Host Country Views of Short-Term Medical Missions: Community-Based Research in Ghana, Uganda, and Guatemala

Background: Growing attention to the proliferation of short-term medical missions (STMMs) in the Global South has increasingly taken the form of critiques of inadequately prepared volunteers, lack of community control and continuity. In response, scholars and practitioners in high-income countries have created guidelines for best practices. These have rarely incorporated the views of host community members and leaders. While research has begun to address what host countries want from STMMs, these projects have also been carried out almost exclusively by scholars from the Global North. Objectives: The aims were to provide additional insights into host views in three countries that are frequent destinations for STMMs and to explore the possibility that design and direction by host country researchers would yield new perspectives. Methods: Scholars from Ghana, Uganda, and Guatemala designed and directed studies of medical staff, public officials, and patients from multiple locations around each country. Interviews and focus groups were carried out with a total of 129 people. Findings: All three studies found widespread appreciation of STMMs for providing needed medical services. In Ghana and Guatemala, language differences were cited as a major barrier, while Ugandan participants criticized volunteers' lack of skills and mismatch between their expertise and community needs. Ghanaian and Ugandan participants voiced resentment of patients' preference for white volunteers and the arrogance of some visitors. The amount of time and effort required to host was a common theme. Conclusion: The findings confirm the importance for STMMs of understanding the local health context and language and working collaboratively and respectfully with hosts. Direction by host country researchers enhanced the value in several ways, including access to officials and establishment of trust with interviewees.