Helping and Hurting

PREFACE:

Hello to my loyal followers! (AKA Mom, Dad, Nanny, friends, and many of my mother’s coworkers (: …you all rock) My apologies for not writing in such a long time. Whatever downtime I have had has been spent exploring, especially considering I leave Santiago on Saturday (!!!) for ten days of travel with my parents, and then return to the States on December 10th. To say this semester has flown by would be an incredible understatement. I feel like I just arrived yesterday, yet at the same time, it seems like I have lived here my whole life. I have been so lucky to have travelled to a large part of Chile and a few other Latin American countries. I have made some truly delightful friends here in Santiago, and also met other inspiring travelers in hostels all across the region. I promise to write about all of my trips once I’m back home with time to reflect on it all. It has been a semester I want to both share in writing with you and preserve it in writing for myself! As I mentioned before, I owe us both lots of updates and pictures from my journeys…but for the time being I am crazy busy wrapping up the academic semester here. And now we arrive at the reason for this blog post. In my POLI 340 class: Politics of Latin America, we have spent the semester addressing the history, current situations, and challenges facing the region. I have learned a lot about development, inequality, environmental and resource pressures, and how countries like the United States play a role in Latin America. About midway through the semester, we were given the opportunity to select a specific country, research, and present on a topic that was of particular interest to us. I chose to study the health care system in Mexico: areas where it succeeds, areas where it could be improved, what specific health concerns dominate in the country, and how other nations might fit into the picture of addressing these issues. I hope you are not dismayed by my writing about a school assignment, it is actually really fascinating and something that I am quite passionate about. This particular blog serves as my reflection and expansion on the topic I presented in class. I think it’s pretty neat that I can share with you what I am working on academically here…I hope you find it as interesting and thought-provoking as I do.

IMG_8224.JPGAnd for a transitionary image, I present you with a picture of my lovely, sarcastic, beautiful, and wildly intelligent PoliSci professor, Rosa! Yes, she too is reading this post. Do I think this flattery will earn me a few extra points? Well I certainly wouldn’t complain if it did! (:

 

A REVIEW:

First, I’d like to revisit some of the facts and figures about Mexico’s health situation that I discussed in class for those of you who would like a refresher or who were not present to see the presentation in the first place.

  • Demographics
    • Mexico supports a population of 123,166,749 people and this population is growing at a rate of 1.15%.
    • 6.3% of Mexico’s GDP goes towards health expenditures.
    • 27.6% of adults are classified as obese.
  • Health Concerns
    • Cardiovascular disease and diabetes are the two leading causes of death.
    • Noncommunicable diseases, in general, present the biggest health concerns.

cause-of-deathbroad-cause-group

  • Measures Currently in Place to Provide Health Care
    • IMSS (Instituto Mexicano de Seguro Social) – Mexico’s social security program incorporates coverage for sickness, maternity, and work injury
    • Oportunidades program – a cash grant system integrated into the IMSS that provides support, education, and affordable or free health services.
    • Seguro Pupolar – Mexico’s attempt at providing universal health care
  • Want to know more?
    • Visit this site for more extensive demographic figures from Mexico.
    • Pop over to the World Health Organization’s country profile of Mexico for visuals, statistics, and a compilation of development goals.
    • Click here for an extensive breakdown of Mexico’s social security policy.
    • Read more about Mexico’s efforts to bring health care to all its citizens through programs like Seguro Popular and Oportunidades. And read one researcher’s interpretation on the cost and effectiveness of health care and preventative medicine in Latin America and how to better this system.

I could spend a significantly larger amount of time delving into Mexico’s position, progress, and efforts in public health, but I have already spent significant class time covering and discussing this with my peers. Essentially, Mexico is making great strides in health care and working to ensure that all of its constituents have access. The troubling fact is that spending on non communicable diseases has continued to increase despite the implementation of some great state programs. The simple nature of noncommunicable diseases is that the onset can often be delayed or even prevented by avoidance of major risk factors and a healthy lifestyle. I think increased availability of medical services, medication, and education programs will work wonders in the case of Mexico. At the end of my presentation, I asked if my class felt like the US or other countries have a place in helping Mexico to develop their health care system by donating time, efforts, resources, etc. This sparked a really interesting discussion about medical and general mission work to underprivileged countries. With this blog, my goal is to lay out various sources, cite my own personal experiences, give you my opinion the matter, and hopefully encourage you to reflect and come to your own personal conclusions as well.

THOUGHTS:

Sure the United States has a place in helping Mexico and other Latin American countries with medical and developmental assistance! We can send our time and efforts in the form of mission trips! That is the answer I would have most likely given you, had you asked me several years ago. Lately, I have spent a lot of time thinking about where the US belongs in reference to other countries and Latin America specifically. While I think that medical (and other themed) mission trips have the potential to do a  lot of good, I think that short term mission trips unfortunately propagate the image of the United States as the big brother stepping in to clean up everyone’s mess and to do for “lesser” countries what they cannot do for themselves. This sort of mentality is damaging to parties on both sides. It fosters ignorance and pridefulness on the side of the Americans who truly believe that we must step in personally and meddle in everyone else’s affairs. And it is damaging to the identity and self worth of those on the receiving end of our charity because they have so much to be proud of, yet they know that they are clearly the inferior party in this relationship. There is a huge boom in the short term missions culture. We love to spend our Christmas, Spring, Fall, and Summer breaks traveling to some remote part of the world and participating in bettering someones life in some way or another. It makes us feel good! Who would turn down the opportunity to rock a orphaned child, to lay the bricks for a family’s new home, or to pass out medications to huge crowds of needy people? But I think we need to ask ourselves how much are we doing this mission trip for those less fortunate, and how much are we doing this for ourselves? I don’t want to sound like I am one hundred percent opposed to mission work. There are millions of people making grand differences all across the world through missions. I do not doubt that the hearts of the volunteers are in the right place. Nor do I doubt that the communities visited by volunteer workers are grateful for the help they receive. My suggestion is that we look at both the good and the bad that come out of short term mission trips, make changes to this system, and more forward in a more productive and efficient way.

For those of you that know me, you know that I have participated in several mission trips. The most recent, and also most significant trip I took was to Namaisgue, Honduras this past December. I went with a group of 45 students through an organization called Global Brigades. Our trip was specifically a medical brigade. We brought a wide variety of medical supplies that had been both donated and purchased, and set up a three day clinic in a rural school. Over the course of just three days, our clinic served 959 Hondurans. The clinic had sections for triage, dentistry, gynecology, general care, education, and pharmacy. The organization, Global Brigades, takes many measures to ensure that their programs are as sustainable and effective as possible. The student volunteers provide all of the medication for the clinic days. Global Brigades hires Honduran doctors, dentists, and gynecologists to treat the patients while myself and the other student volunteers assist them and help manage the large volume of patients at triage, pharmacy, and education. The eye-opening aspect of this trip was that the biggest needs of the patients were quite simple. We provided them with medications like ibuprofen for headaches, allergy medicine, diet enrichment supplements, and metformin (for type 2 diabetes). One man who came in had already had one foot amputated and the doctors said the other would most likely need to remove the other. He had gotten a cut on the bottom of his foot and since diabetes affects blood flow, his body was unable to heal appropriately and he had contracted a nasty infection. Another woman was brought in unconscious because her extremely high blood sugar had put her into a sort of coma. It’s hard to see diabetes take such a toll on people in other countries just because they lack the medicinal resources to control and manage their diabetes. In the United States, we have the same diabetes, the difference is that more people have access to medical care and treatment than in Honduras.

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It was an incredible trip, but in retrospect, you have to wonder if it was the best use of our time and resources. Each student fundraised approximately $1,850 in order to fund their portion of the trip.If you multiply that by the 45 student participants, then we are talking about $83,250!! Imagine putting all of that money directly towards medicine or care in Honduras. I think a major issue with medical missions is the allocation of funds. We pay huge airfare because WE want to be the one to hand over the prenatal vitamins to the pregnant woman or the one to watch as the dentist finally extracts that painful tooth for the old man. Several studies have addressed the use of missions funds. In her literature review of medical missions to low and middle income countries, Alexandra Martinuik quoted a missions participant as saying, “what business did our team of 10 members (have in doing this, given the 10 members) have spent approximately $30,000 toward travel and hotel costs…. when the entire cost of building a new 30-bed wing for the hospital in Ghana was $60,000?”. In his paper on the impact of short term missions, Kurt Alan Ver Beek states that a short term missions group “spent on average over $30,000 to build a house the local Christian organization could build for $2000.” However, I  worry that if we cancel the missions trips, that this level of monetary support would not be given to fund in-country projects. Martinuik spells out some of the critiques of medical missions work specifically in her paper. Often times, unqualified or unexperienced medical professionals are asked to complete operations and treat patients in a way that they might not be totally prepared for. Another serious concern of medical missions is whether or not patients have access to or are receiving adequate follow-up care. Often times, post-operation complications arise once the volunteers have flown home to return to their comfortable lives, which begs the question of whether we have really helped or rather created a more dangerous problem in some cases.

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In my research I came across Ver Beek’s incredible article. He did a case study in Honduras on the effectiveness of short term medical missions. His study came at a great time – Honduras had recently been hit by a hurricane so there was a flood of foreign volunteers as well as local organizations working to help rebuild. Ver Beek was able to compare the effectiveness of missions work as opposed to the efforts of local organizations. He was also able to interview both Hondurans and American volunteers on their perspectives. I strongly suggest that you read it! The case study offers some great insights. In addition to the monetary aspect mentioned in the previous paragraph, the benefit of local groups providing relief efforts was that it provides jobs to skilled local workers and their work is done more efficiently than that of a group of 7 or more volunteers working on one structure. In general, the Hondurans were immensely thankful for the Americans investing their time and energy. In many studies, including this one, recipients of mission work say that when volunteers come to their aid, that it makes them feel like there is a hope for the future now that these people can see first hand what they are struggling with. However, in Ver Beek’s study, they came to the ultimate conclusion that as nice as it was for the volunteers to come and help, it would have been more effective had they just sent money so that the locals could afford to do more rebuilding. Ver Beek also analyzed if there was an increase in monetary giving after short term missions trip and unfortunately there was no significant increase.

After all of my reading and considering my personal experience on the matter, I can say that there is much room for improvement when it comes to short term mission work. Volunteers need to be adequately trained for what they will encounter in the receiving country in both the medical realm and the cultural realm. Missions groups need to be reduced in size. It is incredible the amount of people who want to give their full support, but at times end up creating a crowded work space where the volunteers actually get in the way of work efforts. Better avenues for follow up conversation must be created. There is a lack of communication post-mission work between the volunteers and the recipients of the aid. Even if the volunteers wanted to commit to regular donations to the host organization or even keep in touch with those families they met, the lack of follow-up efforts permit this type of relationship. Most importantly, I want to urge people to consider their intentions pre-mission. First they need to do a little introspection to make sure that they aren’t just spending a fortune to go on a mini vacation, play with orphan children, and then watch as their facebook post about the humbling experience gets them the most likes yet. Once they confirm that their hearts and their minds are in the right place, they should then seriously ask themselves if this is the best way for them to make an impact in the lives of those who need it. Sure, it’s more fun to fly to the faraway country and get your hands dirty, but if you truly want the best aid for those in need, you should consider a monetary donation instead. Once we begin to fund and focus on developing in-country resources and humanitarian organizations, I think better and more productive mission work will follow. We should heed the advice of professionals living in these areas of need because they have unique insight into the needs of their communities. By listening to the locals we can also change the narrative of the US as the savior stepping in during the hour of need, to a more sustainable, well-balanced, and healthy relationship between two countries who share the same goals of equality, health, and strong communities worldwide.

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If at any point, over the course of this post, I have piqued your interests, I strongly encourage you to check out some of these sources I read in my research on the subject. And also get out there and do your own searches! Look for ways you can donate your time, money, and energy to contribute to a better world. The most important thing is that you continue striving to make this world a better place. Love your neighbor in every way you can!

Stay lovely! (:

Reilly

Sources:

http://www.postandcourier.com/news/do-no-harm-the-pros-and-cons-of-short-term/article_17f4cf56-a842-11e6-be97-a7c74edac56a.html

http://www.academia.edu/2222551/Researching_the_short-term_mission_movement

http://nfjcl.depaul.edu/Resources/Ver%20Beek%20The%20impact%20of%20short%20term%20missions.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179995/

https://www.inphilanthropy.org/sites/default/files/files/pages/Toxic%20Charity%20Synopsis.pdf

http://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-12-134

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