Healthcare placement tourism is becoming more and more popular but you should consider the ethical implications.
Not a day goes by on which I don’t hear about students’ excited plans of placements abroad, and get requests to contribute to fundraisers to pay companies arranging their placements to Ghana, Nepal etc.
I hesitate to call these placements voluntourism, as it is mostly is very much a paid for experience, which feel more like an exciting adventure for many students and is accompanied by safaris, excursions etc.
It would appear to be the ideal combination of work, learning, and play, with the added bonus of disadvantaged communities reaping the benefit of voluntary contributions from healthcare students.
But is it really a win-win? Perhaps not.
To get the most out of your placement and to understand the very deep-rooted issues that may accompany a placement abroad, here are some questions you may want to ask yourself and the company you are paying for your placement.
Why are you doing this placement?
Before making any arrangements you need to establish your reasons for wanting to volunteer.
Is it out of a deeply felt need to help others? Are you going to gain experience? Or are you going to gain insight into another culture?
You should also consider how your visit could benefit or impact your future practice.
Check out the numerous research studies on the subject of medical volunteering and international student placements.
Do you have the skills to meaningfully contribute to this community?
Do you have skills that you can meaningfully contribute to the community you are visiting?
Do you feel that you can competently manage yourself during difficult or emergency situations you may encounter – either in a healthcare, cultural or communication context?
Also consider if your presence could actually have a negative impact on the community. Would the patient or service user have a better experience if you were not present?
Are you very clear on what your role will be?
The company should be able to tell you exactly the work you will be undertaking – including how many hours a day and how many days a week.
Ethical Volunteering states that the biggest complaint for volunteers if that the work isn’t always what they planned, or paid, to do.
Does the company have good links with local organisations?
Companies should have connections with local organisations and be connected to the local community at a grassroots level.
Make sure you can be provided with contacts within the community you will be visiting.
Do you know where the money you have paid is going?
Many volunteer organisations charge a significant amount of money – but where does it go?
Be clear on how much is going back to the community which you are ultimately trying to improve, how much is going towards your food and accommodation and finally how much the company is taking as profit.
Does the company you are working with have an ethical policy?
Running volunteer programmes is ethically complex.
If you want to make a truly valuable contribution to the community you are going to work within, you have a responsibility to ensure that the organisation with which you travel has proper eco and ethical policies. Seek out organisations that have commitment to a community, employ local staff and have some mechanism for local consultation and decision-making.
You should bear in mind that consent and evidence-based practice are sometimes not usually high up on the list of priority in developing countries.
Do you know how much support and training you will get?
Organisations can offer wildly different amounts of support and training.
Aim to arrange your trip with a company who offers pre-trip training alongside having a training or support contact at your destination.
Traveling half the way around the world and entering a different culture can be lonely – ensure you will have the support you need.
Did you answer no to any of the questions?
If you have to answer any of them with ‘no’, more research on your part and exploration of your companies practices may help you to make a more informed decision on where, why and if to go on a placement abroad.
Another crucially important question to ask yourself too is whether you are absolutely happy for the ability of service users to consent to or decline your involvement in their care (even if the placement is only observational). Are you sure there is no coercion taking place (overt or otherwise) to accept your presence when service users are already living in the context of diminished rights and bodily autonomy with a backdrop of poverty when it comes to healthcare.
Having said all this, if you can truly answer all these questions with a resounding yes I hope you have a mutually enriching placement that benefits local communities as well as your personal professional development.
