How can mission hospitals share Christ whilst doing medical work? This was a key question I pondered in preparing to travel to Madagascar for my elective. My brief experience in UK hospitals made me feel somewhat daunted by the idea of a hospital so openly declaring Christ whilst treating patients, yet also wonderfully excited. In the UK, medicine can feel much like a 'closed country' – staff working as 'tentmakers', sometimes fearful of 'going too far' in sharing their faith – in contrast, here was a hospital that proclaimed the gospel openly, beginning with its name...

Hopitaly Vaovao Mahafaly – ' Good News Hospital' – lies in an isolated region of northern Madagascar, serving a population of around 200,000 or more around the town of Mandritsara and out outlying villages. The staff of 40 or so includes locally trained auxiliary nurses and maintenance staff, Malagasy missionaries from the capital, Tana, and missionaries from Europe. Their focus is clear – to preach Christ, whilst attending to people's physical needs. They make no apology for this, but instead evangelism and Christian fellowship are integrated into all aspects of hospital life.

Firstly, there is a service for the whole hospital staff and in addition a Bible study for missionary staff every week, which build up the staff and encourage everyone in their own spiritual life and evangelism. Secondly, every morning there is a gospel talk in the waiting area and on the wards simultaneously, sharing the Good News with the patients. The community team also does this work during vaccination and sanitation programmes in the villages. Thirdly, the giving of tracts is a regular part of the consultation – tracts for many situations (for example 'Your new baby' and 'I'm better!') have been written in the local language, and while not every patient can read, all know someone who can.

Finally, praying with patients is made a priority – every patient we brought into theatre, we prayed with or for. This introduced me to a key question which I heard many, many times – “Do you pray?” This simple question opened me up to a new way of evangelism. I have often asked people what they believe, but never whether or not they pray, and to whom. Yet the latter gives a much clearer view of someone's beliefs, as prayer reveals 'belief in action'. We often get caught up in philosophical debates about beliefs, yet asking about prayer gets to the heart of the matter – do you trust in a god, talk to him or her and make god an important and influential of your life? Seeing the use of “do you pray?” in action as a way to understand patients and as an opening for evangelism has been one of the most useful lessons of my time at HVM.

So, how can mission hospitals share Christ whilst doing medical work? I have been privileged to spend 5 weeks on elective at HVM, and see how they put this into practice. Several features of the hospital allow this work to go forward. Firstly, they have a staff of locals, nationals and internationals who are committed Christians, building each other up and encouraging each other in their work. Secondly, the local and national staff who speak at the morning talks handle the Bible with discernment and wisdom. Thirdly, they are unashamed of their proclamation of the gospel to patients – it is integral to their lives and therefore their work. Finally, they commit all their work to the Lord – He guides them both individually and collectively, so personal and collective prayer are vital.

I enjoyed my time at HVM greatly. The challenges of speaking and understanding French, eating so much rice and being in an alien culture were completely outweighed by the blessings of fellowship and evangelism and the medical and surgical experience I gained. However, I still struggle as to how I can bring the lessons I have learnt at HVM back to a UK medical context. The situation seems so vastly different, that it cannot even be compared. For the present time, I continue to look for opportunities to ask “do you pray?” and ponder upon the rest...