The village stretcher is slowly carried up the last steep rocky climb to the hospital. Why are hospitals built on the top of hills? Is it because Christians like to be nearer God? Far below, the river winds it’s way through the valley marking the border with the neighbouring country. After another ten minutes the stretcher arrives at the already busy Out Patients Department. This Diocesan hospital is the only hospital for a good distance, & is thus designated as a District hospital by the Government, serving many patients each day. The Medical Assistant Yusefu receives the patient into his consulting room, eyeing the forty or so patients waiting outside and more are arriving. He sighs, "If only the hospital was not so short staffed," he thinks to himself. "If only Daudi had not left last week, leaving only three of us to cover OPD and on-call too." He knows that it will be difficult for the hospital to find a replacement for Daudi. "After all, who wants to work in a rural area? What is there to attract anyone here?" Yusefu questions himself. He has been a faithful member of staff for three years, & seen eight Medical Assistants come and go. But what reward is there? "I seldom even get a thank you for my work, let alone a salary that arrives on time!" When he first arrived, Yusefu remembered how enthusiastic he was, he had ideas and wanted to have discussions on various medical issues, but no one wanted to know. He quickly learned that in order to survive, he had to follow the accepted route, not alter the balance, not suggest new methods, but keep to the status quo. During his first six months there were weekly Clinical meetings, these were good times of discussion, and they learned from each other & the mission doctors too. But the meetings ceased, perhaps because one of the mission doctors left, or perhaps because no one seemed enthusiastic to learn as new methods were rarely implemented. Yusefu thought quietly for a while, then he exclaimed out loud, "I’m tired of having no stimulation. Just what is there for me here? It would even be bearable if I felt there was something on a spiritual level, but morning prayers is attended by eight people on a good day, and there is no fellowship group here at the hospital. Oh how I would love to learn more medically too, especially in paediatrics. I could be assigned to the children’s ward, & we could improve some of the procedures, & in the nutrition unit we could…" He stopped abruptly, his excitement drained away. "How silly I am" he thought, "There is so little hope of further training. Where would sponsorship come from? If I worked for one of the refugee agencies in town, I would earn a real wage & have the possibility of training. We have mission partners here, but they never speak of sponsorship, and anyway, I don’t think the committee would allow me to go away, because they are short staffed." Quietly over the next few weeks, Yusefu used his spare time to visit the refugee agencies. It was tough, but at last he was offered a short contract of six months. A short time, he realised that, but he was willing to take the risk. After all, what had the hospital offered him over the past three years? Yes, a few positive things, certainly, but what future was there? And certainly there had been little obvious appreciation of his work. Two months later, Yusefu left the hospital.
Carol, wearing a kanga & carrying a small rucksack, made her way to the Landrover. Today was a ‘village’ day. The Community Based Rehabilitation team, true to its name, spent the majority of the week facilitating services with people with disabilities in the community, although the team were based at the hospital. God had been faithful in so many ways in the setting up of a new programme, & it was now possible for Carol to hand over the responsibility to the dedicated team of national colleagues. They had the ability to run the programme, but Carol knew there were one or two stumbling blocks. "However am I to hand over the management of finances without putting Daudi in a difficult position?" she thought. At present the CBR account books, like all the different project account books at the hospital, were held by one person. "It is true" she reasoned, "this relieves Daudi of some of the responsibility to the donor" but she knew from experience the deep frustrations of trying to access money at the time it was needed. The money had not been misused, but so many times access was difficult, & programme activities had suffered as a result. In the moments of tiredness, Carol had a sinking feeling the programme could not survive, as power over many vital issues lay in the hands of one or two people. In fact, it often seemed that no decisions could be made in any departments at all. Carol mused: "I wonder where the Diocese comes into all this?" But as a Mission Partner she knew she must patiently live out the love of God in an atmosphere that dampened the hope of change. Reluctantly she admitted to herself that her patience was not always as evident as it might be. Maybe externally no one noticed, but she regretted the frustration & resentment within. "Oh well" she tried to reason, "I may be judging harshly without knowing the full picture. May God forgive me for being judgmental."
Dr. Fred was happy to be located at the hospital, because as a Mission Partner, he felt it would embody both areas so close to his heart, that of sharing the Gospel, and using his medical skills. "Wasn’t God good to open up both areas?" he thought. He was new to overseas work, but had spent a time in cross-cultural training, so he knew he could draw on the teaching he had received. He tried to attend morning prayers regularly, "But" he shared with another mission partner "I do struggle with the language. How can I worship God when I cannot understand much of what goes on?" Work became increasingly busy, as a mission partner doctor left and was not replaced, so he really had to carry more responsibility. "If I am to complete all the work, I think I shall have to forgo morning prayers," he decided.
Fred remembered that at the cross-cultural training they had been advised that, as far as possible, their role was not just ‘doing something’ themselves, but teaching others to do it. "That’s all very well" thought Fred, "but it takes so much longer to teach someone else to do something, it’s so much quicker to do it myself, especially when the pressure of work is high." Fred did an excellent job as a doctor, taking much responsibility on himself. He felt it just could not be avoided.
Fred had many highly supportive church groups in the UK, so when there were obvious needs in the hospital, such as mosquito nets for all the beds in the children’s ward, he wrote to his churches & he received money directly from them - more than enough to meet the need, so he used the remaining money in gifts in various ways. He was rather surprised and upset when one day his offer of money to buy something was turned down. "Surely the need is obvious?" he said to himself, "why refuse the money?"
As time went on, Fred began to sense that the relationship was severely strained between the ‘parent’ of the hospital, namely the Diocese, and the hospital itself. Superficially all seemed fairly calm, but underlying currents seemed to pull the work this way and that, with a possessiveness regarding the material at the hospital. Fred learned that there was a history to all this, "but is there no space for forgiveness?" he wondered. It became obvious that there were ‘hospital staff’ and ‘Diocese staff’, hospital houses and Diocese houses, despite the fact that the hospital was a diocesan hospital. One day, the Medical Officer in Charge confided to Fred, "Do you know, Fred, never once have we been invited to join a diocesan delegation to visit the UK to explain our needs at the hospital. It’s always Diocesan staff that go on visits. And in 50 years of receiving Mission Partners to our hospital, never has a mission society offered to send a member of staff for training, despite my asking. Do your missions not understand the importance of ‘enabling’ for our country? How can we be independent without training?" Fred could not answer.
Fred’s time at the hospital was drawing to a close. His mission intimated that it was unlikely a replacement doctor would be found, and other previously involved missions had also failed to find a doctor. The Medical Officer in Charge asked his wife, "After 50 years, is this the end of the mission societies involvement with us? Is our relationship with the missions dependant on the presence of a mission partner?" "Only time will tell," she replied.
Back in the UK, Fred took time to reflect on his time in East Africa. How could things have been different? What would have attracted trained and enthusiastic staff to stay at the hospital? He felt the low morale was pulling the hospital apart. If there had been some chance of in-service training, it would have helped many people. If there could be a specialist doctor who could spend maybe 6 - 12 months at the hospital, teaching his specialism to those interested, it might encourage the staff to stay. Different staff could learn at different levels, the nurses in how to care for patients after this specialist surgery, Medical Assistant’s in how to recognise patients with the problem and the procedures that follow, and national doctors in how to perform this surgery. Fred thought more deeply about his experiences; maybe if the hospital could actually be a centre of excellence for a specific area of medicine (where a resident doctor was on a contract for 3 years) then the opportunity to train under the specialist would attract medical assistants or newly qualified doctors to the hospital. Once the hospital gained a reputation as a training centre, then the morale would rise, & the staff would gain enthusiasm. However, Fred realised that there was still the question of making all this sustainable, but at least it was an idea that could be useful. Six months after returning to the UK, Fred began to question whether the needs at the hospital were only in the area of medicine? And was the traditional pattern of long-term mission partners necessarily right any more? And was the key to the problem in the relationship between the Diocese and the hospital? Fred eventually decided that the answers to the problems were not simple, and needed much wisdom and prayer. It somehow seemed that nothing had changed for years & trust in God had largely been replaced by ‘safety in age-old methods.’
As he was reading a Diocesan newspaper one day, Fred read something that made his heart jump a little! The Bishop of Buckingham, Bishop Mike Hill was quoted saying: "If you want to walk on water, you’ve got to get out of the boat." That was a challenge, risk taking is not comfortable, but risk taking with God is a different matter, especially as the Bishop continued by saying: "Personally I think water walking is for people who are prepared to invest unusual trust in God." "Is this the challenge for the hospital?" Fred asked himself.
Carol, wearing a kanga & carrying a small rucksack, made her way to the Landrover. Today was a ‘village’ day. The Community Based Rehabilitation team, true to its name, spent the majority of the week facilitating services with people with disabilities in the community, although the team were based at the hospital. God had been faithful in so many ways in the setting up of a new programme, & it was now possible for Carol to hand over the responsibility to the dedicated team of national colleagues. They had the ability to run the programme, but Carol knew there were one or two stumbling blocks. "However am I to hand over the management of finances without putting Daudi in a difficult position?" she thought. At present the CBR account books, like all the different project account books at the hospital, were held by one person. "It is true" she reasoned, "this relieves Daudi of some of the responsibility to the donor" but she knew from experience the deep frustrations of trying to access money at the time it was needed. The money had not been misused, but so many times access was difficult, & programme activities had suffered as a result. In the moments of tiredness, Carol had a sinking feeling the programme could not survive, as power over many vital issues lay in the hands of one or two people. In fact, it often seemed that no decisions could be made in any departments at all. Carol mused: "I wonder where the Diocese comes into all this?" But as a Mission Partner she knew she must patiently live out the love of God in an atmosphere that dampened the hope of change. Reluctantly she admitted to herself that her patience was not always as evident as it might be. Maybe externally no one noticed, but she regretted the frustration & resentment within. "Oh well" she tried to reason, "I may be judging harshly without knowing the full picture. May God forgive me for being judgmental."
Dr. Fred was happy to be located at the hospital, because as a Mission Partner, he felt it would embody both areas so close to his heart, that of sharing the Gospel, and using his medical skills. "Wasn’t God good to open up both areas?" he thought. He was new to overseas work, but had spent a time in cross-cultural training, so he knew he could draw on the teaching he had received. He tried to attend morning prayers regularly, "But" he shared with another mission partner "I do struggle with the language. How can I worship God when I cannot understand much of what goes on?" Work became increasingly busy, as a mission partner doctor left and was not replaced, so he really had to carry more responsibility. "If I am to complete all the work, I think I shall have to forgo morning prayers," he decided.
Fred remembered that at the cross-cultural training they had been advised that, as far as possible, their role was not just ‘doing something’ themselves, but teaching others to do it. "That’s all very well" thought Fred, "but it takes so much longer to teach someone else to do something, it’s so much quicker to do it myself, especially when the pressure of work is high." Fred did an excellent job as a doctor, taking much responsibility on himself. He felt it just could not be avoided.
Fred had many highly supportive church groups in the UK, so when there were obvious needs in the hospital, such as mosquito nets for all the beds in the children’s ward, he wrote to his churches & he received money directly from them - more than enough to meet the need, so he used the remaining money in gifts in various ways. He was rather surprised and upset when one day his offer of money to buy something was turned down. "Surely the need is obvious?" he said to himself, "why refuse the money?"
As time went on, Fred began to sense that the relationship was severely strained between the ‘parent’ of the hospital, namely the Diocese, and the hospital itself. Superficially all seemed fairly calm, but underlying currents seemed to pull the work this way and that, with a possessiveness regarding the material at the hospital. Fred learned that there was a history to all this, "but is there no space for forgiveness?" he wondered. It became obvious that there were ‘hospital staff’ and ‘Diocese staff’, hospital houses and Diocese houses, despite the fact that the hospital was a diocesan hospital. One day, the Medical Officer in Charge confided to Fred, "Do you know, Fred, never once have we been invited to join a diocesan delegation to visit the UK to explain our needs at the hospital. It’s always Diocesan staff that go on visits. And in 50 years of receiving Mission Partners to our hospital, never has a mission society offered to send a member of staff for training, despite my asking. Do your missions not understand the importance of ‘enabling’ for our country? How can we be independent without training?" Fred could not answer.
Fred’s time at the hospital was drawing to a close. His mission intimated that it was unlikely a replacement doctor would be found, and other previously involved missions had also failed to find a doctor. The Medical Officer in Charge asked his wife, "After 50 years, is this the end of the mission societies involvement with us? Is our relationship with the missions dependant on the presence of a mission partner?" "Only time will tell," she replied.
Back in the UK, Fred took time to reflect on his time in East Africa. How could things have been different? What would have attracted trained and enthusiastic staff to stay at the hospital? He felt the low morale was pulling the hospital apart. If there had been some chance of in-service training, it would have helped many people. If there could be a specialist doctor who could spend maybe 6 - 12 months at the hospital, teaching his specialism to those interested, it might encourage the staff to stay. Different staff could learn at different levels, the nurses in how to care for patients after this specialist surgery, Medical Assistant’s in how to recognise patients with the problem and the procedures that follow, and national doctors in how to perform this surgery. Fred thought more deeply about his experiences; maybe if the hospital could actually be a centre of excellence for a specific area of medicine (where a resident doctor was on a contract for 3 years) then the opportunity to train under the specialist would attract medical assistants or newly qualified doctors to the hospital. Once the hospital gained a reputation as a training centre, then the morale would rise, & the staff would gain enthusiasm. However, Fred realised that there was still the question of making all this sustainable, but at least it was an idea that could be useful. Six months after returning to the UK, Fred began to question whether the needs at the hospital were only in the area of medicine? And was the traditional pattern of long-term mission partners necessarily right any more? And was the key to the problem in the relationship between the Diocese and the hospital? Fred eventually decided that the answers to the problems were not simple, and needed much wisdom and prayer. It somehow seemed that nothing had changed for years & trust in God had largely been replaced by ‘safety in age-old methods.’
As he was reading a Diocesan newspaper one day, Fred read something that made his heart jump a little! The Bishop of Buckingham, Bishop Mike Hill was quoted saying: "If you want to walk on water, you’ve got to get out of the boat." That was a challenge, risk taking is not comfortable, but risk taking with God is a different matter, especially as the Bishop continued by saying: "Personally I think water walking is for people who are prepared to invest unusual trust in God." "Is this the challenge for the hospital?" Fred asked himself.
