Are We Even Making a Difference?: Health Sustainability in Practice

Life saving - drinking waterAfter receiving his undergraduate degree, my brother spent a year helping provide clean water to people living in an underserved village in Rajastan, India. However, setting up water filtration systems in the village was only half the battle. The real trouble was convincing the locals that purchasing clean water was vital for their health, even though it was a more expensive alternative to the readily available fluorine-laden water. Intensive education measures and constant persuasion were necessary to ensure that these resources were not in vain. If an entire year of constant interaction with the villagers was needed to convince them, would the effectiveness of such an endeavor have changed had the project run for just one week, or even three?

The abridged form of international medical activism has become a fad on college campuses. Washington University in St. Louis (WUSTL) hosts a number of medically-oriented trips that attempt such activism through groups such as Global Brigades, Engineers Without Borders, and China Care.

These clubs share a similar component in their missions: providing awareness and potential solutions to issues affecting international communities. Just a few examples include playing with orphans after their surgery, innovating cheap and sustainable technology for use in under-resourced hospitals, and working toward preventing water-related ailments.

How are these initiatives best implemented within communities that find Western healthcare methods foreign? According to Brian Redline, Internal Co-President of GlobeMed at WashU, “local voices and vision must drive community change.” Four GlobeMed interns work with their partner in Uganda for 8-10 weeks each summer, helping their partner implement local solutions to local issues.

The sustainability of the benefits from projects is also dependent on how locals decide to utilize resources and ideas after volunteers leave. Without the consent and input of the community, ventures such as these would not be possible and would not succeed long after the trip ends.

Claire Edelman, president of WUSTL’s chapter of Global Brigades, said that “Global Brigades strategically selects communities in which to begin working and does so upon the consent of that community.” Global Brigade’s national organization also addresses their model for sustainability. According to their website, “the brigades alone aren’t enough. Projects need community members and local technicians to design and perpetuate them outside of brigades” (

Organizations also focus on creating tangible change in the communities where they work. Engineers Without Borders president Charles Wu said he was confident about how the group’s innovations were benefitting the local communities, as the group “goes back each year to check on previous years’ efforts in order to create sustainable projects.”

In contrast, China Care volunteers work with a larger international organization, Half the Sky, which is the WUSTL group’s backbone. According to Delia Shen, co-president of China Care, sending students abroad is “more effective in raising awareness and exposing students to the international/global health problems abroad” than anything else. Students are educated about the issues plaguing the underprivileged in China in order to act as “ambassadors” when returning to St. Louis.

The outcome-based approach and the education-based approach are two distinct methods of tackling change, both positive in their own right. While the outcome-based approach aims to confront international issues through visible change, it must be able to maintain the those changes by promoting community awareness and involvement in tackling the issues, especially after volunteers leave. On the other hand, the education-based approach utilizes the ties international organizations already have with communities. Thus, change is on-going through this approach even if that change is not necessarily brought about by WUSTL volunteers.

The takeaway is this: creating change does not end with a week-long excursion to a foreign country.  Many WUSTL organizations’ missions are not complete until “progress” and “change” can be supported by visibly higher standards of living in their selected communities. Efforts and benefits should not only be visible but also sustainable, and sustainability shows itself in different ways.

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