Top of the agenda at the meeting in London on 18th February was putting flesh on a framework document product of the first 'summit' held a year ago. That meeting proposed creating a new umbrella organisation to bring new impetus to medical missions. Within weeks we can expect to see the birth of 'HealthServe'. Funding for its first year is already in place.
The changing scene
Everyone agrees the mission scene is changing. The biggest change of all is that 'mission' is no longer 'the West reaching out to the rest'. Over a century and a half the modern missionary movement planted the Christian church in some form on every continent. In the last two generations what were once mission fields have become churches in their own right. Most are led by their own people. Few depend financially on the West for day to day operational costs. It is widely recognised, moreover, that the West is now itself a 'mission field'.
Many third world churches are now missionary-senders. Dr David Barrett, author of the World Christian Encyclopaedia, believes that early in the new millennium the numbers of third world 'missionaries' will eclipse those from the West. It is estimated there are currently more than 1,500 third world missionaries working in Britain. If there was a major flaw in the blueprint for the 1999 Medical Missions Summit it was that the voice of the third world was nowhere to be heard directly.
Why medical missions?
All this change raises particular questions for medical missions. With political independence, many third world governments aspired to something approaching the British National Health Service. Missions were asked to hand over many of their hospitals and medical facilities. Soon, however, governments discovered that running these institutions was beyond their resources. In some places the outcome was an 'on-again off-again' relationship between non-governmental organizations, missions and government.
Now there are places where NG0s and missions effectively provide the only health service. It is a good question, however whether this can be funded indefinitely. Moreover, money can be a source of tension. A Westerner suggesting a 'low tech' or low cost solution may sometimes be accused of seeking to deprive third world people of 'the best'which they are surely entitled to receive'. While some work reflects the character of mission work of earlier years, it is not always possible to maintain a distinctly Christian ethos. So where and how does the 'mission' part of it fit in the picture?
New questions
There are other factors in play. Are hospitals always the best base possible for medical mission work? A doctor-medical missionary based in Uganda told me recently: 'I could spend all my time at this hospital, doing operations, and prescribing treatment and medicines. But none of that addresses the root causes of why people get sick with illnesses that could be prevented.'
He is a keen convert to community-based healthcare, run in partnership with a team of local workers. What is certain is that it is often only Christ-like motivation that can lead a health professional with a family to accept the deprivations of working in an isolated third world situation rather than in an institution which as well as everything else confers status and prestige.
The spectre of AIDS carries an enormous threat to health care as we know it in the third world. It prompted one respected former missionary doctor to tell me: 'The AIDS epidemic could easily wipe out completely every semblance of third world healthcare'.
There have been times when Western-style healthcare, administered in an arrogant way, has received its comeuppance. In Nigeria in the 1920s some medical missions confidently told people there was no value in traditional remedies, or use of touch or prayer for healing. But then a virulent influenza epidemic defied even their ministrations. Out of the crisis came a breakaway African church that practises a combination of Western-style medicine and prayer for healing in a local form.
What is health anyway?
Experiences such as these have prompted some medical missions to engage in dialogue with local people about the nature of health itself. It is very easy for Western health professionals to arrive on a scene and immediately pronounce on what needs to be done. Some find themselves bewildered to discover that patients still die despite receiving the 'right' treatment.
Healthcare is both a science and an art. This is why, even in the 'West, a good GP will sometimes ask a patient 'How are you in yourself?' Sometimes third world patients are unable to conceive that they can be brought back to health without a 'touch' or even being prayed over. Can we learn something here from how Jesus worked with the sick?
Theological foundations
One issue somewhat absent at the Summit was consideration of the theological basis for medical missions. HealthServe is rightly seeking balance between pragmatism and principle. Healthcare professionals are essentially practical people. Doctrinal statements can easily become a distraction or a source the missionary origins of their churches and that the mandate of unnecessary disagreement. So HealthServe, with a short doctrinal affirmation, is seeking to travel light. Nevertheless it recognises the need for sources of thoughtful reflection to help Christian health professionals, for example:
Some key concepts
I would humbly offer the following as key concepts that underpin what medical 'mission' is all about.
1. 'Incarnation'. Christ is the message. And he is the supreme model for what Christians seek to do in his name. When God in Jesus took human form he immersed himself completely in the life of a family, a community, a nation, and (even) a religion. 'That which he could not become he could not redeem' (lrenaus). Here is a radical vision for what mission is about and how it is done.
2. 'What Jesus did'. We get Jesus wrong if we think his work was fully accomplished over a long weekend (his death and resurrection). His life and ministry are important too. Sometimes the Gospels speak of the healing acts of Jesus as 'signs' of the coming rule of God. Sometimes Jesus heals out of the sheer goodness of his heart with nothing more said. People engaged in healthcare mission will sometimes be given opportunities to explain their motivation and it is worth having a ready answer. Equally the ministry of Jesus suggests that acts of healing, generosity and compassion can often be left to speak for themselves.
3. 'General revelation'. We do not 'take' Christ with us. He is already present as the creator and sustainer of all things, present in all that is good, and present by his Spirit, in his Church, and at work in the lives of God-fearers.
4. 'Presence'. This takes on special significance in places where opportunities to speak openly are restricted. Presence in other cultures is in itself beneficial. Third world Christians say that the presence of missionaries and tentmakers reminds them of the missionary origins of their churches and that the mandate for mission never ends. Presence in the West of third world Christians often challenges timidity in witness and the 'tendency' to privatise matters of faith.
5. 'The Great Commision' ( Matt 28: 19-20 ). This has often been misinterpreted by enthusiastic apologists for missions. In Greek, the imperative is not 'go', but 'make disciples'. The declaration assumes that followers of Jesus are a people on the move: 'As you go, make disciples.'
Conclusion
The emergence of Healthserve is a highly important development. Moreover it is good news for the UK scene for at least two reasons:
The changing scene
Everyone agrees the mission scene is changing. The biggest change of all is that 'mission' is no longer 'the West reaching out to the rest'. Over a century and a half the modern missionary movement planted the Christian church in some form on every continent. In the last two generations what were once mission fields have become churches in their own right. Most are led by their own people. Few depend financially on the West for day to day operational costs. It is widely recognised, moreover, that the West is now itself a 'mission field'.
Many third world churches are now missionary-senders. Dr David Barrett, author of the World Christian Encyclopaedia, believes that early in the new millennium the numbers of third world 'missionaries' will eclipse those from the West. It is estimated there are currently more than 1,500 third world missionaries working in Britain. If there was a major flaw in the blueprint for the 1999 Medical Missions Summit it was that the voice of the third world was nowhere to be heard directly.
Why medical missions?
All this change raises particular questions for medical missions. With political independence, many third world governments aspired to something approaching the British National Health Service. Missions were asked to hand over many of their hospitals and medical facilities. Soon, however, governments discovered that running these institutions was beyond their resources. In some places the outcome was an 'on-again off-again' relationship between non-governmental organizations, missions and government.
Now there are places where NG0s and missions effectively provide the only health service. It is a good question, however whether this can be funded indefinitely. Moreover, money can be a source of tension. A Westerner suggesting a 'low tech' or low cost solution may sometimes be accused of seeking to deprive third world people of 'the best'which they are surely entitled to receive'. While some work reflects the character of mission work of earlier years, it is not always possible to maintain a distinctly Christian ethos. So where and how does the 'mission' part of it fit in the picture?
New questions
There are other factors in play. Are hospitals always the best base possible for medical mission work? A doctor-medical missionary based in Uganda told me recently: 'I could spend all my time at this hospital, doing operations, and prescribing treatment and medicines. But none of that addresses the root causes of why people get sick with illnesses that could be prevented.'
He is a keen convert to community-based healthcare, run in partnership with a team of local workers. What is certain is that it is often only Christ-like motivation that can lead a health professional with a family to accept the deprivations of working in an isolated third world situation rather than in an institution which as well as everything else confers status and prestige.
The spectre of AIDS carries an enormous threat to health care as we know it in the third world. It prompted one respected former missionary doctor to tell me: 'The AIDS epidemic could easily wipe out completely every semblance of third world healthcare'.
There have been times when Western-style healthcare, administered in an arrogant way, has received its comeuppance. In Nigeria in the 1920s some medical missions confidently told people there was no value in traditional remedies, or use of touch or prayer for healing. But then a virulent influenza epidemic defied even their ministrations. Out of the crisis came a breakaway African church that practises a combination of Western-style medicine and prayer for healing in a local form.
What is health anyway?
Experiences such as these have prompted some medical missions to engage in dialogue with local people about the nature of health itself. It is very easy for Western health professionals to arrive on a scene and immediately pronounce on what needs to be done. Some find themselves bewildered to discover that patients still die despite receiving the 'right' treatment.
Healthcare is both a science and an art. This is why, even in the 'West, a good GP will sometimes ask a patient 'How are you in yourself?' Sometimes third world patients are unable to conceive that they can be brought back to health without a 'touch' or even being prayed over. Can we learn something here from how Jesus worked with the sick?
Theological foundations
One issue somewhat absent at the Summit was consideration of the theological basis for medical missions. HealthServe is rightly seeking balance between pragmatism and principle. Healthcare professionals are essentially practical people. Doctrinal statements can easily become a distraction or a source the missionary origins of their churches and that the mandate of unnecessary disagreement. So HealthServe, with a short doctrinal affirmation, is seeking to travel light. Nevertheless it recognises the need for sources of thoughtful reflection to help Christian health professionals, for example:
- to articulate cogent reasons for what they are doing including the meaning of Christian 'witness' in day to day work, or in situations where formal Christian activities are restricted, even by the law of the land.
- to think through the ethical dimensions of the questions confronting Christian health professionals in their work, including how to adapt to another culture.
Some key concepts
I would humbly offer the following as key concepts that underpin what medical 'mission' is all about.
1. 'Incarnation'. Christ is the message. And he is the supreme model for what Christians seek to do in his name. When God in Jesus took human form he immersed himself completely in the life of a family, a community, a nation, and (even) a religion. 'That which he could not become he could not redeem' (lrenaus). Here is a radical vision for what mission is about and how it is done.
2. 'What Jesus did'. We get Jesus wrong if we think his work was fully accomplished over a long weekend (his death and resurrection). His life and ministry are important too. Sometimes the Gospels speak of the healing acts of Jesus as 'signs' of the coming rule of God. Sometimes Jesus heals out of the sheer goodness of his heart with nothing more said. People engaged in healthcare mission will sometimes be given opportunities to explain their motivation and it is worth having a ready answer. Equally the ministry of Jesus suggests that acts of healing, generosity and compassion can often be left to speak for themselves.
3. 'General revelation'. We do not 'take' Christ with us. He is already present as the creator and sustainer of all things, present in all that is good, and present by his Spirit, in his Church, and at work in the lives of God-fearers.
4. 'Presence'. This takes on special significance in places where opportunities to speak openly are restricted. Presence in other cultures is in itself beneficial. Third world Christians say that the presence of missionaries and tentmakers reminds them of the missionary origins of their churches and that the mandate for mission never ends. Presence in the West of third world Christians often challenges timidity in witness and the 'tendency' to privatise matters of faith.
5. 'The Great Commision' ( Matt 28: 19-20 ). This has often been misinterpreted by enthusiastic apologists for missions. In Greek, the imperative is not 'go', but 'make disciples'. The declaration assumes that followers of Jesus are a people on the move: 'As you go, make disciples.'
Conclusion
The emergence of Healthserve is a highly important development. Moreover it is good news for the UK scene for at least two reasons:
- More and more health professionals are being encouraged to seek out opportunities for electives overseas as part of their training and development. Without necessarily competing with other agencies HealthServe will be an important clearing house, identifying opportunities and helping those who go to be fully prepared.
- Christian health professionals are almost invisible. A major developmental job is needed to identify the Christian health professionals in this country and to discover what sort of support they need. It all points to the need new approaches. Healthserve's first priority will be to enlist the help of churches to identify Christian health professionals, and link them up in interesting new ways. I wish it every success.
