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In Reply: In "Duffle Bag Medicine," I presented one particular concern: people, even physicians, genuinely hoping to do good may still harm international communities. I described how even donated vitamins can have negative consequences; net good is not accomplished merely through international presence. I did not conclude that a particular type of irresponsible care represents standard behavior. Instead, I argued that one egregious example can help us all examine a broader issue in refining the practice of international medicine.

The duffle bags that often accompany international work bring more than just medicine; we all carry social and cultural baggage. This can begin to be acknowledged by tackling the more obvious challenges of cultural exchange and volunteer training. However, equally important, and frequently overlooked, is the need to establish consistent accountability and sustainable infrastructure.

World Health Organization drug donation guidelines, although a good first step, are not always implemented. Indeed, the . . . [Full Text of this Article]

Maya Roberts, BA
maya.roberts@yale.edu
Yale University School of Medicine
New Haven, Conn

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