Making surgical missions a joint operation: NGO experiences of visiting surgical teams and the formal health care system in Guatemala

Abstract

Each year, thousands of Guatemalans receive non-emergent surgical care from short-term medical missions (STMMs) hosted by local non-governmental organizations (NGOs) and staffed by foreign visiting medical teams (VMTs). The purpose of this study was to explore the perspectives of individuals based in NGOs involved in the coordination of surgical missions to better understand how these missions articulate with the larger Guatemalan health care system. During the summers of 2011 and 2013, in-depth interviews were conducted with 25 representatives from 11 different Guatemalan NGOs with experience with surgical missions. Transcripts were analysed for major themes using an inductive qualitative data analysis process. NGOs made use of the formal health care system but were limited by several factors, including cost, issues of trust and current ministry of health policy. Participants viewed the government health care system as a potential resource and expressed a desire for more collaboration. The current practices of STMMs are not conducive to health system strengthening. The role of STMMs must be defined and widely understood by all stakeholders in order to improve patient safety and effectively utilise health resources. Priority should be placed on aligning the work of VMTs with that of the larger health care system.

Systematic review of low-income and middle-income country perceptions of visiting surgical teams from high-income countries

“… 17 25 29 46 Another example of administrative shortcoming was HIC surgeons failing to adhere to regulations regarding registration of planned visits to local authorities 41 or reporting outcomes. 42 …”

“…Twenty-five studies (83%) described advantages with visiting surgical teams,17 19–42 further subgrouped into skills improvement, immediate clinical patient care, system-level strengthening, academic and career benefits and broader collaboration opportunities.…”

Collaboration between the government and nongovernmental organizations in providing health-care services

“…[ 48 49 50 ] Similarly, the reluctance and distrust of the public sector to collaborate with NGOs are reported by Roche to be among the challenges of their collaboration in Guatemala, resulting in the ineffective implementation of the referral system and reduced continuity of care services. [ 60 ]…”

Global health volunteering, the Ebola outbreak, and instrumental humanitarianisms in Sierra Leone

“…Given the conceptual and practical significance of global health volunteering, critical engagements in medical anthropology and the health sciences have understandably been thematically far-reaching. These include the perceptions of local hosts (Roche & Hall-Clifford, 2015;Lukolyo et al, 2016;Kung et al, 2016a;Sullivan, 2016b;2016b;Bozinoff et al, 2014;Wendland, 2012), the possible negative impacts of volunteers on healthcare settings and patients (Guttentag, 2009;Sullivan, 2017a;Dowell & Merrylees, 2009;Berry, 2014) and the ethics of volunteering (Wallace, 2012;Crump & Sugarman, 2008;Brown & Prince, 2016). Research has also explored the differing motivations for taking part in volunteering schemes between volunteer and host (Sullivan, 2016a); the changing nature of African domestic volunteering (Brown & Green, 2015) and volunteering under specific emergency contexts (Redfield, 2016).…”