The Perils of Voluntourism

When helping others ends up hurting—and what to do about it.

Posted Dec 18, 2019

The early morning flights from Miami to Haiti are often filled with cheery volunteers traveling to the poorest country in the Western Hemisphere to “help out.” Just a few hundred miles from the U.S. mainland, church and other groups arrive daily in the capital of Port-au-Prince, optimistic they are making a difference for those most in need. They spend days rather than months in the country, hauling buckets on construction projects, creating websites, teaching English, or providing basic medical care.

Shorter-term international volunteering, or “voluntourism,” is one of the fastest-growing types of travel. Something like a million Americans volunteers internationally each year, many for just a week or two at a time. Volunteers mostly go, because helping others feels good. For those trying to build a professional profile, it can also be an important resume builder. For those training to work in public health or medicine, for example, it can give students a chance to work intimately with patients with incomplete professional qualifications and see diseases they would rarely encounter otherwise.

But the rising wave of voluntourism raises an important question: Who is really being helped? For the volunteers, the value is clear. But the benefits to those in the host countries are not always what volunteers imagine them to be.

Consider the findings of a study on the impacts of medical volunteers in a hospital in Arusha, northern Tanzania. It’s a popular placement site because it’s close to some amazing African game parks and hiking on Mount Kilimanjaro. And the medical needs in the area are significant, with hospitals having limited facilities and serving local communities with little means to pay for treatments.

While the visitors pay up to $6,000 for a six-week student placement, the hospitals hosting them received less than $150 of that. The doctors, nurses, and other health professionals are completely uncompensated, even while expected to supervise and translate for the visiting foreigners who have come to “help.” The local medical staff report that volunteers greatly overestimate their skills, assuming they are qualified to practice in a hospital—even though they weren’t legally allowed to do so at home.

The local medical staff accordingly have the additional work of ensuring their patients stay safe from malpractice. The volunteers thus mostly just add a burden to an already over-burdened health care system. The clear winner? Those brokering the arrangements. This also speaks to a massive problem in voluntourism: the incorrect belief that impoverished communities benefit from any additional care, irrespective of its quality.

Another basic challenge is that many volunteers do not well understand the local cultural landscape. Yet, for any projects that volunteer groups implement, this is a basic requirement to work well after the volunteers leave. In Haiti, one of the most desperate local needs is clean water—something like 40 percent of rural households are without it. In the wake of the 2010 earthquake, Haiti is one of the only countries in the world where basic sanitation coverage has been going backward. The many projects initiated by volunteer groups in Haiti since 2010—most with no serious oversight—provide thousands of examples of well-intentioned reconstruction projects that completely derail.

Long-term tracking on one such project, a church mission project in the central Haiti highlands, shows how easily “helping” can distract from implementing water projects that actually have a chance of working. The volunteers designed, paid for, and implemented a bucket-based water filtration system that required neighbors to share equipment. But shortly after, the whole project fell apart.

People were very uncomfortable being reliant on being given water by others or going to others' houses to use the filtration systems. The buckets ended up being used for non-water chores. The filters ended up mostly in the hands of local church leaders, who had been left with the responsibility for the project after the volunteers left. The end result of all that work: Many of the households the volunteers were trying to help ended up without access to safe, clean water.

Vive Peru
Students volunteering with Vive Peru community projects in Trujillo, northern Peru
Source: Vive Peru

Choosing to work directly with small-scale, local non-profit groups that have a proven track record is one way to maximize impact and minimize possible harm. We channel our own students to two small, high-impact organizations with whom we have built collaborations over many years; it helps that both have ties to Arizona where we are based.

With Vive Peru, students live with host families and work with their permanent staff to implement community health programs on the coast of Northern Peru. We also have students intern with the International Alliance for the Prevention of AIDS (IAPA) in Chennai, India, assisting by teaching a basic HIV prevention curriculum in local schools. Because we have worked directly with both charitable organizations over many years, they are familiar with the skills and limitations offered by our undergraduate students. What makes the programs work especially well is really top-notch local mentorship the interns pay for as part of the cost of the experience, and that helps them navigate the experience successfully. The experience is consistently positive for everyone involved—which is always the primary goal.

Some serious self-questioning should be central to each potential voluntourist's planning process: Are you trying to “fix” things? (You can’t.) Are you trying to tell people how things should be? (Stop it.) Who is really getting the benefits, and who is really bearing the costs? Done thoughtfully, voluntourism can benefit everyone involved.

But it is important to do lots of research. Balance the ethical issues. Align your own skills and qualifications with the opportunity. Ensure you have a local mentor, and that they are adequately compensated. Ask lots of questions when you are there, and be adaptable. And have a safe trip.

References

Lough, Benjamin (2015). A Decade of International Volunteering from the United States, 2004 to 2014. Washington University in St. Louis.

Miller, W. C., Corey, G. R., Lallinger, G. J., & Durack, D. T. (1995). International health and internal medicine residency training: the Duke University experience. The American Journal of Medicine, 99(3), 291-297.

Platt, C. M. (2019). A Failed Water Intervention in the Haitian Central Plateau. Doctoral dissertation, The University of Memphis.

Bishop, R. A., & Litch, J. A. (2000). Medical tourism can do harm. BMJ, 320(7240), 1017.

Sullivan, N. (2018). International clinical volunteering in Tanzania: A postcolonial analysis of a Global Health business. Global Public Health, 13(3), 310-324.