Abstract

PIP: The purpose of the Organization of Netherlands Volunteers (ONV), founded in 1965, is to assign volunteers to work in developing countries in order to contribute towards cooperation with such countries and to stimulate awarencess of development problems in the Netherlands. Primary health care (PHC) programs meet the ONV criteria to a large extent. They lend themselves to the development of volunteers because of the need for close cooperation with the target group. Although PHC seems to be the only approach to health care that is appropriate to the population in rural areas in the 3rd world, certain problems have to be faced in practice. These are illustrated by reference to some experiences of the volunteers. PHC does not always comply with the desires of the target group. The target group usually wants a western approach to health care, involving well equipped clinics providing curative care, preferably in their own villages. It takes a long time to arouse enthusiasm for primary health care to such a degree that people are willing to become actively involved in the program. In due course, people realize the benefit of PHC. It is important to start with activities that show immediate results such as an anti-malaria campaign for children or a vaccination scheme. PHC does not conform to the requirements of the local medical staff, which usually has been trained in curative medicine. PHC often takes up considerably more time for which they are not always paid, and it gives them no extra status. PHC is expensive. Although PHC was designed as an alternative to the costly "western" model of health care, each PHC program involves a certain amount of financial expenditure, particularly in connection with the transport of local medical staff and the purchase of medicine. Governments of some of the poorest countries cannot afford to run PHC programs. In conclusion, ONV has decided to assign a volunteer to the Kaya project in Burkina-Faso because the introduction of new vaccines seems to be a step towards combatting common diseases in the 3rd world. ONV advocates the integration of these vaccination campaigns into PHC programs so that they may make a more structured contribution to a lasting health care system in the 3rd world.