Reflections on Medical Missions

Let me reflect on some common queries regarding Medical Missions in the minds of Christian medical students and on ways forward:

  1. Who is a missionary? I found this definition from Wikipedia (3) quite comprehensive, “A missionary is a member of a religious group sent into an area to do evangelism or ministries of service, such as education, literacy, social justice, health care and economic development. The word “mission” originates from 1598 when the Jesuits sent members abroad, derived from the Latin missionem (nom. missio), meaning “act of sending” or mittere, meaning “to send”. The word was used in light of its biblical usage; in the Latin translation of the Bible, Christ uses the word when sending the disciples to preach in his name. The term is most commonly used for Christian missions, but can be used for any creed or ideology.” A Christian medical missionary would therefore be someone sent to provide health care on behalf of a Christian church or group and Christian medical missions would be the work done collectively by a group of such people.
  2. What are some of the characteristics of medical missionary work? I think that medical missionaries (like all other missionaries) need to be sent out to areas where they are relatively out of their comfort zone (vulnerable) and to help people who are poor and marginalized. They must excel in their professional work as well as serve in the Spirit of Christ, so that others may see Christ in and through their work. This would enable other Christian services to be offered through the activities of the mission compound.
  3. Does Medical Mission work have to be only in remote rural areas? Many of the present locations of mission hospitals in India were once rural – towns have developed around the mission compounds! However, after Indian independence, there has been a significant movement of people to urban areas and many live in slums. These people are also poor and marginalized – they do not have access to high quality medical care at affordable cost and this is an opportunity for mission hospitals in urban areas. Mission hospitals have great potential as they are among the few entities which focus on people whom nobody else is interested in.
  4. Are there opportunities for pioneering new Medical Mission work in India? Yes, Arunachal Pradesh is at present the only state in India without a Christian mission hospital. (Tripura too did not have one until we started a hospital there in 2005). There are large tracts of land in forgotten corners of our country where new hospitals are needed and can be started. However, due to local land and entry laws, it is not easy for outsiders.States such as Arunachal Pradesh, Mizoram and Nagaland require an Inner Line Permit – similar to a visa – for non-locals to enter and several states have restrictions on non-locals purchasing land). Similarly, great opportunities for transformation exist in other needy parts of the world where few want to go.
  5. Can Medical Mission work be done in hostile areas? When Makunda started the work in Tripura, Dhalai district was the most affected by militancy with murder and abduction being common and all public transportation possible only through armed convoys. However, the work at the hospital was never affected as it was seen as a humanitarian service to the poor. I had the privilege to visit Africa last year – mission hospitals are the only long-term health facilities that work well in conflict areas because of the commitment of staff. Other NGOs (like Red Cross and MSF) offer short-term medical support services. Warring groups usually do not target missionary services, recognising their humanitarian value and universal appeal.
  6. Is Medical Mission work a sacrifice? We are called to be ‘living sacrifices’ – meaning that we offer ourselves to a life of obedience to God. Medical mission work (especially in remote rural areas) is front-line work and not easy. However, in the light of the words of the Bible, I would say that the trials and difficulties are ‘temporary and trivial inconveniences’! We should not dwell on sacrifice as it makes people into ineffective self-styled martyrs! There is no sacrifice too great for a missionary – when we feel that we have been brought to life from death by the sacrifice of Jesus on the cross, we should be ready to die for Him. When we look at missionary history, many missionaries (often unheard and unsung) gave their lives so that the church may be built in remote areas all over the world – truly the present Christian church in these areas has been built on their sweat and blood. In comparison, the problems we face today in India are indeed trivial.
  7. Can Medical Mission work be professionally challenging? I have heard many people say that mission hospitals (especially remote rural ones) treat only diarrhea and ear discharge! When I completed my M.Ch in Pediatric Surgery at CMC Vellore, there were people who even asked why I wasted a M.Ch seat which could have been given to someone who was more likely to use it! I would like to say that I have seen and operated on some of the most professionally challenging conditions at Makunda. Since CT scans, nuclear scans and the services of other experts are often unavailable in these locations, missionary doctors need to innovate to be able to treat patients cost effectively with what is available.. I have operated on a teratoma in the right middle lobe of the lung (middle lobectomy with composite resection of two overlying ribs), ectopia cordis (unfortunately, this patient died), 35 kg ovarian tumor, retrograde jejunogastric intussusception, intra-abdominal cocoon (several cases) and so on. There have also been challenging medical as well as other specialties’ cases. All these years, I was the only full-time pediatric surgeon in the states of Mizoram, Tripura, Meghalaya, Manipur and southern Assam – so there are certainly a huge variety of patients who need treatment (and who cannot go elsewhere because they are poor), it is only logical to conclude that professionally, medical missionaries are in for exciting opportunities.
  8. Is it not difficult to be in a ‘vulnerable’ situation? Humanly speaking, it is. However, I would say that from a spiritual perspective, this is the greatest factor in favor of Medical Missions. Vulnerability is a blessing in disguise – how else will we see God at work? God specialises in helping us as we face circumstances beyond our control. Miracles do not happen when we are in control of situations. When all else fails and we totally depend on God, we see Him at work. It is an exciting experience to see God at work and see Him build up His kingdom and be partners in this great ministry.
  9. Is Medical Mission work drudgery with few opportunities to relax? When I was in school, I was interested in tennis, rifle shooting and rowing. In college, I cultivated an interest in electronics. However, many of these activities were not possible at Makunda. I discovered that nature observation and photography are excellent for relaxation. My observations in and around Makunda have been posted and published in many sites. (4,5) If someone is looking for the nearest mall to relax in, he may be disappointed but there are other (and maybe greater) opportunities to compensate.
  10. Can work focused on the poor be self-sustaining? When we re-started Makunda, we were told that it was impossible to work primarily for the poor on a self-sustaining basis and that all successful mission hospitals subsidise treatment of the poor by treating the rich at higher rates. However, we decided to be a hospital primarily for the poor with no special facilities for the rich as a part of our ‘pro-poor’ branding strategy. All patients wait in the same queues irrespective of their social class or wealth and the same general wards are used to admit them. Charges are low and charity is liberal – the hospital is flooded with patients and high capacity utilisation leads to high efficiency and lowered costs. God has blessed the work and we have been able to invest in new equipment and buildings, start a new school, the branch in Tripura and nursing school without major grants (the external funding received each year was less than 1 percent of income for many years). When we treat the poor who cannot afford to pay, God pays their bills – often in ways that money cannot buy – by giving us satisfaction, contentment and wealth in heaven.
  11. Why is there a high attrition rate in mission hospitals? Work in mission hospitals is not easy and not for every one. There is peer-pressure from families and friends. People look for comforts and sometimes are unable to adjust to life in mission hospitals. Many are short-term and do not want to stay on to solve local problems. There is a high attrition rate in Medical Mission work all over the world – maybe <10 per cent of new staff stay on long-term. However, most staff leave after tasting God at work and often say that the best years of their lives were at the mission hospital!
  12. Are many mission hospitals today ‘beyond redemption’? Sadly, many mission hospitals are ‘sick’. This is due to inability to adapt to rapid changes, poor governance and the absence of committed long-term staff at a leadership level. Being at the cutting edge of mission work, I am sure there would also be an element of spiritual warfare. However, no hospital is beyond redemption. Major changes may need to be done to resolve problems but all of them can be revived. If a completely shut hospital (like Makunda) with severe local problems can be revived to become a thriving community, there is hope for all the other sick ones too! God is able to do great things. He just needs a few volunteers willing to submit to Him.

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Obeying a call to Medical Missions – a Testimony

In 1982, as a second year under-graduate medical student at the Kilpauk Medical College in Madras (1), I made a lifelong commitment to Jesus Christ. I started a Bible Study group in college and we discussed how to live the Christian life and make decisions that were approved in God’s sight. We heard many messages on the topic, “Finding God’s Will” but many of us were not able to get a clear convincing personal answer to this burning question. My query was answered one day when I was reading Jeremiah 29:11-13 (2) – I felt God telling me that I was not able to find His will for my life because I was not seeking with all my heart and that He was waiting to answer as soon as I realised that He had the best possible plans for my life. I also realised that I did not want to hand over my life totally into His hands; I wanted to retain control and this attitude was preventing me from seeing His plans for me. I felt God speaking to me and made a vow that I would obey Him and go where He wanted me to go and do what He wanted me to do with all my time, talents and treasure. It soon became clear to me that I should go where few others wanted to go, so that I could make a difference to people who had no access to good health care. Since the southern four states of India were well provisioned with healthcare, I had to go far away from home.

After my internship, I was not confident to run a remote hospital by myself and joined the Christian Fellowship Hospital (3) at Oddanchatram in 1987 and spent 3 wonderful years there, learning to become a more confident doctor. I also spent the 3 years (every Thursday) exploring villages in the hills of Pachalur (30 kilometers from Oddanchatram), doing medical work with some local missionaries and seeing God answering the simple prayers of poor people powerfully. For the next few years, I was involved in conducting the annual Medical Missionary Meets for medical college students of Tamil Nadu at Pachalur organised by the CF Hospital – I visited medical college fellowships in Tamil Nadu, wrote numerous letters to a large number of students and learnt many things about working with medical students.

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Democracy: Debate, Dissent, Discussion and Decision

Rt. Rev. Dr. P. C. Singh – President, NCCI.

In the life of States, organizations and movements decision making is an ongoing life process. History has witnessed many forms of governance and decision making. Kingship, autocracy, oligarchy, and democracy are some of them. The world has suffered from tyrant kings and reckless autocrats. Kingship has disappeared from many nations though many of the Middle Eastern countries are even now ruled by Kings and Sheikhs. For that matter, our own country emerged as a union of many small kingdoms.

Of all the forms of governance, democracy has been tested and found the best form of government. Democracy is government of the people by the people for the people. Our country is world’s largest democracy.

However, early church had a much simpler form of governance. They gathered together spent time in prayer and made decisions in one mind, probably guided by the elders. Their appointments and nominations were by casting lots. As the church grew up most of the mainline churches adopted democracy as their form of governance. Now CNI, CSI, MarThoma and many other churches are fully democratic. Yet, we cannot boast that our democratic process is without flaw. In many cases we fail to observe that salient features of democratic decision making process.

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Prophetic role of Church leaders in the midst of injustices: A Biblical insight.

Should Church Leaders keep silent when they see injustices being done in the society? Should Church Leaders speak out against all the wrongs that they see happening in the country? Should Church Leaders submit meekly to the Government and its Laws even when they very well know that the Political Rulers are not following the noble principles and good values enshrined in the Constitution of the country?

Very often Christians turn to biblical texts which seem to instruct Christians to be submissive to socio-political authorities. One such text is I Pet.2: 13-14.

For the Lord’s sake accept the authority of every human institution, whether of the emperor as supreme, or of governors, as sent by him to punish those who do wrong and to praise those who do right. (NRSV)

Where the NRSV says rather mildly “accept the authority of every human institution”, the RSV puts it strongly as “Be subject to every human institution.” It is biblical texts, such as this one, which have been interpreted to mean that Christian individuals and Churches must passively submit to the decrees of the ruling government or any other political, social, and religious authority. Such an interpretation does not encourage or exhort Church Leaders to play a prophetic role in society.

Did Peter really intend to assert that Christians should be submissive to every authority at all times? Read more

A Moment of Introspection and Reflection

Rt. Rev. Dr. P. C. Singh – President, NCCI.

Greetings

Introduction

We have come together for the annual meetings of NCCI and CSA. As President I take this time to greet you all and welcome you to these sessions of deliberations. This is also an occasion of our mutual accountability. This responsibility will be carried out officially through the reports of the General Secretary, Treasurer and the secretaries and directors who are in charge of various activities of our great ecumenical movement. What I wish to do is to take a moment to introspect and reflect on our work during the past year. This, as you know, is a spiritual exercise which will provide a focus to our deliberations.

I wish to place before you a question around which we can do our introspection. How faithful and effective were we in fulfilling our quadrennial commitment of building up just and inclusive communities? We have completed sixteen months since the quadrennial meeting in Jabalpur. After observing and participating in many meetings, consultations and conversations since then, with appreciation I can say that we have made good progress in enhancing inclusivity.

Let us have a look at the development of our understanding of inclusivity. About two decades ago, NCCI’s agenda of inclusivity was very traditional. NCCI itself has been an umbrella of ecumenism for its member churches. Slowly the umbrella became larger to accommodate Roman Catholic Church and the Evangelicals with a new name NUCF. Side by side we had also occasions of dialogue with people of other faiths. Our understanding of gender equality was limited to giving equal status to men and women. Even for that, we did not succeed in giving equal status to men and women in all the member churches of NCCI.

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Open letter to The Prime Minister of India.

To

Shri Narendra Modi,
The Prime Minister of India

Dear Prime Minister,

Greetings!

Though a Christian pastor, and serving the National Council of Churches in India as its General Secretary, I am writing this open letter to you as an Indian citizen, joining all Indian citizens who are concerned about the state of affairs in our country, India

You have been giving the country very impressive slogans about its future, be it “Achhe Din!” or “New India!” Harping on “Development” you have been advocating and initiating schemes such as “Make in India”, “Skill India”, “Start-up India”, “Digital India”, “Smart Cities”, etc.

The question which many would like to ask: Achhe Din for whom? New India for whom? The Preamble to the Constitution of India gives us a vision for all citizens:

We the People of India, having solemnly resolved to constitute India into a Sovereign Socialist Secular Democratic Republic, and to secure to all its citizens:

JUSTICE, social, economic and political;
LIBERTY of thought, expression, belief, faith and worship;
EQUALITY of status and of opportunity;
and to promote among them all
FRATERNITY assuring the dignity of the individual and the unity and integrity of the Nation

However many people who belong to your government, party, and other likeminded bodies give us a different picture of Achhe Din and of New India where the values of Justice, Liberty, Equality, and Fraternity are stifled. “Vigilantism” has become a popular methodology of such persons and bodies.

Cow Vigilantism: Cow reverence and cow protection has become a very serious concern among such people. They claim that the cow represents their religion and culture. I appreciate the cow symbol as it represents love, compassion, service, sacrifice, and non-violent living. People, when they become politically emotional about this symbol, tend to give expression to hatred, cruelty, harm, murder, and violent life-styles. I wonder whether the cow would approve of such things done in her name. Read more

Easter Message from General Secretary of NCCI – “Who will roll away the Stone? Any Easter Hope?”

The crucifixion and burial of Jesus in the tomb was not merely an individual tragedy. It symbolized something much deeper. His death and entombment marked the end of the hope of the Jews of his time to be delivered out of the Roman bondage and of the vision of Messianic rule.

A shoot shall come out from the stump of Jesse, and a branch shall grow out of his roots. The spirit of the Lord shall rest on him, the spirit of wisdom and understanding, the spirit of counsel and might, the spirit of knowledge and the fear of the Lord. His delight shall be in the fear of the Lord. He shall not judge by what his eyes see, or decide by what his ears hear; but with righteousness he shall judge the poor, and decide with equity for the meek of the earth (Isa.11:1-4).

The travellers on the road to Emmaus express this utter disappointment when they lamented, “But we had hoped that he was the one to redeem Israel. Yes, and besides all this, it is now the third day since this happened.”(Lk.24:21) The tomb-stone had dashed the hopes of the people for the coming of the reign of God. Even today people in India have been waiting expectantly for “Achhe Din!” Listen to a report from Abhinav Rajput and Prawesh Lama in Hindustan Times, updated on February 6, 2017:

Rocking the youngest of his five children in his arms, street vendor Daata Ram watches his wife tend to two sick cows whose milk once supplemented their meagre income. The 66-year-old’s family of seven survives on what he now makes by selling small quantities of puffed rice in Pandra Sikanpur, a one-street, hardscrabble town of 5,000 in Uttar Pradesh. “I took a loan of Rs 30,000 to buy those cows but I think they are no good now,” says Ram, who uses a fourth of his monthly earnings of Rs5000-6000 to repay the local moneylender.

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A “Good Friday” reflection

‘Happy Good Friday to you’, greeted my learned Hindu friend, one Good Friday, though I was puzzled about the prefix ‘Happy’. I thanked my friend and we departed.

This unusual greeting set me thinking about my own faith and the faith of my friends living in a religious pluralistic society like ours.  From my Hindu friend’s point of view any religious observance is basically both Good and Happy.  More so, because, Friday of the Holy Week is universally known as ‘Good Friday’.  The numerous Greetings like ‘Happy Diwali’, ‘Happy Id’, ‘Happy Christmas’, ‘Happy Dushera’, etc are exchanged in India.  While it does denote secular outlook and religious tolerance it also shows that individuals lack a true understanding of each other’s faith. One’s faith is regarded as a purely personal matter and is to be observed on certain designated occasions.  This was true prior to the coming of Jesus Christ who revolutionized the world view of Religion, Faith and The life of people.

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Christmas message from NCCI General Secretary: “LOVE CAME DOWN AT CHRISTMAS!”

We live in a loveless world

We live in a loveless world. Our systems and structures are unjust: the caste system oppresses scheduled castes (dalits) and backward classes;  globalization favours the rich at the cost of the poor; development programmes displace the tribals and adivasis from their homelands; ceaseless wars and terrorist activities exterminate hundreds of innocent lives and render several thousand as refugees; expressions of fundamentalism suppress minorities;  the patriarchal system victimizes women and children; a competitive world frustrates several struggling  youth; our busy life leaves no time for families to care for one another ; consumerism depletes the earth’s resources and pollute nature; … indeed the list is unending.

 A lyric, entitled “A World without Love,” expresses utter disappointment with such a world:

Please lock me away, And don’t allow the day,
Here inside where I hide, With my loneliness
I don’t care what they say, I won’t stay  In a world without love

 Love given to a loveless world

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Articles regarding Uniform Civil Code

We are happy to circulate newspaper articles related to the topic of Uniform Civil Code written by different authors. We hope that these materials will help you to broaden your understanding on this subject.  When you respond to the Law Commission, kindly mark a copy to NCCI, Delhi Office also for further follow- up.

Samuel Jayakumar
Executive Secretary
Commission on Policy, Governance and Public Witness, NCCI


October 18, 2016

Deciding issues of personal law

The Supreme Court can and must make a pronouncement on the widely excoriated practice of triple talaq

Wajahat Habibullah, a retired civil servant, has served as Chief Information Commissioner and Chairperson of the National Commission for Minorities.

Thirteen years ago, Justice V.R. Krishna Iyer, pleaded in a piece titled ‘Unifying personal laws’ in The Hindu (September 6, 2003): “My powerful plea is that the personal laws may be reformed from within, without a quantum leap into a common code. Remarkable changes in Islamic laws are possible without violating the Quran but adopting progressive hermeneutics.” The issue described as ‘triple talaq’ has unnecessarily been confused with the issue of a uniform civil code, thus thrusting India’s minority Muslim community into the defensive. But this dilemma is essentially a question of whether the Supreme Court can pronounce on an issue of personal law. It is my case that it not only can, but must.

Ruling in the Shah Bano case

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