Short-term Medical Missions: Critical Humanitarianism

Faculty: Stephanie Roche, MPH & Rachel Hall-Clifford, PhD, MPH, MSc

Project Objectives

To understand the role of local and international non-governmental organizations (NGOs) in the provision of essential health services in Guatemala
To investigate the interactions of local and international NGOs and government agencies in Guatemala in order to understand the impacts of humanitarian aid paradigms and policies
To elucidate the process that visiting medical teams must navigate in order to legally provide care in Guatemala
To explore the perspectives of Guatemalan health care providers and the medical establishment on their experiences of visiting medical teams
To facilitate communication among NGOs and relevant health agencies to promote effective resource utilization and improve patient experiences of short-term medical missions
To develop occupational perspectives and analyses on NGO activities by and with staff and the communities or populations served

Project Activities

While the Guatemalan government health system provides largely adequate coverage for emergency and tertiary care surgical needs, patients requiring non-emergency and specialist surgeries are often left under-served. This gap in service provision is in part filled by visiting surgical teams, largely volunteers from North America. Visiting surgical teams are typically hosted by local Guatemalan NGOs, who each use their own system of connecting patients with surgeons. Short-term medical missions are an important source of health care in Guatemala and globally, but they have been criticized for failing to build in-country capacity and for providing care that would not meet the standard of care in their countries of origin. The 2018 project will build on the initial work on this topic of NAPA-OT Field School Students in 2011, An Investigation of the Surgical Referral Process Utilized by Non-Governmental Organizations in Guatemala, in 2013, Patient Experiences of Medical Missions, and 2014, Sustainable Technology for Surgical Referrals: Pilot Implementation of an Electronic Medical Referral System for Short-term Surgical Missions. The 2018 Short-term Medical Missions (STMMs) group will investigate the interactions of health-focused NGOs and government health agencies in the Antigua area and at the national policy level, particularly focusing on surgical care and the perspectives of Guatemalan providers.

Employing qualitative research methods, students will interview Guatemalan health care providers and NGO stakeholders. Based on this first-hand research, students will highlight specific issues with STMMs from the perspective of Guatemalan providers and pinpoint areas for improved NGO collaboration. Both the research findings and suggestions for improving the referral process will be shared with participating agencies, NGOs, and other stakeholders.

Key competencies gained will include: in-depth knowledge of the international NGO structure; qualitative research techniques; basics of public health intervention mapping and evaluation; development of an occupational critique, and policy-brief and executive report writing.

NOTE: Students’ willingness to contribute to the report in the 2-4 weeks following the field school end date of August 3 is requested, in order to complete the writing, editing, and/or posting of the report.