GLOBAL HEALTH AGING

Hoping to Help: The Promises and Pitfalls of Global Health Volunteering, written by Judith N. Lasker, shines light on healthcare-based volunteering in developing contexts. While it does not explicitly focus on aging, this book poses a bold and poignant question: Does international medical volunteering really help patients?

Developing countries struggle with both acute diseases such as malaria that are less prevalent in developed countries, as well as many of the same chronic diseases, such as diabetes, that routinely affect people in nations like the United States. According to the World Health Organization, chronic diseases, which often impact older adults, are the leading cause of death or disability in the world. Many medical professionals who volunteer abroad often end up treating patients with such chronic diseases.

For example, International Volunteer HQ – a large volunteer-host connection service – offers North American medical tourists the opportunity to work with older adults in Argentina, Colombia, Guatemala, Sri Lanka and Zambia. Another NGO, UBELONG, offers short term volunteer trips to Ecuador, Costa Rica, and Peru. Other programs, such as the volunteer surgeons who perform cataract operations, also target diseases that primarily impact older adults.

In Hoping to Help, Lasker investigates the impact of global medical volunteerism on patient health. She finds little evidence that global medical volunteer trips are actually helpful to the patients:

• Lasker points out that most trips have no follow-up. Thus it is impossible to determine whether the patient benefited from medical care.
• Most trips do not provide long-term solutions to chronic diseases; many individuals were prescribed medication –for example, blood pressure – without having access to a sustainable supply of the medicine. Once the volunteer leaves, the patient may become worse. Even a seemingly innocuous treatment, such as medication to reduce hypertension, can lead to a rebound hypertensive effect.
• Finally, volunteer medical students or nurses will often conduct procedures or give treatment that is outside their scope of practice in their home countries.

The positive or negative effect on the health of patients treated by these practitioners are not well known, but it is safe to say that the impacts of global health volunteering are not all positive. There are many debates about the possible good or harm international medical volunteers can do to host communities – while some have compared the practice to colonialism, others have defended the noble intentions of these programs. What this debate leaves out, however, is the patient’s version of the story.

For individuals who wish to volunteer and contribute to aging in developing nations, Lasker’s book serves as a useful guide. She clearly delineates the positives and negatives of the programs. Volunteering is one way to help aging individuals in developing countries, but an investment in infrastructure development in the health sector will have a more meaningful, long-term, and sustainable impact.

Grace Mandel is a project manager for the Baltimore Fall Reduction Initiative Engaging Neighborhoods and Data (B’FRIEND) at the Baltimore City Department of Health.