Content Resources

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.

In a world characterized by the Covid-19 pandemic that has brought death, and the fear of death to the front of conversations, how we respond matters. This is an opportunity to show the love of Christ and by this, they will know we are his disciples.

When I arrived in Nigeria I thought my main role would be taking care of my 6-month-old daughter. When people asked before we left, “What are you going to do?” I almost apologetically said I would be a “homemaker.” Shortly after arriving I struggled to know my role as “an accompanying spouse.” I was not prepared for this undefined role and sometimes felt like a “second class missionary” because I was not in a specific ministry. It did not take long before the Lord opened up for me amazing opportunities for ministry, some in our home and others in our community. During this workshop I will share my journey, the many wonderful doors of significant opportunity God opened for me to serve using my past experiences, education and gifts to eventually serve many unreached women and children in our community and in Nigeria. We will also explore ways in which male “accompanying spouses” also got involved and had an impact in their own unique ways and the significance of culture on these decisions.

Fear, in its various manifestations, is one of the Enemy's most effective means of limiting our obedience. The Bible offers practical strategies for overcoming fear with faith--many of which are demonstrated in an Old Testament story of sex trafficking, racial hatred, and genocide.

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.

As a health care professional on the mission field, the task of language learning is both essential and complicated. We say that language learning is a high value and priority for ourselves as missionaries, and yet it often is the first thing to take a back seat in life and ministry. Why is that? How can we do better? With over 15 years of experience in educating, training, and coaching missionaries in language and culture learning, Dr. Mullen will cast a vision for what it takes to truly become “fluent” in your target host language. She will offer biblical, theoretical, and practical advice for missionaries and missions leaders alike on how to prepare, execute, and continually improve communicative competence in a second language and cross-cultural setting.

Sending organizations spend tens of millions of dollars each year sending clinicians and support staff overseas. They invest very little in comparison on the leaders who are essential to preventing their burnout. Competent and compassionate administrative leaders are not only essential for developing and sustaining resilient healthcare and ministry teams; they also shepherd the systems that optimize human, technological and financial resources and prevent waste of resources and harm to patients. Despite its necessity, health care leadership and management training often scarce in many of the world’s most marginalized places. In this presentation, Anderson makes a case for the necessity of building leadership capacity and introduces practical tools that help address this training gap while building vibrant, sustainable mission teams.

When we think of God's global mission, we cannot overlook the U.S. as a mission field. It is a nation in spiritual decline, and widening gaps between the church and groups that are becoming increasingly unreached. What works in international missions, works here. This session will focus on the medical missions movement here in the United States, how it relates to overseas medical work, and how the two go hand in hand. We will look at several case studies, and address challenges and bottlenecks in this growing movement.

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.