Professionalism/Voluntourism

Voluntourism is a form of international traveling by volunteers from wealthy western countries to resource-poor settings - primarily the Global South, which includes Africa, Asia, and Latin America - with a primary purpose of serving the host community. These trips are typically coordinated by intermediate agencies which connect volunteers to host organizations addressing educational, health-related, environmental and economic issues. Participants are often young adults, and trips are typically under 3 months in duration. More than 1.6 million volunteer-tourists spend around two billion dollars on these activities each year. Agencies coordinating international volunteer programs focus upon the experience of the volunteer rather than the social good achieved, such as Global Crossroad, a popular voluntourism site with the tagline “over 20,000 happy volunteers since 2003" . Another agency, Hope of Life International, writes on its website, "[local orphans'] parents are too poor to help them—but you can rescue a child and nurse them back to health" simultaneously targeting the reader's sympathy for a donation while portraying local families as incapable. These organizations strategically perpetuate images of poverty and helplessness within local communities, incorporating paternalistic and racist views among volunteers towards the non-developed world.

Origins
The modern idea of providing external volunteer support to foreign communities is oftentimes traced to the creation of the Peace Corps in 1961. The field grew in popularity in the 1990s and adopted the name "voluntourism," which was originally coined in 1998 by the governor of Nevada to describe volunteer efforts that made local state tourism more attractive.

Evolutionary science suggests that humans are satisfied through actively helping one another. Although many participants in international volunteering are hoping to pad their resume or improve their public image, this sense of purpose and fulfillment is another common and more benign motivation of volunteers. However, the assumption that westerners with little background knowledge or skill in a given subject matter can fly over and immediately benefit a community of individuals intimately familiar with the challenges facing them. The privilege of volunteers who can afford the financial costs and time associated with these programs often contributes to a White Savior complex in which white men or women step into difficult situations believing that they can heroically leverage their power, money, and intellect to solve problems. This affliction oftentimes feeds into an overly simplistic perspective of complex foreign problems and blinds participants to the negative consequences of their engagements.

International Volunteering and Neocolonialism
In order to preserve voluntourism's exploitative nature, agencies portray a self-flattering story of service. The White Man's Burden fiction sets the perception that these agencies are doing good by rescuing underdeveloped regions. These agencies justify their presence in foreign countries with the narrative that the local's affliction arises from their ignorance not colonialism. In both colonialism and voluntourism, the implicit message tends to be that a white person with no specialized skills is automatically in a position to be of use as a teacher, orphanage worker, or medical professional. As in colonialism, local exploiters have become a component in the neocolonial machine. This modern mechanism now allows volunteers to benefit from traveling experience and improving their curriculum by exploiting impoverished countries. By establishing an incentive for participants to gain from voluntourism, core issues in impoverished countries are never effectively solved but rather kept in place (such as orphanages) so that wealthy foreigners may pay to participate in a seemingly charitable activity.

Background
Seeking to gain clinical experiences unavailable in their native home countries due to medical regulations, unqualified volunteers often perform important, high-risk procedures including administering vaccines, delivering babies, and even conducting surgeries.

Noelle Sullivan, global health professor at Northwestern university, has "studied medical volunteering in Tanzania since 2011, including over 1,600 hours observing volunteer-patient interactions across six health facilities" and has found that the practice "opens the door to potentially disastrous outcomes". Volunteers on these trips are sometimes medical students seeking experience, but many programs require no training, certifications, or knowledge of the local language. Sullivan has observed these individuals routinely violating best practices in ways that threaten the wellbeing and livelihoods of patients, creating complications that lead to future healthcare burdens.

A 1998 article by British medical experts suggested that "any student studying in such countries who is unregistered but who pretends to be a doctor does so both unethically and illegally". These authors put much of the onus on medical schools, which they suggest should implement more stringent and clear guidelines to prevent unethical field work by prospective and admitted students. Others have suggested that "a larger paradigm shift" is necessary, with potential action items including increased certification standards, visa fees for volunteers that go directly to host nation governments rather than private third party organizations, and accountability for volunteers to understand local health systems.

Ethical Concerns

 * Volunteer-Centric Medicine - One reason that medical voluntourism is widely critiqued as a short-term bandage fix rather than sustainable change is that volunteers assume responsibility for procedures and accordingly develop their own medical skills rather than helping to train local individuals. Since volunteers are often inexperienced students or doctors hoping to perform procedures they cannot pursue back home, there have been countless reports of individuals treating patients like test subjects rather than human beings worthy of diligent care. These local health workers are also left with the responsibility of providing subsequent care and addressing complications for these patients with whom they have been unable to develop relationships and familiarity.
 * Substandard Quality of Care - Patients with medical needs in target communities are unlikely to refuse services offered to them, and volunteers assume that "any care is better than nothing," and use this mindset to excuse their lack of responsibility for patient outcomes and lower standards for treatment quality . The fact that volunteers do not stay embedded within communities for long enough to witness and bear responsibility for the results of their treatments also removes incentives to perform at a high level and breeds carelessness.

Orphanage Voluntourism
Well-intentioned westerners perpetuate a highly damaging system encouraging the creation and expansion of orphanages, run as businesses, breaking up families in very poor countries. Over 80 percent of the 5.4 million children in the world’s orphanages have at least one living parent and most have relatives. They should be at home with their families, not in institutions. What orphanage children and their parents really need is to be reunited, with all the support and services that will enable those families - no matter how poor - to give their children what they need to thrive and reach their full potential.

Research proves that children do best in a family. They’re far less likely experience abuse, cruelty or neglect. Even in a well-run facility, children do not develop normally given the lack physical and emotional contact. Therefore, the institutionalization of children in wealthy countries has almost completely stopped. Governments offer supportive services that help families keep their children with them; if that is not possible, they seek adoptive parents or foster families. Wealthy countries, who consider orphanages harmful for their own children, provide a stream of charitable giving enabling the business of orphanages abroad. In Haiti, some 30,000 children live in orphanages. These institutions receive $100 million a year in foreign donations, which is half the total amount of US aid to Haiti last year, five times the budget of Haiti’s social affairs ministry, and 130 times the country’s child protection budget.

Orphanages convince desperate parents that it's their only option. This results in girls growing up to be ten times more likely to be involved in prostitution and all children being forty times more likely to have a criminal record and five-hundred times more likely to commit suicide. Instead, aid should be redirected to poor families through financial support, teaching, and training enabling each child to be feel love and connection. Rwanda is a poster child for de-institutionalization; the nation has placed four out of five children in safe, nurturing, monitored homes, turned orphanages into day-care centers, and retrained staff as day-care workers, while supporting and monitoring families who take in children.

Conclusion
Despite being rooted in altruistic intentions, voluntourism is overwhelmingly damaging to local communities. Wealthy westerners can much more effectively improve health and socioeconomic outcomes by instead directing their money towards supporting and expanding existing permanent infrastructures in target areas. Folks participating in voluntourism have misaligned their primary goal of achieving good and meaningful work. Thought the goal claims to be helping others, participants actualized effects are far from their intentions. The generalized lesson learned is to establish a goal of doing good work with meaningful metrics and holistically analyzing impacts of methods enacted towards that goal.

Evaluating, promoting, and pursuing aid activities based upon outcomes rather than volunteer experiences is an essential first step to reforming voluntourism. Effective altruism proponent William MacAskill writes that "we very often fail to think as carefully about helping others as we could, mistakenly believing that applying data and rationality to a charitable endeavor robs the act of virtue. And that means we pass up opportunities to make a tremendous difference” . In this case, countless stories of failed aid necessitate an intentional and objective review of voluntourism efforts that continue at a large scale despite widespread criticism.

Regardless of intentions, impacts cause tremendous problems for communities. Foreign aid is viewed by many to be counterproductive, forcing countries to rely on outside help.

Out Scoping
The debate regarding the effect of both travel and volunteering should not be used to end their pursuits but rather broaden awareness of the systems and the complexity of voluntourism to create more effective and impactful volunteer and travel opportunities. The voluntourism debate addresses identity, race, privilege, and class, but the issues reach beyond Westerner’s actions. With rising middle classes worldwide, more schools, companies, and individuals are volunteering, implementing broken models. An English camp in Thailand designed by international schools encourages students from the city to travel to small villages to teach English, yet in reality does not teach English at all. Speaking solely in Thai, continually taking pictures while villagers go through the motions of the day waiting for their gifts result in no improvements of skills, no genuine exchange, and more litter left in the village than prior to their arrival. From Bulgaria to the Philippines, local volunteer initiatives face many of the same mistakes and challenges as Western voluntourists.

Future Work
Areas this chapter may be improved upon include investigating why people engage in charitable activities as well as psychological and social forces that cause people to believe they are doing good work. Further investigations on other case studies of harmful voluntourism would supplement this chapter's body. Looking into the professional benefits of a rich curriculum vitae would also prove to be useful in identifying the extent to which participants gain from voluntourism.

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