Revisiting 5 Themes of Ill Health Amongst Global Workers

As we serve the Lord in this complex task of missions, here are some of our vulnerabilities. This site is not directed exculsively to medical workers, but I see a lot of these same issues in medical missions. Thanks, Scott, for helping us see ourselves. This should cause us to stop, examine priorities and assumptions, and get back to basics. Whose mission is this anyway, ours or our Lord’s?

Tending Scattered Wool

A couple of years ago I posted five entries on five themes I saw consistently amongst global workers that cause or lead to ill health and ineffectiveness. Some of these entries are the most read on this sight. Below is the list of the five topics, the first two being the most repeatedly viewed:

  1. Spiritual Anemia
  2. Total Exhaustion
  3. Relationships in Crisis
  4. Identity attached to Role and Responsibility
  5. Lack of Permission for Personal Development and Care

Based on the first two being the most viewed, we may be a spiritually thin, tired bunch.

I am going to revisit these themes with some reflections and resources on what I have learned and observed over the past couple of years.

The Interesting Observation of these Same Themes Amongst Member Care Providers
I have increasingly been investing more time in training, coaching, mentoring, and advising other member care providers. What I have quickly observed is that these…

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“…not merely a doctor”

“The doctor has so objectified himself that he never faces up to himself and his own life at all.”

“Somewhere in Pembrokshire a tombstone is said to bear the inscription, ‘John Jones, born a man, died a grocer.’ There are many whom I have had the privilege of meeting whose tombstone might well bear the grim epitath: ‘…. born a man, died a doctor’! The greatest danger which confronts the medical man is that he may become lost in his profession.”

D Martyn Lloyd Jones, in “Healing and the Scriptures.”

Dr. Martyn Lloyd Jones was a brilliant British physician and an outstanding preacher, and offers great medical wisdom and spiritual insight. This book was published in 1982 but still contains “a masterful view of the Christian physician’s calling, and of the dimensions of ministry to the whole man.” (Quote from J.I.Packer).

How often our identity is tied up with being medical professionals. Lloyd Jones challenges us to view success not merely as the accumulation of medical knowlege, reputatation and material wealth, but fruitfulness for Christ and His kingdom. The foundation of our identity must be in God, not ourselves; we are creatures made in the image of God and created for fellowship with God — all of which is only possible through the salvation obtained by Jesus at the cross.

Dr. Lloyd Jones says to us, “I beseech you not to allow the profession to make you forget yourself, that you are a man, and not merely a doctor.”  And to bring the vocabulary in the 21st century, we’d say, “you are a man or a woman, not merely a doctor!”

Navigating a path to sustainable Chinese medical mission participation

Take a look at some the challenges that Chinese Christian doctors could face as they consider God’s call to missions. And this article doesn’t even begin to address the cross-cultural issues of Eastern and Western medical worldviews!

As you consider these hurdles, let’s not think ‘it can’t be done!’ Rather, let’s think that “God is the God of the impossible.”  How might God move us as Western mission workers to include and partner with missionaries from other cultures.  Not so much to use them for ‘our’ work but to bless them for the sake of the Kingdom of God.

At the same time let us use our resources not just to do ‘our’ work but to develop spiritual leadership for medical missions which is diverse — celebrating and demonstrating the Kingdom of Jesus.

Challenges?  Yes. Opportunities? Definitely.  Needed? Leadership. Why?  Because this reflects the character of God and reflects His glory.

Jesus taught us, “With God all things are possible.”  Matthew 19:26

 

Life-risking courage in the cause of love

This audio podcast by John Piper helps us address the question of loving others. How do I love to the fullest measure?  How do I ensure that my good deeds are not selfish ambition disguised as love?

He says, “If you abandon your quest to be satisfied in God to the fullest measure, you will not be able to love people to the fullest measure.”

Our love for others should be an overflow of the joy and satisfaction we have with our Savior, the Lord Jesus Christ.  The danger is that otherwise it can become manipulative, looking for some kind of return from our good works (e.g. glory, fame, recognition).

Loving people means seeking to expand your joy in God by including them in it, whatever the cost, even if it costs you your life.”

Jesus’ love for the world (John 3:16) cost Him his life; love is cut from the cloth of sacrifice.

This is helpful to me as a medical doctor who seeks to serve others out of love; this is not about my own reputation or identity.  One blogger put it this way:  “For instance, I do good deeds, because by doing them , I feel better and good inside. So, technically, it’s for myself. I am proud and pleasant of myself for doing them. But, today, some of my classmates said that it’s worthless doing good deeds, because you don’t get anything good from doing them.”

Finding our satisfaction and joy in Christ enables us to love others.  God is glorified and magnified as we serve other and seek to include them in the joy we have found in Christ. So we do good deeds not for ourselves but as an overflow of our satisfaction with Jesus.

 

Finding meaning as a Christian in mission

is a trauma and critical care surgeon who recently left clinical practice to homeschool her children. She teaches at Harvard Medical School, and has contributed to the literature on surgical critical care and medical education. She and her family live in the woods north of Boston.

This is her journey from medical mission mayhem to meaning.

Assessing the learning needs of medical mission workers

How does one assess the learning needs of healthcare missionaries or mission workers?  If you are looking to assess your own needs, here is an article that is a good place to start. How would you do it for an entire organization, or the entire enterprise of healthcare missions?

The Global Healthcare Workers Needs Assessment (GHWNA) Survey Report was completed in 2015 by Mark Strand and Amber Wood, under the sponsorship of MedSend and endorsed by the Christian Medical and Dental Association of the US. The aim was included in the title of the report: “That Healthcare Missionaries Might Flourish.”  The aim was to “investigate how to better equip healthcare missionaries for long-term service.” It builds on the PRISM survey which was more about the training, support and satifaction of healthcare missionaries with their role, with a view towards making needed changes in selection, preparation and equipping of these workers.

Some key findings:

Healthcare missionary respondents had a mean age of 41 years. Years in cross-cultural service were 7.2 for those currently serving and 4.8 for those who had returned from the field. All were American missionaries, so we need to generalize with care.

85-90% of these healthcare missionaries reported that they were able to see lives transformed, meet spiritual needs, and share the gospel with those they served.

While there was a high degree of satisfaction with their roles in healthcare (93% and 84% of currently serving and returned missionaries, respectively), many (33 and 34%) reported a discrepancy between their roles and what they expected. Role inconsistency is a problem for medical missionaries.

Those currently serving spend less of their time on clinical work, and more on administration, church or mission agency responsibilities, and general organizational leadership, than post-field missionaries did when serving on the field.

In terms of needs assessment, healthcare workers serving overseas find themselves with many jobs for which they are unprepared. These cross-cultural healthcare workers rated professional development and leadership training as important as cross-cultural training in preparation for the field. Those serving on the field weigh public health equally to clinical skills in terms of training.

Leadership training needs reported by respondents in order of importance were: mentoring, strategic planning, and general leadership skills. However only 38% of all respondents had mentors, and only 18% of sending agencies assign mentors who are healthcare professionals themselves.

Of note, 18% of those serving and 20% of those previously serving were individuals at risk for burnout based on callouseness, and 8% and 20% based on exhaustion.

Half of post-field respondents left the field for potentially preventable reasons, most often burnout, interpersonal conflict, or emotional exhaustion.

Learning needs for American medical missionaries might therefore include not only cross cultural preparation and clinical competence but leadership and management skills, burnout awareness and prevention, conflict management and emotional awareness. When possible there should be intentional mentoring which is delivered by healthcare professionals who understand the challenges of cross-cultural service.

How would you assess your learning needs in terms of service as a healthcare worker? Where would you agree or disagree with these survey findings?

 

Third culture leadership

William Dryness points out two parallel realities in our world: (1) the mobility of our times, and (2) the changing demographics of Christianity.  Not only are the majority of Christians no longer “Western,” but they are increasingly found in countries with young and growing populations, frequently among the poor, and exhibiting a vital evangelistic faith.

What are the implications for missions?  How must traditional mission organizations adapt to these new realities?

Based on the two realities (mobility as well as increasing impact of non-Western Christians) traditional missions will need to consider:

  • Missions must re-imagine ourselves as learning structures. This means that communication is not one way (from the West to the rest) but mutual sharing across cultural boundaries.
  • Dryness talks about “third culture leadership.”  Mission leadership should include prominently ‘bridge people’ who embody (ethnically and experientally) the diverse realities of our pluralistic world.
  • Facilitation of multiple forms of witness (where the grand strategy is under leadership of the Holy Spirit).
  • Longer term regional strategies, based on mutual exchanges and regional parterships.

I know that as a mission we are increasingly seeing the Lord develop “third culture leadership.” This is not a matter of Western vs. non-Western, but a mixture of gifts, ethnicities and cultures working together in leadership.

I have an Indian friend and brother trained in medicine in India, but also quite famliar with our Western ways, working in a Western mission agency.  In problem solving, he understood how we as Westerners want to go on a ‘straight line’ from problem to solution. Yet as an Asian, he is also quite comfortable ‘meandering around’ with a problem until a solution could be found.  Eventually, he said, either way would get us to a solution.  “When I do it as an Asia,” he added, “it may take me longer to get there, but I’ll have everyone with me when I arrive!”

So we need each other. There is no one right way and wrong way to tackle the serious problems we are facing in the world, whether we are considering impoverished medical care or impoverished friendships. We need cultural bridges, or third culture leadership.

How are the realities of mobility and increasing leadership from non-Western Christians impacting your efforts?