Last year, I spoke with an American woman who brought troupes of foreign volunteers to do a few weeks of “giving back” in Cambodia. The main objectives of her non for profit organisation are to provide tourists with the experience of helping out those who are less fortunate, in international locations, so that an intercultural learning experience occurs. If the people in poor countries benefit, it seems like a fortunate by-product.
I stumbled across this organisation in my work with a small organisation called CABDICO, that works with people with disabilities in poor communities in Cambodia. The American organisation was giving adult-sized wheelchairs to children with disabilities, because despite their suppliers making adult wheelchairs, they preferred their volunteers to interact with children.
The wheelchairs are designed in the USA by a partner organisation. They are made in China, flat packed in containers, and shipped from Shanghai to the destination of need. Once they arrive in the country, such as Cambodia, they are assembled by local workers or volunteers.
These people don’t need any particular skills to assemble them, and in fact the design is intentionally dumbed down so that, for example, unskilled tourists could assemble them together at "wheelchair parties”. On top of this, they are made from parts that can't be found locally. If they break down, the communities can't repair them.
In the process of being given to recipients, the distributor works with local partner organisations to “verify need”. Yet, as this occurs right at the end, this step seems somewhat tokenistic. The need is verified, but there are no other possible solutions because only one type of wheelchair exists.
So even if the product doesn't fit the need (adult wheelchairs for children), there is no alternative available. In the absence of any real alternatives, it’s hard to imagine that any poor family would refuse something if it is given for free.
A representative from another local organisation in Cambodia recently told me that he estimated that 75 per cent of these wheelchairs aren't used as wheelchairs. Instead, they are commonly used as pieces of furniture for other family members. We can probably speculate that this is because they were inappropriately prescribed, or they broke down and were unable to be fixed, or the need changed and there was no follow up or reassessment.
On the website of the manufacturer and distributor, Free Wheelchair Mission, they claim to have delivered 8,250 wheelchairs to Cambodia. The cost of one wheelchair, according to their site, is $71.88: incredibly cheap for a wheelchair, but expensive for a piece of furniture.
This means that they have been responsible for delivering the sum total of $445,000 worth of IKEA-like furniture, direct from factories in China, to Cambodia. There’s your aid money at work right there.
When I raised my concerns about the effectiveness and dangers of this program, the organiser's response was to say that she was inspiring people from developed nations to care. She was “lighting a fire” underneath them, so that they would do more good in their lives in the future. My response to this was "what is the point of this, if you don't make a difference to people's lives in Cambodia?"
As nonsensical as this approach is, this kind of “voluntourism” is rife in places like Cambodia, and not just in the disability sector. “Orphanage tourism”, where rich white tourists are able to visit orphanages, play with children for a while and generally feel good about themselves, is a booming industry in Cambodia. Yet the dangers are well documented. Supporting a system of institutional care for vulnerable children, when there are better alternatives, is only one reason why this is problematic.
Elsewhere, unskilled Western tourists have been transported at great expense to build schools, churches and other buildings in poor places, often supplanting local labour and hence depressing the local economy.
It’s perhaps too easy to sneer at well-intentioned, clueless foreigners who come to poor countries to help. Perhaps they don't know better. However, there are a range of better initiatives that do make a difference in places like Cambodia.
Regarding wheelchair provision, some Cambodian people, aided by foreigners who play a supporting role, are tackling some incredibly difficult problems step by step.
This wheelchair is a good example. It has large bicycle wheels so the person can travel longer distances and a smaller castor that drops down for manoeuvring indoors. The user can travel by road, while also being able to use the wheelchair inside their own house.
I spoke to the Cambodian man who leads the team that makes them. He has worked with foreigners, like myself, previously with some good success. For example, he worked with a British engineer who listened to what the Cambodian people needed, provided his own technical expertise, and then worked with him to come up with the design. Once he left, the work could be continued independently by Cambodians.
The story of this Cambodian man is in itself quite inspiring. He only graduated from high school during the civil war, travelled overseas to educate himself and source ideas, and now works virtually unnoticed making and modifying equipment like this for people with disabilities. He is so humble that he wouldn't even let me take his photo. His team of 18 mechanics trained by him all have disabilities.
Often, the answers to all the problems are often right in front of us. Foreigners should take a supportive role in helping people access resources, be they financial, technical or otherwise — not pretend to help while really putting ourselves in the picture.