Heal the brokenhearted

Once in a while it is good to remind ourselves that Bible believing Christians over the centuries have been in the forefront of social concern, demonstrating the character of Jesus by good works of compassion.  Things changed somewhere in the early 1900s, but especially before that the church was a model for many social programs.

In Glasgow, Scotland, Thomas Chalmers operated a church school in the early 1800s, with an aim of lifting up the lives of children who had no access to education. His church also took on responsibility “for raising and distributing poor relief in its parish.”*

“In a society without state social welfare provision, a large range of philanthropic effort was undertaken by churches and Christian organizations. Children were a particular focus of concern. Education was largely in the hands of the churches until the State began its own efforts in the 1870s. Anglican and Catholic orphanages were widely established. The London Congregational minister Andrew Reed (1787-1862) started three orphanages, a hospital for children with severe learning difficulties and a home for people with incurable illness. George Muller’s Ashley Down Orphanage supported some 2,000 children in Bristol in the 1880s. In the East End of London, Thomas Barnardo (1845-1905), who started a mission for young people, had by the time of his death rescued around 60,000 children. He pioneered approaches to fostering, operating a ‘no destitute child refused admission’ policy. In 1905 Barnardo’s children’s homes were caring for over 8,500 children, of whom 1,300 were disabled or suffering from serious illness.

“One of Britain’s most widely respected philanthropists and social reformers was Lord Shaftesbury (1801-85). He was strongly motivated by his evangelical social conscience, and steered legislation through Parliament to outlaw the employment of children in underground coal mines, to reduce the hours of children worked in mills, and to improve housing conditions and the care offered to people with mental illness. Evangelical social reformers and philanthopists in Britain helped ameliorate some of the worst social ills of the Industrial revolution; indeed the nineteenth century has been called ‘the Evangelical Century.’ However, other issues remained unaddressed, and the biggest social reform provisions such as universal pensions and unemployment pay had to wait until government intervention at the start of the new century.”

*See “Christianity: The Biography — 2000 Years of Global History” by Ian J Shaw (Zondervan 2016)

There are a great many ways that public health skills are being used in preventive and community health programs around the world. Yet when we think of ‘medical missions’ over the last 200 years there has been a strong clinical (medical) approach.  Why should a preventive approach complement this strong medical component of medical missions?

If diseases all responded to a curative approach, there might not be a need for disease prevention. But in almost any category of “disease,” there is need for BOTH a curative and a  preventive approach.  This can be illustrated with just an example or two.

Neonatal tetanus must be dealt with by antitoxin and medication to avert death and respiratory paralysis, and yet it can be prevented by careful care of the umbilical cord at birth. In one animistic tribe in Ethiopia there was the belief that the umbilicus must be covered with dirt from the entrance of the house in order to control access to the spirits to the entrance of the body; clearly there was a need for both medical intervention for the sick but also for education – addressing not only the biology but also the fear of spirits which were part of the local worldview.

In Nepal there is a high maternal mortality rate because of lack of access to facilities with good midwifery and caesarian section capability. The problem cannot be addressed with clinical care alone, but there must be attention to community education, early detection of high risk pregnancies, and training of community based midwives.

Ebola needed both treatment units (highly intensive and technical) as well as community education and contact tracing – both a highly clinical approach to the individual as well as a highly preventive approach in the community.

Road traffic accidents must be treated with competent facilities and personnel, but to reduce the incidence of accidents also requires community and government initiative, safe roads, helmets, seat belts, and a shift in mindset away from fatalism.

Almost every condition requires both a clinical and non-clinical approach. Physicians and nurses are superb at what they do, but there is much that remains undone, either in prevention of illness and injury, or in follow up management of those with chronic conditions, infections and disabilities.

God’s covenant promise to Abraham was to bless all the nations of the earth through him and through his descendants. God showed his concern for justice and human flourishing as he gave to his descendants the commands, promises and laws which reflect the best of human flourishing. Jesus – the descendant of Abraham – continued to show God’s character by healing many and sending his disciples out preach good news and to heal many others. The compassion of Jesus has led many over the centuries to sacrifice their own comfort out of compassion for others.

Is God concerned with prevention of human suffering? Does He encourage us to promote health as well as cure disease?  Yes!  God’s Word stands in contrast to the thinking of behaviorists or other forms of fatalism – those who believe we can’t really change things.  We are not able to manipulate the universe but God does sovereignly control the world and works out all things according to His purposes and design.  He has demonstrated His promised blessing to Abraham and His children, and ultimately in the person of Jesus Christ.  This is a universe created and sustained by a Person – good, righteous and true — not an impersonal force.

A Christian can confidently work to show God’s care for human life. As followers of Jesus Christ we trust that the Lord of the universe can change things (He has authority and power) and that He (not we) ultimately works for the blessing of mankind. The salvation Jesus accomplished on the cross bridges the sin problem (our separation from God) and thus enables us, by His grace, to both love God and love our neighbor. That love extends not only to care but to the prevention of human misery.  That’s public health from a Christian point of view.