Examining Health-Care Volunteerism in a Food- and Financially-Insecure World

By Maes, Kenneth | Bulletin of the World Health Organization, November 2010 | Go to article overview

Examining Health-Care Volunteerism in a Food- and Financially-Insecure World


Maes, Kenneth, Bulletin of the World Health Organization


Introduction

The problem of severe shortages in global health workforces is addressed in many places by using community volunteers. Whether it is unjust and/or unsustainable to rely on volunteerism in low-income settings, particularly in sub-Saharan Africa, has become a major concern for a widening group of researchers and community health practitioners, particularly in the wake of the 2008 food and financial crises.

The World Health Organization (WHO) recommends that "essential health services cannot be provided by people working on a voluntary basis if they are to be sustainable. While volunteers can make a valuable contribution on a short-term or part-time basis, trained health workers ... should receive adequate wages and/or other appropriate and commensurate incentives". (1) In other words, volunteerism is not a sustainable practice in low-income settings, in particular because the lack of regular, predictable remuneration leads to high turnover rates in volunteer workforces, and thus wastes substantial resources on recruitment and training. But will various" players in HIV/AIDS treatment and care attempt to adhere to WHO's recommendation?

For the recommendation to be effective, policy-makers and practitioners will need to do (at least) three things: first, examine the myth of the humble, sacrificing volunteer spirit; second, determine how --and whether it is even possible--to hold volunteers accountable for the quality of the work that they do; and third, come to some consensus on what is meant by sustainable.

The myth of the selfless volunteer

Volunteer HIV/AIDS-care projects in low-income settings rest on the assumption that local communities are full of "untapped" moral and social energy, producing an abundance of individuals ready to donate their labour to make their communities healthier. Armed with this convenient assumption, the question of why one does not have to pay for labour is easily answered--because locals are simply willing to do it for free. This myth is apparent in discourses of major international nongovernmental organizations: in its 2007 Ethiopia report, Family Health International boasted that it had trained more than 11000 volunteers for home-based care and antiretroviral treatment support, and wrote, "The level of interest and commitment of volunteers to the program has been overwhelming.... The program has shown the untapped spirit of volunteerism that exists within Ethiopian communities despite such pervasive poverty". (2)

How should we interpret this "spirit" that international organizations, public health and donor communities are so keen to tap ? Underlying this question is the issue of whether a loaded term like "volunteer spirit" is a veneer for labour exploitation. Choosing a stance on this issue depends on one's perspective.

On the one hand, lay persons who have been affected by HIV/AIDS are often uniquely capable of providing culturally-congruent and compassionate chronic disease care. (3,4) Further, many volunteers involved in the struggle to roll out antiretroviral therapies say that they derive spiritual satisfaction and meaningful relationships by helping others. (5) Thus from this perspective, community health programmes have the potential to generate psychosocial and health "capital" derived from volunteers' pro-social motivations. This is a far cry from straightforward labour exploitation.

On the other hand, recognizing the production of such psychosocial benefits suggests that the pro-social "spirit" of volunteers--not just their physical labour--is usurped by the programmes that they serve.

From this perspective, the organizers of volunteer workforces attempt to generate and maintain Durkheimian solidarity or "shared emotional energies" (6,7) among volunteers and the communities they serve. The ritual reinforcement of religious and pro-social values among volunteers occurs in training programmes, "appreciation" ceremonies and every-day interactions between supervisors, patients and volunteers. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Examining Health-Care Volunteerism in a Food- and Financially-Insecure World
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.