Short-term medical missions (STMMs) can be great opportunities for trained experts to volunteer their skills in places where there are health human resource shortages. However, the outcomes of these experiences are not always as beneficial for the countries in need as they could be.
Dr. Patti Tracey, a faculty member in the Trent/Fleming School of Nursing, first became aware of this imbalance when she was a front-line nurse on a mission to Honduras following the devastation caused by Hurricane Mitch in 1998.
“I quickly realized that these sorts of experiences typically benefited the participants coming from the high-income country, but not always so much from the host country’s perspective,” says Professor Tracey. “I was concerned that those I was working with in Honduras weren’t having the same experience.”
After a number of years working abroad as a nurse, Prof. Tracey saw a need to standardize best practices of STMMs, one that involved significant input from host countries. As the lead consultant on a research study through the Partnership for Quality Medical Donations (PQMD), she has interviewed key health officials and health care providers in Malawi, Honduras and the Philippines as part of the PQMD’s Healthcare System Strengthening/Medical Mission Initiative.
Prof. Tracey hopes the results of this research will lead to change at both the individual organizational and policy level. At the organizational level, the PQMD has created “Standards for Medical Mission Partnerships and Practices,” and published online checklists that cover everything from needs assessments to codes of conduct to post-trip follow up, from the perspectives of both the host and “sending” organizations. At the policy level, this initiative along with other key thought leaders from the Advocacy for Global Health Partnerships - North American coalition plans to present a declaration to the World Health Organization to promote appropriate short-term engagements.
When Prof. Tracey works with students at Trent, some who travel with her to Honduras as part of their own studies, she stresses the need to look at the social determinants of health, rather than focusing solely on treatment and medicine. For example, focusing on the need for cleaner water sources as opposed to solely treating parasites caused by drinking contaminated water. As well, she emphasizes the importance of collaborating with local healthcare systems, in an effort to strengthen and support bi-directional learning because otherwise the work of STMMs may not be sustainable once the volunteers pack up and leave.
“If an organization wants to get involved in short-term health experiences it needs to follow certain standards, the same standards of practice as in Canada,” says Prof. Tracey. “It’s about what sort of supports the host country needs, not what we think they need. We’ve learned, and now we have to advocate for change.”