Scrutinizing global short-term medical outreach.

A bout five year.> ago, I was among a dozen or so med­ ical and nursing students involved in a. short-term medical outreach trip to Honduras. By "short-term medical outreach trip," I mean those brief trips to developing countries taken by medical professionals and often organized by health professional schools in the United States. The idea behind them is that they expose students and faculty to peo­ ple in developing countries, often for the first time, and bring much-needed care to the countries. The visitors run an acute care clinic or ambulatory surgery center, distribute donated medications, engage in health education, and learn about health care in the developing world. At the time, I assumed that what I was doing was "ethical" and maybe even commendable. I thought it was altruistic. No doubt many with me shared this belief. But as time passes, the value of what the Hondurans gave me, in moral and educa­ tional terms, seems to surpass the value of the acute medical care I helped deliver. I did not intend this; in I thought my participation would help Hondurans much more than it would help me. But if I was wrong, and the benefit went mainly to someone outside the local community, then was the trip fundamentally different from the international AIDS clinical trials that years before received such scrutiny? If so, why did our trip-and others like the ethical scrutiny applied to clinical research in developing countries?