Moral Dilemma 2: Do volunteers do any good?

"Sharing Skills, Changing Lives” – that’s what I’m here for, and VSO’s strapline certainly had me hooked. For a liberal do-gooder like me, it’s an attractive prospect: I get to go to a poor country and do something useful for once.

This opportunity came at just the right time for me, when I was looking for meaning and adventure – a mid-life crisis if you must (I quibble more with the ‘mid-life’ than the ‘crisis’!).

It also suited me professionally, as I’d been planning for a while to move on from my rich, popular and stress-free career as a hospital manager in pursuit of, well, something else. Voluntary sector promised similarly passionate colleagues working for a shared cause, hopefully somewhere where our efforts show quick and visible results.

So all looked great. And it got better - VSO had already set up a work placement, the host having specifically requested someone with my particular skills and experience. What’s more I get all sorts of generous support from VSO - development and cultural awareness training, payment of flights and accommodation, language training, health insurance, you name it – plus a great bunch of other volunteers for peer support.

But after nearly 6 months in Cambodia, I still have a nagging, undramatic but rather fundamental doubt – I can’t help asking myself: am I actually doing any good here?

It’s a real dilemma. I’ve worked in the NHS long enough that I reckon I can wander into a hospital and pretty quickly know how well it’s working and what needs to improve. I’m also confident that I can build good relationships with staff and work with them to make real improvements. So I just need to get working, yes?

Asking around volunteers here in Cambodia, some certainly have got stuck into their posts with gusto, busying themselves with training staff, writing plans, raising funds – doing stuff.
And on the face of it many are getting good results – their hosts seem happy that their volunteer has produced something tangible so soon, possibly filling gaping holes in their organisation. And it’s great for the volunteer, as they can quickly feel they are useful, that they are making a contribution.

But is this actually the point? It might feel good in the short term, but isn’t there is a real risk that if we get stuck in early like this we may get some short-term kicks at the expense of creating a longer-term dependency culture? Could this approach even be seen as selfish, giving the volunteers some early satisfaction but not actually contributing anything sustainable to the county? Kind of like getting our quick white rice sugar-rush without the longer-term slow-release energy of the less glamorous husk.

The alternative, paradoxically, may be to hold back, observe, assess, build relationships, learn – but not do.

There is logic here – the whole idea is that the contribution of volunteers is sustainable – once we leave, local people will be able to manage without us, benefitting from the skills we shared and able to improve people’s lives without western do-gooders like me.

But you know, sitting back and doing nothing is really hard! As I talk with the hospital director I’m dying to investigate why, if we referred 20 patients to the bigger hospital down the road last month, their records show only 16 arrived? I’d love to know why staff don’t appear for work in the afternoons. And I’m incensed that some apparently ask for bribes or steal drugs and equipment to sell outside (though maybe they wouldn’t be like this if we could find a way to pay them more than the present $1 a day).

More immediately, as we walk through the slightly shabby buildings at Thmar Pouk I’m positively itching to harangue the ward staff to improve the care and facilities to patients. Why are hands and floors unwashed? Should the fans be turned off whilst patients sweat profusely? Is it appropriate to use drip stands to dry fish?

But much as I’d love to throw what's left of my weight about a bit, my job here isn’t so much to fix these things short term, as much as to help staff here have the knowledge and confidence (call it ‘building management capacity’ if you must) so that they ask the questions and notice the problems, and they initiate solutions. This will then continue long after I’ve left for my lucrative new career running a donkey sanctuary in Darfur or an eco lodge in Equador.

So after 5 and a bit months I’m not sure I’ve done much sharing of skills or changing of lives – yet. However, despite my frustration, I’m going to continue following the advice of the incomparable Rob, a nursing colleague from my management training days, who even at that stage had clearly already seen one too many half-baked NHS-restructurings:

Oly, to begin with it’s best to do the really hard thing: ‘don’t just do something, sit there’.