Content Resources

This session will explore the value of healthcare education as a form of mission experience, both in the short and long term, as well as to inspire and equip participants to explore healthcare education opportunities as an answer to God’s call to missions.

This is not our grandparents' world, with clear First, Second, and Third World nations. Accelerating worldwide social, cultural, and political changes call for reflection and alteration of our missionary strategies.

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.

In India, it is not easy to witness to Urban dwellers about the Lord. Cannot go from door to door. Most of the church planting has been done in rural areas.Home based care gives health care workers an opportunity to develop relationships with our Urban non-Christian neighbors. More than 60 million Indians go below the poverty line each year due to medical care expenses. Often the hospital admissions and investigations are unnecessary. Home based care can help reduce health care expenses. We present what our home based care company PISCES health and Wellness is doing in India.

Refugees and Internally Displaced Persons (IDPs) face significant challenges to their health and well-being that are unique due to lack of necessary resources including food, water, sanitation, shelter, security, and healthcare. Caring for people in these situations requires an understanding of their unique needs as well as having realistic goals regarding what can and cannot be done for them. Our experiences in providing healthcare for the victims of disasters in Congo, Indonesia, Pakistan, Myanmar, Afghanistan, Honduras, Nepal, Kurdistan, and Turkey – both natural and manmade – highlight the need to be well prepared when serving in these difficult situations. We are called to serve “the least of these,” and the victims of disasters and crises certainly qualify. Often these events, though causing much hardship and suffering, create the possibility for doors and hearts to be open to the message of Jesus that otherwise would be closed. We must be both willing and well prepared if we are to serve well when we are called to respond to those in need.

The Changing Face of Missions in An Age of Pandemic: * Is to Help Christians see the Movement of the Holy Spirit in the Spread of the Global Church around the World in Spite of the Global Pandemic.

For the next few months, we are going to look at encouraging medical missionaries. We want to look at it from several different angles and get a real picture of what we can do to fortify those serving on the field – and we’re going to start with the development of God-honoring boundaries. We are excited to have a guest blogger today, Jim Ritchie. Jim served 25 years in the U.S. Navy and was emergency medicine residency director, deployed twice to busy 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 later taught widely on the subject. Upon retiring as a captain from the Navy in 2013, he became a medical missionary and moved to Chogoria Mission Hospital in rural Kenya, helping to start a family medicine residency with faculty from four mission agencies. He continued to encounter psychological trauma in cross-cultural medical missionary practice and was heavily involved with the growth of the hospital chaplaincy program, with whom he shared the theology of illness, healing, and death. In 2021, Jim and his family moved from Kenya to Virginia, where he now serves as VP of Partner Strategies with MedSend. We hope you enjoy reading some of Jim’s wisdom today! Boundaries Help Prevent Burnout Burnout is epidemic in the healthcare professions in the West, in part due to a work ethic that prioritizes the needs of the patients and places great responsibility for outcomes on the medical team.  When members of the medical team go to the developing world, we encounter far greater need, far fewer medical workers, and far less control regarding outcomes.  Burnout seems inevitable.  But when we embrace our God-given limitations and develop God-honoring boundaries, we can serve for full careers – staying healthy and with emotionally healthy families. Mistaken expectations We Christians can confuse ourselves by misunderstanding Scripture.  Some verses may seem to imply endless physical endurance: “They shall run, and not be weary.  They shall walk and not faint.” (Isaiah 40:31) or “I can do all things through Christ who strengthens me.”  (Philippians 4:13) But these verses are poetic metaphor and principle regarding hope in God and contentment, not a promise to be able to work without sleep. Instead, God gave us limitations.  We must sleep.  We must take time to build and maintain relationships.  We are not in control of life and death.  We are not omnipotent.  Ignoring our God-given limitations can be sinful.  Embracing our God-given limitations can be worshipful. Even Jesus, in His earthly life, embraced His limitations.  At times, Jesus sent the crowds away!  Sure, He worked hard, sometimes even through the night.  But at times, He stopped healing and went away, despite the disappointment of crowds of people.  And unless we think we are “Super Jesus,” able to work when He could not, we should do likewise. A swamp has no borders and no destination.  No boundaries.  The swamp is stagnant and breeds disease.  A river has banks and a destination, and it is powerful and life-giving.  The river has boundaries.  Setting Boundaries  Sometimes we can be hesitant to adopt boundaries, thinking that we are distancing ourselves from our calling. But healthy boundaries aren’t like a huge, imposing stone wall with razor wire on top, keeping us away from the people we’re called to serve.  Also, healthy boundaries aren’t like a line in the sand, able to be crossed with no effort.  Instead, healthy boundaries are like a substantial green hedge with a gate.  And you are in control of the gate.  At times, the gate is open, and we are in full contact with other people.  And at times, we close the gate to rest, prepare, build relationships, and work on other responsibilities.  In establishing healthy boundaries, it’s important to identify the driving idea.  Is your life dictated by the work that needs to be done and by others’ expectations of you?  If so, the overwhelming needs and unrealistic expectations will strongly tend to drive you to overwork and burnout.  Or, instead, is your life guided by a recognition of your God-given limitations and assurance of God’s love?  If so, you can establish your own guidelines for healthy living and working.  Make yourself available for work and social activities within those guidelines. What are some reasonable boundaries for healthcare missionaries?  Most healthy boundaries reflect a sound theology of human limitations, which are then translated into specific practices. Healthy Boundaries One healthy boundary is a reasonable workweek.    We have many responsibilities as healthcare missionaries: patient care, teaching, communicating with supporters, mission agency communication and admin, growing in relationship with our spouse and children (when applicable, of course) and with friends, growing in relationship with God, learning language and culture, resting for sustainability, building community, participating in special ministries, meeting licensure and immigrations requirements, and many more.  If we allow patient care to dominate our lives, we try to cram our many other responsibilities into remaining time and wind up with spiritual and relational anemia and failed duties.  Instead, we can decide to structure our weeks for fruitful medical practice and healthy lives.  One pattern that has proven to be sustainable in several locations is a five-day workweek, with four clinical days and one day for other professional responsibilities mentioned above.  Allocate one day for community building or other ministries and one day for Sabbath.  This pattern may seem odd to Western healthcare missionaries, but, when adopted by the whole team, it has proven to be restorative and sustainable while providing healthy, vibrant missionaries on the field. Another healthy boundary is a limited queue of patients.  An unlimited queue of patients has become traditional in some settings.  But this pattern can lead to frustration, not only with the medical staff but also with patients.  Establishing limitations for the numbers of patients to be seen in a day is a simple acknowledgement of personal limitations and of other legitimate responsibilities.  A friend in a surgical specialty found herself in a hospital with a tradition of unlimited clinic queues, and she suffered through that paradigm for a time, along with the tired clinic staff.  But then she required a limitation of 30 patients per clinic and assigned a nurse to be the “gatekeeper.”  There was some initial pushback, but shortly this pattern became normal in the eyes of the staff and there was a new enthusiasm for caring for the patients.  This sort of limitation usually should be associated with a triage plan, so the neediest patients are included in the numbers to be seen.  The same idea can be put in place for ward rounds, limiting the time available.  It may not be possible to see every patient every day, and a stratagem for prioritizing the patients who are seen must be established.  But this boundary has proven to be life-renewing for many healthcare missionaries.  The same idea can be put in place for meetings, regarding duration, number, attendance, and time of day.  Do you want to see life return to a tired missionary’s eyes?  Cancel a meeting! Boundaries need boundaries.  Boundaries can divide teams if some members insist on boundaries and other members resist them.  This can produce resentment and accusation and guilt.  This is lamentable, especially because God loves unity in His people.  The Bible emphasizes the need for unity, and our witness to our community can be closely tied to our team relations.  It’s very important to consider boundaries as a team dynamic.  As often as possible, the boundaries should be agreed-upon by the entire team, especially the leadership.  This promotes unity and a bearing -up of each other's burdens. We have seen individual missionaries adopt so many boundaries that they do not integrate with their communities and do not become valued by the hospital leadership.  Even boundaries need boundaries.  The development of God-honoring boundaries is a critical skill for healthcare missionaries.  Such boundaries honor our God-given limitations, honor our many responsibilities, and honor our important personal relationships.  May God guide you in honoring Him in this way.

As we see an increasing number of culturally diverse patients in our practices, there is no doubt of the importance of cultural competency in medicine. Specific circumstances and miscommunications have been well documented. But how can we develop an eye to see where a patient’s values and worldview may differ from our own? We will review an approach to cultural competency highlighted by medical missions case studies.

We’ve seen the church thrive around the world through missionary efforts. How do we leverage the impact of the global church to the nations where there is no church sharing all the things God has uniquely given us?

Failure is an unacceptable word in our society. Yet the Bible repeatedly shows God’s grace and mercy in finding us in our brokenness and in using us as His instruments when we are weak. This session explores what it means to fail in missions, how to (sometimes) avoid it, and how to get through it. Join us as we discuss what it looks like to thrive in missions and in life as we follow the Author and Perfecter of our faith.

Despite very different settings, HIV care in the United States and sub-Saharan Africa share a lot in common. This breakout session will explore similarities and differences in HIV care between these settings including the widespread challenge of HIV-related stigma.

Modern bioethics will be placed into millenia of scholarship. The major problem with bioethics is that it lacks an adequate base to be authorative; it assumes a moral consensus which no does not exist. Why societies that put loyalty first have different ethics from societies which put truth first will illustrate the missionary problem.