Best intentions do not equal best practices

Something is not always better than nothing. Low-resource settings do not permit lower standards. the high standards we follow in the u.s. — in delivering health care and developing partnerships — should not be set aside when working abroad. the laws of the country must be followed, the men and women providing services must be competent in their roles, and outcomes must be measured by quality, not simply quantity.

Is appropriate orientation being done for those involved in international projects?

• Orientation should be designed and facilitated in a manner that provides participants time for personal discernment and knowledge that leads to cultural competency appropriate for the tasks assigned.
  
  

Is safety as seriously attended to abroad as in U.S.-based facilities?

• Dispensing of expired medications or the dispensing of medications without child-proof containers to homes with children would not happen in the U.S. and should not happen in international projects.
  
  

Are the same professional standards being used in international projects?

• A volunteer should not be fit into any given slot. For example, an untrained relative should not be assisting with a surgery or an accountant should not serve as the pharmacist if they would not be allowed to do so in the U.S.
  
  

Are the global standards associated with health systems strengthening incorporated into international project metrics?

• Impact on the local health workforce and local health system finances can often go overlooked even though short-term interventions can impact them greatly.
  
  

Are any of the skills of the U.S. partner volunteers, leadership or administration transferable?

• Providing education around administrative policies to the leadership and governance of your local community partner, or continuing medical education to the clinical staff can promote long-term capacity building.
  
  

What kind of infrastructure can be built to address root causes?

• Water-borne illness may be treated effectively with medications in the short-term, but a long-term infrastructure plan can be incorporated into a group's use of resources.
  
  

How many people in the organization know the local language?

• Trusting relationships with the local community partner are more likely to be built if some of the U.S. personnel can speak the local language.