Trip review: VIDA pre-vet volunteering program in Guatemala

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A patient recovers from surgery anesthesia on a heating pad in a school room in Guatemala

 

This is a long post. To give you a “too long; didn’t read” summary: VIDA was my most frustrating, most ethically problematic, and most expensive international volunteer experience. I do not recommend the program.

VIDA is, first and foremost, a tourism company that sells an emotionally fulfilling experience by painting Central America people as helpless, creating the need for a hero role that customers can play during their one or two weeks as a volunteer. VIDA is fantasy fulfillment for students like me who want to feel like we’re helping more than it is a effective charity for the communities in which it visits. VIDA was the trip where I had the highest expectations going in, since it’s hyped as the ultimate boot camp for pre-vet and vet students. (VIDA is so good at marketing, in fact, that several times a fellow student expressed surprise that there are organizations besides VIDA that do any sort of international spay/neuter work.) Because of their popularity among pre-vet and vet students, combined with my bad experience, my review of VIDA is in greater depth than other trip reviews. I recommend against spending your money on a VIDA trip for a number of reasons. It’s become my personal example about the perils of the voluntourism industry and how some companies care more about selling feel-good resume items to privileged college students than they do about providing quality patient care or fostering sustainable development.

It’s also important to note that my review of the VIDA program is shaped by my being very different from their target market: I was 29 when I did my trip, I was an experienced solo traveler, I had volunteered internationally before, I want to work in global veterinary medicine as a long-term career goal, and I view development in a nuanced way. For a student who is in their teens or early twenties, has never been outside America, and has never been exposed to postcolonial theory or debates around ethics in development, VIDA is definitely going to be an exciting and life-changing experience simply because it brings students into some contact with people who are different from them. But that is not a function of VIDA, it’s a function of travel. I don’t think the job of an international vet clinic should be “opening the eyes” of Western college students to the fact that poverty exists — I think participants should come to those nonprofits with their eyes at least partially open. After all, how are you supposed to “make a difference” if you don’t understand the context in which you’re working? VIDA keeps it simple for participants by avoiding all those sticky issues. You’re a hero! You’re changing the world. Now, get back on tour bus and let’s go get pizza!

Official pitch

“Vida stresses cultural integration and opening of the mind and heart to global healthcare and human issues. One of our long term goals is to have an impact on the future health professionals of the world while providing basic medical services to Central Americans… Many of our volunteers are pre-health professionals, though we do welcome advanced students, as well as professionals to join us in our adventures.”

More: vidavolunteertravel.org

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Maximiliana, an incredibly friendly cat who purred and kneaded throughout her exam

 

Costs

VIDA’s program fee for my two week trip was about $1600, but the whole thing costs more than that, since you have to pay for your own flights and some meals and supplies.  (Something that one participant didn’t realize when she signed up.)  I spent just over $3000 on my entire trip. Another student spent around $4000, because she had a more expensive flight and needed to buy supplies I already owned, like several sets of scrubs, a head lamp, and stethoscope. For that price tag, I logged 51 hours of veterinary experience with VIDA.  The four of us on my pre-vet trip collectively spent around $15,000 to participate in clinics that provided only 18 spay/neuter surgeries (and many more vaccinations) over the course of our 6 clinics days.  (That’s a ton of money for those tiny results.)

Basic information

VIDA’s two week trips spend 6 days volunteering, 1 day on orientation, and the other 7 days on sightseeing and having fun. VIDA operates in Central America, running pre-vet, vet student, pre-med, and pre-dental trips. They advertise heavily on college campuses, and student organizers get the reward of a free trip if they enroll enough paying participants. VIDA is most famous for its controversial position of (sometimes? usually?) letting pre-vet students as young as high school age perform surgery after only a brief training session. While VIDA doesn’t advertise this on their web site, if you attend a sales presentation by a recruiter, you’re likely to be told that the reason to “do VIDA” is to be able to perform surgery yourself. Even though I didn’t go in thinking I could safely perform a spay as an undergrad, I was thinking I would probably feel comfortable doing cat neuters under supervision of a vet.  (I was actually assuming they’d start us all on cat neuters, the simplest and least invasive of the sterilization procedures, and then move someone up to spays if they were doing well with cat neuters.)

My trip was in Guatemala, although VIDA also runs trips in Nicaragua and Costa Rica. My trip had both pre-vet ad pre-med students. We worked in three rural towns, operating free clinics that focused on sterilizations. Here’s the schedule from my trip to give you an idea of how the trip is structured, but keep in mind that each trip is going to be different. The clinics all took place in school rooms that we’d converted into DIY operating rooms, and the lighting was generally poor.

I signed out of my VIDA trip early because I was so unhappy with the balance of how little good work we were doing compared to the large amount of time we were spending on recreation. Despite my experience with VIDA, I do want to say that my trip leader went out of his way to make it less stressful for me, and I appreciate that greatly. When I wasn’t keen on dining in an American-style sports bar with high-definition TVs with the rest of the group, he took me to a great little local restaurant, and overall did a good job of helping make VIDA a tolerable experience for me.

Housing

I thought I was signing up for home stays in rural communities in Guatemala, but what I got was Western-class hotels in tourist districts in Guatemala City, Antigua, and Panajachel. Room shares had 3-5 people per room, depending on where we were staying. After several nights of trying to sleep through the loud slumber party atmosphere of my room share, I had reached my sleep deprivation breaking point and my trip leader negotiated with the hotels to give me a free small single room to myself. I would have gladly paid for my own single room to get some sleep.

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Part of our medicine collection, labeled and organized on a table near surgery

 

Other volunteers

The students on the pre-vet team with me were all mature and responsible, but I found many girls on the pre-med team to be obnoxious and flat-out offensive. They’d stay up late gossiping about how disgusting their patients’ hygiene was, or whining about how upsetting it was that they didn’t have hair dryers and that their makeup/hair didn’t look right. I couldn’t handle listening to chatter about how gross poor people are, spoken by college girls oblivious to their status as highly privileged people.

I was incredibly thankful that the pre-med team wasn’t doing pap smears on the women at their clinics, because the girls laughed hysterically at the idea of seeing a vagina while reading about pap smears in their program manuals. None of them really knew what a pap smear involved when I asked. The social leader of the pre-med girls confidently told the others, “It means having a giant dildo shoved up in you!” (I’m assuming she thought that a vaginal speculum is the same thing as a dildo?) These girls were the worst people on earth to try and introduce a life-saving screening test to an indigenous population not accustomed to having strangers see them naked, let alone having strange white kids giggle at their reproductive organs while jabbing them randomly with cervical swabs. The idea that girls like that can do pap smears on other VIDA trips absolutely horrifies me.

Cultural immersion and vacation factors

I don’t like how VIDA markets itself as such a cultural experience, when in reality, they insulate you from the local culture as much as possible. VIDA plays up its homestays, but in Guatemala, they don’t do homestays at all. I was disappointed that we stayed in touristy hotels, and our first stop in the country was a luxury mall so we could exchange money, eat lunch, and have free time. After days of being annoyed about being taken to American-style eateries, I was told by our VIDA vet that I’d really get a chance to see more of the great local culture on our Sunday off when we toured around Lake Panajachel. When that day came, we took a boat across the lake to another very touristy town and hung out at an Israeli hotel’s pool. We learned so much about the indigenous Mayan cultural traditions of… Rosh Hashana and cocktails and American pop music.

Maybe a limited drink menu and slow wifi counted as “roughing it in the third world” to some VIDA participants, but I was disappointed in how there wasn’t any information on understanding the needs and histories of our client communities. We showed up, worked a bit, and then left to go back to our hotels to post photos of each other hugging brown children on Facebook. It was like a parody of self-indulgent volunteering. There was zero context provided whatsoever, other than a few passing mentions of how people in “this part of the world” were “poor.” Devoid of context, or really even acknowledging clients as people with complex lives guided by complex political and economic realities, the focus was on us, the VIDA participants, the world-changers.

To me, there was this huge dangling question, “What happens here when there isn’t a group of American college students with a lot of money? How do these communities address their medical needs during the majority of the year?” The VIDA program is not about learning how healthcare works in different countries, it’s learning how one well-funded NGO operates when they show up as outsiders and host sporadic clinics. I think we did some good things in our communities, but we may have also done harm.

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Our daily routine: instructions for surgery intake and consult appointments.

 

Training provided by VIDA

We had a one-day training in our first hotel in Guatemala City. We were told up front that we would all be provided with excellent letters of recommendation for VMCAS, and I wonder if vet school admission committees know that VIDA letters of recommendation are purchased. We went over clinic setup, protocols, and suturing techniques, and spent an hour practicing suturing on foam boards. We watched videos of spay and neuter surgeries, and went through our program manuals outlining how VIDA’s veterinary program works.

We had one young Guatemala City-based veterinarian who was with us the whole trip. For the first half, we had a Guatemalan vet student helping as well, and then a Guatemalan vet tech. I have mixed feelings about our trip’s vet, and we didn’t particularly get along. On the one hand, I believe she had the best of intentions and a true love of animals, but she had only been a vet for 2 years, made some risky language/translation mistakes, took one to two hours to perform a surgery that an American spay/neuter vet could do in 10-15 minutes, and overall didn’t seem terribly competent. Having volunteered in a shelter in the states that usually had 4th year DVM students rotating through, I would say our VIDA vet’s surgical skills were little better than the average clinical year vet student’s, so it felt a bit like the blind leading the blind. (VIDA hires different vets for different trips, so your milage will vary.)

There were some occasional translation issues that got frustrating, such as when the vet asked for “zero point five CCs” when she meant “five point zero CCs,” and then got cranky if you brought her that dosage. Good thing volunteers were all on top of checking and re-checking dosages, but I see this as a big potential danger area when you’re using IV anesthesia. Language barriers are unavoidable, but what grated on me was that the vet would never accept the blame when she had misspoken to us, and instead assumed that we had done the task wrong and seemed disappointed. This only happened about a dozen times, but any one of those times could have been a deadly mistake, so it’s a problem worth mentioning. Pre-vet students like us didn’t yet know how to roughly “eyeball” a dose of a certain medication and know if it looked about right for the size of the patient.

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Gloves, a sharps container, disinfectants, and intubation tubes 

 

Typical work day

I imagine each trip is different depending on the vet they’ve hired and the level of experience of participants, but on my trip, our program fee upgraded us to vet techs, not surgeons. No volunteer performed any solo surgeries, only some assisting.

We had an intake area where animals were given exams and prepped for surgery, a surgery area nearest the best light, and a recovery area with blankets and heating pads where we’d monitor as animals woke up and prepared take-home medications with Spanish instructions. When an animal arrived at the clinic site, we’d give it an exam, dewormer, flea treatment, and vaccines. If it was there for a sterilization, we as pre-vet students would place a catheter (you were allowed only one chance on a cat, but multiple tries on a dog), administer pre-anesthesia, intubate using a lighted laryngeal scope, induce anesthesia using an IV cocktail, and then work in pairs so one person would monitor the patient’s vitals and inject more anesthesia while the other was assisting in surgery. VIDA vet clinics were cleaner than the two clinics I’ve seen in Africa and the Middle East. Not how we’d normally practice in the US, because of the lack of an autoclav and gas anesthesia, but I think they did a decent job given the circumstances and being prepared to work without electricity. (Still not the best learning environment, though.) The animals were under IV anesthesia for a very long time: at least 60-90 minutes for an uncomplicated spay, almost as long for a dog neuter. One dog with pyometra was on the table for several hours.

What did “assisting” mean on my trip? Mostly it meant handing the vet instruments or gauze, or holding a clamp for her (which was just to give us something to do — vets don’t need anyone holding hemostats after they’ve been applied and clicked into place). After the first day, we would also be involved in tattooing animals to mark them as sterilized, and placing the occasional sutures or ligations. For example, the vet might do one ligation, then you might get to do the second ligation in the same fashion as the vet carefully walked you through it. We were allowed to sometimes place a closing suture or two, or try a few bites of intradermal suturing on the skin layer closure. We were also allowed near the end of the trip a few tries with a spay hook at retrieving the uterus. (I tried three times with a spay hook to find one kitty’s uterine horn, but I kept pulling omentum. Then the vet took over. This was the most invasive thing I did on my trip.) We didn’t do more than 2-3 little things like this during any one surgery, and the vet definitely took her time very slowly doing the rest. I couldn’t tell if she was working at a snail’s pace and keeping the animal under IV anesthesia for extended periods to give us a chance to see everything (not good), or if she just wasn’t very good at surgery (also not good). Aside from the amount of time taken by the vet, VIDA did surgery pretty much like you’d do in a clinic at home, except the animal is under IV anesthesia. The surgery part of VIDA like shadowing with the occasional “suturing bonus.” It was interesting, but more than the surgeries themselves, I liked learning how to place IV catheters. I assisted with 3 dog neuters and 1 cat spay. We all got to assist with 4-5 animals.

Something that still makes me quite sad in retrospect was how our VIDA vet treated curious local children — the very people we should have been there, in part, to engage with about veterinary medicine and animals. When the village kids would come to the windows of our school room clinics, eager to see what was going on, the vet would yell at them and demand that they leave. I recently heard a heartwarming tale from a long-term international volunteer about a local boy who had gone from a gawker to a dedicated clinic volunteer as he grew up. This contrast underscored how VIDA exists for their paying participants, and will chase away potential future doctors among the local children. A kid might not be able to monitor anesthesia yet, but he could help with cleaning. And then, in a few years, he can be helping with recovery, giving vaccinations, and maybe thinking of applying to vet school. Why yell at him to go away?

I want to be a part of international vet groups that seek to work alongside the community, rather than intimidate them into leaving us alone so we can work “in peace.” Much like how we were insulated from Guatemalans in other ways, the VIDA attitude was, local people are a hassle you don’t want to deal with. It was like they were just props, there to “look poor” and make us feel good about ourselves as we volunteered. It was an uncomfortable power dynamic that still doesn’t sit well with me.

Types of animals

During our standard clinic days, I’d guess that we saw about 80% dogs and 20% cats. When we did our farm animal day, we vaccinated hundreds of chickens and other poultry, and maybe a dozen cows/steers and pigs.

Most memorable case

I enjoyed our farm animal day the most. Being a city person, I have very little experience with cows, pigs, and poultry. I liked that we were roaming around in the rural town, offering our free vaccine services, rather than waiting for people to come to us. If you have kids, housework, food preparation, laundry, and crops to tend to, you’re not likely to drag your 30 chickens to even a free vet clinic for vaccines. This was the only example of VIDA putting our client community’s needs above the comfort of participants.  (We normally stayed in the shade in our makeshift clinic, not wandering in the rain, sun, and mud.)

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One of the pigs we vaccinated during our door-to-door farm animal vaccination day

 

Why I left my VIDA trip early

If you want to see what normal Central American veterinary care and animal welfare is like, you’re going to have to be assertive and supplement your VIDA trip. I was initially told that I was not allowed abstain from any group activity for any reason, but after pushing, I was given a discharge/liability waiver and allowed to go do my own thing. If you’re not getting what you want out of VIDA, or any other expensive pay-to-volunteer program, speak up. If you’re in Guatemala, I highly suggest contrasting your VIDA trip with helping out in recovery during one of Ayuda‘s weekly spay/neuter clinic days. I’m so glad I found this locally-run nonprofit to volunteer with for two days, it was like finally being allowed to sit at the adult’s table again. (Here’s my post with more details about volunteering with Ayuda.) Rather than spending two days on zip lining and a farewell party, I am glad I met the people behind Ayuda and learned about their awesome work. Ayuda was the highlight of my trip to Guatemala, and I hope to go back some day.

What I’d do differently if I went again

I would have done a paid voluntourism trip with World Vets’ IVM program. Right after getting home, I figured that at least I did get some decent training out of VIDA, but I have since decided that I regret spending my money on a group with so many ethical problems and such a blundering approach to development and animal health. Since doing a VIDA trip and learning more about World Vets’ options, I think that the latter offers a better experience for students who want to develop more hands-on veterinary skills, and has higher standards of care for their patients. World Vets’ IVM trips are similar to VIDA trips in that the focus is on teaching you new skills, but those sessions are in a modern style clinic setting (in Nicaragua) with gas anesthesia, sterilization, proper lighting, and more “normal” conditions under which participants learn the same skills. (And no, World Vets doesn’t let you try your hand at surgery if you’re a pre-vet student.) As I’ve written about before, I don’t think voluntourism is always a bad thing for students, and World Vets overall sounds like they offer a better learning environment for students, a cleaner and safer clinic for patients, while focusing less of your program fee on recreation. Win-win!

If you insist on doing a VIDA trip (or any voluntourism trip for that matter), I strongly recommend that you augment the official program by visiting a small, locally-run nonprofit afterwards in order to learn about the day-to-day work of animal aid organizations that don’t have lots of money and a big marketing department. How do you find such a group? Read this post for advice on finding free and independent international volunteering with animals.

I wish VIDA helped people to prepare before leaving home. I took the initiative to learn suturing skills on my own. VIDA didn’t even suggest that maybe we could practice suturing at home first, but since suturing is the “big thing” you get to do, I think it would really benefit participants. You should be familiar with basic dog and cat anatomy, names of surgical instruments, surgical knots, and lymph node locations for physical exams.

If you can, practice restraining terrified/panicked dogs, because plenty of your patients will be strong and unhappy. (I got a mild bloody nose when one poor dog was thrashing wildly and his skull smashed into my face.) Animals at VIDA clinics have never been seen by a vet, aren’t used to be handled or restrained, and are much more freaked out than most American animals. Do bring extra scrubs to each clinic, because you are going to get pooped on and have anal glands expressed on you. (Much, much more than you’d deal with at home.) The dogs we saw were the most “wild” of any of my volunteering experiences, but the cats were average with sociability.

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A cat recovering from a sterilization, with a 1mL syringe to cap his IV catheter.

 

The bottom line?

For all my criticisms, I think that the animals of Central America are probably slightly better off in a world with VIDA than without — but I say that cautiously. Without students willing to pay thousands of dollars to do some suturing (or surgery) on a VIDA trip, there would be fewer free clinics in these rural towns, end of story. Your money funds services that would otherwise not be offered, even though those services are inefficient and sloppy. The entrepreneur in me thinks that it’s good that VIDA has found a way to tap into the market demand for “hands on experiences” and channel that to providing useful services. However, other international veterinary groups have been working longer and harder at providing better quality vet care at a fraction of the price.

On yet another flipside, there’s also the question of whether the complication and infection rates produced by voluntourism clinics run by inexperienced short-term volunteers negate the small benefits that these clinics provide. Did we do more harm than good? I’ll never know.

All in all, though, there is no compelling reason to give VIDA your money or participate in a VIDA trip. Don’t just settle for “we hopefully didn’t kill any of our patients and maybe did a tiny bit of good” when selecting an international volunteering experience. There are many other organizations doing really amazing work, and they would love a conscientious volunteer.

Overall, the trip was a good fit for you if…

* Your only aim for the trip is learning hands-on skills
* You want plenty of vacation time included in your program
* You want to stay in tourist-class hotels with Western amenities and to eat in American-style restaurants (VIDA doesn’t do homestays in Guatemala)
* You want to volunteer with a big group of students
* You have not been outside the country before and don’t want to go off the beaten track
* You want an itinerary that you don’t have to plan yourself
* You need a letter of recommendation for your vet school applications, and are happy to purchase one

And the trip was not best fit if…

* You want to learn about how veterinary care works in another country
* You want to interact with the day-to-day culture of another country
* You want to help a locally-driven nonprofit with a focus on long-term sustainable care
* You are an older student or don’t want a slumber party experience at night
* You want to have a say in how you spend your time
* You want to support an organization that puts patient care first and efficiently uses your program fee/donation to provide care for the greatest number of animals possible

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