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Our Story in the Story of the World
Today we're going to continue with our theme of encouraging medical missionaries. We hope that this series of guest blog posts is encouraging you and bolstering your faith as you strive to live out the Gospel in whatever context you are in. Our guest contributor for today is Mike. Mike serves as Director of Personnel and Training at Interserve USA. A theologian by training, he previously served twenty years at a global seminary teaching Old Testament. He is passionate about helping followers of Christ engage their workplace vocation with the good news of the transformation of all things. He is married to a pediatrician and has three adult children. We know you are going to be challenged and encouraged by Mike's words! The Bible's Story The Bible tells a story, a very big story. Yes, it is comprised of lots of little stories (many of us know them from Sunday School), and it is replete with all sorts of places, people and behaviors that are utterly foreign to us. But standing behind all those smaller “stories” is one, capacious, overarching narrative. Have we really grasped what this means not just for interpretation of the Bible, but for the way we live our lives? The way we are involved in missional healthcare? How our lives “matter” in the grand scheme of things, even boldly asking how our life matters in the story of the whole world? Theologian Lesslie Newbigin famously writes of his encounter with a learned friend in Asia who said to him: I can’t understand why you...present the Bible to us in [my country] as a book of religion. It is not a book of religion—and anyway we have plenty of books on religion [here in my country]. We don’t need any more! I find your Bible a unique interpretation of universal history, the history of the whole creation and the history of the human race. And therefore a unique interpretation of the human person as a responsible actor in history. That is unique. There is nothing else in the whole religious literature of the world to put alongside it. I remember the first time I read that quote. I put down the book in my hands and sat speechless. I realized that I had unwittingly done just what Newbigin’s friend had accused these emissaries to Asia of doing —the Bible to me was just a book of religion, and to read it meant to derive “religion” from it. Its message was wholly other-worldly, and served to prepare my “soul” for a different place. Humanity's Story But the story of the whole world? And humanity’s role in the story of the world, a story that involved healing, and flourishing, and justice and mercy? I realized, to my shame, that I didn’t really care about the world. I would never have admitted that, because I did have compassion for the suffering (at least I thought I did). I was a pre-med student for a reason, to become a medical missionary to serve the poor. I felt sorry for them. But of greatest import? I was just supposed to get my soul, and as many souls around me as I could, ready to die. But this world, if I really thought about it? Not much use for it. The grand story of the world, and God’s intention for justice, mercy and life in this, his good, created world, was lost on me. Newbigin awakened me to another way of perceiving the world and my work in the world. He awakened me to a way of reading the Bible that drew my perception of my work in the world as not just something to pass time to get to the really important stuff, but actually to join in a large story, God’s story, of restoration of the whole universe. Could the Bible really be that simple? Just one sprawling story? Yes, I discovered; there is a narrative backbone to the whole of the Bible. God created a world that turned away from his intention of integrity and flourishing, and in Jesus Christ, God came himself, not by proxy, to reverse the tide. And that great tidal reversal continues today, through the restoration of things we can actually see and feel and hear. Restored things often unravel again, for sure. But the very work of restoration demonstrates that restoration is the ultimate goal of the world. The bitesize pieces of restoration nourishment we now engage are crumbs from a great and final restoration feast we await. Admittedly, the Bible narrates this great story through diverse literary genres, languages that are unknown to most people who sit down to read the Bible, nations, peoples, cities whose names we stumble over if we have the misfortune of being called on to read from the Old Testament in public. Its capacious quality—the scope of the story, from beginning to end, creation to consummation—is not only a quality that draws us to the Bible but hinders our ability to insert ourselves at any moment in its pages. We are too quickly lost. So backing up, just for a moment, and asking the big question about God’s big story can be really helpful, even for the day-to-day seeming tedium of our lives and work in healthcare. The story of the Bible in its most basic scheme is like the greatest stories known to humankind. An idyllic scene, shattered by tragedy—in the case of the Bible’s story, the revolt of the beloved in the face of the Lover—and a long and gradual rebuilding and even surpassing of that first scene through a drama of the self-giving of the Lover. Restoration in the Story But the drama involves more than just an ethereal “relationship.” The drama includes the restoration of the whole scene, the whole theater if you will, in which this drama is being enacted. Restoration is the key, the restoration of “all things.” See Colossians 1:16-20, and take a look at the “all things.” This is one of those instances where there is no hidden meaning in the Greek of “all.” All means all. “All things have been created through him and for him. He is before all things, and in him all things hold together...For God was pleased to have all his fullness dwell in him, and through him to reconcile to himself all things, whether things on earth or things in heaven, by making peace through his blood, shed on the cross.” (NIV) With this overarching view of the narrative, small steps in the drama of our daily life can take on a larger import than simply what we see immediately before us. Honestly, what is before us is often enough to process! But what if we could shift our perspective, even just a bit, to see even a small interaction—with a worried patient, a grieving family, an obstreperous administrator, an obstructive government official—as a little dialogue or action in a greater drama of restoration? Might that re-shape the way we go through a moment-by-moment unfolding of our day? Through Jesus Christ, restoration—reconciliation—has come to this hurting and chaotic world. Yes, the unraveling—the lingering effects of rebellion and wayward stubbornness—continues. But against the backdrop of the great drama of Scripture, of God himself coming in Jesus Christ to bring all things back to him, we push against that unraveling. We become his agents. Our work in missional healthcare, from this perspective, isn’t just an add-on, or a platform to do some other work. It’s part of the core story. Done in the name of Jesus, it becomes part of God’s great drama of cosmic restoration: it is the smile of God on a saddened world. That’s a perspective adjustment worth thinking about.
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Sustainability: Keeping the Faith When Ministry gets Difficult
We're going to continue our theme on the blog of encouraging medical missionaries. Today's guest blogger is Susan Post. Susan is the Director of Esperanza Health Center, a bilingual primary care center in North Philadelphia. She lives in the community where she serves and is integrated into the lives of neighbors who are also patients and friends.  Many of the people in her community face significant difficulties related to poverty, and Susan has a unique perspective to share with us today.   What Does Suffering have to do with Sustainability? The readers of MedicalMissions.com are diverse in age, profession, stage of life, and geography. You might be a student considering medical missions, or maybe you’re seeking God’s calling on your life, or maybe you’re like me and you’ve been in ministry for a while.  Wherever we are in our lives, we need to consider sustainability and how God helps us to stay faithful to Him in the places He calls us.  People often begin ministry enthusiastically and then get surprised when difficulties arise and they’re unprepared to face them. Sometimes people even leave ministry because they have difficulty addressing sustainability.   I come to you as a fellow journey person, together with you asking God to show us how to find and strengthen our ministry sustainability during these times when the work is uncertain and often difficult.   In the book of Philippians, Paul describes the suffering of Christ and the power of his resurrection. Lately I find myself dwelling on what it means to “share in the fellowship of his sufferings”.  Typically, we move on to talk about the power of His resurrection, but I have been feeling the need to be honest about how hard it is to share in suffering.  I began to see that the sharing of God’s sufferings – my neighbors, patients, and even mine, were integral to the power of the resurrection that we all long to see.  These are not polar opposites, but rather complementary.  The overall picture, even including our own weakness, leads us to see our Savior’s glory in a magnificent way.  Sometimes our trials are actually the route to experiencing God’s resurrection glory – a route we wouldn’t want to miss, and, if it were up to us, we might try to avoid.    Once I started talking with colleagues about suffering, some honest conversations began.  Tears were often shed as we discussed the pain of failures the wounds from serving.  It was a privilege to hear their stories and see their sacrifice, but in many cases, on the brink of brokenness themselves.  I realized then that there is something vital about going deep in our ministry, but also going deep in sustainability.  It’s not a matter of having our own inner strength to just move on. In fact, sometimes I think it is the opposite.  As the years of ministry go by for me, I see how God is at work in the difficulty. He sees well before I do my own weaknesses, places of potential, and actual failure. I see how His glory is always tied to weakness and He is at work in ways I often cannot see.  If I can move with Him during the difficulties of ministry, His glory will be more realized and I will find the sustainability He has already set in place for me.   Ministry difficulties                                             The Work itself – ministry itself is tough.  There is great joy in it, and it is amazing to get to be part of seeing God at work in our world.  But many days, it is also hard. When the patient doesn’t recover When a patient with substance use disorder relapses When a patient manipulates When you witness the affects of childhood trauma on an adult The cycle of suffering that life brings people in poor communities The constant limitations that finances or other resources can put on ministry When the church doesn’t understand your ministry   Fatigue and Loneliness – As a leader, I often feel quite lonely even though I have a significant number of great people around me.  But at the end of the day, when hard decisions have to be made, it is up to me.  The effect of fatigue sometimes makes it hard to see clearly all that God would have us see. It is hard to walk by faith rather than by sight when the sight in front of you looks so big and you’re so tired.  Failures - Failures can come in many different packages.  Sometimes there is little fruit, despite a lot of trying and hard work.  Sometimes we make mistakes or misjudgments.  Sometimes we have relational conflicts with others that we work with or those we are serving.  Sometimes sin brings personal and ministry failure.  When God recorded Peter’s denial of Christ, Peter must have felt himself to be the biggest failure.  But God didn’t see Peter that way.  In fact, Jesus commissioned Peter into further ministry after that all happened.  Losing our Passion – When we begin to experience burnout, we may begin to see our patients, coworkers, or even the community, as the enemy.  Sometimes we can lean toward pride or self-dependence, not realizing it is always only God who brings the fruit.  And we might not even realize we have become proud in that way.  We can also lean toward self-protection. That often happens when we count the cost and don’t believe something is worth working toward.  There is certainly wisdom in counting the cost, but generally God tells us that we don’t have to self-protect if we are trusting Him in what He has called us to do.  A fine line, but an important one to consider.  We can also feel distant from the Lord which can cause us to lose our passion. Personal Challenges – Ministry can be hard when we are going through other personal hardships – grief, family concerns, health issues, financial concerns, which can distract us from our work.  We might be suffering, but the ministry is still there with decisions to be made and patients to be seen.  It can be difficult to contribute during a time when your heart is broken, but the demands of ministry are there all the same.  Lack of confidence – There are always times in ministry when we realize that we can’t do it by ourselves.  This can be positive if it brings us to depend on God, but sometimes a lack of confidence can cause confusion and an inability to move forward.  We see this in scripture too, especially after failures, but, in the case of Elijah, even after victories.    When Healing Comes We are broken people, serving broken people, in a broken world.  We all need healing. And when things get difficult, we may begin to doubt. We doubt our calling, we doubt ourselves, or even doubt that God is good.   One passage of scripture that has given me a glimpse into how God sees this can be found in the book of John, chapters 13-17.    These chapters resonate because they portray Jesus as he faced his most difficult days at the end of his life.  He knew he was leaving His father’s work in the hands of his disciples, and that this would be his last time to talk to them before the traumatic events that lay ahead. We can look at what God did to prepare His followers on earth for “difficulty in ministry”:   He remembered who He was and what God was doing.   3 Jesus, knowing that the Father had given all things into his hands, and that he had come from God and was going back to God, 4 rose from supper. He laid aside his outer garments, and taking a towel, tied it around his waist.   Jesus stepped back to remind himself of the truths He knew – The father had given all things into his hands, He had come from God, and was going back to God. Reminding Himself of who He was and what God had called him to do gave Him the strength, fortitude, and humility to move forward – to wash the feet of those He knew would deny and betray Him.   There are times in ministry when we don’t know what God is doing – and that is God’s design.   Peter balked at Jesus washing his feet.  It makes sense that Peter would not think it proper or right for his teacher, his messiah, to wash his feet.   Peter declares, NO, Lord, you shall never wash MY feet!  Jesus responds kindly to Peter saying, “You do not understand what I am doing now, but afterward you will understand.”  Is God perhaps saying this to you right now? We need to trust Him and give Him a YES, even if we don’t understand right now.  Who am I to think I have a plan that is better than His?    We are partners with Him in the work   We certainly know this in our heads – we go into ministry to participate in God’s work in our world.But it is very easy to forget when the ministry gets tough or when you feel you need to add more of yourself to make it work.I think Jesus knew our propensity for this and so he told his disciples, and us, over and over again in these chapters that we are doing His Work, and in that there is great joy, love, and grace.   Abide in me, and I in you. As the branch cannot bear fruit by itself, unless it abides in the vine, neither can you, unless you abide in me. 15:4   This is to my Father’s glory, that you bear much fruit, showing yourselves to be my disciples. 15:8   Serving Jesus is an intimately loving relationship   We serve in ministry because we are built to be involved in God’s purposes and plans for His kingdom.What Jesus shows us in these scriptures is that this is .He lovingly expresses this until His last breath in the book of John.   John 14:1-3“Let not your hearts be troubled. Believe in God; believe also in me. 2 In my Father's house are many rooms. If it were not so, would I have told you that I go to prepare a place for you? 3 And if I go and prepare a place for you, I will come again and will take you to myself, that where I am you may be also.   I used to read that scripture and think, wow, I’m going to go live in a mansion that Jesus prepared for me.But it’s not about the it’s about being with Him.It is about a beautiful intimacy in which we will never be alone.   Sustainability for Life There are a few things that can help sustain us as we seek to live out sustainable ministry in light of God’s love. Re-Centering - Re-centering is to ask God how he sees your life situation. One way to do this is to try a prayer of examen each day. When you read Luke 24, Jesus meets the disciples on the road to Emmaus.  Jesus asks them what is happening and then he opens up the Word to the disciples to show them that their story is really part of a bigger story that God is doing.  To try the Prayer of Examen, tell Jesus about your day. Pour it out to Him. Then listen.  Have Jesus re-tell your story WITH HIS PRESENCE in the story. As we do this, we gain eyes to see what God is doing, and it will likely look very different.    Rest and Recreation – We need to rest.  We need to move out of the work and accomplishment mode so that we can recharge, refresh, and restore.  If you are like me and you love work, you will need to be intentional in this area.  Rest and recreation, or re-creation, are not just napping on Sundays and keeping your ministry hours in check.  There are far more ways to rest: Stay intentionally involved with those who restore you. Find beauty – nature, music, art.  Exercise What brings you rest and refreshment?   Reckon– the definition of reckon is to count, calculate, conclude, think.  Stop regularly and reckon, dwell on God’s truths.  Allow them to become part of your frame of reference throughout your day.  Slow down.  Contemplate, meditate on Him and what you know of Him.     Intimacy with God - I had a sabbatical last year, for 6 weeks, and I happened to be celebrating my 60th birthday.  I walked El Camino de Santiago, a 500-mile pilgrimage starting in the Pyrenees Mountains in France.  During this journey, these truths were imprinted on my heart: The purpose of our journey of life is to walk with and to Jesus Abide in Him Take time to rest in His presence Psalms of Laments – Allow Him to be your comfort   Worship – Lastly, all of this allows us to live lives of worship.  Worship moves our focus from ourselves onto God’s character. It relieves the burdens that we carry as we cast our earthly concerns on Him. The persecuted church around the world throughout history has relied on worship as a way to sustain through the most difficult times, and we should too.
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What is the Future of Medical Missions?
We have been focusing on encouraging our missionaries here on the blog, and today, we want to discuss why this is so extremely important.  What Are We Facing? Over the last several decades, healthcare missions has experienced a steady stream of missionaries both entering the field and exiting the field (for retirement, job changes, etc.). This has created a net zero effect, a rate that has been mostly sustainable for those that are actively working in mission fields around the globe. But don’t get me wrong - medical missions has never been easy. The challenges of being on the field are a never-ending list of needs that outweigh resources available. And that includes the human resources. Nurses, doctors, physical therapists, surgeons…you name the specialty, and they are all desperately needed in cities and villages and towns and countries spread across God’s earth.   So what happens when a global pandemic shuts the world down for more than a year, and medical missionaries are left alone on the field? No short-term teams to bring much needed manpower and supplies. No mid-term professionals coming to step in so that a veteran provider can take a much needed week of vacation. Fewer students entering the field because of the uncertainty around the future of international travel, entry restrictions, and overall ambivalence toward the future.   When all of these pieces add up, they create an untenable situation. Veteran missionaries on the field are left without help, without relief. They are overburdened and cannot sustain the workload. They find themselves spiritually, mentally, emotionally, and physically burned out and unable to go on. And as they leave the field, less people are entering the field, creating a spiral effect of what some would say is a 20-25% decrease in overall medical missionaries on the field. Unless we do something to dramatically change this trajectory, it will only get worse as those on the field have less and less human resources to rely upon. They are sticking it out for now, but how long can they really last?   According to MedSend President and CEO Rick Allen, over the last seven years, MedSend, which strategically funds qualified healthcare professionals to serve the physical and spiritual needs of people around the world, has been setting record numbers of applications each year. But those record numbers still equal out to that net zero we talked about earlier – the same number of people entering the field as coming home from the field. But over the past year, instead of the average 45 applications that MedSend typically approves, there were only 18. They have seen significant burnout and trauma on the field in the past 18 months and believe that in situations like these, we need significant interventions to stop the bleed. According to Allen, MedSend “recognized that there were challenges, but this has magnified them.”   What are the Solutions? So what would help sustain our current workforce of medical missionaries? The obvious answer is more workers. We need more healthcare professionals to go to the mission field and fill the gaps. But maybe the current pipelines just aren’t big enough to stem the tide…Then what?   Some other ideas that leaders in medical missions are thinking through include more opportunities for short term help. And not short term as in 2 weeks, which is just more of a burden on the field staff. But short term as in 3 months, which could be a truly significant asset. Maybe talk with Universities about how to collaborate to get medical students to do one of their rotations at field hospitals in international locations. Another idea is to have a professionals rotation. Workers sign up for two weeks at a time, but they go on a regular rotation so that field staff aren’t constantly taking up all their time training visitors.   Organizations like MedSend also realize that they want to prepare new missionaries more thoroughly before they head to the mission field. So often young missionary doctors and nurses are sent to the field only to be a burden to the veteran workers as they learn language, culture, low resource setting skills, etc. The young, inexperienced professionals get discouraged and end up leaving the field before they’ve ever had a chance to really settle in and find their groove. The responsibility of training these new professionals is a project that Jim Ritchie, with MedSend, is going to try to tackle. Jim served 25 years in the U.S. Navy. He was an emergency medicine residency director and deployed twice to combat support roles in Afghanistan. In Afghanistan, he developed an interest in combat medicine ethics and the psychological aspects of trauma relating to physicians working in difficult and under-resourced environments. He knows a little something about the challenges faced by those of you entering into medical missions. Jim is going to lead the Longevity Project, preparing and supporting MedSend Grant Recipients to handle the burdens which are unique to cross-cultural healthcare. He works closely with the mission organizations with whom MedSend partners to support them in their challenging responsibilities.