Competence and confidence

I’ve been talking about a lot of big ideas in these posts: how to share the love of Christ in healthcare ministry ‘over there.’  You may get the impression, “Hey, there are a lot of big ideas here.  Am I competent to do this?  How can I have enough confidence that I can make a difference?”  You are not alone!!  This was one of the biggest lessons Paul learned as an apostle, and I believe there is a way that the Lord Jesus develops our confidence and competence as we follow Him, serving others through healthcare.

Continue reading Competence and confidence

The LORD, a God merciful and gracious


Last week I wrote about a possible erosion of compassion in our healthcare service.   Those of us in healthcare as a profession can be inundated with the suffering in this world.  And beyond the physical aspects of suffering there is the question of meaning.  Even more painful than suffering is to suffer something that has not meaning.

Yet in the midst of the pain of suffering and the human condition, we find some hope and meaning in the Scriptures:

  • the pain of childbirth and the agony of death, which speak to us of the suffering of creation, are not random events, but are connected to the choices our first parents (Adam and Eve) made and the subsequent consequences which God made in Genesis 3:14-21
  • the consequences God put in place were not only curses but an amazing promise (that the seed of the woman would bruise Satan on the head – fatally).  Thus at some point the suffering will end and justice will be done
  • while suffering is often due to sin and rebellion it is not always due to personal sin (‘my sin’) but to our common lot as children of Adam and Eve
  • the good news is that redemption from sin is also not due to my personal goodness (‘my righteousness’) but to the righteousness of Jesus Christ, the second Adam
  • Jesus announced that suffering is a necessary part of His mission! See Mark 10:45
  • As followers of Jesus we are called to come alongside others in their suffering. Matthew 5:4-7
  • Thus the reason we serve others is not to be for money or our own reputation or influence. The character of God must be our motivation.  The LORD is merciful and gracious.   Yes he is strict with sin, not allowing it to be unpunished.  Yet by comparison His graciousness is overwhelming and extends so much farther than we can imagine (compare 3-4 generations to 1,000 generations)
  • We have every reason to serve others with compassion, and all the grace of our Lord Jesus Christ to actually do it!

Surprised by Hope: Rethinking Heaven, the Resurrection and the Mission of the Church

NT WrightWhat would the resurrection have to do with the mission of the church? NT Wright makes a plea for us to connect the two.  Our modern assumptions about life after death seem to disconnect the reality of life in this world and the next, but the Bible does just the opposite.

“It has often been observed that the robust Jewish and Christian doctrine of the resurrection, as part of God’s new creation, gives more value, not less, to the present world and to our present bodies. What these doctrines give.. is a sense of continuity as well as discontinuity, between the present world and the future, whatever it shall be, with the result that the present matters tremendously.”

As a boy growing up in a major Christian tradition, I came to believe that what really matters is what is going on “in my soul.” My body seemed to be less important, less spiritual.  Wright shows us that this is so far from the truth. “In other words, the idea that every human possesses an immortal soul, which is the ‘real’ part of him, finds little support in the Bible,” he says.

The Scripture is clear that at the end of the present age there will be a resurrection of the bodies of the dead; see for example the book of Daniel where we read, “And many from those sleeping ⌊in the dusty ground⌋ will awake, some to ⌊everlasting life⌋ and some to disgrace and ⌊everlasting contempt⌋.” Daniel 12:2.

“Paul speaks of the future resurrection as a major motive for treating our bodies properly in the present time (1 Cor 6:14), and as the reason for not sitting back and waiting for it all to happen but for working hard in the present..”

Remember Jesus has risen from the dead, having conquered sin and death, and he came forth with a physical body, not unlike the body he had before death. Remember he still had (and has) the scars of the nails in his hands. And today he is still has a physical body, a kind of early “fruit” of what a the renewed earth will be like when he returns!

“It was people who believed robustly in the resurrection, not the people who compromised and went in for a mere spiritualized survival, who stood up against Caesar in the first centuries of the Christian era. A piety that sees death as the moment of ‘going home at last,’ the time when we are ‘called to God’s eternal peace,’ has no quarrel with power-mongers who want to carve up the word to suit their own ends. Resurrection, by contrast, has always gone with a strong view of God’s justice and of God as the good creator. Those twin beliefs give rise not to a meek acquiescence to injustice in the world but to a robust determination to oppose it. English evangelicals gave up believing in the urgent imperative to improve society (such as we find with Wilberforce in the late eighteenth century and early nineteenth century) about the same time that they gave up believing robustly in resurrection and settled for a disembodied heaven instead.”

It is not just our souls that are important but our bodies, both on earth now, before death, in the new heaven and new earth to come.  At Easter Jesus surprised the whole world by coming forward from that future into the present with His resurrection body. Let us trust and honor Him, who provides the only bridge between these worlds; this means obeying Him and being light and salt in this world around us!

Are we losing our compassion?

CMF Compassion

When we reflect on the reasons to come alongside those who are hurting physically and serve them around the world, compassion must be the #1 reason. It was the foundation of the early church’s response to human suffering around them, even before medical care became more professional.  The prophet Malachi exhorts God’s people to “do justice, love mercy and walk humbly before our God.” So are we in danger of losing our compassion?

This article in the Christian Medical Fellowship journal by Richard Vincent says there is good evidence that we are losing our compassion. Over 17,000 scholarly publications have appeared investigating the loss of compassion around the world.  A 2014 report in the UK brought the failure of compassionate care “into sharp public focus.”

We are tempted to think of compassion as something subjective, or perhaps not quite as real as observable facts like blood pressure and screening blood tests. Compassion has BOTH a subjective and objective element. It is not just what we feel, but what we do about coming alongside others in their suffering.

Vincent shows how the parable of the Good Samaritan paints a picture of compassionate care, showing its main components: attentiveness, empathy and action. See Luke 10:30-35.

Attentiveness means “choosing to give someone your undivided attention.” Wow, this is huge. Rather than focusing on my workload, I choose to give attention to someone in their suffering. This is from the heart of God. And not just attentiveness but empathy. The sense of what it would be like to be in the other person’s position. “Jesus identified with the harassed and helpless.. prompting Him to weep.”  Empathy establishes a connection with the patient and is quickly appreciated, he says.  It will take some time and energy of our own body, mind and spirit. Yet can we truly practice Christ-like medicine without it?

Why the loss of compassion?  “The focus on materialistic science is strong in both medical education and clinical practice.  An interest in mechanisms, measurements, and data predominates, leading patients to be seen as cases rather than as persons, an attitude that may be reinforced by clinical teachers.” He suggests some helpful ways to return to compassion as Christian healthcare providers.

I may diagnose and treat with competency and cleverness, but if I have not love, it is just like a noisy gong or a clanging cymbal.  (see 1 Corinthians 13).

We certainly want to be good healthcare providers and use the training to care for others well; let’s not let our profession squeeze us into a mold which is not shaped by compassion.  How do you find ways — little or big — to show compassion?  Your small efforts may encourage all of us.


How should we do justice?

I’ve mentioned Tim Keller’s “Generous Justice” before. Today I’d like to underline a practical and theological issue about “how.”  Keller tells us about Abraham Kuyper, a Dutch theologian and statesman who ‘remade the churches into voluntary institutions’ in Holland over a century ago.  According to Kuyper, the church was both and organism and an institution (See Kuyper’s work “Rooted and Grounded — the church as organism and institution.)  God has designed the church to be like a body (organic, rooted) and house (institutional, grounded on a foundation).  It needs solid outer shape but it must have inner life.  The church not only grows, but it is also built with structure.

Keller says that Kuyper distinguishes the congregation meeting under its leaders as the institutional church, and “all Christians, functioning in the world as individuals and through various agencies and voluntary organizations,” as the organic church (“Generous Justice,” page 145).

Keller continues, “As we have said, churches under their leaders should definitely carry out ministries of relief and some development among their own members and in their neighborhoods and cities, as the natural and crucial way to show the world God’s character, and to love the people they are evangelizing and discipling. But if we apply Kuyper’s view, then when we get to the more ambitious work of social reform and the addressing of social structure, believers should work through associations and organizations rather than through the local church.  While the institutional church should do relief inside and around its community, the ‘organic’ church should be doing development and social reform.”

He goes on to say that many of the churches that practice this sort of model of ministry (of the sort championed by John Perkins) form community development organizations, distinct from their congregations, to operate programs in their community. Otherwise the work of community renew and social justice can easily overwhelm the work of building up the church by evangelism and discipleship.

Mission organizations plant churches and disciple individuals and can be well suited to do ‘organic’ type ministries of justice and social transformation. However, mission organizations are specialized in seed sowing and building foundations, not in the ongoing work of the ministry — which must increasingly fit the local context with local leadership.  So just as we plant churches in various places, we have a vision to plant local mission organizations that can glorify Christ and address issues of justice and social needs.

Would you be happy to join with a view to this sort of gospel-centered mission to serve in the area of justice and social transformation?

Medical Missions, an assessment by a historian

Sent to Heal by Christoffer H Grundmann
Sent to Heal by Christoffer H Grundmann

Christoffer Grundmann writes, “Most nineteenth-century people, medics and theologians alike, paid little, if any attention to medical missions — even if they were addressing mission. And when they did, they almost always did so in very limited confines, leaving their discussions to circles of experts. This isolation made it even more difficult for any general discussion of the subject to be carried on. At the same time, this indicates that medical missions hardly – if ever – succeeded in formulating and communicating the rationale for their work in such a way that others could fully understand them. Thus their potential impact on theology, medicine, intercultural dialogue, and dialogue between science and religion was considerably hampered by this inability (on the part of most of them) to engage in adequate reflection on the subject. This might simply have been the cost of their enormous day-to-day demands of the work itself, which consumed their energies…

“From the outset, however, medical missionaries were compelled to validate their work in the face of the common assumption that only those who preached and taught the gospel explicitly were real ‘missionaries.’ It was not surprising then, that medical missionaries tended to defend their work somewhat apologetically.”

Without adequately reflecting on medical missions, how do we expect to engage the next generation in the amazing opportunities God has put before us to bring healing to the nations?  Our physical bodies were made by God and declared “good,” although distorted by sin from God’s original design.  We need plenty of people to adequately reflect on this subject.  That’s why I am writing this blog!  It is my intention to stimulate you to think about the needs of this world from God’s perspective, and get involved.  Physical and spiritual needs were all of concern to Jesus as he walked this earth.  The foundation of all healing is the work He did on the cross, bridging the divide between heaven and earth.  But his work is not done only by addressing the heart need of man; He is also a God who cares about physical suffering, justice, and manifold other mental, relational and spiritual needs.  Let’s not be so busy we cannot talk together and help one another accomplish what is good.

How can local believers show compassion through healthcare ministries?

As we communicate the love of Christ in another culture, it is easy to think that the ministry revolves around our activities. In fact, the key word in Christ’s “Great Commission” is to make disciples.  That means enabling others to learn from Christ. It also implies that we ourselves learn in the process. Here is a learning activity.

“What are some ways that local believers can show Christ’s compassion through health ministries?”  

Take a few minutes with your team to explore this question. It may be the first time for some of us to ask the question.  There is no one correct answer.  But the Spirit of God does give creativity; as we follow Christ, He can lead us to meet physical, spiritual and emotional needs that could not be met by foreigners alone.

Here is a start; I’m sure there are many others.  Would you be willing to share some with me?

  • prayer for the sick
  • home-based health education
  • integrating a Biblical view of health and sickness into teaching the Bible (many Bible lessons help us integrate the spiritual, physical and relational aspects of health)
  • meet some physical needs of orphans or widows — who do not have the means to help themselves (see James 1:27)
  • do good for someone who is not ordinarily a friend
  • begin a palliative care ministry for those who are dying
  • help train other local believers to do this
  • help handicapped people
  • discuss with local medical professionals how to enable others who don’t have the technical medical background (healthcare is not just a professional domain)
  • write a short story about health in the community
  • put on a health play
  • find out more about CHE, or Community Health Education/Evangelism
  • find out the needs of the poor and how to meet them closer to their home
  • befriend someone in need
  • ask God to show you how to show compassion
  • don’t despise small beginnings; you cant change it all at once
  • ask your local doctors and nurses for their own perspective
  • pray with others

What are your ideas?


Highlights shared by SIM medical missionaries

We have 250 medical professionals serving in SIM. We recently surveyed some of them.  We asked each one to share a highlight of their ministry. Here are some of their responses.  One bullet point per person:

  • The opportunity to develop relationships with Muslims as patients, staff and colleagues
  • Working with vesicovaginal fistula patients (VVF). The majority of our work is in this area, and we are seeing huge life changes as well as large numbers of people choosing to place their faith in Christ through VVF ministries as well.  A close second – working with the family practice residents (all nationals)
  • Proclaiming the gospel as the Spirit enables
  • Discipling men that have initially resisted studying the Bible, but later study it voraciously
  • Meeting desperate physical needs, training interns, and the joy of caring for patients.  Answers to prayer by the Lord sending a doctor who spends part of his time doing rural medicine outreach in areas of the country where there has been no gospel witness (using the hospital as a base)
  • The impact I can make here, compared to what it would be in the U.S.  To see individual lives touched each week; to see the sickest of the HIV and TB patients receive compassionate care and actually survive.  To see a wider impact that we can have in the area together with the Ministry of Health.  To see the institution built up; it is a unique privilege and joy to see every piece of the puzzle as it comes together, to know the story of each item supplied, the input of each individual/church/organization, and so on (the reward of effective leadership in administration)
  • Enjoyed working with the kids ministry
  • That we were able to go to a closed area of this country (highly secure country); and that they are known as Christians who show compassion.  That we can have a significant impact on health education among local doctors.  That we can create avenues for ministry among local believers
  • We are excited to see how the younger generation of church leadership is responding to the AIDS teaching, applying it and seeing people’s lives transformed. At an HIV camp they see how the truth of God’s word gives them a future and a hope.  Also they are surprised how palliative care has opened doors to sharing Christ
  • It is a joy to help dental students get a better level of training as well as discipling them or leading them to Christ. It is also a blessing to work side by side with Bible translation team and see God’s word changing lives and strengthening the church. The work of the mission hospital has given improved dental health of the young people, especially children, who are taught about dental hygiene early
  • To see the replication of the dental training, not only the medical teaching but the spiritual.
  • Enjoyed the team dynamics
  • In the beginning it was a highlight taking care of patients; now I am more in an administrative role and the highlight is working closely with two Nigerians who are mentors to me.  Loved the six months of teaching I did with the nursing staff
  • Although I am not now on the field, many of the graduates I trained are now serving the poor and being Christ to those who do not yet know HIM.  Even one man who was not a believer spends one day a week doing a clinic where he is not paid
  • Direct patient care and teaching
  • Openness and willingness of patients to hear the gospel. Growth and development of staff
  • Developing relationships with hospital staff
  • One of the big highlights is to have been in the same place for 35 years and have relationships with people over a long time.  I have been able to follow some people through many stages of their lives.  As a doctor it is a highlight when you can come into someone’s life and connect with them and make Christ real to them. It has been rewarding to see how much has changed in many areas: AIDS epidemic, malnutrition, malaria, measles and many other diseases have improved with medical care and education. Lately I have been much more aware of the need to share Christ.
  • Sharing the gospel in our particular context of medical mission. It’s neat working in a situation where that is possible, working in conjunction with local evangelists. Lots of natural opportunity to do this.  Another highlight is seeing sick folks get better through your intervention (and by contrast a low light is seeing folks die in spite of — or even worse — because of your intervention!)

Do you see why we have joy in medical missions?


Myths of medical missions

1 Timothy 4.7

Medical mission work must have an vision, a framework for understanding how it fits into the work of God in the world. This framework must come out of our understanding of Scripture. Many times however we can operate on faulty frameworks, wrong assumptions about God, the world, healing and redemption. Here are a few “myths” of medical missions. I think there are many more. Can you identify any and respond?

  • “I can dispense healing”
  • “Healing is from medicine, surgery and scientific advances, and doesn’t have much to do with relationships.”
  • “What ‘I’ do is the key to success.”
  • “‘I’ am the answer for ‘them.'”
  • “I must be in control.”
  • “I am not broken.” (or my brokenness does not interfere at all with my medical work)
  • “If others knew my own brokenness it would discourage them.” (and so I must hide it)
  • “I am defined by my medical training.”

Underlying these assumptions – and others — are two foundational myths:

  1. A distorted view of God
  2. A distorted view of self

What myths can you identify?  I look forward to hearing from you!


The Cape Town Commitment of faith and call to action – – the mission of God

Cape Town Commitment

Here is a rich description of the mission which God calls us to as believers, expressed in the words of the Lausanne commitment at Cape Town, South Africa

This is section 10 of that commitment word for word. It is an exciting and joyous mission. How are you involved?

We love the mission of God

We are committed to world mission, because it is central to our understanding of God, the Bible, the Church, human history and the ultimate future. The whole Bible reveals the mission of God to bring all things in heaven and earth into unity under Christ, reconciling them through the blood of his cross. In fulfilling his mission, God will transform the creation broken by sin and evil into the new creation in which there is no more sin or curse. God will fulfil his promise to Abraham to bless all nations on the earth, through the gospel of Jesus, the Messiah, the seed of Abraham. God will transform the fractured world of nations that are scattered under the judgment of God into the new humanity that will be redeemed by the blood of Christ from every tribe, nation, people and language, and will be gathered to worship our God and Saviour. God will destroy the reign of death, corruption and violence when Christ returns to establish his eternal reign of life, justice and peace. Then God, Immanuel, will dwell with us, and the kingdom of the world will become the kingdom of our Lord and of his Christ and he shall reign for ever and ever.[53]

A) Our participation in God’s mission. God calls his people to share his mission. The Church from all nations stands in continuity through the Messiah Jesus with God’s people in the Old Testament. With them we have been called through Abraham and commissioned to be a blessing and a light to the nations. With them, we are to be shaped and taught through the law and the prophets to be a community of holiness, compassion and justice in a world of sin and suffering. We have been redeemed through the cross and resurrection of Jesus Christ, and empowered by the Holy Spirit to bear witness to what God has done in Christ. The Church exists to worship and glorify God for all eternity and to participate in the transforming mission of God within history. Our mission is wholly derived from God’s mission, addresses the whole of God’s creation, and is grounded at its centre in the redeeming victory of the cross. This is the people to whom we belong, whose faith we confess and whose mission we share.

B) The integrity of our mission. The source of all our mission is what God has done in Christ for the redemption of the whole world, as revealed in the Bible. Our evangelistic task is to make that good news known to all nations. The context of all our mission is the world in which we live, the world of sin, suffering, injustice, and creational disorder, into which God sends us to love and serve for Christ’s sake. All our mission must therefore reflect the integration of evangelism and committed engagement in the world, both being ordered and driven by the whole biblical revelation of the gospel of God.

‘Evangelism itself is the proclamation of the historical, biblical Christ as Saviour and Lord, with a view to persuading people to come to him personally and so be reconciled to God…The results of evangelism include obedience to Christ, incorporation into his Church and responsible service in the world… We affirm that evangelism and socio-political involvement are both part of our Christian duty. For both are necessary expressions of our doctrines of God and humankind, our love for our neighbour and our obedience to Jesus Christ…The salvation we proclaim should be transforming us in the totality of our personal and social responsibilities. Faith without works is dead.’[54]

‘Integral mission is the proclamation and demonstration of the gospel. It is not simply that evangelism and social involvement are to be done alongside each other. Rather, in integral mission our proclamation has social consequences as we call people to love and repentance in all areas of life. And our social involvement has evangelistic consequences as we bear witness to the transforming grace of Jesus Christ. If we ignore the world, we betray the Word of God which sends us out to serve the world. If we ignore the Word of God, we have nothing to bring to the world.’[55]

We commit ourselves to the integral and dynamic exercise of all dimensions of mission to which God calls his Church.

God commands us to make known to all nations the truth of God’s revelation and the gospel of God’s saving grace through Jesus Christ, calling all people to repentance, faith, baptism and obedient discipleship.
God commands us to reflect his own character through compassionate care for the needy, and to demonstrate the values and the power of the kingdom of God in striving for justice and peace and in caring for God’s creation.
In response to God’s boundless love for us in Christ, and out of our overflowing love for him, we rededicate ourselves, with the help of the Holy Spirit, fully to obey all that God commands, with self-denying humility, joy and courage. We renew this covenant with the Lord – the Lord we love because he first loved us.