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Dr. and Mrs. McDonald have served in international ministry with over 30 years of experience. Offered an international career with the UN and World Bank, they took the path less traveled, and it has made all the difference…for eternity! With work experience in over 50 countries, together they have helped set up or empower scores of development projects that continue today. These include hospitals, clinics, medical training, orphanages, community centers, schools from preschool to graduate level, businesses, farms, plantations, factories, safe houses, all providing products and services for the local community and export. Trial and error have revealed ten important principles foundational to success in social enterprise. One of them of particular interest in ministry is the issue of multiple “bottom lines.” Profit, the usual bottom line, cannot stand alone. Their core value is that any effort must produce spiritual results, at least in opening doors. Results are God ordained, not man driven. For what profits a man to gain the whole world, and lose his soul? Other principles flow from this core foundational premise. How do you determine the most strategic set of needs when there are so many? And how do you prioritize? How do you find a competitive advantage? How do you diversify to minimize risk? How do you write a business plan to know viability? How do you find the “Champion” if you are not on the ground yourself? How do you avoid colonialism while creating accountability? How do you measure results? How do you avoid corruption? Be encouraged that there is nothing greater than empowering a people group sold out to Christ to become independent to leverage the gospel in their own community! The story of McDonald’s journey is there’s no greater joy than seeing men, women and children come to know the True and Living God while standing free and reaching their own through economic, social and spiritual empowerment! Phil holds a Ph.D. from Michigan State in international development and is the CEO of L.E.A.D. Inc. Rebecca is the Founder and CEO of Women At Risk, Int’l, addressing multiple risk issues in 56 countries and licensed in all 50 states to train medical professionals in anti-trafficking. As a family, they raised four children in the developing world and know the unique challenges of marriage, family, career, ministry, business, and social entrepreneurship in a cross-cultural environment. They never expected to be serial entrepreneurs. Last year Phil authored an Amazon bestselling book entitled, “unreal: Adventures of a Family’s Global Life.” Written in memoir form, the book recounts 90 stories that highlight 60 principles learned from more than 30 years of experience.

As we approach the annual Global Missions Health Conference, I get more and more excited to see everyone together. I know we’re still in the midst of the ravaging effects of Covid-19, but I truly hope and pray that our time together will serve as a time to bolster our faith as we move forward in God’s mission. As a group of healthcare professionals, you are the exact people that are most in need right now. You are the people that can bring the only hope and healing that we need in the world – both physically and spiritually. We’ve been talking about short term trip opportunities this month on the blog and the Global Missions Health Conference always provides unique ways to engage in every kind of mission opportunity. We’re excited to see all the organizations and agencies you will interact with and learn from. One of those organizations that you will see is CMDA – Christian Medical & Dental Associations. Dr. Shari Falkenheimer, MD, MPH, MA (Bioethics), PhD works with CMDA USA as the Director of Medical Education International. She is going to share a story with us today about how short-term trips really can make a difference. We hope you will take the time to meet many others like Dr. Falkenheimer, who can share all of their resources, time, and wisdom with you while at the GMHC.                         Are short-term teams really beneficial? Can short-term trips have a long-term impact spiritually and medically? If done right, they can! Here’s an example... A US short-term medical education ministry was asked by the Kenyan Christian Medical & Dental Association (KCMDA) to provide training in trauma life support. Like many countries, motor vehicle and other trauma are common causes of death, and they wanted to be able to provide appropriate life-saving care. The US ministry sent five small teams over five years to meet the KCMDA’s goals. The Kenyans set up and advertised the training, arranged the venue, registered attendees and charged to cover their costs. The US team taught trauma life support principles, along with skills labs and a final mega-code practical to ensure students were able to use what they learned in a realistic scenario. A large number of participants attended these courses in Nairobi, many funded by a local Muslim hospital system. Optional devotions were offered each morning. After a couple of years, top graduates of the program were mentored and trained to teach the course and were mentored by the US team the first time they taught it. It was truly a training of trainers, multiplying the impact of the US team. This training became the standard of care in Nairobi medical facilities. And those Kenyan trainers took the course to over 1500 Kenyan medical personnel in 3 cities over the next 2 years and to an adjacent nation. Not long after the training, the Kenyan doctors were faced with post-election violence. They credited the course as having taught them how to respond to the resulting trauma patients. One even credited his relative’s survival to the training. Those who attended devotions were exposed to the gospel. The Kenyan CMDA became better known and appreciated for bringing the training to their country. Remaining funds from registration helped their ministry. And the KCMDA’s goal was met – they brought real improvement in trauma care not only to Nairobi but other cities and an adjacent country. So, can short-term teams really have an impact? Clearly, yes! To take a deeper dive into the world of short term trips, find more resources and a trip list here: https://www.medicalmissions.com/missions/shortterm To download our FREE 30 Day Journal: https://www.medicalmissions.com/finding-my-place-in-short-term-missions

The COVID-19 pandemic has taken it’s toll on every family, from frustration with being stuck at home, to job loss, to loneliness and social deprivation. But for many families, those three factors have been the perfect combination to provide an environment ripe for trauma. For children, we see that trauma has an impact on the development of the brain that effects learning, relationships, and emotional regulation. This seminar will give you a greater understanding of the developmental impact of trauma and tools to help children and adults grow in resilience rather than destruction through hard circumstances.

In September, MedicalMissions.com hosted a virtual event featuring several people from around the world that are involved in healthcare missions. That virtual event was a time to explore the realities of the mission landscape today. That reality is something that we wrote about a couple of months ago on this blog - that long term missionaries are facing some very difficult circumstances with very little relief. The fact is, we need more people to step up and help these long-term servants as they carry on the good work that they have set out to do. The virtual event essentially made the case for short-term trip involvement that promotes sustainability through consistent commitment. During that virtual event, we also gave attendees the chance to download a 30-Day Journal, exploring our place in short term missions. We want to highlight some of the content from that journal in hopes that you will be inspired to take a 30-day dive into how you could engage short term missions as well. Principles for Engaging with Short Term Trips So, we’re going to start with the very basics. What are short term mission trips? Perhaps a great place to start with short-term missions is to look at history. The first missions we see are in the book of Acts and the journeys of Paul and others. These groups go out with a purpose to various regions of the world to share the good news. And how did they do that? Well, that’s where it's so crazy... every instance is different. They take different paths, they stay different lengths of time, they work in some places and not in others, and so on. I believe that this presents a model where the Lord desires for us to respond to the climate and needs of each culture. But what remains consistent is that people went. In modern history, over the past 100 years, there has been a huge increase in modern short-term missions. This was obviously aided by more modern advancements in travel and technology. In many ways, the North American church has made short-term trips the vast majority of what we consider mission work. Is that good or bad? Thankfully, that’s not for us to tackle here. But what we can tackle are a few principles that do make engaging in short- term missions healthier. Let’s unpack just a few of these. Work with long-term teams-short-term teams (groups or individuals) should always be working with long-term teams to partner in the long-term impact. Regularity of location-greater impact can come when groups and individuals find a rhythm of regular service to the same location. Seen as a step, not an end goal-short-term trips should always be seen as a step in someone’s journey... not the end goal. Even if a short-term trip leads to another, a lifestyle of serving is the end goal. Leave your skills behind-when possible, train up others and leave your professional skills behind. Of course, you can’t quickly train surgery but you can leave other meaningful skills behind with the team and other indigenous leaders. But What About the Time?? Time might be our greatest commodity today and there’s no way to gain more of it. Thankfully, we serve a God who is the Lord of time and He gives us so much helpful guidance on our use of time... He made time after all! As we focus on short-term engagement in missions, it certainly might feel like there’s just no time to engage. There might not be... but there may also be some ways to leverage your time that you haven’t thought about. Let’s unpack just a few ways you might leverage your time for the Kingdom: Any length of time is worth something – no matter how much time you have to commit and give to engaging in short-term healthcare missions. It's helpful in some way to someone. Combine this with other things you’re already doing – do you have vacation time or sabbatical time? Could you do a clinical rotation overseas? Consider leveraging that time to engage in short-term healthcare mission work. And yes, you can often bring your family along for the great adventure. Stepping stones to going are great – are you just wrestling with the commitment of jumping on a plane and going? That’s okay for a season, but still take advantage of this time to support and engage somehow. Be creative in your approach – think about your schedule and your time and look at things through the creative lens of managing your time. Be prayerful about how the Lord could leverage your time to engage. There is no doubt we’re all extremely busy. The challenge is to stop to reflect on the time the Lord has given you (it all belongs to Him) and prayerfully consider how you might “make time” to engage in short-term healthcare missions. To take a deeper dive into the world of short term trips, find more resources and a trip list here: https://www.medicalmissions.com/missions/shortterm To download our FREE 30 Day Journal: https://www.medicalmissions.com/finding-my-place-in-short-term-missions

We have another guest blog post today. We're going to be hearing from a missionary that serves with YWAM, and is also a presenter at this year's GMHC. We hope that this experienced missionary's words can give you hope, freedom, and excitement for all that the Lord wants to do with your life. Enjoy!   Amy was excited to be moving into a Central Asian country. Her dream of becoming a missionary was about to be fulfilled. She and her husband Sam (names changed) had prayed and prepared for two years to make this move. This was the first assignment for this young couple. At first, it felt exciting. Everything was new and a bit confusing, but this is where the Lord had sent them. After a few months the novelty wore off, and the reality of how difficult it was to fit into a new culture, master a new language, make new friends, and “do ministry” began to settle in. Amy felt increasingly isolated, fearful, hopeless, worthless (not her personality). She began to lose her joy. Everything was hard. Unknowingly, Amy was coming under “the spirits of the land,” those dark powers that ruled that region, blinded its inhabitants to the truth, and held people in thrall to the kingdom of darkness. Those powers identified them as a threat, and focused on Amy as the strategic target. While Sam seemed to do quite well adapting, he was at a loss to help his wife who was increasingly depressed and homesick. They stuck it out for close to two years, but in the end left on at least an extended, or perhaps, permanent leave. I was called in to assess and consult with this couple and try to figure out what happened to a once vibrant woman who was certain God called her to live among and minister to His lost sheep. As I began to listen to their experiences, I could discern the clear marks of people who were ill-prepared to deal with the reality of spiritual warfare. Spiritual warfare is the advance of the Kingdom of God throughout the earth so that God is glorified and people are set free. It is necessary because there is an enemy kingdom which has stolen what belongs to God, and the Lord wants it all back, but has chosen to do it through redeemed children who carry His Image and authority. It is helpful to divide spiritual warfare into three main levels: 1) ground level, which also includes the personal; 2) occult level, which deals with witchcraft, Satanism, etc.; and 3) strategic level, which deals with the principalities and powers that rule over cities and regions. It is important to discern what level of warfare you are dealing with. For brevity, I will skip the last two, more advanced levels and only comment on the first and most prevalent- the ground level. The ground level, which involve ordinary demons, is common to the believer’s experience. People are afflicted by these daily, in ways that appear to be natural but is spiritual in origin. The enemy blinds people from seeing the truth (2Cor. 4:4) and fetters them to his kingdom. Christians who struggle with their desires, have habitual sin, etc. are also being opposed by these forces. The good news is that Jesus has given His own authority over them! “And as you go, preach, saying, ‘The kingdom of heaven is at hand.’ Heal the sick, cleanse the lepers, raise the dead, cast out demons” (Mt. 10:7-8). These are the marching orders of the Kingdom of God, and He is faithful to back up what we are obedient to declare and do in faith. For many believers, who have no awareness of the enemy’s reality nor his tactics, it is often difficult to get free from their bondages, let alone deliver others from theirs. Of course, the enemy does his best work in darkness! Yet I’ve seen many delivered from his snares as they understand who God is, how He works, and identify the enemy’s schemes (2Cor. 2:11). Jesus truly has power to set us free (Jn 8:36) into life abundant (Jn. 10:10). As I went deeper into Amy’s story, it was clear the enemy had planted land mines in her past that wounded her and reactivated fear in her life. The Islamic culture she lived in subjugated women, made them subservient to men, and gave them scant worth nor honor. Without realizing the spiritual dynamics she was immersed in daily, she began to take on these characteristics, and Sam, to a lesser degree, began to regard her more like husbands in that region regarded their wives. Once the light of Truth was shone into their story, they began to realize they were blindsided by not being prepared and armored up (2Cor. 10:4-5; Eph. 6:10-18). The wounds she carried from past traumas served as a breeding ground for the enemy’s activity (as in the natural, demons are attracted to wounds as vermin are attracted to garbage and decay). The way to deal with the past is not through vengeance nor justice, but forgiveness, and the Holy Spirit tenderly healed many traumatic wounds hidden in her soul. We displaced lies and deceptions she had come to believe with Truth, and she pledged her covenant loyalty to God to be faithful to believe His Word (both Logos and Rhema) rather than the enemy’s. She learned how to identify the schemes of darkness and how to come in the opposite spirit (as Jesus did), acting according to her Father’s will and ways rather than reacting to the bait of the enemy. When we were finally done, she shone with a joy she’d not had for well over a year. They were going to return, and there would be a rematch! They stayed a while longer and learned more about how good and great their God was. They returned and it was like night and day! They had learned to conquer through Him who conquered all!

Already, vaccines prevent millions of premature deaths and avoid bothersome days of sickness each year. Now, during the COVID-19 pandemic, vaccines have again risen to the level of headlines, conspiracy theories, and active research. During this session, we will discuss the mechanisms and means of appropriately vaccinating patients, review ethical and social concerns about vaccines, identify sources of appropriate vaccination information and administration for international travelers, and provide updated information about the development of COVID-19 vaccines.

In a suffering world reeling from global pandemics and health disparities, it is high time to think theologically about the devastating experience of disease, and to address our God-inspired responsibility to understand its origins and engage in its management. In a fragmented world, we need a unifying and integrated perspective on people in communities embedded in a fractured ecology. In an academic world blind to the spiritual world and imbalanced toward technical solutions, the global church must articulate a contemporary metanarrative that is moral, practical, and deeply transformational. All Creation Groans brings together multiple perspectives for a compelling global-health approach to the pathologies of the world as a part of the missio Dei. The authors paint a unifying perspective on God's healing intentions in creation, redemption, and consummation, and the opposing nature-corrupting effects of the rebellion of created moral agents. It is a fresh call for the global church to engage in aligning with God's healing action for eternally sustainable global health.  

Some mission experts estimate that up to 90% of young people who consider missions cease to pursue it because of various fears and obstacles, including the fear of fundraising. This session will help participants: 1. Identify various obstacles and fears relating to fundraising 2. Consider ways that God can help us overcome these barriers 3. Become aware of best resources and training materials used to help missionaries build and maintain a full and engaged prayer and financial support team 4. Know what questions to ask about support raising with possible mission agencies when evaluating where and how God will have you serve

This session focuses on women in mission and will highlight the role of women in missions, challenges faced, and some practical ways to overcome those challenges.

We tend to perceive our health by the physiological functionality of our bodies. The gospel message and the Kingdom perspective of the parables paint a wholistic picture of health that defines us as spiritual beings with specific roles to play in God’s Kingdom expansion around the world. The life-giving attributes of God’s Spirit seen in Jesus’s life and stories depict an intentionality worthy of deeper assessment so that we too can have a greater impact in and through our lives.

Today we're going to continue looking at how to encourage medical missionaries, and we're going to hear from another experienced physician who understands what this is all about. David Narita, his wife Lara, and their three children served with OMF International for 13 years in Northwest Cambodia. Currently they live in California where he facilitates OMF healthcare missions.   Red Strings When we first arrived in Cambodia, part of our settling in was learning the Khmer language and culture. I remember my instructor pointed out one day, “The red strings you see everywhere are a symbol for protection. Cambodians tie it on their wrists, bicycles, doors, everywhere like a good luck charm.” He made them sound like they were everywhere, but I hadn’t recalled seeing many of them. Yet as I walked out of class, I felt like I was in a different world. There were red strings everywhere.  There’s an idea I call the Red String Principle. If you name something, you’ll see it. All those red strings were there before; I just wasn’t looking for them. You can understand it. Now those strings had significance to me. And that new understanding allowed me to engage with their meaning. What do I think about those strings? What will I say if someone offers one to me? Ultimately naming something gives us a bit of control. Nothing I’m going to share with you is new. It’s always been there. But I hope by putting a name on it and drawing your attention to it, you’ll be able to see what’s happening, understand it and be able to engage those situations in a more thoughtful, godly way. Preach the Gospel Daily Two men went up into the church to pray, one a missionary and the other a really bad guy. The missionary, standing by himself, prayed: ‘God, I thank you that I am not like others, caught up in their worldliness and using their gifts for themselves. I value what you value; I mean I gave up my family, my career, my nice suburban life all for You.’ But the really bad guy, standing far off, would not even lift up his eyes to heaven but beat his breast saying, ‘God be merciful to me, a sinner!’ We exist because of God’s grace. None of us in any real sense is more righteous than the next in God’s eyes. We have all sinned and fallen short of God’s holy standard. John Stott wrote, “Nothing in history or in the universe cuts us down to size like the cross. All of us have inflated views of ourselves, especially in self-righteousness, until we have visited a place called Calvary. It is here, at the foot of the cross that we shrink to our true size.” (Stott, John R. W. The Message of the Galatians: John R.W. Stott. Leicester, England: Inter-Varsity Press, 1986. P. 179.) I am a proud and self-righteous person. I love to feel like I’m doing the right thing; doing better than those around me. I’m a great Pharisee. But this isn’t the way of Christ. Pride is a path that leads to bitterness and discontent, to emptiness and fruitlessness. Godliness with contentment comes from knowing that our works do not earn our salvation; that no one is better or more ahead than anyone else. Not super apostles, not missionaries, not really bad guys. We are all sustained by God’s grace through Christ. So before we go out to minister we come to the cross and preach the gospel to ourselves first. What will you do when you start feeling like a Pharisee? When your self-righteousness threatens to take away the grace God has given you? What will keep the grace of God before you day after day? Remember Christ’s Body We arrived in Cambodia very excited. But you know excitement is often just another word for stress – with a positive spin.  Naturally to bring order to that sense of chaos, we organized and categorized things in our minds. For example, we’d be asked where we stood on issues such as taking the time to learn the local language or use a translator, providing food/resources to people in need or protect a community’s sustainability, paying local pastors or encourage them to be bi-vocational. We accepted that there was a right way to do ministry and a wrong way. Lines were drawn. Those lines formed groups. Groups led to polarization. And polarization can lead to conflict. Maybe not outright hostility but a sense of separation and distance.  A veteran missionary reminded us that Christ unites while Satan divides. Recognize that our real battle isn’t with those around us. Not with your spouse, your children, the nationals, other groups, your leadership, your teammates. They’re typically not the ones out to get us. Remember there’s an enemy who would rather you give up and go home. He divides us when we judge our way of ministry is better than another’s, when we allow something small to consume us, when we grow bitter towards others. That’s our sinful nature controlling us. Satan divides but Christ unites. And uniting means valuing others as Christ does.  We’re not all supposed to be the same. We would never say, “Everyone needs to be a doctor.” What an un-fun world that would be! Neither does every Christian need to be just like me. I’m thankful for a colleague passionate about theological education as much as those feeding orphans. Both have equal and important callings from God. We’re very different members of His body doing very different things but serving the same Lord. Always be humble and gentle. Patiently put up with each other and love each other. Try your best to let God’s Spirit keep your hearts united. Do this by living at peace.  Eph 4:2-3 CEV When you feel that judgment and division say, “Satan, I’m not going to let you win!” Pray that God will give you a heart of genuine love and respect for others, allowing others to follow God as He’s called them, and be a unifying force for His kingdom. Look for the good in others, the ways they are reflecting God. Focus on that and thank God for them. When the lines seem to grow deeper between fellow believers, how can you love them as Christ does? When you’re tired and hot, people are pushing all the wrong buttons and you feel like you should just go home, what will you say to yourself to help you live at peace? Know Yourself It took me a while to realize this, but there are two kinds of people in this world – journey people and destination people. In simplest terms, it takes journey people two weeks to drive across the country. They see, they experience, they make new friends, they laugh and cry. Destination people: 38 hours and 23 minutes without traffic. In medicine, journey people want diabetics to take ownership of their disease. To work hard at diet and exercise. To care for their feet and find a new normal. Destination people: Medicine, A1c down, done. Are the most important characteristics in your church planting keeping it simple, sustainable and nationally-led or do you primarily picture a community of local believers? Journey and destination. Another way of saying this is to ask if you’re values-driven or vision-driven. Do you see the values embraced in the process as your motivation or is it the end result - what you hope to achieve – that you picture in your head? As you work with and lead others, this could be a huge source of unity or disagreement. Seek to understand the other person’s motivation; what makes the other person tick. Someone who is vision-driven will become incredibly frustrated by the seeming lack of focus of a values-driven person. And a values-driven missionary may feel a vision-driven colleague is a little too pragmatic, maybe to the point of compromise. I’m not saying one is better than the other, but if we can recognize our differences, we can all work together better. People hold pretty strongly to their positions because I believe it’s where they get their significance. It’s what makes them feel successful and worthy. Do you gain your significance by being a certain kind of person – upholding those values.  Or is it about accomplishing something – seeing a vision fulfilled? Am I here on the field in obedience? To become more like Jesus? To meet needs? You need to understand yourself, who you are and what you need in order to survive on their field. Why are you going to the mission field and what will give you the significance to keep you there? Do you have a vision for what you will do, what will happen? Are there core values you desire to live out? Maintain Perspective A lot of us look to Abraham’s life as an example of missions. Called by God, blessed to be a blessing, promised fruitfulness like the stars. We came to see our lives as that journey toward Canaan – a journey through school, more school, residency, years paying off debt. Abraham arrived in the hills, built an altar to God, pitched his tent. And I believed that perhaps like Abraham in that moment, when I arrived on the field everything would come together. I’d be able to use all those years of experience and the gifts God gave me fully in an incredible satisfying way. Getting to the mission field was a dream years in the making come true. But the biblical text continues: “Now there was a famine in the land.” What? Famine in the land of your calling? And sometimes there isn’t even time to settling in. Famine just overtakes you.  It looks like misunderstandings with your team members or your leadership. Stressors come from changing not only job roles and locale but also from culture and financial status, tensions come with our kids, our spouses – even from within ourselves.  A lot of this is normal – reactions to changes and loss. But realize that the enemy sows this; he delights in it. “Did God say...” The questions come. Was this what you signed up for? Will it get easier? Will it get better? Famine feeds our doubts, our disappointments, our insecurities. Several years ago I was sitting in an ICU in Thailand. You know what that’s like - the sounds and smells are the same all around the world. But I wasn’t there as a doctor but as a friend, sitting at the bedside of our fellow missionaries’ 17 year old son. Weeks earlier, he developed diabetic ketoacidosis. We were able to evacuate him from rural Cambodia into Thailand. And in the intervening time we prayed like we had never prayed before. People literally around the world, hundreds of people, lifted up countless prayers and fasted for this young man. We believed God would heal him. We had faith. We put our trust in God. We assured ourselves that He would do it. But in the end, this young man died. And it sent shockwaves through our team. God, they’re missionaries. They’ve given up everything to serve you. They’re faithful. We prayed so much, we prayed with such faith. What do we believe? What does God promise us? What has He told us and what do we assume? Do we think we’re special, that God will take care of us? How will we respond when famine comes in the very place God has called you? Remember that God is with us - in the famine, in the conflicts, disappointment and suffering. The incredible truth in Christianity is that He walks with us.  “Lo, I am with you always…” Like Peter walking on water, we keep afloat as we keep our eyes on Him. What assumptions are you making about God and how He works? What do you think will happen in life, ministry? Where is your hope? When doubts overwhelm and you feel like you’re about to drown, what will help you to fix your eyes on Christ? Seek Your Own Transformation In Christian circles, we like to emphasize servanthood. But I think that mindset creates a sense work, ideas and resources flowing from the servant to the served.  As a result, we think missions is for those we are serving. A better way to think about the whole endeavor of mission is “mutuality.” It’s a give and take – like a marriage, a partnership, any healthy relationship. In this way we can see missions as for both those we are serving and also for me and my family. Missions is an ideal opportunity for us to grow in our faith.  When we first started with OMF, a quote of Hudson Taylor’s struck me. “Unless there is an element of risk in our exploits for God, there is no need for faith” I wanted greater faith so what does “risk” look like? For me, getting to the mission field was a checklist of doing. College – check, med school – check, residency – check. Find someone who is both willing to marry me and go on the mission field – check. Pay off debt, gain work experience, find an organization, find a field to join, raise support… but who did I become in that process? How was it making me more like Christ? My checklist life became more challenging when we reached raising support or partnership development. We contacted people, we told them what we were going to do and then our organization tracked the progress of our support. Looking back I believe this is an unhelpful model. Why? It can reinforce the belief that what we do leads to God’s blessing; that we are in control. That success is defined by checking a box. It’s a works-based way of thinking. And unfortunately a way of thinking that we can carry over into the field. I think a picture of a sower is better. We are not in control of our crops; we’re not driving the ship. But we are in control of who we are, our attitudes as we spread seed. We sow and allow God to bring fruitfulness. It moves from a mindset of what I do to who I am. Don’t get me wrong – doing is important. But doing without becoming – without understanding this need to depend on God, seeing Him as the one who provides – leads to spiritual dryness and burnout. This is a vital realization for a successful ministry – we are not determining spiritual outcomes of fruitfulness. It is only God who can bring understanding and growth. “Unless there is an element of risk in our exploits for God, there is no need for faith.” If everything you do is within your control (or you think it’s in your control) where is there room to exercise faith and see God at work in your life? It’s only in the stretching, the moving beyond what we can accomplish on our own that we’ll see God. Be intentional – plan God into your lives. Acknowledge that you’re not in control but that God is. Embrace the uncontrollable, the things that you can’t check off or put in a box, because that uncertainty binds us together with God. It is the birthplace of faith. Where can I relinquish control and leave room for God to work in my life? How can I be intentional in seeking my own transformation through missions?

Advanced practice providers (APPs), such as nurse anesthetists, nurse midwives, nurse practitioners, and physicians assistants, have and can continue to bridge gaps by increasing access and quality of health care in cost effective ways especially in underserved communities in low and middle income countries (LMICs). Interviews with APPs and other healthcare professionals, personal experience living and working as an APP in LMICs, and literature reviews reveal similar results: utilizing APPs provides cost-effective health care access, improves morbidity and mortality outcomes, and enhances patient satisfaction without compromising the quality of care given in underserved areas. Challenges to APPs in LMICs include lack of access and standardization of higher education programs, role and title variability, physician resistance, limited research, and inconsistent legislation and licensing restrictions. When these challenges are overcome, APPs improve health care access in difficult to reach locations, exhibit adaptability and flexibility in challenging circumstances, and fill in the gaps of physician shortages particularly in primary care and rural locations. APPs are a vital, but underused role in health care. Enhancing APP training programs, defining roles and titles, educating health care providers and legislature writers, and promoting research in LMICs can improve the availability and implementation of APPs in LMIC and thus bridge gaps in global heath care. This presentation will provide personal perspectives from APPs who have worked around the World as well as present research that addresses advantages, challenges, and the necessity of APPs worldwide in bridging healthcare gaps.