Volunteering has been integrated in my childhood, and missionary work quickly became one of my passions after my first missionary trip in Ensenada, Mexico. Nevertheless, I never realized how my perception could be so skewed of something I cared about so immensely. The novel When Healthcare Hurts by Greg Seager and this course, Ethical Traveler, have completely reframed my view of missionary work, an ethical method of doing it, and its main purpose.
The purpose of volunteering and missionary work are to help other people selflessly; therefore, the primary concern should be the people receiving the help and their safety. I initially defined someone needing help as someone who is incapable of doing an action without another’s assistance. By stating that broad definition, it is now easier for me to recognize how paternalistic my view was. In describing someone as “incapable” is demeaning as it is, and when I view it as them “needing” my help, it is all the more demoralizing.
Growing up, my parents have always encouraged me to volunteer with them in homeless shelters, food pantries, and local churches. They took me on my first missionary trip with Youth with a Mission to Ensenada, Mexico in 2015, and we have returned annually since then. The trip director has received many applications from families in his hometown explaining why they would be the best candidate to receive a house to replace their current one. My family and I come with a mission group to build a house for one of the selected families in a week. This course has challenged me to accept my wrong belief of me being a hero and helping these “helpless” people in poverty.
Poverty is the state of being deprived in some way. One can be in poverty socially, financially, or even morally. A source of poverty is an obstacle in life most people work to overcome. It challenges the community to come together and support one another. I thought I was truly witnessing “poverty” for the first time in my life when I crossed over into Mexico. Seeing all the dilapidated buildings, and outdated vehicles. Nevertheless, I now realize even though that was poverty, it is just as much “poverty” as anything in America. Location should not be a factor in determining poverty. It is easy to focus on another country’s problems and feel entitled, but we truly have similar problems in our backyard. Every country has a different means of addressing issues such as public healthcare systems or passing certain laws, but the problems of facing deprivation are not changed by location. Therefore, it is important to consider the location’s culture when coming to help to do it without being a disruption in their livelihood. Poverty should be defined by its case and severity. Moreover, the act of helping is salient in life because facing conflict is a part of life. Nevertheless, poverty does not define a person or an individual’s worth.
The family we built a house for on the first trip were living in poor conditions. Like the majority of their neighbors’ homes, their old house was composed of wood and cardboard scraps without flooring. The trip director informed us of floorless-homes being a prominent cause of respiratory issues from all the dust in the town. Therefore, our goal was to build a new house with a floor to lower chances of respiratory issues and help promote a sense of security for the family. We believed having a home of solid wood would be better defense against weather conditions or environmental conditions, such as pests getting in.
Building a home for a family seems like a grand gesture of love, but I do not know to what degree we truly improved their lives. I believe the family could have saved up enough money with time to build a new house, but I also believe our mission trip had the potential of helping them achieve financial stability much sooner in their lives. Nevertheless, there are many factors to consider if our help was more than helping. Giving someone a whole new environment is a disruption in their everyday routine. Although a wooden house seems more secure, it could potentially be more to keep up with or be a bigger target for burglars in the town. There are scenarios such as the house breaking, and the family possibly did not have the materials to repair it. Perhaps there are better methods in helping the family.
A quote in the book that stuck out to me is when the author said “something is better than nothing” and “quantity is more important than quality” are both very incorrect statements (Seager 14). When I go on mission trips, I get so caught up in trying to help as many people as possible that purpose is skewed. It should not matter how much I change for people but how profoundly I am able to help people. Furthermore, the help I can give has a limit, and I need to acknowledge it instead of trying to help when I can. There is a fine line between helping someone to the best of my ability and helping someone with something I am uncertain of.
Moreover, the number one concern, as I briefly mentioned before, is the patient’s safety. Keeping safety as the priority helps one learn from past experience, prevent errors, and build a culture of safety to the patients. There are many measures that can be taken to promote a safe environment: keeping safety in the core of the training, featuring protocols on the organization’s website, putting time aside at meetings to discuss safety issues, and having a patient-safety officer (Seager 43-44). These are the fundamentals to create an optimal atmosphere. Keeping these factors in mind, pre-training is necessary. Before the volunteers board the plane and before the volunteers serve, there should be meetings to discuss safety measures. Reflecting back, there was minimal pre-training during my mission trip to Ensenada. We did not receive any protocol until we boarded the bus on the way to the worksite. The trip was very organized which helped keep everything in order. There were experienced volunteers mixed with new volunteers. Regardless, there could have been more of an effort to ensure everyone understood their role on site completely. We were working right beside the family’s old home with them still living there.
On the trip, a part that conflicted me was why the trip director discouraged passing out candy to the local children. Naturally, if I were uninstructed, I would hand out all the candy I had to villagers. I thought handing out candy was a kind gesture to them, so I asked the director why I shouldn’t share my m&m’s. He gave me a brief response of, “It’s for their safety.” Then, it did not make a lot of sense to me. Initially, all ll I could think of was that my candy is not poisonous, so it should be safe. I eventually concluded with the theory that we did not have enough candy to share with everyone, so it would not be fair to only give some kids candy. Nevertheless, I listened because it was a part of the safety protocol. Looking back, I realize that it was a safety measure in the sense the director did not want to encourage local children to come by since we were always working with power tools on site. This stresses the importance of having a training orientation to not harm the community unintentionally.
With all the uncertainties, of how much we helped, in account, another main purpose of mission trips is empowerment. Empowerment is defined in the book as, “the quality of people’s participation in the decisions and processes affecting their lives” (Seager 69). Although the extent to which the new house impacted their lives is unknown since I have not been able to visit again, I believe it gave the family a sense of empowerment. I know this is true and still remember some strong words the mother, Veronica, said. She said that her family and her were going through very hard times. She and her daughter often would cry and pray to themselves to sleep and forget about their hunger. Now, with a new house, they are around ten years in life since they feel more secure and can spend the money to buy food instead of coughing medicine or new “parts” for their homes. She then proclaimed that she can now satisfy her other hunger in life _ her hunger to serve others. She was so inspired by the love we all felt within the few days and wanted to go do missionary work as well. This was a beautiful testimony that touched my heart. I do not know if Veronica was ever able to go out and do missionary work, but she was able to even consider it a possibility.
Empowerment is so important because mission trips should not hurt or demoralize the local community inadvertently. Reflecting back on the reasons why I could not pass out m&m’s, I realize there was more beyond the primary prevention of having them around dangerous power tools. The book states, “short-term health projects exist for one purpose: to serve and support the needs of the community, with their goals and priorities” (Seager 81). My goal was to help build a house; it was not to pass out candy. I figured since I was there and had candy, it was good to share it. Nevertheless, the book continues on to state, “If we do not take time to do this right, we create… paternalism” (Seager 82).
Paternalism is the act of imposing our decision as what is best for the community. I have to think more long-term even with the simplest acts to ensure I am not dehumanizing anyone. I am sad I could not share my candy, but I know it was for the best. Passing out candy could be passing on more than a few pieces of chocolate. I could be indirectly and falsely teaching them it is safe to take candy from strangers. Moreover, it is good to share, but if I am passing the candy out, I am not sharing. Therefore, they could receive the impression of how things will be handed to them in life. Unfortunately, while I was in Mexico, I witnessed many children on the streets begging for money or food. I am heart-broken by the thought of a young child having to spend hours begging, but do not want to encourage this act by handing out candy. Nevertheless, it should be up to their parents at home if they should get candy or not.
In When Healthcare Hurts, Greg Seager stated, “Helping people is about encouragement, edification, and facilitating the achievement of self sufficiency” (Seager 77). The goal is to impact others with a lasting effect on their lives. It is important to help others when we can, but sometimes we can best help others by simply leaving them alone to grow independently.
Patient safety and empowerment are integral aspects of a mission trip to consider before, during, and after a mission trip. This course has reframed my previous view of missionary works to incorporate these aspects and to keep them as a priority. Since my first mission trip, I have been on others and medical missionary trips. I realize in all those trips that I was too focused on helping that I lost sight of my ability to hurt. I thought I viewed others with compassion, but there was also paternalism in my view. There is a very fine line between the two: one is expressing empathy and concern for others while the other is deciding what is wrong with others for them. In an article “Finding the Patient in Patient Safety,” by Su-yin Hor, she states “Patients are qualified to judge the safety of their care” (Hor 568). This reaffirms how the patients are the primary concern. We are there for them because their safety is our goal.
Moreover, coming in with a vertical approach is dehumanizing and disruptive. A vertical hospital-based healthcare program “is provided by outsiders with specialized scientific knowledge” (Seager 93). The sound of “outsider” is a red flag for something being wrong. Coming from a different country, volunteers are easily held to be more knowledgeable. Therefore, keeping empowerment in mind is necessary to affirm we are all equal. In contrast, having a horizontal approach is more beneficial to promote openness. It is an approach when people see eye-to-eye. In the article, “Empowerment Effects across Cultures,” Michael K. Hui states, “The empowerment approach may vary across cultures” (Hui 46).
Every community is different, and it is necessary to recognize that. The purpose is for the community to realize their solution was always within them. This leads to the point that there should be an acknowledged limit to help. The purpose of empowerment is so the people can realize their ability to be independent and not grow dependent on our short term interventions. There are countries, such as Vietnam, which have too many missionaries coming through to “provide assistance.” These groups cause them to depend on free short-term clinics too much and lose interest in their local healthcare. This only adds to the country’s governmental corruption since a lot of money is lost because no one is willing to pay for healthcare.
Similar to unique scenarios, every culture will have a different means of communicating and reaching the solution. The way I have experienced communicating with people in America, Vietnam, and Mexico are all different. There are the same basics of having respect and care. Nevertheless, there are cultural cues that are different. For example, patients in Mexico are much more open about their healthcare history than the people we worked with in Vietnam. I did not think twice about the first video the mission trip had us watch until now. It was a video recapping past trips to Ensenada and had interviews with volunteers and the locals. This video was more than an informational video. It was meant to expose us to the community’s culture and means of communicating. We also got to hear incredible stories and also conflicts to learn from.
The title of the book the course was centered around is When Healthcare Hurts. It is a very incredible and true paradox. Healthcare can hurt when an individual’s priorities are not set straight. I hope to continue going on missionary trips with my reformed view of a heightened focus on patient safety and patient empowerment. I am not some hero coming in to save the community. Rather, my approach should be more like a neighbor coming to help out. I hope to take two steps towards being a better missionary: keep safety as priority and change the role of the patient. I am too easily distracted by trying to help in any way I can that I lose sight of myself potentially hurting people, so keeping safety as priority in paying more attention during pre-training is a way to improve. Also, I hope to approach more mission trips with a new perspective of a patient held at higher esteem and respect. Poverty exists as a challenge in the community, but with the right approach, it can be overcome by communities helping one another and building each other up to face life challenges.
