Problematizing “Activism”: Medical Volunteer Tourism in Central America, Local Resistance, and Academic Activism

This paper critically examines epistemological, ontological and axiological tensions of activism in three related contexts. These are, first, (primarily medical) volunteer tourism ideologies and practices in Central America –including US-American teenagers volunteering in medical centres where, entirely untrained, they do sutures and injections, deliver babies, and help with amputations. Second, the paper considers and critiques local norms (e.g. widespread homophobia) and materials (e.g the use of short-handled agricultural hoes) that may be discursively constructed as resistance to western imperialism. Finally, the critique turns back on the researcher gaze itself, problematizing the notion of academic activism in spaces, like these, where criticality itself is an imported –arguably luxurious– folly. Local people, it is apparent, do not want convoluted theorizing or Western hand-wringing; they want proper medical care. The paper therefore considers the extent to which academic work in such spaces can call itself activism at all. Three years of ethnographic research inform the paper (2013 to 2015, predominantly in Guatemala and Nicaragua), including hundreds of hours of interviews and participant observational fieldwork, in Spanish and English, with local stakeholders (e.g. teachers and homestay hosts) and Western volunteer tourists. The paper is theorized with reference to postcolonialism, critical medical ethics, models of structural violence, and Gutiérrez’s liberation theology