(Blog post at http://www.steeres.com)
by Mardi Steere
Reprinted by permission of the author

I've read a few articles lately about how short-term teams are negatively impacting children in orphanages, how shoddy building projects mock underemployed communities, how quick-fixes can cause long term damage.

As someone who is regularly on the receiving end of short-term visitors, let me say this - I am so grateful for people who want to go, to serve, to encourage, and I believe there are ways to do it well.  So rather than an article on "why your medical short term team will destroy the community", I thought I might ask a few questions you may want to consider if you desire to serve effectively and sustainably.

If you are thinking of sending some doctors and nurses to help a resource-poor community overseas, consider these:

1.  Would you send this same team to do this same work to a Native American Reservation / outback Australian community / impoverished suburb of Glasgow?
Would a team of a midwife, a pharmacist and a plastic surgeon materially assist your own underserved/needy community by doing a mobile clinic, treating HIV/TB with donated drugs or giving nutritional advice?  Are their areas of knowledge and expertise suited to that specific community?

If the answer is no, then rural Uganda is probably also not the place for your team to make a helpful, sustainable impact either, even if a Ugandan pastor has asked you to come.

2.  Does your medical team have an understanding of the big picture?
If you are sending a team to one of the world's largest slums, such as Kibera in Nairobi, does your team know that chronic abdominal pain in a 12 year old could be related to a sexually transmitted infection, given that 66% of girls trade sex for food by the age of 16 and are mostly likely not practicing safe sex?  Or that strange symptoms may be explained by glue sniffing or changaa, a home brew?  Or that the reason for chronic diarrhea may be due to the fact that there are 600 toilets for a million people?

Without an understanding of these issues, you risk only scratching the surface with your diagnosis and treatment.

3.  Does your medical missions team understand local illnesses?
Does your team surgeon know that a chubby looking, tired child with mouth ulcers doesn't have canker/cold sores but actually has kwashiorkor (a severe and chronic lack of protein in their diet)?  Or that the wheeze they are listening to is not asthma, but pneumonia from a common complication of AIDS?

This is incredibly important - by giving antibiotics or inhalers without knowing the underlying condition, you are not just providing a temporary fix with no long-term assistance.  You may be actually doing harm by demonstrating a dangerous fallacy in a resource-poor society:  "Modern medicine DOES NOT WORK.  It would be better for me to not spend the money on transport or treatment, and to visit the local mganga (traditional healer) instead."

If your team doesn't know local illnesses, it's OK - just make sure the first time they volunteer overseas that they are buddied up with a local professional or a team member who does have experience.  And then, when they've learned a little on their first trip, get them to come back again next year.  And the year after that.  And the year after that.

4.  Do you really know what medical care is already available to the people you are going to help?
I know firsthand of a medical missions team that came to Kenya a few years ago to run an eye camp.  They brought ophthalmologists, assessment equipment and lots of glasses.  They coordinated it through a local pastor.  They set up their clinic for "people that had no other way to get help".  While in Kenya, they sent out a prayer letter to their supporters in advance of their clinic asking for intercessory prayer "because they were encountering resistance from the local authorities".

They didn't ask why they were encountering resistance - it was because they were running their clinic two blocks from the nation's best known eye hospital.

They didn't ask how they could connect with and support an overwhelmed but functioning system - they just came anyway, did their week long camp, and rejoiced that they had handed out some eyeglasses to people, for whom they had not made a follow-up plan.

Even if the local system is imperfect, I can promise you that the government or an NGO or someone on the ground is trying, somewhere, to do something.  Find those guys and help them.

5.  Are the people who have invited you a part of, or have local connections to, the existing health care system?
I saw an appeal on Facebook last week, asking people to give tens of thousands of dollars to send a child from Kenya with an abnormal lump in their face to the US for surgery  - and we do that surgery in Kijabe every week.

If you see someone who has a crazy tumour on their face, do you need to raise $100,000 to send them to the Mayo craniofacial unit in the US, or is there actually a centre with NGO funding closer to home that is less expensive, and less disruptive for the family to be referred to?

Find out what's available - not just in the village you've been invited to, but within 10km, 50 km, or the same country or region.  Figure out a sustainable way to get a bus from the village to that health care on a regular basis.  Or if that's too far, find out what people are already trying to strengthen the system.   Work with your host on forming some relationships with local government or NGO or long term mission to find out what they are already trying to do - I can promise you they care about the health of their own community at least as much as you do, and they're already connected to the national plan, however stretched it may be. Get in touch.  Stay in touch.

Check back next week for #6-10!