We have finally reached the final statement for what we believe are the minimum set of standards that lead to excellence in short term and long term health related missions activities. Or in other words adopting and implementing these standards will lead to sufficient knowledge to match the zeal many feel for doing good through health outreaches in the name of Christ.

Todays statement has to do with multiplication. Christ spent 3 years with a very select group of 12 disciples whom he knew he would have to count on to carry on the work after his death on the cross. Yes He was aware that this group and their future followers would be equipped with the Holy Spirit to help them on their journey but his presence in the flesh provided an unprecedented level of mentorship that the world will never witness again. Now I am not implying that we (this is written chiefly to westerners involved with inter-cultural health work) should view ourselves as the world’s answer to providing mentorship to those serving in developing nation settings. On the contrary I think we have just as much to learn from them as they from us. What is taught and learned varies. But I am saying that if we who are blessed with material resources are working with developing nation partners we should always do so with a mindset of doing what we can to multiply our efforts. Make every effort to work ourselves out of a job. Or work so that at some point in the future (not too distant) our services/assistance is no longer necessary. This will require strategies of multiplication. Some ideas include:

  • We need more laborers in the harvest field! How many Christian healthcare providers are there who have felt a calling to do healthcare missions activities in international locations that are very difficult and challenging? It is likely there are MANY. Been there, done that. This article is one that helped change my life: http://www.worldmag.com/1999/06/not_to_be_served/page1If many are called but few go then our efforts at multiplication will fall short. (2X2 equals a lot less than 20X20) 
  • Encourage the creation of Christian health professional groups.
  • Multiplicative training – encouraging indigenous Christian health professionals to be engaged in missions themselves.
  • Give a man a fish -> Teach a man to fish -> Enable/Encourage a man to teach others to fish – a major challenge in the work of multiplication is that knowledge is power and as such it is shared with others sparingly. Yes, even in the church. As we help educate/equip our global partners to be more effective in their own efforts at health related kingdom initiatives we must do all we can to assure that this knowledge is shared just as freely with those they work with and serve.

No doubt many of you have other ideas about how to multiply our efforts so please add them to this discussion. Shalom, mike and the Health for All Nations team. 


The emphasis of this posting has to do with the focus of our Christian health ministries. In all the hustle and bustle of STMM’s it is easy to lose sight of the primary reason we are serving in such a capacity. The busy-ness of the week (or whatever short term time frame you are working within) makes it easy to let logistical details overtake the primary focus of serving people. Our western mindset is so often centered on getting things done so that we can make our reports to our supporters that we leave out making a personal connection with those in need.

Language barriers are always a challenge but this simply highlights the importance of working through trusted partnerships (trust that goes both ways) so that the deep spiritual issues that may come to light during a healthcare outreach can be effectively addressed by our local partners.

Our statement 11 then is that if we are truly focusing on people then we will need to make some adjustments in our expectations. We will need to take into account that the time it takes to translate effectively, teaching as we go along will surely make us adjust things such as surgical times and surgical case volumes. One could certainly make the case that a surgeon who is going to do a series of cases that have already been arranged by a local partner may not have to work on a slower schedule at all and some indeed do more cases in a day than they would at home. Leaving the personal touch to the local partner. That may serve to satisfy a severe need to for getting as many cases dealt with as quickly as possible but it really doesn’t satisfy the desire by many to have a genuine connection/relationship with those they are serving.

Here are our recommendations for doing surgery in limited resource settings:

  • Adjust time/task expectations
    • Consider:
      • translation time
      • educational time
      • surgical times
  • Surgical teams can be a great blessing
    • Only perform procedures that you do at home
    • OPlan to do less than you normally do at home
      • Translation
      • Education takes time
    • Share your knowledge with other physicians
      • Example: Cochlear implant project
      • Great chance for surgical CME – sharing new knowledge
  • WHO Surgical Guidelines: http://www.who.int/topics/surgery/en/
  • Emergency Surgical Care
    • http://www.who.int/surgery/publications/imeesc/en/index.html
  • OEmergency Surgical Care in Disaster Situations
    • http://www.who.int/surgery/publications/BestPracticeGuidelinesonESCinDisasters.pdf

Nothing creates fear (for some in the Church) as much as the thought of sharing Christ with non-believers. Add to this the difficulty we have when doing this with “educated” people. But we all don’t need to have the expertise of apologist Ravi Zacharias to be effective witnesses of the kingdom of God. There is a wonderful chapter in “Walking With the Poor” (Myers, 2011) in which Bryant Myers discusses why we MUST witness and then goes on to describe the difference between proclamation evangelism and what is sometimes referred to as lifestyle evangelism.

Our work will always be a witness to something. And according to Jayakumar Christian whatever we put at the center of our development program (in our case health outreaches)  during its lifetime will tend to be what the community worships in the end. (1998, “Reflections On Poverty and Transformation.” Lecture series for the WVI Board of Directors)  The way in which we conduct our health related missions activities is a witness not only to those we are serving but also to those who are observing. By this I mean those who perhaps have given us permission to conduct health care services in needy areas but who are not themselves followers of Christ. Local health ministry officials, hospital administrators, mayors and the list goes on. This would also include “development” workers who are also a witness to our work. For example members of Doctors Without Borders works in many of the most difficult to reach and work regions of the world. And we have good news for them as much as we have good news for those we are directly serving in delivering healthcare in Christs name.

Newbigin (1989, The Gospel in a Pluralist Society pg 132-33)  highlights the fact that in Acts the examples we read of proclaiming the good news came as an opportunity to answer questions raised in the minds of onlookers who were witness to signs and wonders. Peter’s first public statement of the gospel, the healing of the cripple at the temple gate and in the story of Stephen) The proclamation comes not as a planned event but in reaction to questions raised because of the activity of the disciples in the community. Conducting health related ministry work with excellence and with an uncompromising care for each person as a unique individual created in the image of God will be enough to create questions in the minds of those observing our work to ask us what it is that motivates us to do what we are doing. This doesn’t create a setting where we feel inadequate to respond unless we have a theological degree but is the time for witnessing to the good news of the person of Jesus the Christ and what he was able to accomplish on the cross some 2000 years ago.

So when the time comes we must be ready to respond not with eloquent words but truth in love.

I Corinthians 2: 1 And I, brethren, when I came to you, did not come with excellence of speech or of wisdom declaring to you the 1 testimony of God. 2 For I determined not to know anything among you a except Jesus Christ and Him crucified. 3 b I was with you c in weakness, in fear, and in much trembling. 4 And my speech and my preaching d were not with persuasive words of 2 human wisdom, e but in demonstration of the Spirit and of power, 5 that your faith should not be in the wisdom of men but in the f power of God.

Greetings once again from the ZealWithKnowledge blog at the Health for All Nations. With this installment we address the issue of using strategies that identify the type of situation we will be encountering when working in another culture. In their best seller “When Helping Hurts,” Corbett and Fikkert rightfully highlight the importance of knowing what type of situation we are working within. Is it a relief effort, (post tsunami Indonesia or post-earthquake Haiti for example) a recovery effort (they actually use the term rehabilitation) or a development situation? This is important for several reasons. It will change the type of team member we ask to participate (an ER doc is going to be more useful than a radiologist) and there will be a difference in the type of meds we arrange to be made available. But the most important factor may be our strategy for how we do things. In a relief effort we are doing all we can to save as many as we can and we will likely find ourselves in positions of leadership that are more in line with just getting done what needs to get done. Whereas in a development situation our approach will be entirely different. So our Statement 8 reads:

We will differentiate between relief, recovery and development efforts

  • Disaster relief
    • Short-term
      • Providing free or minimal cost care
      • Caring for emergent medical needs
      • Those who are most capable of saving the most lives are in positions of leadership with the approval of local authorities.
  • Recovery phase:
    • Medium term
      • Begin shifting focus of leadership toward local trusted individuals/entities
      • ID those who were previously doing sustainable (or at least moving toward) development work and review with them there strategies. Give feedback and input when asked.
      • Assist those with no long term strategy for sustainability to ID means by which they can move in that direction.
      • Assess healthcare infrastructure (assets) and fill in the gaps where local means are not sufficient.
  • Development
    • Long-term
      • Building healthcare capacity
      • Education
      • Assist in implementing strategies likely to lead to self-sustainability – Encouraging Primary Care, maternal/child care and Community Health.

This is obviously not an exhaustive list of activities at each level but you get the picture. I think we are very good at the relief level and probably with the recovery phase, however when it comes to the more long term development phase we have a lot of trouble. This is where issues related to culture come into effect and we have not too well over the years along these lines. Western culture is more interested in short term results and giving glowing reports about #’s of people treated and lives saved. But when it comes to reports related to achievements in the long term we are much less patient. If done right long term reports on transformation will have much more to do with what our local partner is accomplishing for their own community rather than what we as outsiders are doing for them. As always we welcome feedback. Mike and the Health for All Nations team.