Today I think I will rant a little. I feel entitled but can’t give you a reason why. I just do.
I returned a week ago from the International Medical Missions Conference in Kansas City. I love KC and aside from the worst pro baseball team known to man, it is a wonderful small city a little under 2 million metro area here in the Mid West. Many fountains and parks and winding boulevards to enjoy. If you have the chance to visit sometime please indulge. It is a neat place as we say.
There are several ties that bind America to sub Saharan Africa, and one of these is the propensity for us to think we need to come over there and help you all ( southern term) out. Perhaps we do, but that begs the question. Is what sometimes comes down really a help? Does a 2 week medical mission to say Zimbabwe, one that has only a few medical professionals interspersed with many more do-gooders really accomplish much? What are the long term outcomes? Are they better population health? I don’t know.
Let me digress and say that one of the best speakers I heard was a native Kenyan named John Wilson. What he is doing is simply amazing and I encourage all of you to look at Hope Kenya as a model of what can be accomplished in efficacy and sustainability when the right model is accessed and utilized to its fullest.
Now back to the rant.
The conference was scheduled and run over 4 floors of the new and impressive student center on the Kansas City campus of the University of Missouri. About 1300 people attended. It was sponsored by many but mainly organized by the Medical School there which is one of the few that offers a specialty in international medicine. On each floor were the co sponsor booths. Some were travel agents that booked the flights and such, and the insurance people. Mercy Ships was there, but the majority were purveyors of these 2 week junkets to Nepal, …South America…or Cambodia or and mainly sub Saharan Africa. For the princely sum of 4000 to 5000 dollars one can go on a choreographed and sanitized trip to bring health and religion to some remote area that has not been gone to before and probably will not be found on any itinerary again in the near future.
So we can on these missions treat hypertension with drugs that cannot be gotten again after the supply left behind is exhausted… or we can medicate a myriad of maladies in a manner that does not address local needs or cultural competency or even the most basic Public Health mandates of efficacy and sustainability. But damn… ( pardon the language) we now have done our part for the poor and forgotten of the world and we feel really good… and wow, did we get some cool digital nature shots at the same time. So glad I bought the new Minolta.
Now do not get me wrong, individual good is done. We heard from a team of Ophthalmologist- Surgeons that over a week placed 300 corneal implants on people in need on an island in the Caribbean: people that now can see and would have also never afforded or been able to access this treatment in any other way. We also heard them tell us the left behind 600 more patients wanting the treatment when time ran out and they had to go. Some ethical questions here as well.
So let’s cut to the chase ( old western movie term). What is right here and what is wrong? Let me frame this by what I want to do as a medical mission should I find a way in the future. I’m not 24 anymore and I hope to accomplish this in the near term. What I want to do is establish a dental mission someplace in South Africa that needs it. I do not want to send American Dentistry over there with the standards we have and keep to compete with local professionals. This has to be someplace of need. Then it has to be sustainable and repeatable. I want a “bricks and mortar” setting perhaps associated with an existing community health clinic that has no current oral health department. The idea is I can send multiple professional peers to that same clinic so that it is a center for needs dental care for that area and can be counted on to be there for the future needs as well. This will be seamless care, just by different oral health providers on a rotation basis. A tent under a tree that is there for 2 weeks and gone severs nothing on a population basis… I want more.
One component needs to be self help and education to any mission. While the procedures must be done by trained professionals ( in America a DDS degree is 9 years) much of the preventive and education components can be trained to a permanent staff for this part of the model is what really finally brings health. I have the doctors and equipment to ship… I need a place.
This model I project is what I think is lacking in so many of the short term feel good trips that pervade the mission landscape. Do you see the difference?
But now after the advertisement, is the moral. It is indeed possible that the short term missions do more harm than good. They help a few but then they move on… and the care providers are back home making money and showing slides of the trip… and where they left is still the same and still in need.
I do not know how to change this. These short trips appeal and again South Africa has a higher standard of living that other areas. Much of your nation can afford decent care and does not need this indulgence. Still whether it is Zimbabwe or Kenya or where ever, there have to be ways to help those that hurt and are infected and need a place to turn to. They planners just need to do better. Sustainability is how it has to work and cultural competency has to be the mode of operation and finally self help is the spine that makes it all intersect.
Thanks for indulging me. I appreciate it.