer talking about delivering babies unsupervised in Tanzania, and to a volunteer posting pictures of herself on Instagram suturing a head laceration in Vietnam.
Noelle Sullivan, an assistant professor of Global Health Studies and Anthropology at Northwestern University in US America who has been studying medical volunteers in Tanzania, says, “You get anybody from a secondary school student all the way up to full practitioners . . . But the vast majority of these people that I’ve been watching in Tanzania for several years don’t actually have a lot of medical qualifications. Many of them have none and yet they are performing procedures on patients.”
Dr Jessica Evert, executive director at Child Family Health International who as the first year student was asked to perform the lumbar puncture in Kenya, says the conditions are there for a “perfect storm,” as “tens of thousands of students want to go to med school but they will never even get into an interview.” With medical schools asking for “clinical experience,” many prospective students believe medical volunteering overseas will help get them accepted to study. Hospitals are also being paid to participate in the volunteer programme.
Evert warns that this kind of experience is sending wrong messages to volunteers; from patient safety to social justice.
“There is a disconnect here between what students are seeing and doing and what we want to nurture in them,” she says.
Similarly, Sullivan warns that the benefits of volunteering are limited.
She contends volunteers are “not necessarily learning skills that are relevant in their region. The drugs are called different names and the procedures are done differently based on the country and the medical culture.”
Pointing to the large sums of money spent on helping volunteers travel across the globe, Dr Evert says, “If you took that money you could pay a salary for one to two years, depending on where you are, or put a nurse through nursing school.”
Daniel Motunga, a Kenyan healthcare professional, says “there is a role for medical volunteers in developing countries” as they often “come in with a lot of resources.”
“If a voluntourist wouldn’t do something in their home country, they shouldn’t be doing it in a developing country,”Pipple Biddle, a former medical volunteer, says in a video. “There are no ethical choices to be made by volunteers other than to get themselves out of positions that require training and expertise, whether it’s taking someone’s blood, helping in a surgical room, or any other volunteer position inside or outside of medical volunteering that you would not want a novice doing to you, you should not be doing to anybody else.”
The World Health Organization (WHO) of the United Nations says volunteers provide 40% of the health services in Sub-Saharan Africa.
That volunteers with little training or experience are performing risky operations could explain why a survey by the Center for Medical Missions shows that 20% of its volunteer doctors had been sued over work they had done in the field.