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我们做得好吗?非政府组织、利益冲突与危地马拉索洛拉短期医疗任务评估。

Did we do good? NGOs, conflicts of interest and the evaluation of short-term medical missions in Sololá, Guatemala.

机构信息

Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, B.C., V5A 1S6 Canada.

出版信息

Soc Sci Med. 2014 Nov;120:344-51. doi: 10.1016/j.socscimed.2014.05.006. Epub 2014 May 6.

DOI:10.1016/j.socscimed.2014.05.006
PMID:24834868
Abstract

This article focuses on current trends in scholarly literature concerning the evaluation of short-term medical missions. The paucity of information on short-term medical missions in general has contributed to the lack of sufficient frameworks for evaluating them. While examples in the scholarly literature are sparse, in those rare cases where missions are evaluated, they tend to (1) produce their own criteria for evaluation, and (2) evaluate themselves based on metrics that emphasize their perceptions of accomplishments. I draw on interviews (n=31) as well as participant-observation regarding medical missions, to critique these trends. The data analyzed derive from an on-going ethnographic study began in Sololá, Guatemala in 1999, which since 2011 has been directly focused on short-term medical missions. More specifically, my data suggest potential conflict of interest inherent to both volunteering and hosting a short-term medical mission. NGO hosts, who maintain long-term residence in Sololá, may differ from short-term volunteers in both how they understand volunteer obligations as well what they consider helpful volunteer activity. These same organizations may remain financially tied to volunteer labour, limiting their own perceptions of what missions can or should do. I argue that these conflicts of interest have created an evaluation environment where critical questions are not asked. Unless these hard questions are addressed, short-term medical mission providers cannot be certain that their own activities are consonant with the moral imperatives that purportedly drive this particular humanitarian effort. This study demonstrates how ethnographic methods can be instrumental in attempts to evaluate humanitarian endeavours.

摘要

这篇文章主要关注当前学术文献中有关短期医疗任务评估的趋势。一般来说,由于缺乏关于短期医疗任务的足够信息,因此缺乏充分的评估框架。尽管学术文献中的例子很少,但在那些对任务进行评估的罕见情况下,它们往往(1)制定自己的评估标准,(2)根据强调自身成就感知的指标来评估自己。我通过访谈(n=31)以及对医疗任务的参与式观察,对这些趋势进行了批评。分析的数据源自于 1999 年在危地马拉索洛拉开始的一项正在进行的民族志研究,自 2011 年以来,该研究一直直接关注短期医疗任务。更具体地说,我的数据表明,短期医疗任务中的志愿服务和主办工作都存在潜在的利益冲突。在索洛拉长期居住的非政府组织主办者,可能与短期志愿者在理解志愿者义务以及他们认为有帮助的志愿者活动方面有所不同。这些组织可能仍然与志愿者劳动有经济联系,从而限制了他们对任务可以或应该做什么的看法。我认为,这些利益冲突创造了一个没有提出关键问题的评估环境。除非这些棘手的问题得到解决,否则短期医疗任务提供者无法确定自己的活动是否符合据称推动这一特定人道主义努力的道德要求。这项研究表明,民族志方法如何在评估人道主义努力方面发挥作用。

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