Volunteering in Africa: Impact, Illusions, and Ethical Questions

Volunteering in Africa offers the profound joy of giving to communities with limited resources, often leaving a lasting impact on both volunteers and those they serve. However, meaningful engagement also requires a thoughtful approach that respects local norms and establishes clear ethical and safety boundaries to ensure that our efforts uphold the integrity and well-being of all involved. How do we speak up when we're only there to help?

During my 4^th year of medical school, I had the opportunity to travel to Arusha, Tanzania, where I volunteered at an under-resourced women’s and children’s hospital and joined outreach trips to surrounding villages. The conditions were unlike anything I had seen before. Buckets lined the halls to catch water leaking from cracks in the ceiling. Gloves, masks and gowns were often absent, even when handling bloody specimens. In the labor and delivery unit, a bucket system was used to sterilize equipment between patients. Each day brought a mix of awe and humility. Patients and families welcomed care with deep gratitude, and clinicians from all over the world worked tirelessly with far fewer resources than I had ever imagined practicing without.

  What struck me most was the duality of medical mission work. On the one hand, our presence meant access—vaccines, prenatal checkups, and acute care for children who otherwise might not have been seen. On the other hand, I became aware of how well-meaning interventions can sometimes disrupt fragile systems. Cultural norms in one context can be a direct threat in another, and in environments where resources are so scarce, depravity and corruption are difficult to avoid. Even the best-intentioned efforts can unintentionally undermine the very systems they aim to support. That tension has stayed with me.

  At times, I caught small glimpses of how scarcity created opportunities for transactions outside of the system. Patients might quietly hand over a few bills to ensure access to medications that were meant to be free. It was never entirely clear where the line lay between survival and necessity. It revealed to me how fragile trust can be in a health care system where resources are stretched to the breaking point.

  The experience challenged me to think more critically about global health. Doing good is not just about showing up, it’s about listening, understanding, and ensuring sustainability after the volunteers have gone home. I wish I was able to make more of an impact during my time there. I still think back to the buckets in the hospital halls. Those images stay with me as reminders that medicine requires not only knowledge but humility, that leadership means partnership rather than paternalism, and that the systems holding up patient care can be as fragile as the patients themselves.