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.

  • We will promote using STMM’s to support long term, locally administered and sustainable health related missions

    • We seek long-term relationships, not medical missions tourism.

    • We will be health educators whenever and wherever we can.

    • We will encourage and support community health evangelism/education

Here we would do well to begin our thinking based on the approach promoted in “When Helping Hurts.” Are we going to serve in a relief, recovery or development setting? One aspect of relieving physical suffering that we have gotten very good at is dealing with natural disasters where a short term “relief” approach is most effective. We are also pretty good at recovery efforts but what we struggle with is finding out how we are most useful in the development phase. It is similar, I would say, to the Churches efforts at spreading the good news and announcing the kingdom. We are great at evangelistic campaigns that look good on the surface (lots of folks raise their hands to indicate a desire to follow Christ) but which produce no long term change in the lives of the people not their culture. So long term health development efforts are similar to (and one could argue are the same) what should be happening in places where new churches have been planted. This is the long and arduous process of being in relation with new believers and carefully shepherding/discipling them into maturity in Christ. 

We feel strongly, as do others (MEI at CMDA for example), that building into our STMM’s a component of health education is important. How one interprets “health” will surely have a lot to do with what is taught. Our feeling is that health as a biblical concept has more to do with right relationships than with physical well-being. And a healthy community may have more to do with a healthy local church rather than a good healthcare system. In any case we believe it is useful to conform our educational efforts to the wishes of the local healthcare providers. Find out what it is they wish to learn about and build your teachings on this framework. This requires having a long term partner in that community who can network with the local churches and healthcare workers to ask what they feel they would benefit most from learning. 

An excellent base on which to build is the Community Health Evangelism (CHE) program. It is a proven approach for using biblical health teachings to evangelize people be it in rural or urban settings. This is something we can encourage our local partners to learn and use in their communities. At the next level we can prepare programs that help address the most crucial needs in an individual community or region. Again it is the local partner through interactions with local healthcare providers who will be able to guide you in preparing the most useful health education program to carry out during your STMM. A lot can be taught even in a short one week trip. 

And finally a word about sustainability. This was a key component of the original description of Primary Health Care as expressed in the Alma Ata declaration. We absolutely must promote healthcare initiatives that are sustainable after we leave. This again is something that requires a strong local partner with whom we have a trusting relationship. One indicator of a true partnership of equals is if our local partner feels comfortable telling us an idea we have is dumb and won’t work! If you get to this point you are further along than most. But our partner will provide the kind of input we need to develop health and healthcare projects that are sustainable over the long term.