Taking it in steps?

A missionary doctor, nurse or health provider in his or her first term is all enthusiasm. After all, he or she may think, “After all that preparation, let’s get on with the real work!”

But those first few years show how much more there is to learn! First there is the adjustment to the new sights and sounds, then a new set of co-workers, then a new job, and of course there is langauge learning!  We want to provide excellent medical care but face the obstacles that often exist in resource-poor settings.

On top of these things, in those first years we may also be working on:

  • issues of marriage and singleness
  • growing a family
  • integrating spiritual and physical ministry into practice
  • understanding how our role fits with the vision and strategy of mission and church
  • doing things outside of his or her training, such as leading a team or projects
  • conflict and team formation
  • identity issues (“who am I really?”)

During this intense time of learning and growing, sometimes I am asked for advice on getting futher training: should I do an MPH degree?  get tropical medicine? learn more about management and leadership?

Looking back over my own 30 years with SIM in medical missions, I think I tried to do too much too early. So my suggestion is this: take a longer view and then break it up into steps.

The complexity of the task means that if we try too much too soon, we won’t do anything well. So in the early years it may be best to focus on the basics: our relationships, especially marriage/singleness/family; language learning; and practicing what we have been trained to do.

Then it will become clear what is needed for later stages.  Not everyone needs to go on and do a public health degree.  Not everyone needs to go to seminary.  Not everyone needs to become skilled in management.  But everyone should grow in their understading of their gifts and abilities, and over time, take on new challenges. Everyone should grow in grace and the knowledge of our Lord Jesus Christ.

“For we are His workmanship, created in Christ Jesus for good works, which God prepared beforehand that we should walk in them.” (Eph 2:10).

The process of discovering those good works prepared for us by God is a journey.

Let’s take it one step at a time.

 

Too much to do? Time to re-examine our own assumptions!

Stress and burnout are recognized themes in medical missions.  One source of stress is the sheer magnitude of physical needs; one billion people in our world have no access to a trained health worker and healthcare workers often stand in the gap.

In the face of overwhelming need how do we maintain healthy margins?  Overextended, we lose our compassion, damage relationships, and often leave our fields of service early.  Yet, the pressure is there, since the patients show up, the children are literally dying, and there is often no alternative for those who are the most marginalized.  Wouldn’t Jesus have compassion on the sick and dying?

In the late 1980s I was in a similar situation in southern Ethiopia, where I was called to lead a small team to treat patients dying among the Mursi tribe; hundreds were dying around us from meningococcal meningitis.  While we had some effective antibiotics we couldn’t get ahead of the need – patients were dying faster than we could treat them.  In our case, the answer was not so difficult, as the Ethiopian ministry of health asked us to bring along their workers and meningitis vaccine; thus we were both able to save many who were ill, but also prevent new cases with vaccine.  Caring for the ill and prevention went hand in hand – with a team approach.

But what about a hospital or clinic where the people come each day and yet the facility and staff are still overwhelmed?

One approach has been to assign numbers to non-emergency patients to limit those who can be seen on a given day.  Other barriers have been erected, such as raising fees – although this limits care to those who are most vulnerable and thus tends to defeat our purpose.  Outpatient clinic hours can be trimmed.  Specialty clinics can be opened only certain days.  All these efforts are ways of establishing boundaries and limits.  Some are needed; some are painful.

Yet, our hearts as medical providers are driven by compassion; we want to see as many as possible.  Compassion is from the Lord, and our instincts may be noble. But unexamined assumptions may contribute to our own burnout and long term lack of fruitfulness.

As medical healthcare workers and missionaries, do we recognize our own limits and vulnerabilities?  Or are we driven by a “Savior” complex where we must be the answer to everyone’s need?  Do we allow the needs to constitute our call, or does Jesus Christ shape the call?  If we are called and empowered by Him (as the true vine) then we (as his branches) can only produce eternal fruit as we allow Him to work through us.  Yes, this kind of ministry can be overwhelming, even impossible.  Are we connected to Him as the vine well enough that the life-giving grace of God gives us wisdom and strength?  Or have we subtly become “the vine” ourselves in the midst of the needs?

We do want to give our lives for others.  Good.  But our own wisdom and strength quickly fades and we must come to Christ and His word.  We might have the desire to “burn out for Jesus” but taken to the extreme we will damage our family and other relationships.  Exhaustion and callousness on a chronic basis are not the ‘living stream of water’ that Jesus promised would come from our hearts!

What is our ultimate purpose in medical missions?  It is to glorify Jesus Christ.  We become like a seed which falls into the ground; it must die and spring up with new life.  My hospital, my program, my health teaching – these are all means God uses to show His character through suffering and healing, to make disciples, to enable others to connect to the vine – ultimately serving others by God’s grace.

We must reflect on this ‘Me-first’ mentality.  Do we assume that these health ministries are about us and our ability?  That’s a prescription for the prosperity gospel!  Let’s not promote a false gospel based on our works rather than grace.

The ultimate purpose is to establish God’s reign, God’s kingdom on earth – or some small signpost of the kingdom in a broken and twisted world. We can make a real difference. However it is not by our trying hard enough, but by abiding in the Vine. We don’t want to plant our program; we want to plant the mission of Jesus.

Health is not just about the physical needs of those who come to us, but about their social, economic and relational needs. I fear that too often we apply a Western mindset [think separation of physical from spiritual/non-physical reality].  One way of creating more helpful margins is to actually involve local staff and others from churches and community in the care of those who come to us – enabling them to connect with our programs as whole people, not just disease conditions.

This takes building leadership for healthcare missions, not just adding medical practitioners.

Eventually this means we work with local doctors, community, nurses, churches, believers – to build healing communities. Only through teamwork can we begin to meet the overwhelming needs of those around us in a deeper way.  And yet in this way – as we die to our own ambitions – we are enabling others to see and to know and to serve the Lord Jesus Christ.  He is the King and Savior and healer and He is building His kingdom. We get the privilege to be a small part of His work. He is worthy!

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.