Beneath the Spin: Moral Complexity &amp; Rhetorical Simplicity in ‘Global Health’ Volunteering

Wendland, Claire; Erikson, Susan L.; Sullivan, Noelle

doi:10.1017/9781782046691.008

Cited by 8 publications

(8 citation statements)

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“…The community-driven aspect of the above definition eliminates the paternalistic view of ISL as motivation for individuals from high-income countries to address “problems” in LMICs, encourages participant reflection and dialogue using a social justice model, and fosters the community's trust in its local personnel. 58 This prevents the “powerful flattening” 39(p179) that takes place when services delivered by unskilled [students] are seen as equal to those that are skilled and trained. Theme 1 of this study Student Experience is Prioritized and Theme 3: Foreigners Undermine Local Capital highlight that placing the focus on ISL as a learning opportunity for students to practice their skills could cause this “powerful flattening.” 39(p179) In working with nongovernmental organizations (NGOs) as host partners, it is worth reflecting on how the ISL experience adds value for the host community outside of what the NGO may already be providing.…”

Section: Discussionmentioning

confidence: 99%

“…58 This prevents the “powerful flattening” 39(p179) that takes place when services delivered by unskilled [students] are seen as equal to those that are skilled and trained. Theme 1 of this study Student Experience is Prioritized and Theme 3: Foreigners Undermine Local Capital highlight that placing the focus on ISL as a learning opportunity for students to practice their skills could cause this “powerful flattening.” 39(p179) In working with nongovernmental organizations (NGOs) as host partners, it is worth reflecting on how the ISL experience adds value for the host community outside of what the NGO may already be providing. It also becomes important to ascertain that the NGO is truly working in collaboration with the community members, wherein community members are in positions of power and decision making within the NGO.…”

Section: Discussionmentioning

confidence: 99%

“…37,38 Universities may also benefit from donors who seek to give money to institutions that support global health programs. 26,39 While universities may promote these experiences intending to develop students into altruistic practitioners, longitudinal data to support this are lacking. Without a formal plan or support from the university, students' intentions to pursue such goals diminish upon return to the home country.…”

Section: Review Of Literaturementioning

confidence: 99%

“…Failing to do so demonstrates silencing behavior, albeit unintentionally, while celebrating ISL's perceived altruism. 39 Wendland et al 39 posit that even if resources are scarce, that "something" is not always the better option, and that silencing the critical examination of such endeavors makes us complicit in trying to tune out inequalities. rough critical reflection, we recalibrate the intent to view the community as a strong macrosystem that can sustain itself, even in the absence of foreign support and avoid the potential of foreigners undermining local practitioners.…”

Section: Movement Towards An Ideal Islmentioning

confidence: 99%

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Uncovering Ethical Dilemmas in International Service-Learning: A Grounded Theory

Dholakia

Willgens

Rubertone

et al. 2021

JOPTE

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Introduction.International Service-Learning (ISL) is a model of experiential learning offered by Doctor of Physical Therapy (DPT) programs in the United States. Over the past several years, the number of these experiences has grown rapidly.Review of Literature.Recent evidence has uncovered detrimental impacts of short-term health-related experiences, such as ISL, on the host community; however, to date, ethical situations arising in ISL in DPT education have not been explored. From the perspective of the American Physical Therapy Association (APTA's) Code of Ethics and the Realm-Individual Process-Situation (RIPS) model of ethical decision making, the aims of this study were to (1) explore the experiences, perceptions, and insights of faculty, students, and alumni, who attended an ISL experience and (2) analyze their ethical nature.Subjects.Ten students, 6 faculty members, and 5 alumni from 4 DPT programs participated. All participants, except one alumnus, traveled to the same Central American country and partnered with the same host organization for the ISL experience.Method.This study used a constructivist grounded theory approach.Results.Data analyses indicated that ISL as experienced by participants in this study did not align with APTA's ethical principles 2A, 3B, and 8B. Furthermore, the RIPS situational analysis indicated that the primary themes arising from this study reflected ethical issues/problems and an ethical temptation, with an overarching ethical silence.Discussion and Conclusion.In their desire to be altruistic and provide global experiential opportunities to students, educators may overlook ethical situations arising from ISL. Research demonstrating the benefit of ISL to patients and the host community, and to establish best practice standards to minimize detrimental impacts to the host should be undertaken.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Review Of Literaturementioning

confidence: 99%

Section: Movement Towards An Ideal Islmentioning

confidence: 99%

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Uncovering Ethical Dilemmas in International Service-Learning: A Grounded Theory

Dholakia

Willgens

Rubertone

et al. 2021

JOPTE

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“…This has led to current international electives facing rigorous monitoring and criticism [ 19 – 21 ]. Cole noted how international medical electives are carried out predominantly by privileged groups, which assume that, ‘they can make a difference without understanding the complexities of context of those being helped’ [ 22 ], perpetuating the notion that, ‘some care is better than none’ [ 23 ]. Sullivan observed that electives, ‘commonly arrive lacking contextual and cultural knowledge, let alone specific notions of what precisely they will do.…”

Section: Introductionmentioning

confidence: 99%

International medical electives in Sub-Saharan Africa: experiences from a 19-year NGO-driven initiative

et al. 2023

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Background Mainstream medical education remains largely focused on national health issues. Therefore, in order to expose medical students to international health issues, it is beneficial to facilitate international medical electives. Methods This article describes the Junior Project Officer (JPO) program, a medical experience based on clinical electives in Sub-Saharan Africa, supported by a Non-Governmental Organisation (NGO). Residents spend 6 months as part of a multidisciplinary medical team in Africa. A post-elective online survey was administered to all who participated in the program in the period 2002–2020. The questionnaire comprised three domains: (i) general and pre-departure information; (ii) the experience; (iii) the post-experience. Results Questionnaires were received from 157/241 subjects, a response rate of 65%. The most common specialties were pediatrics, public health, and internal medicine. Of all, 87% carried out clinical activities; 45% also worked in the management of health services, and 60% carried out research activities. About 64% reported difficulties linked to a lack of equipment, different ways of working (57%), and exposure to situations for which they did not feel technically prepared (56%). In 25% of cases, residents reported that their school’s attitude to their doing the elective was not positive: upon their return, over 50% felt that their experience was not sufficiently valued by their institution. Respondents considered the experience important for professional and personal growth (93% and 80% respectively ). Forty-two participants (27%) reported that the experience had a significant impact on their future career choices. Conclusion Despite the difficulties encountered, a well-structured experience in international health can have a positive impact on residents, professionally and personally. Key factors behind the positive outcomes are the substantial length (6 months) of the experience, and the long term working relationships between the sending and receiving institutions. The schools in Italy that provide the students for the electives need to see more evidence that international electives are worth the investment.

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An Exploratory Study of Physical Therapists From High-Income Countries Practising Outside of Their Scope in Low and Middle-Income Countries

Hartman,

Dholakia

2023

Bioethical Inquiry

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Beneath the Spin: Moral Complexity & Rhetorical Simplicity in ‘Global Health’ Volunteering

Cited by 8 publications

References 0 publications

Uncovering Ethical Dilemmas in International Service-Learning: A Grounded Theory

Uncovering Ethical Dilemmas in International Service-Learning: A Grounded Theory

International medical electives in Sub-Saharan Africa: experiences from a 19-year NGO-driven initiative

An Exploratory Study of Physical Therapists From High-Income Countries Practising Outside of Their Scope in Low and Middle-Income Countries

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