Volunteering abroad is a hotly contested topic these days, and not just when it comes to medical volunteering. From orphanages to animal conservation to disaster relief, there are endless opportunities, and just as many individuals and organizations trying to steer us away from them. If you’re not aware of some of the issues, you’ll get a sense of some of them in this post. I also highly recommend doing your own research on this topic (this article is a great place to start).
I’ve had one volunteer experience abroad as a physiotherapist and I had many doubts prior to leaving. Not because I was fearful of travelling to Kenya, but because I didn’t want to be yet another Westerner that left doing more harm than good. Though I was confident that the organization I was going to travel with was working in a sustainable way, in partnership with Kenyans, I couldn’t help but seek approval from the locals while I was there.
The idea of medical volunteering is indeed a tricky one and I don’t believe there is an easy answer when it comes to picking a side. The purpose of this post is not to stop you from volunteering abroad but if you’re considering doing so, to encourage you to take the time consider your motivations and understand the issues surrounding global health volunteering. I reached out to 4 physiotherapists with experience in this area to hear their thoughts and learn from their experiences with volunteering abroad.
Those physical therapists were:
Joanne from Toronto, Ontario, a retired physiotherapist having practiced for 49 years
Mona from Red Deer, Alberta, physiotherapist of 30 years
Karen from Lacombe, Alberta, physiotherapist of 39 years
Krysta from Victoria, British Columbia, physiotherapist of 3 years and creator of the Global Physio Podcast
Where it all began – first volunteer placements abroad
Joanne first travelled abroad in a physiotherapy role in the early 2000’s. Over a 3 year period, she joined Friends of Honduran Children in Honduras for 2 weeks at a time. Though she recalls doing a little bit of physio with children with disabilities, as well as with adults with arthritic conditions, she played mostly a supportive role on these trips, assisting the work of a team of doctors, nurses and dentists.
An international placement through Samuha in rural India was Krysta’s first volunteer experience abroad. As a physiotherapy student, she worked alongside local rehabilitation workers to assist people living with cerebral palsy, autism, and Down Syndrome. Krysta also spent time in the Spinal Cord Injury Rehabilitation Centre where she helped young men gain independence following their injury.
In 1991, Karen had the opportunity to join her father, a recently retired physiotherapy professor, on an invitation to provide training for rehabilitation assistants in Kenya. Based at a rural hospital and school for children with disabilities, they delivered a 3 month training program for 6 staff, working primarily with children with polio.
Mona’s first volunteer experience was also in Kenya, in 2015 with A Better World Canada. Over a 2 week period, she worked in 3 different communities with children with special needs, their families, teachers and community members. She describes each community having a different level of awareness, acceptance and service provision for children with disabilities.
For more on my first volunteer placement abroad, check out this post.
A chance at volunteering
For myself, the idea of going on a volunteer experience abroad first came to me many years ago. But due to circumstances, it wasn’t at the forefront of my mind for years. When I had returned home from living abroad, and was listening to the Global Physio podcast for the first time, the desire resurfaced. From there, I contacted one of the physiotherapists who was interviewed in that particular episode, setting the wheels in motion for my first volunteer experience 6 months later. (shoutout to Karen!)
What steps led these physical therapists to commit
to a volunteer experience abroad?
Joanne had always wanted to do humanitarian work so when the opportunity came up through a doctor she was working with, she jumped at it. But after 3 trips of mainly a supportive role, she was ready to find a group where she could use her physiotherapy skills. At a physiotherapy school reunion, she got introduced to A Better World Canada and has never looked back, travelling to Kenya with the organization annually since 2006.
Mona describes having a similar long-lasting desire for global health volunteering. Having young children at home, however, made it out of the question to work away for an extended length of time. Like Joanne, she became involved with A Better World Canada by chance, after someone suggested she get in touch with them for assistance with a shoe drive she initiated. They quickly realized she was an experienced paediatric physiotherapist and saw the benefit of having her join the rehabilitation team in traveling to Kenya. At this time Mona was in a better position to consider being away from her family and a bond was quickly formed.
At the time when Karen’s father was invited to Kenya, she was choosing between accompanying him and accepting an international job offer. Being single at the time, as well as between jobs and therefore having the flexibility to arrange 4 months away, led her to decide on joining him. For Karen, it was important to know that she was with people she could trust and would not be alone.
Surprises for first time volunteers abroad
With many interacting factors playing a role, no two volunteer experiences will be the same. Consider location, level of physiotherapy experience, travel history, and expectations, just to name a few.
Was there anything that surprised these physiotherapists about
their first volunteer experience?
Despite feeling confident and prepared going into the trip, Mona remembers being overwhelmed by the work day – the sights, sounds, smells, environmental conditions, working through a translator, meeting very low functioning children, and educating parents about illnesses that have no cures. Throw in time constraints associated with the number of children and families that wanted to be seen, as well as questions without easy answers, and you have some difficult days indeed.
Mona isn’t alone in also coming to understand that ‘getting more than you give’ is truly an understatement. Volunteer work is rewarding from many different perspectives, providing countless opportunities to learn about yourself, a culture different from your own, travel, problem solving, resiliency, global health, physiotherapy abroad, team-building and so on. In return, you give only your time, knowledge and compassion. Though the locals are often kind and express their appreciation, the scale often doesn’t feel balanced for many volunteers.
Some therapists will describe what Joanne did – being surprised only by how much they loved the experience and how comfortable they were “roughing” it. Joanne knew from that first trip that she could handle just about anything. While others, like Krysta, recall being surprised by how dramatic people’s disabilities were compared to what she’d been exposed to in Canada. At the same time, she found it incredibly inspiring that these same people didn’t let their disability get in the way of their participation in life.
Advice for first time global health volunteers
Knowing what they know now, what advice would our therapists give themselves before their first volunteer trip abroad?
Step back and observe. Slow down. Do less. Set reasonable expectations.
With many rehabilitation professionals going on short-term volunteer trips, the pace of a trip is often hard to keep up with. Add in the emotional rush that comes along with helping someone less fortunate, and many volunteers will find that they sacrifice time to rest or eat, and don’t make time to process what is happening around them, or within them. Don’t underestimate what taking the time to step back, observe, and check in with yourself will add to your experience. I couldn’t agree more.
Expecting to make a big difference, or similarly, trying to accomplish too much, hinders many therapists in truly helping the people they are working with. Consider writing down your expectations before you travel, and going back to them throughout the trip, adjusting them as necessary. Like stepping back and slowing down, writing things down is also often an underestimated task. The level of preparation and understanding that it can bring to your volunteer experience, however, is invaluable.
Complete pre-departure training for volunteers
Be on the lookout for pre-departure training, where you can gain insight into such topics as cultural humility and reverse culture shock, either from the organization you are volunteering with, or elsewhere. Be aware that this type of training is not standardized but can be helpful in guiding your actions while away, thereby minimizing negative impact on the host community.
Ask yourself this before committing to a volunteer trip abroad
Your turn for questions. To help with deciding whether to volunteer abroad, the physiotherapists surveyed suggested looking within, and asking yourself the following questions.
- What are my motivations for going abroad? Be sure to recognize any selfish reasons.
- What will my role be? Will it be purely hands-on, or will I be in a teaching or collaborative role? Am I taking work from a local person?
- Will I be able to partner with local professionals? Will my visit contribute to a long range plan for rehabilitation in the area?
- Am I comfortable travelling to any country, wherever there is a need?
- Am I flexible, easy-going and willing to put the needs of others before myself? Am I willing, at times, to do without some of the things we take for granted each day such as a warm shower, a meal, clean clothes, a flushing toilet?
- Am I willing to put my ego aside and only help with what’s asked of me?
- What are my pre-existing biases about volunteering abroad as a health professional?
How to best choose an organization to volunteer with
There are a few key things to consider when choosing an organization to volunteer with. Take it away, physios:
- Are the organization’s values in line with your own?
- How long is the volunteer trip? (many global health professionals believe that a trip of 4-6 months or longer is best)
- Does the organization require the specific skills that you have to offer?
- How long has the organization worked in this area?
- Does the organization involve the community it’s trying to help in planning and decision-making? Does it have a proven track record of sustainability with its projects?
- Is the organization purely humanitarian or do they have ulterior motives? For example, hoping to sway people to their particular religion?
- Consider the funding model of the organization. Are funds allocated to projects actually being spent on the projects? Does the organization demonstrate accountability?
- Have there been any adverse events that have occurred to the volunteers? If so, how was this handled?
- How much support does the organization provide you with abroad, and upon return home?
Doing more harm than good
Hopefully we all realize by now that not all volunteer experiences as created equal. Here’s what to keep an eye out for.
Long term impact
Long term impact is crucial to consider. Short term visits (i.e., 1-2 weeks) are extremely popular as many people can’t commit to being away for longer. These types of visits, when not part of a longer term development project, are strongly believed to do more harm than good. This goes back to considering the organization’s track record in terms of sustainability – are their projects designed with the eventual goal of the locals running them, allowing the organization to leave the area entirely? If not, steer clear.
For purely hands-on experiences, we must consider the effect one or two visits with a patient will have long-term. Can we create meaningful change in two visits, especially in individuals with often very challenging circumstances? Instead, look for an organization that offers a collaborative role with the local professionals. And involves a partnership in which the local community is heavily involved in decision-making. No one knows their changing needs better than they do.
Avoid experiences where you’ll be doing the work that a local can do. Not only are you taking work away from the local community but if you are unqualified to work with a particular population, you are likely to do more harm than good. Westerners with zero building experience travelling abroad to build schools is a prime example of this.
Attitude and empowerment
I hope it’s clearer by now that a whole host of problems are possible with volunteering abroad, both for ourselves and the host community. Our physiotherapists brought attention to a few more concerns.
Karen and Joanne believe that the attitude you bring to the table can make a huge difference. When we come across as so much more knowledgeable than the local professionals this can lead to a lack of confidence and a dissatisfaction among them. From the outset we need to acknowledge the good work they are doing and look for ways to partner with them, instead of doing the work for them. Our best roles may be continuing education and empowerment, says Karen.
Being mindful and aware of how we’re behaving, not to mention being culturally sensitive, can help keep our impact positive, too. Even after years of volunteering in Kenya, Karen continues to experience lessons of humility.
Health and safety for volunteers
As always, do your research prior to travelling with regards to health and safety in the region you’re heading to. Source out a travel medical clinic that’s knowledgeable on that part of the world to best prepare yourself against local illnesses.
What does sustainable medical volunteering abroad look like?
Unanimously, the physiotherapy experts I surveyed reiterated the following.
Sustainable medical volunteering involves creating a collaborative environment by partnering with the local host community, allowing them full control of determining their needs and knowledge gaps. Krysta Wark, of the Global Physio podcast summed it up very well:
“The mark of a sustainable project means there is an exit strategy,
where enough capacity has been built that the local community
no longer requires international assistance.”
Please join me in thanking these four physiotherapists for sharing their insight on volunteering abroad in the comments below.
> For those readers considering volunteering abroad, keep an eye out for a pre-departure training module currently in development by the Global Health Division of the Canadian Physiotherapy Association. <<