It is one of the most rewarding experiences for many dentists but is volunteer tourism doing more harm than good? Kerry Faulkner reports
Mahatma Gandhi said, “The best way to find yourself is to lose yourself in the service of others”—a sentiment that has compelled thousands of Australians, many of them well-meaning young people, to travel overseas as community volunteers.
Volunteer tourism or ‘voluntourism’ has grown from small, scattered health and education aid programs offered in poorer countries through churches, charities and non-government agencies, into a vast money-making industry estimated to be worth $2 billion globally a year.
But the willingness of volunteers to pay for the experience has created problems, particularly in popular orphanage voluntourism which faces growing claims that it fosters human trafficking and child exploitation. There are growing calls internationally for it to be halted.
However, there’s a huge range of volunteer projects outside orphanages from building schools to teaching English, correcting cleft palates and lending legal advice to poor landowners.
Associate professor Stephen Wearing, author of Volunteer Tourism and a number of academic articles since, says it’s the commercialisation of the programs that has created many of their problems. He believes that in the drive to deliver profits, businesses often remove from the projects the essential elements that initially made them work so well.
He cites as an example the experience of two sisters. One volunteered overseas through an organisation to help teach children English. After the teacher gave the lesson to the class, she worked individually with students and had a fantastic experience. However, when her sister went on the same program three years later, it had been taken over by a venture capital company. It was more economical for the company to use a volunteer as the teacher than a trained professional, so the young Australian woman was the teacher, a role she didn’t feel qualified to fill resulting in an unfulfilling volunteering experience.
“The tourism industry is very tight,” Wearing explains. “The only way to make money is to cut things in the program and that’s often in the program delivery. It’s probably happening in medical tourism to some extent. Volunteers who before were not actively engaged with patients but may have been observing or helping in other ways may now be actively engaged in dentistry, for example, and in someone’s mouth.
“The problem is that no-one has been monitoring that. We have no research, no-one’s funding research to look at this, so we need much more factual-based research to look at these programs.”
Taking away local jobs
Practising beyond the scope of their expertise is just one of the negatives of medical volunteer programs detailed in a 2017 study by Queensland academic Dr Irmgard Bauer, who says over-zealous and underqualified practitioners in the health sphere can result in harmful treatments and a lowering of ethical standards.
Her research shows international volunteering can also take away local jobs, create dependency on foreign aid and remove incentives for governments to invest in their own health care or preventative care programs. In addition, she says western volunteer services compete with local services, so the situation arises where patients would rather wait for the next round of overseas aid than use a local provider.
“[Volunteering] encourages young people to be altruistic; to go and do things in other countries when they are starting to have a global perspective, particularly in Australia where we are isolated.”—Dr Irmgard Bauer, QLD academic
However, Wearing says to see overseas volunteering end would be unfortunate. “The concept is good—it encourages young people to be altruistic; to go and do things in other countries when they are starting to have a global perspective, particularly in Australia where we are isolated.”
Word of mouth
Volunteers can find projects in a number of ways: some via offers while travelling, others through agencies, professional groups, religious or educational institutions. Wearing’s advice though is to listen to what others who’ve worked on the program say; word-of-mouth is the best recommendation and he suggests steering toward non-government organisations with strong links to other local groups already working in the area.
Practice manager Elaine Lancaster in Morningside’s Richmond Road Dental in QLD is working on just such a project and has done so since 2008 when she and her practice colleague, Dr Petrina Bowden, first landed in Cambodia with a huge 75kg of dental equipment.
They work through M’Lop Tapang at Sihanoukville, a beach resort on the southern coast whose slums have swelled with the influx of people from poorer provinces looking for a better life.
The organisation helps 5000 local children providing meals, shelter, medical care and education. Lancaster explains almost anyone can ‘put up a chair’ and call themselves a dentist in this part of Cambodia but even they are beyond the reach of these poorer kids.
“Early on, we put a lot of teeth in buckets and did a lot of pain management. We’ve started charting kids and now when dentists return, we see kids come back. Several years later, the biggest thing we see is they’re learning oral hygiene,” she says. “For many, the only access they have to water is a well, so it’s hard to even have somewhere to keep a toothbrush.
“After that initial trip, Petrina did a lot of fundraising and found room in the M’Lop centre to build a purpose-built room, so now we have two modern chairs in addition to the old portable chair which can be taken out to the slums to treat people out there, so it really has grown into quite a concern.”
Volunteers are welcome and are placed on a roster; two at a time will work in the Cambodian clinic, many incorporating this into a holiday to the pretty coastal resort area. Volunteers are vetted stringently.
Lancaster describes volunteering as one of the most rewarding experiences of her life, recalling being particularly moved by an elderly woman who’d lived through the torturous rule of the Khmer Rouge, and whose missing fingers and toes were a testament to that time. She only had a few teeth left and had walked kilometres to the clinic to have a painful tooth removed. She then wouldn’t leave because she didn’t believe they’d pulled it out. Only after looking in a mirror was she convinced—and thrilled that she’d had a pain-free extraction.
“For a dentist of any age, it’s great. It’s one of the most rewarding things I’ve ever done; the Cambodian people are so appreciative,” she says.