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

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.