February 6, 2020
I believe that being able to serve in Costa Rica for two weeks was a mind-opening experience. It was my first time flying out of the country, so I was exposed to a new culture while doing what I love, serving others. However, volunteer experiences abroad follow a thin line of what is acceptable vs. unacceptable.hat is acceptable vs. unacceptable.
There are many potential issues with serving abroad which can turn into "voluntourism." The first, and most important, is when individuals act beyond their level of training. There are stories of people who “participated in surgery” and “held organs” and many other things that would be considered illegal if done in the US by college students. On our trip, we were in teams of 3-4 students who worked with a translator to take basic patient vitals: height, weight, blood pressure, etc. These are all things that I am currently doing back in the US in a volunteer role. We were also able to take patient history and obtain their chief complaint, but at the end, the provider came over, confirmed all of the history, and ultimately made the diagnosis. Even though I didn’t have an invasive role, I learned so much. The doctors explained why they did each test, how to properly do physical exams, and every diagnosis they made. At the end of the day, we had lessons on topics such as nutrition or did workshops such as practicing injections (on oranges, of course)!
Another issue is the discontinuity of care. Volunteers from the US pop up for a few days, see some patients, and then leave. On my trip, we saw many illnesses that needed continuous, follow up care instead of acute treatment. The thing that I love is that ISL works in these communities year-round. The chapter at my school takes 3 trips to Costa Rica each summer and has been doing that for over five years. The locations will not always be the same, but we saw one patient that needed follow up care for a wound, and the team in Costa Rica worked to arrange that. Additionally, education is key!! For every patient that we saw, we sent them off with relevant handouts; anything from child development to healthy eating. We did this because we can’t be there every day, but we can give them some of the tools to make better health choices.
Lastly, the laws in every country are different and "voluntourism" may cause individuals not to seek care through the country’s healthcare system. If individuals know that visitors will be back, that may cause them to wait around to get care which is not good. One thing that I loved about my trip was that the doctors that we worked with were from Costa Rica, so they had an understanding of the healthcare system. For individuals that we did not have the capacity to treat, they knew where to direct them for more intensive care.
I believe that there are companies out there just to get pre-med students’ money instead of actually helping people, but there are also many that provide a fulfilling experience. If you are interested in volunteering abroad, do it!! Just make sure to find a program that is reputable, talk with past participants to get their experience, and make sure that you will be practicing volunteerism, not "voluntourism."
Costa Rica was the first time that I truly envisioned myself as a physician, just because I was able to be the first point of contact for patients and just take vitals. It doesn’t take some cool story or participating in a surgery to make your global health experience memorable. All it takes is a servant’s heart and an open mind.
This is one of the families I met in Costa Rica. I had the ability to participate in appointments with the twin boys and young girl. (photo taken with permission)
Here is a link to an article by the AAMC on Global Health Experiences: https://students-residents.aamc.org/applying-medical-school/article/dos-and-donts-global-health-experience/