Global
HealthCare Volunteering Trends – The Discrepancy in Volunteering
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Author 1:
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Neilesh
Patel, BS (DDS Candidate)
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Institutional
Affiliations:
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Email
Address:
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neil.patel@healthcarevolunteer.com
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Author 2:
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Elliot
Steven Mendelsohn, BS (MD Candidate)
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Institutional
Affiliations:
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Email
Address:
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elliot.mendelsohn@healthcarevolunteer.com
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Corresponding
Address:
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HealthCare Volunteer
P.O Box #251444
Los Angeles, CA 90025-1444
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Corresponding
Phone:
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(310)
928 – 3611
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Corresponding
Fax:
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Corresponding
Email:
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neil.patel@healthcarevolunteer.com
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Date:
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January 14, 2007
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For
all authors, no financial or other potential conflicts of interest exist.
Abstract
Background: However, no matter where volunteers decide to serve,
everyone seems to agree that volunteering is instrumental in providing
healthcare, due to the global shortage of up to 2.4 million health workers.[1] As in any industry, supply and demand analysis for
volunteers needs to be correlated with volunteering preferences and aid
organization locations. The analysis would give funding organizations,
government administrators and aid organizations, the ability to prioritize
funding for and development of new volunteering programs in certain areas. Much
emphasis has been put on research of the paid healthcare force around the
world, but no research has been conducted on the global volunteer healthcare
force which is extremely instrumental to the healthcare of the poorest people
in each country.
Methods: From April, 2006 through December,
2006 using the Healthcare Volunteer search engine (www.healthcarevolunteer.com),
19,570 searches were received. From
April, 2006 through December, 2006 using the Dental Volunteer search engine (www.dentalvolunteer.com),
10,461 searches were received. Combined,
the search results page loaded 30,031 times. Only subsets of these total
searches were used for purposes of this research. Data was collected on volunteer
search preferences with regards to location, religion and specialty using the
Healthcare Volunteer and Dental Volunteer search engine. All data was stored using databases driven by
industry standard computer programming languages: PHP for web programming and
MySQL for databases. Statistics on volunteers actual physical location at the
time of searching was tracked by Google Adwords program using IP Address
locations. This information was used only to generalize physical locations of
volunteers at the time of their search requests.
Results: Volunteers searched from over 119 countries with the
greatest number of volunteers being physically located in United States (76%), Canada
(7%), United Kingdom (5%), Australia (1%), Kenya
(1%) and India
(1%). The other 113 countries totaled less than 1% per country. Of the total
number of searches combining data from both dental and healthcare volunteer
search results, 36% of total searches were for states and territories with the United States. This was followed by other parts of North
America (18%), South America (8%), Europe (6%), Asia (15%), Africa (14%) and Oceania (3%). Of the volunteer searching by specialist
(6,277), the most commonly searched entities were trainable volunteers (30%)
and nursing (17%) (Table. 1). Of the
volunteers searching by religion (1,087), the most commonly searched religion
was Christianity (62%) followed by Catholicism (17%) (Table. 2).
Conclusions: Nevertheless, these volunteering trends show that certain countries
have historically been targeted by healthcare aid organizations, and these
countries attract a proportionately higher amount of volunteer interest. In
order to foster new aid organizations to areas that have been neglected or
perhaps forgotten by healthcare volunteers, we must educate volunteers about
the overwhelming need in new areas, and subsequently work with local NGO and
government organizations in these countries to foster a wider spread of aid
instead of a mere concentration of aid. If one of the goals of healthcare
volunteering is to create a bit of equality in healthcare among needy people,
then we must ensure that our altruistic efforts are not actually enhancing
inequality.
Key words
healthcare volunteering
trends, dental volunteering trends
Abbreviation
List
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PR
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Puerto
Rico
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AQ
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American Samoa
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YT
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Yukon Territory
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CQ
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Northern Mariana Islands
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GQ
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Guam
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VI
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US Virgin
Islands
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AB
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Alberta
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BC
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British Columbia
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MB
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Manitoba
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NN
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New Brunswick
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NW
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Newfoundland
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NT
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Northwest
Territory
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NS
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Nova Scotia
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ON
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Ontario
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PZ
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Prince Edward Island
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QB
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Quebec
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SS
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Saskatchewan
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DC
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District of Columbia
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All other 2 letter abbreviations
use standard U.S.
state abbreviations
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Unsolicited manuscripts
Research, Policy and practice, and Lessons from the field papers must
be accompannied
by two paragraphs indicating what they add to the literature: a brief
explanation of what was already known about the topic conccerned; a brief
outline of what we know as a result of your paper.
At
least 1.3 billion people worldwide lack access to the most basic healthcare,
often because there is no health worker. "The global population is
growing, but the number of health workers is stagnating or even falling in many
of the places where they are needed most," said Lee Jong-wook, director-general
of the World Health Organization in April, 2006. HealthCare volunteering has
become a blooming field as globalization has fostered a new period of
multi-national and borderless healthcare treatment programs.
A
PubMed search for search terms: “volunteering trends” (11 results), “volunteer
+ international” (586 results) and “international volunteering” (23 results)
yielded 0 articles in published literature that provide critical data on
international healthcare volunteering trends. Previous research on international
volunteering in healthcare has focused on single country-specific trends,
disease-specific trends, anecdotal accounts, or paradigm shifts for
volunteering.
This
research paper has provided potential aid organizations, volunteers, government
departments and relief groups with invaluable data on volunteering location
trends. In the future, these trends can easily be correlated with the number
and locations of healthcare volunteer work in order to establish supply and
demand data on volunteering opportunities.
Introduction
Every day thousands of health
care workers scour the various sources
looking for a way to use their health care training in an altruistic manner.
For years healthcare workers such as doctors have complained about the
difficulty for willing, qualified and much-needed volunteers to go overseas for
volunteering.[2] Many
healthcare workers have to use their vacation time in order to volunteer and
this has become another nuisance as obtaining vacation time for charity work
has become difficult. Many volunteers
want to volunteer in a different location from where they work due to their
desires for idealism, opportunities for adventure and chances for learning
about a new culture.[3] Less than 1% of U.S. healthcare professionals work
abroad while up to 13% of Cuban healthcare professionals are working abroad.
This statistic may explain the discrepancy in the desire for volunteers from
certain countries having a greater desire to volunteer in foreign countries.
2 For example, a volunteer from the United States
may have a larger interest in volunteering abroad than a Cuban volunteer, since
the United States-based volunteer has not had as much opportunity to work
abroad already. On the other hand, some people also argue that a United
States-based volunteer may not have as much familiarity, conviction or desire
to venture out of his or her community to volunteer, and thus make them more
likely to volunteer locally. Previous
studies have shown that physicians, dentists and nurses are the most likely
U.S.-based professionals to volunteer in health care.2
Volunteering
has become a globalized movement with the boom of the Internet in the 1990’s.
People travel more and are connected easier to volunteering opportunities. For
decades, national volunteer organizations of developing countries have
contended that programs run by limited groups of health workers are less
effective than programs run by large groups of community lay volunteers who
work directly with the villagers.[4] However,
no matter where volunteers decide to serve, everyone seems to agree that
volunteering is instrumental in providing healthcare, due to the global
shortage of up to 2.4 million health workers.[5] As
in any industry, supply and demand analysis for volunteers needs to be
correlated with volunteering preferences and aid organization locations. The
analysis would give funding organizations, government administrators and aid
organizations, the ability to prioritize funding for and development of new volunteering
programs in certain areas. Much emphasis has been put on research of the paid
healthcare force around the world, but no research has been conducted on the global
volunteer healthcare force which is extremely instrumental to the healthcare of
the poorest people in each country.
Methods
Data Collection
A “search” was not defined as a unique search but instead the number of
times that the search results page loaded.
From April, 2006 through December, 2006 using the Healthcare Volunteer
search engine (www.healthcarevolunteer.com), 19,570 searches were
received. From April, 2006 through
December, 2006 using the Dental Volunteer search engine (www.dentalvolunteer.com),
10,461 searches were received. Combined,
the search results page loaded 30,031 times. Only subsets of these total
searches were used for purposes of this research. Volunteers could search by
location, specialty/function, religion, organization name, organization
description, school affiliation and types of students allowed to participate
using the Healthcare Volunteer search engine. Volunteers could search by
organization name, organization description, location, school affiliation,
dental procedure and religion using the Dental Volunteer search engine. Complex
searches (a search by using more than one search criteria) were disregarded,
but individual data such as location or specialty was recorded from complex
searches. Data was collected on
volunteer search preferences with regards to location, religion and specialty
using the Healthcare Volunteer and Dental Volunteer search engine. All data was stored using databases driven by
industry standard computer programming languages: PHP for web programming and
MySQL for databases. The majority of volunteers were attracted to our site
through press releases, web-based search engines, word-of-mouth and website
links. Statistics on volunteers actual
physical location at the time of searching was tracked by Google Adwords
program using IP Address locations. This information was used only to
generalize physical locations of volunteers at the time of their search requests.
Results
Overall,
states and territories within the United States were the most
commonly search location for volunteering (Tables 1, 2, 3). Of the total number of searches combining
data from both dental and healthcare volunteer search results, 36% of total
searches were for states and territories with the United States. This was followed by other parts of North
America (18%), South America (8%), Europe (6%), Asia (15%), Africa (14%) and Oceania (3%).
Within the United States,
California
was the most commonly searched state with 9% of total searches. In North America, Mexico was the most commonly
searched country (3%). In Africa, Kenya
was the most commonly searched county (2%).
In Europe, the United
Kingdom was the most commonly searched
country (1%). In South America, Peru
was the most commonly searched country (2%).
In Asia, India
was the most commonly searched country (3%).
And in Oceania, Australia
was the most commonly searched country (1%).
The
volunteering trends were similar between dental and healthcare volunteers with
the majority desiring to volunteer in the United
States (with California
being the most desirable state. Based off of continent, North America (22%) was
the most popular place for dental volunteers followed by Africa (12%), Asia
(19%), South America (9%), Europe (9%).
Of
the volunteer searching by specialist (6,277), the most commonly searched
entities were trainable volunteers (30%) and nursing (17%) (Table. 1). Of those volunteers with the opportunity to
search by specialty, 32% did. The
remainder of the volunteers searched for a variety of specialties among the
healthcare and dental profession.
Of
the volunteers searching by religion (1,087), the most commonly searched
religion was Christianity (62%) followed by Catholicism (17%) (Table. 2). Of those volunteers with the opportunity to
search by religion, 6% did. The
remainder of the volunteer searches were split between Jewish, Muslim, Mormon,
Buddhist, Hindu, and Other.
Volunteers searched from over 119 countries with the
greatest number of volunteers being physically located in United States (76%), Canada
(7%), United Kingdom (5%), Australia (1%), Kenya
(1%) and India
(1%). The other 113 countries totaled less than 1% per country.
Discussion / Conclusion
States and territories within the United States were the most
commonly searched locations by dental and healthcare volunteers. The majority of HealthCare Volunteer press
releases regarding the search engine for volunteering opportunities were
published by US publishing organizations.
The majority of US searches were for “California”.
We are based in Los Angeles
and this fact may explain how immediate, local attention could have driven
this. Another reason for this statistic could have been that California
is the most populous country in the United States
and this could have skewed the amount of volunteers searching for California.
The impact of religion on volunteering preferences
seemed to play an important role for some volunteers with the majority of users
interested in religious volunteer opportunities searching for
Christianity. Missions and religiously
motivated volunteers are an important group of the volunteer force.
Nearly half of total volunteers searching by a
particular specialty represented trainable volunteers or nurses. Specialists and medically licensed volunteers
represented the remainder of those searching by specialty. The availability of time and flexibility in
work schedule are important factors in determining volunteering interests.
Moreover, there was a very general inverse correlation between the number of
years of training for a certain specialty and the number of people searching
for a specific healthcare specialties. Some of the outliers included OB/GYN,
Family Medicine, Emergency Medicine, Dentistry and Internal Medicine as these
specialties were more searched than other healthcare training programs that
take less time to complete. A relatively
small percentage of those volunteers with the opportunity to search by religion
or specialty chose to do so.
Our search results serve as an overestimate of the
actual number of unique searches because of the way that a search was
defined. Although the absolute number of
searches may be an overestimate of actual searches, the relative number of
search results should not be affected as this phenomenon should equally affect
all data.
The fewest number of users searched for volunteering
opportunities in the Oceania region, which includes Australia,
New Zealand
and the Pacific islands. Overall, Africa had more searches than either South
America or Europe. One reason may have been
because of a heightened awareness of an urgent need in public health epidemics
such as HIV/AIDS in Africa. Within Africa, Ghana was the most popular destination in
Western Africa, while Kenya
and Tanzania were the most
popular in Eastern Africa. Overall, Asia’s two
most populous countries, India
and China, were the two most
popular locations for volunteers interested in Asia.
One reason for the popularity of India
and China
could be due to the larger number of aid organizations currently operating in
these countries compared to other Asian nations. In North America, Mexico was the most popular destination out side
of the United States.
An explanation for this trend could be that since the majority of searches were
performed from the United States, people who wanted to travel abroad to
volunteer may have chosen to volunteer as close as possible to their home
country. To support this idea, the U.S.-border countries of Mexico and Canada
were the two most popular North American countries besides the United States
itself.
The
discrepancy between the demand for certain volunteer locations and the actual
healthcare worker shortage in that country was severely mismatched. For
instance, when comparing the density / 1000 people of physicians in the most
popular country and least popular country, it was ironic to find that countries
with greater healthcare access limitations had less volunteers searching to go
there. For instance, in South America, the most popular country, Brazil, has a
1.15:1000 physician to population ratio while the least popular country
Suriname had a 0.45:1000 ratio.4 However, in Africa, the most
popular country, Kenya has a 0.17:1000 ratio, while the least popular country Sao
Tome and Principe had a 0.49:1000 ratio.4 Countries such as Burundi
with a 0.03:1000 ratio received only 0.06% of global searches, while countries
such as South Africa with a 0.77:1000 ratio received over 1% of total searches.
These discrepancies show that volunteers need to be educated about new areas
that have not traditionally been the focus of health aid organizations. Another
interesting conjecture is that the majority of volunteers are attracted to
English-speaking countries, which may explain why countries such as Benin and Burundi (French-speaking), may have
had a proportionately lower amount of interest when correlated to their
physician per capita ratio. This would be further warranted as the vast
majority of volunteers tracked in this research were from English-speaking
countries.
Nevertheless, these volunteering trends show that
certain countries have historically been targeted by healthcare aid organizations,
and these countries attract a proportionately higher amount of volunteer
interest. In order to foster new aid organizations to areas that have been
neglected or perhaps forgotten by healthcare volunteers, we must educate
volunteers about the overwhelming need in new areas, and subsequently work with
local NGO and government organizations in these countries to foster a wider
spread of aid instead of a mere concentration of aid. If one of the goals of
healthcare volunteering is to create a bit of equality in healthcare among
needy people, then we must ensure that our altruistic efforts are not actually
enhancing inequality.
References