“We all sat at the same table.”

 

When resources are scarce and medical professionals are few, one gets overwhelmed with the physical needs of patients needing care.  Emotional, spiritual and community care seem like a luxury.  Yet the challenge is how to make a long range impact in these communities.  Here is an example from the Hopkins Medicine journal which shows how one group of professionals brought patients and community to ‘the same table’ – and thus began to discuss deeper issues.

After trying to engage women in breast cancer screening through a local church, these medical professionals felt like failures; only two women signed up. Lesson 1. Short term outreach which does not involve the community from the start has limited long term impact.

Despite their disappointment, they asked for feedback from the church, and were invited to a monthly meeting. “Someone stood up and said, ‘Doc, no one wants to be a patient.'” Being a patient was perceived as a burden, and the outreach was thus an invitation to become a burden.  “It was a hard lesson,” the author concluded, “that picking up medical services and dropping into a neighborhood without taking into account the communities priorities, stuggles, or having trust — that’s a formula for failure.”  Lesson 2. Our best intentions may be perceived very differently than we intend, and we must be humble enough to receive feedback from the community’s perspective.  (Think about short term medical missions; how often do we proceed with our own agenda?)

The author and his colleagues modified their approach to emphasize “knowing the science, knowing the patient and knowing the community.”  They launched an organization called “Medicine for the Greater Good,” to engage the socioeconomic determinants of health. Through this organization they created community partnershps which included not only the patients at risk but churches, schools, City Hall and health department — all sitting at the same table.  “We discovered that somewhere along our long journey as doctors, we had come to viewhealth as synonymous with medicine: prescriptions, research, guidelines. But for the community, health was more than feeling well.  Health is jobs. Health is providing for one’s family. Health is going to church and going to the park. Health is a sense of purpose.”   Lesson 3. One of the biggest obstacles to long term community transformation is our own misunderstanding of health!

Read the results of their discussions and the fulfillment they began to find.  How do we translate these lessons into health ministry motivated by the love of God and the good news of salvation through Jesus?

  1. Link short term outreach to long term engagement with the community, not an approach driven by one-on-one patient care.  Love demands that we think from both perspectives.
  2. Spend time with the community, not just with the patients that come from the community. This means actually getting out to know community members in their own homes, neighborhoods, churches and places of worship. It means getting meaningful feedback about how we are perceived. Our best intentions may not communicate the love we intend to show.
  3. We must change our minds about health. Health is not just meeting physical needs – but transforming community.  Most of the determinants of health are matters which the good news of Jesus addresses  — such as anger, sexual immorality, greed, guilt and shame.  Our role as health providers is not only to provide relief where we can, but to journey with our patients and community as Jesus builds His kingdom in their midst.  Jesus provides forgiveness of sin and relief from of the shackles that often lead to poverty and ill health.   The good news of the gospel provides meaning even when suffering cannot be fully alleviated.  As Christian health providers let’s not just be caught up in our useful activities, but also learn to sit at that table with the communities in which we serve.

 

Love in action

In SIM we think a lot about how to integrate faith and good deeds. In our Western mindset these are often separate.

One of our missionaries returned home this week and told us that in her country, Christian medical doctors put “faith” and “work” in separate categories.  So it is difficult for them to imagine how to keep them together.

Jesus healed people physically but also ministered to their souls. He knew when to show love and he knew when to speak the words of God to people.  The ministered to the whole man; there was no separation of faith and work.

One unifying theme that runs through all of Jesus life and ministry is love. John tells us that “God is love, and the one who abides in love abides in God.”  Jesus life was motivated by the love of God and love for people. Ultimately His death the cross was the supreme evidence of that love — rescuing us from eternal suffering for sin, and also restoring us to right relationships with God and others. The cross integrates faith and work.

My missionary friend invited another experienced visiting missionary doctor to a lunch meeting where he was asked by younger Christian doctors, “how can you imagine us bringing faith into the chaos of this urban hospital?”

“Remember those patients we saw lying on the floor this morning?” he asked.

“Yes,” they replied.

“Do you think any of them might appreciate prayer?”

“Well, yes,” they replied again.

“How can we find a way, in your cultural context, to love them enough that they would might invite you to pray for them?”

It was the beginning of a journey to bridge that gap between ‘faith’ and ‘work.’  Or more precisely, it was a call to really look into the eyes of individual patients and families and see them as made in the image of God, not just as people with physical needs.

Jesus leads us to do this because of His love for people. He wants them to know love, since it powerfully communicates who He is, and also opens up opportunities to know Him though words that also come from Him.

 

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

 

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.

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?

Preparing for the field

What would I say to someone just preparing to leave to serve Christ in cross-cultural missions? Here are some of the things I hear myself saying to young people at SIM who are in orientation or training:

  • Prepare for a marathon, not a sprint. Missions is a learning experience which spans years, not just months.  We often go with high expectations of changing others but forget that also there are many ways we also need to grow and change.
  • Don’t shortchange language.  Take all the language that is possible.  I had an experienced mission doctor in Ethiopia tell me at the end of his career, “I thought I’d just be able to pick up the language by working; I was wrong. I am sure I lost a number of patients just because I didn’t understand all they were saying.” [As an internist of course I believe the history is the MOST important thing in the patient encounter!]
  • Don’t be surprised by the challenges of living cross-culturally. In our first term we experienced a home break-in; physical illness in ourselves and our children; delay in assignment; conflict with a fellow language school student who was later removed from the field; plus the adjustments to the sights, sounds and culture.  Would I trade it for something easier? No! Was it something I could have prepared for better?  Yes, by adjusting my expectations down just a little.  Medical folks like me tend to go for perfection.
  • Get cross-cultural training before you go.
  • Learn to love people more.  Ministry is all about relationships.  Look at how Jesus cared for those around him. He observed them, listened to them, befriended them, lived among them, cared for them, spoke God’s word to them.  People are the center of ministry, not projects and programs themselves.
  • Embrace your own gifts and callings, but also your own weaknesses.  God will use you as an individual with the strengths you have, but will also work through your weaknesses [which will be more obvious to you as you encounter the stresses and strains of cross-cultural living]. What an adventure!  Live in His grace, not by your own efforts.
  • Make friends, not only foreigners, but local people. You will treasure those friendships someday and they will treasure you. Find a mentor among colleagues but also among local people.
  • Stay close to Jesus and the Word of God. Don’t neglect Scripture, Sabbath, and a balance in life of ministry to self, family and others.  It’s amazing how often we can get busy with work [like we are trained to do] and neglect the inner life of the soul.  “Watch over your heart with all diligence, for from it flows the springs of life.”
  • Enjoy the journey. While it is not all bliss, it is deeply satisfying to be used by God to serve others with compassion and find joy even in little things.

How to prepare medical missionaries

We polled about 100 of our SIM medical doctors, nurses and health professionals, asking them how they would prepare new medical workers for cross cultural mission.  Here are some of their responses:

  • Emphasize language learning; too many medical workers do not get adequate language — and it becomes a career weakness!
  • Prepare them for teamwork including multicultural team training
  • Help them build a good theological and missiological foundation for medical missions, including a robust biblical theology of suffering
  • Emphasize the importance of building healthy marriages and families (for the married ones) and healthy relationships for all
  • Burnout prevention; maintaining margins
  • Developing ministry vision
  • Help them articulate how medical missions is a calling (“real ministry”) and thus begin to form a new ‘identity’ as medical missionaries or healthcare workers
  • Explore with them options for ministry that may be beyond the usual preparation of medical professionals; for example simple ideas such as using home visits to minister to others physically and spiritually
  • Impart to them a vision for eventually becoming leaders in healthcare missions, and learning leadership together with local believers in the context of ‘doing’ mission

Do you have other suggestions from your perspective? I’d love to hear from you.