Global health volunteering — medical missions, health brigades, "flying" surgeons — is a huge and growing enterprise. An estimated two hundred thousand Americans engage in such activities each year, and their time is valued at more than $750 million — not including the hundreds of millions of dollars in direct costs such as air travel, administration, and supplies.
Despite this enormous investment of resources, very little is known about the actual benefits of short-term volunteer service trips, of which the vast majority last less than two weeks. Volunteer trips are seen as opportunities to "make a difference" or to "give back," and most people who engage in such activities intuitively believe they accomplish some measure of good. Yet whether these efforts actually benefit the host communities, how those benefits are measured, and what other objectives are involved are rarely discussed or considered.
As they have grown in popularity, such activities — often grouped under the heading of "voluntourism" — have become a target of criticism. In a scathing critique in the Guardian a few years back, Somalian blogger Ossob Mohamud wrote: "Voluntourism almost always involves a group of idealistic and privileged travelers who have vastly different socio-economic statuses vis-à-vis those they serve. They often enter these communities with little or no understanding of the locals' history, culture, and way of life. All that is understood is the poverty and the presumed neediness of the community, and for the purposes of volunteering that seems to be enough."
Judith N. Lasker engages this debate with her latest book, Hoping to Help: The Promises and Pitfalls of Global Health Volunteering. A professor of sociology at Lehigh University, Lasker examines the landscape of short-term volunteer trips; the benefits and drawbacks of such activity from the perspective of the sponsoring organizations, the volunteers, and the host communities; and what can be done to make such activity more effective, particularly for the latter. The research on which the book is based includes a national survey of a hundred and seventy-seven U.S.-based sponsor organizations, more than a hundred interviews, and participant observation by the author on two short-term trips.
To assess effectiveness, one has to identify program goals, and in the case of voluntourism that ends up being more complicated than simply saying "improving the health of host communities." Indeed, sponsoring organizations — which include churches, universities, hospitals, and NGOs, as well as large corporations and other profit-making companies — often state that providing health services and building public health capacity in underresourced communities is one of their primary goals. However, organizations oftentimes have other, competing interests, including their ability to recruit talented professionals and their own financial sustainability. "[E]nhancing the organization's reputation" and "promoting volunteers' personal growth," writes Lasker, "are often considered just as important [as any benefits created for the host community], raising questions about whether a focus on them might reduce the effectiveness of a group in promoting health."