Packing for the Journey

Justice in healthcare can take many different forms. It is a vital subject that every provider and practitioner needs to grapple with. In this post, we’ll cover a few of the common questions that will come up over the course of a healthcare provider’s work.  We’ll look at justice in healthcare as it relates to a time of a pandemic, social determinants, mental health considerations, and health disparities that often arise and exist when there is injustice in healthcare.  #1 We must understand justice in healthcare during a pandemic. Dr. David Stevens wrote about this topic in A Christian Healthcare Worker's Response to COVID-19.  Justice in healthcare is a tough topic, but it’s compounded during a pandemic, and it quickly becomes way more difficult to discuss. Allocating limited resources raises the ethical issue of justice—how do you treat patients fairly? How do you care for people—especially when so many more people need life and death care—and quickly? Dr. Stevens offers the following advice: First, you always want to be as impartial as the situation allows. Second, do the best you can for the most people with the resources you have. Third, without enough time, personnel, supplies, or supplies, at some point you will be forced to decide who gets and who doesn’t get your limited resource. You have the moral obligation to be constantly working to get the resources you need, so you won’t have to continue to make utilitarian decisions. Lastly, be sure to continue reading for more wisdom in the area of healthcare during a pandemic. #2 We must understand social determinants of health. According to Healthy People 2020, “Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.”  This is an issue of justice in healthcare because professionals must be committed to looking at the whole person, not just the malady. If a person is born and lives in an area with pollution, crime, violence, a poor education system, and few job opportunities, their health concerns will stem from those social determinants. Hospitals, clinics, doctors, and practitioners must be prepared to address these social issues if we want to see widespread improvements in health. #3 We need to understand mental health. Undiagnosed and untreated mental health disorders can lead to an array of serious ramifications including substance abuse, homelessness, interpersonal violence, and more. Ensuring that patients can access healthcare is vital. This might look like hiring community health workers to help navigate difficult systems or accepting patients who are uninsured or underinsured. Helping those who have difficulty navigating complex healthcare systems is a way to ensure that there is justice in healthcare. #4 We must consider health disparities. Another way to focus on justice in healthcare is to concentrate efforts on eliminating the health disparities we see that are based on race in the US. According to the Centers for Disease Control and Prevention, “Community- and faith-based organizations, employers, healthcare systems and providers, public health agencies, policymakers, and others all have a part in helping to promote fair access to health.”  The population health impact of COVID-19 has exposed longstanding inequities that have systematically undermined the physical, social, economic, and emotional health of racial and ethnic minority populations and other population groups that are bearing a disproportionate burden of COVID-19. According to the National Institutes of Health, although significant progress has been made in narrowing the gap in health outcomes (NCHS, 2016), the elimination of disparities in health has yet to be achieved. Despite overall improvements in health over time, some health disparities persist.  For example, while national infant mortality rates decreased overall by 14 percent from 2004 to 2014, Native Americans and Alaskan Natives have an infant mortality rate that is 60 percent higher than the rate for their white counterparts (HHS, 2014) and in 2013, infants born to African American mothers experienced the highest rates of infant mortality. Sadly, African Americans were 30 percent more likely than whites to die prematurely from heart disease in 2010, and African American men are twice as likely as whites to die prematurely from a stroke. Addressing these persistent health disparities in every way that you can is another way to fight for justice in healthcare.  There are so many more issues facing us when it comes to justice in healthcare. However, trying to learn and start to address these four areas, from how we handle these issues in a time of a pandemic, social determinants, mental health considerations, and health disparities, we’ll begin the process of creating a world where there truly is justice in healthcare.

Let me tell you about a medical missionary you have probably never heard about. But, you should know about this missionary. My sincere hope is that reading about this woman’s life will encourage, challenge, and inspire you to take your experience, skills, and passions and use them for God and others like this woman.  Remember, medical missions is constantly changing. In a recent post, we covered the history of medical missions. The enterprise of medical missions has brought physical, emotional, and spiritual health to the world—and opened the doors for the gospel in countless countries.  Medical missions is the term used for Christian missionary endeavors that involve the administration of any kind of medical treatment. Medical missions connects your skills with your calling. We see from reviewing Scripture, in the New Testament for example, that Jesus called for His disciples to heal the sick and serve the poor. He also calls them to "make disciples of all nations". In trying to obey Jesus’ commands, Jesus called for His disciples to heal the sick and serve the poor. He also calls them to "make disciples of all nations". As someone who works in healthcare, your life should be spent doing those exact things. You heal the sick, you serve the poor, and you make disciples of all nations. It's what being a medical missionary is all about.  There are so many avenues for missionary work. We’ve talked before about some popular ways many missionaries serve God. We’ve covered short-term, long-term, marketplace, domestic, international, and medical education as some of the top ways believers find practical avenues to serve God.  Today we want to take you back in history to look at a woman who served as a medical missionary in India. Her name is Dr. Ida Sophia Scudder.  She was born into a medical missionary family in India in 1870. Her grandparents, her father (and seven brothers) were all medical missionaries in India. She went to school in the US at the Northfield Seminary in Massachusetts, then came back to India to visit her parents. She didn’t want to be a missionary. In fact, one article reads that she, “determined never to become one of 'those missionary Scudders'.” But, one evening while she was in India, she witnessed three women die during childbirth because there were no doctors available to women. This happened in 1894. She would go on to call that situation her, “three knocks in the night.” During those days, there were no gynecologists or women practitioners at all, so women were not getting care. She went back to the US and went to Cornell Medical College in New York City, and was part of the first class that accepted women. She returned to India and started a small practice for women in Vellore. Shortly after she returned, her father died, but she treated over 5,000 patients in just two short years. In 1902, Dr. Scudder started the Mary Taber Schell Hospital in Vellore. She also began to realize that she couldn’t serve all the women of India alone, so she started a medical school for women only. During the first year, she had 151 applicants to her school. Eventually, the school became co-educational so that she could get the support of more churches in the United States.  Mahatma Gandhi visited her school in 1928. She went on to raise millions of dollars for the school and hospital. The Vellore Christian Medical Center has been one of the largest Christian hospitals in the world. Today, the Christian Medical College (CMC) in Vellore still honors Dr. Ida Scudder and her determination to serve populations of people that were not being served. According to the website “One of the top-ranked educational, healthcare and research institutes in the country. CMC’s network of primary, secondary, tertiary, and quaternary care teaching hospitals spread across six campuses in and around Vellore, is, together, a 3,000-bedded multi-specialty medical institution of international fame. The Christian Medical College Vellore, located in Vellore, Tamil Nadu, is an unaided minority educational institution established in the year 1900. Started as a single-bedded clinic, under the leadership of Dr. Ida Sophia Scudder, the only daughter of second-generation American missionaries, it grew into a full-fledged medical college imparting education in medical, nursing and allied health sciences.”  I encouraged you recently to keep the continual pursuit of a lifestyle of missional living. A missional life isn’t something we wait to do “one day”. No, the Great Commission tells us to “Go” and we understand this means you live your calling “as you are going.”  In case you missed my last post, I encourage you to, every day, take another intentional next step toward your own mission-focused life. Is that serving at your church? Is that networking and connecting with someone in your field? Is it the next step in education or training? Do it! Take that next baby step.  Review Dr. Scudder’s life and learn from her. Get on a mission with God. God’s will is that we serve Him and love others. It’s that simple and complex! Dr. Scudder’s life is an example and an inspiration to us all. She is one woman who didn’t even think she wanted to be a missionary. But, over her years of faithfully serving God and loving others, she has changed the healthcare system of South India forever. Scudder dedicated her life to the challenges of Indian women and the fight against bubonic plague, cholera, and leprosy. I hope that looking in detail at Dr. Scudders’ life will encourage and inspire you to press on in your calling to God. Often, you can get lost in the daily grind and forget the bigger picture of your life. I hope that in reviewing Ira’s life, you’ve been encouraged and inspired to live out your calling. Like Ira, let’s aim to live out our faith with our entire lives.