This past Saturday I was volunteered (by someone whose name will remain anonymous) for duty at our USCWM/WCUI foodbank. We receive just about to expire and some unsellable food from some local Trader Joes (thanks to TJ) stores and the food is divided into categories and then we each pass through to pick out food we would like to take home. This day I was accompanied by my daughter, Leah, who was to help me see what I needed to do so that I could actually be of some use. Also helping out as a “setup” person (they get to go through the line after the drivers and before all the rest) was Anne who is from Africa. She was there with her 2 lovely daughters and has been involved in this Saturday AM event for some time. I heard her accent and struck up a conversation as we were waiting for the drivers to arrive with the goods.

Enthusiastically she shared her story. Anne had grown up in a central African country and her was family was so poor that their poor neighbors considered her family as poor! But through the messages delivered by her pastor in their home church Anne began to hear God speaking through her pastors teaching and what she heard transformed her mind and her life. My immediate thought when she mentioned the name of her church (the name is too long for me to remember) was that it was probably a “prosperity” gospel church. Oh no Anne replied. What the pastor shared was not the prosperity gospel as most people understand it but a gospel of hope and encouragement that God did not intend that His people sit idly by suffering with poverty and ill health. No, He was a God of true prosperity but prosperity as understood in the concept of shalom. He wants His people to live lives that are full of His peace, the peace that passes all human understanding. This pastor taught that his congregants were responsible for their own well being and that their lives could be made better with their own efforts in tune with the work of the Holy Spirit active and alive in our lives! WOW I wanted to shout thanks be to God that He would allow me to hear such a story. But what has this to do with Zeal and Knowledge?

Let me take us back to the purpose of this blog. It is primarily intended to assist those with a passion/zeal for doing good to acquire a deepening knowledge base for how to match their zeal with sufficient knowledge so as to maximize our efforts for kingdom transformation. This story gets to the heart of this purpose. This story illustrates that there are indeed some excellent churches globally whose pastors are preaching and teaching sound messages that have enough impact to transform thinking and thus lives. There may be more sound messages such as this being preached globally than in the church in the west. So for those in the western church who are involved in global missions activities remember one of the principles we think is foundational to effective involvement cross-culturally is working through local churches who have leadership that is preaching and teaching the truth about the overwhelming good news that not only did Jesus die for our sins that we might have eternal life but that He also, along with the Father and Holy Spirit, desire to see His people living lives of shalom and not lives of poverty and dis-ease. We must acknowledge that God is working through His Church all over the world and if we involve ourselves and our churches in cross-cultural global ministry without being connected to such churches and leaders as Anne describes then we are not practicing zeal with knowledge and we are probably causing more harm than good.

 

I know I said I would start a series on a biblical understanding of health with my next posting but I wanted to explore the role of the church a bit further. I have been privileged to begin an exploration with my own local church as to what our “missions” strategy of the future will be. I used the Lausanne mantra as the foundation for our discussions: “The whole church, taking the whole gospel to the whole world.” Our second week discussion focused on the church (or Church) and we acknowledge that the true Church of God, His bride, those who are truly redeemed, is somewhat invisible. But that the local church, those who are meeting in buildings and calling themselves the church, can be seen quite readily still in the US though it is losing its power and influence. But as the local church we are still trying to figure out how we will go about working through other local churches globally.

Some years ago I (Mike) attended a fairly well known Christian conference (not in Louisville) and one of the main focuses was to be a discussion about working through the local church when doing “development” work. There was the normal level of excitement as the attendees became situated and the short time of sharing by the expert began. I think it safe to say that a good argument was made that the local church, no matter its level of maturity, is the means by which God has chosen to work in this world. The facilitator at our table did a good job of getting our table engaged in the discussion but something was missing. No one explained actually how they have been able to adhere to this policy in their own work globally. Most everyone agreed it was the right way to go about carrying out our individual and organizational calling but I wanted to hear how people were doing it effectively. No one came forward to give us such details. After the conference there was an attempt to put together a “best practices” working group to tackle this topic but it never went anywhere.

This blog is about sharing principles we have all learned so that our zeal to do good will be matched with an equal level of knowledge of how best to do it without mucking things up and leaving things worse off than before we started. So is working through the local church, when it exists, really a good strategy? Or is the local church just too messed up to even consider it as the main focus of our health development efforts?

First I hope we can all agree that yes the church is the earthly means by which the Lord has chosen to continue the spread of the good news which Jesus initiated with His ministry and which His disciples and then His Church carried on with various levels of success since then. DeYoung and Gilbert in their excellent work “What is the Mission of the Church” point out that the “keys of the kingdom of God-the authority of that kingdom, the right to act in its name-are given in this age, by the King, to the church! …. to this ragtag bunch of argumentative, self-centered, struggling-for-holiness but gloriously forgiven sinners.” In Ephesians 3:10 Paul explains that the mystery of the gospel was revealed so that “through the church the complicated, many sided wisdom of God in all its infinite variety and innumerable aspects might now be made known to the angelic rulers and authorities (principalities and powers) in the heavenly sphere.” DeYoung and Gilbert continue “The life of the kingdom of God-a life of poverty of spirit, meekness, mercy, purity and peace (shalom)-will be manifested to the world in the church…. and as the world sees and responds to that kingdom life, the church will not only manifest the kingdom, but also bear witness to it.”

Secondly, if we accept the first point as being true, then what are the strategies that we have found that work best to make this happen effectively? If you are working for a Christian college/university and want to give your students the best experience for learning how effective wholistic/integral transformational health development ministry can happen how do you partner with the local church where you are sending your students? If you are a local church in the west wanting to practice biblical principles in working in other cultures how do you partner with small indigenous churches in other parts of the world? How do large or even small Christian NGO’s make this work? These are some question we must answer:

  1. how does one go about finding a “healthy” local church with whom to work? or does it have to be defined as being healthy?
  2. should we focus on working through local church or pastor’s associations instead of just one single church? if you partner with a specific local church I can tell you that you will immediately lose the participation of many in the community because they belong to a different church which probably exists because of infighting among members who used to be friends.
  3. if we find a local church with whom to develop a relationship and hopefully a long term transformational project then what do we use as our guiding principles for developing that relationship/partnership? Can’t we just shake hands and say let’s go for it and let the Spirit lead?
  4. what if there is NO local church but you are instead seeking to reach an unreached people group? How do “work through the local church” in this scenario?
  5. how do you develop the partnership without creating unhealthy dependency? (or we could say unhealthy co-dependency – if you know what I mean)
  6. how do we help to strengthen the local church in whatever form it exists? should this be our highest priority?

When I talk to groups about development I do encourage working through the local church if possible. I use the illustration of a large Greek temple. The roof of the temple is the local community in which the church exists. The pillars that support the roof are what we like to focus on because that’s where we can show results: these are the pillars of justice, economy, healthcare, education, the environment, and we could throw in agriculture. But the huge foundation of it all is the local church! If we are developing programs, no matter how important, but are ignoring the local church and what we could be doing to strengthen local churches then we are not doing our best. Local pastors of poor rural and urban churches are thirsting for more knowledge as to how effectively shepherd their flocks.

I recently became aware of a wonderful effort by TearFund to address this issue. Check it out here. I am waiting to get approval to post to the Health for All Nations website a paper written by one of their country reps. More later. PLEASE GIVE FEEDBACK with methods you have seen which have worked with regards to this theme.

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.

Statement 4 may be the most difficult aspect of cross-cultural healthcare ministry to get right. I have found in my 11 years serving in Guatemala that the clash of cultures is a major factor in failed “partnerships” since few take the time to carefully craft and care for their long term partnership/relationship with majority world hosts. And this despite the fact that is an abundance of reading available on how to really do Christian networking and partnership right. See the resources page @ the Health for All Nations. Also check out this document from the Best Practices site:

Here then is statement #4 regarding best practices in global health missions:

We will nurture relationships without fostering dependency.

  • People don’t care how much we know until they know how much we care!
  • We will share knowledge with the in-country health professions with whom we work in those areas where they have requested learning opportunities. And we likewise will seek to receive knowledge from them. (Capacity Building)
  • We will honor our hosts by using safe and effective local equipment and procedures whenever we can. (Appropriate Technology)
  • Point to the Biblical God and historical Jesus first, not our materialistic life-styles, Western model of medicine, United States, etc
  • No junk for Jesus

There is perhaps no more important statement in this entire series. It is rare indeed to find a team of healthcare professionals from a Western nation that truly understands how to create a unique and biblical culture within their partnership such that the leaders from the majority world side of the partnership feel as equals and that their opinions and ideas are given highest priority. This is not easy work and can be frustrating for both partners in the relationship. This is why it is critical to also put much emphasis on statement #3. There must be a dedicated champion on each side of the relationship is thoroughly trained in cross-cultural work and who is an excellent communicator. Can you think of other points that could be added to this list?? 

Grettings again from the ZealWithKnowledge blog. We seek to infuse the zeal Christian’s have to meet the needs of the poor with knowledge on how most effectively to do it. We don’t claim to have all the answers and instead seek to learn together how to most effectively relieve the suffering in this world especially as it applies to the health side of the development equation. This week we will again use the award winning “Evangelical Tourism” video series to pin point an issue to highlight. We are now on video two of the series and we don’t need to go very far to reach an important topic to discuss. 

At just 48 seconds into the video we are told “Pastor Jorge Duran finds poor people for AIM (Adventures in Missions) to help.” Pastor Duran goes on to say how he is happy (or content would be a more literal translation of what he actually says) because it is a group of Christians who come to share the love of Christ and the people (those that will receive treatment during the week) need to see this. 

I don’t know if this strikes anyone else as being a bit troubling but it does give me cause for concern. It is good to hear directly from the pastor who is assisting this group but is it really the job of a pastor to be looking for poor people for this group to “help?” The pastors I know in the country in which I serve have an awful lot on their plates already, not the least of which is to help their congregants understand that his job is to equip them to do the work of spreading the good news of Christ among their family, friends and neighbors. The vast majority of pastors in Central America have little theological training and minimal knowledge when it comes to the wholeness of what the Church is called to be in this world. Enrolling pastors to be our tour guides and logistics person is a terrible misuse of the human resources He has given His Church. Admittedly the video doesn’t give us much information about the rest of the local churches involvement so I make comments from a limited understanding but my experience has been consistent with what I have critiqued above.

If we recall how Jesus and then His disciples/apostles (primarily Paul) went about spreading the good news of the coming of the kingdom we never encounter them waiting to bring in the big guns (in this case the NorthAmerican group riding in on their big white horse-or in a big yellow bus) in order to get a foot in the door to a community. This is how it has been explained to me in my own setting. Pastors like to use groups from outside the country in order to attract more people and to make it more likely they’ll get a foot in the door of a difficult community. I just don’t see how that is biblical. When I hear this explanation the first thing that comes to mind is “Why is that pastor or his church finding it so difficult to enter a particular community?” What is the history of this community and why might it be so difficult to enter in? What about the church our pastor friend is sheparding and what about the pastor himself? Is it a healthy church whose members truly demonstrate the love of Christ to all or does it have struggles that are making it a poor example thus making the unreached community more resistant? Is this pastor a true servant or have we been duped into helping someone who simply knows the right things to say to the foreigners to get them interested in a project that primarily benefits the pastor and makes him look good?  Difficult questions to be sure but believe me I don’t bring up these types of questions without some knowledge that this is exactly what happens in some instances.  But once we understand more thoroughly what is usually a very complex situation we can better help this pastor and his church strategize how to make an effective entry. How often do we approach our attempts to spread the good news by asking such probing questions? Not very often I dare say.

There is so much more that could be said but as blog entries are not chapter in books I must keep it short. For example another important question that comes to mind is what does it reinforce in the minds of the local communities when they see the local church bringing in outsiders who stay for a week, see lots of people in the clinic, and then leave? Seems to me it reinforces the common belief that little gets done right unless someone from outside comes in to help. This reinforces the fatalistic worldview that most of the worlds poor have and tragically continues the cycle of dependency that so plagues so many of our efforts at helping the poor live healthier lives. 


[youtube http://www.youtube.com/watch?v=OO2Bp0LODrk&w=420&h=315]

With this posting I come to the third in the series delving into the vision360 video series entitled “Evangelical Tourism.” Again this week we don’t need to listen very long to find another important topic to address relating to the challenges faced in being zealous to do good but not having sufficient knowledge about how to do good without causing harm.

In the opening statement made by the team leader she explains how the team will be breaking up into various smaller groups and that one of the groups will be “building two homes FOR families.” Unfortunately we don’t know more about the details of how this gets done in this particular case but in my experience this often means that the team has folks volunteering to be involved in construction projects but who may have little if any experience doing this type of work. You can just imagine if someone were building a home in the US and a group was visiting from Guatemala and wanted to help with the construction. What would you, as the eventual homeowner, want them to be doing? If one of the visitors stated he/she had experience in construction you would still want an expert you trust to assess this individuals abilities before giving them the responsibility of working on your roof for instance. So why should it be any different in this case? If we are going to send our son’s and daughters (and in this case also a mom who was spending her first time away from her 18 month old baby) to work cross-culturally shouldn’t they be asked to be involved in something they are gifted and trained to do within the context of what the locals identify is a need they cannot fill themselves? Doing FOR the people something they can do for themselves only creates unhealthy dependency. (see Fikkert’s “When Helping Hurts” and Glenn Schwartz’s work “When Charity Destroys Dignity.”) But it sure makes us feel good. 

These same principles apply to health related missions activities as well. This group does have included in their agenda a time for doing a dental clinic. I’m not sure if they also plan on doing medically related work as well but many such teams do. If in country partnerships have been well developed then there should exist the knowledge, having been imparted to the visiting team by the local partner, as to what health related activities are most needed in the communities to be visited. What cannot be provided locally by local health care providers? And if there are significant deficits in healthcare provision why is that the case and what can the visiting team do to correct those deficiencies? The knowledge gained can then be used to implement the most useful strategy to bring about the changes necessary in country so that local capacity is developed and eventually the team no longer is needed to provide services that the locals should be providing for their own people. This will contribute to a much greater chance for sustainability in any project engaged in between resource rich groups and those who are not yet resource rich.