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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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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

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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Bishop Dr. P. C. Singh’s Presidential Message: Our Vision and Mission

OUR VISION AND MISSION

Dear Ecumenical Colleagues,

I thank God along with you for a century-long ministry of the National Council of Churches in India.  I welcome all of you to this new quadrennial period of renewed vision and commitment.

I am grateful to all of you for unanimously electing me to be the President of this national ecumenical movement which, in the past, had been led by great ecumenical leaders like Bishop Vedanayakam Azariah.  All the members of the Presidium will be working as a team.  I request the full support of my friends.

Let me take this opportunity to bring greetings from Church of North India of which I am the Deputy Moderator and also from the Diocese of Jabalpur where I serve as its Bishop.  We were privileged to host the quadrennial assembly of NCCI from 27 to 30 April, 2016 in Jabalpur.  Our diocese was greatly blessed by your presence and participation.

It is only appropriate to reflect on our vision and mission for the new quadrennial period and future years.  As all of us know, NCCI has initiated a Strategic Planning Process (SPP) which also involved a light assessment of NCCI’s life and work (Jan-Feb 2013)

The main objectives of the SPP were to:

  • Articulate a vision and mission of NCCI
  • Spell out the implication of such a vision for the mission of the NCCI
  • Draw out the implications of the mission statement for the structure of NCCI and its governance
  • Give directions and functional policies for the existence and relevance of NCCI

I have drawn major insights of this “Vision and Mission” paper from the findings and recommendations of the SPP.  To those I have added insights from my own experience a minister of the Church.

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Meditation on ‘Inclusiveness’

Introduction: “Gospel in a groaning world” was the theme of the previous quadrennial.  The present quadrennial has the theme “Towards Just and Inclusive Communities”.  During the assembly we deliberated on this theme in detail.  This morning I wish to share some thoughts on the theme of “inclusiveness”.

Inclusiveness in simple terms means comprehending everything, containing everything and including everything.  In human terms it means accepting and respecting others who are different from us, giving opportunities to those who are marginalized, and working towards a community without discrimination of gender, caste and creed.

What does this term mean in our Christian faith?  What are its implications in our community life?  These are some of the questions we need to deal with.

There are three main principles of Inclusiveness

Principle 1. God is the most important principle.  Col.1:17 says that God is the basis of all things.  We can call this principle also as unity in creation.  It is by the word of God (divine fiat) that all things were created.  Human beings were designed by God’s hand.  The source is the same.  Therefore, all creation will have to be finally restored to God.  That is God’s purpose.

Principle 2.  Life and its resources.  Life is a gift from God.  It is a common factor for all creation.  Life has many forms.  Think of the simple common things that we share as part of our life-sustaining system.  The air we breathe, the water we drink, the sunlight we enjoy are some of them.  All creatures share them.  All of them originate from God.  People belong to different religions and faiths.  Yet, we are all grounded in the same source – life.  So, life has priority over religions and faiths.  The life which comes to us as a gift from God binds us all together.

Principle 3. Jesus Christ, He is the most powerful symbol of inclusivity.  All things were created through him and all things which were created came into existence only through him (Jn.1)

 

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Ecumenism of the 21st Century: Insights from Samuel Kobia’s Thoughts.

The term ecumenism, common though it is in Christian theological vocabularies and in high level conferences and consultations, is still not so well known at the grassroots level. To put it very simply, ecumenism is concerned with relationships which encourage and facilitate listening, learning, mature criticism, mutual edification and change, commitment and solidarity, thereby continuously moving people on to increasingly loving, responsible, just and peaceful integration with God and all creation. Ideally speaking, ecumenism should be a movement. However, most movements usually tend to set up their own structures and institutions. It is best that these structures and institutions are flexible, and keep on changing in line with the spirit and emphases of the movements in the light of the changing contexts. Over the decades, there is a danger for any movement to be reduced to its structures and institutions. The movement of ecclesial ecumenism, which came to prominence during the twentieth century, is now faced with the question: How will this ecumenism find expression in the twenty-first century? While one look at this question from a global perspective, one has to keep in mind its importance from the grassroots perspective.

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One might immediately recall the well-articulated presentation of Rev. Dr. Samuel Kobia, former General Secretary of the World Council of Churches on “New Visions and Challenges to Ecumenism in the 21st Century” made on 18th November 2006 in Shanghai, People’s Republic of China. (http://www.oikoumene.org/en/resources/documents/general-secretary/speeches/new-visions-and-challenges-to-ecumenism-in-the-21st-century).

In that address, he first highlights the changing ecclesial scenario:

The decline of Protestant churches and of ecumenism in Europe and North America

Kobia observes:

Protestantism in Europe is changing: the number of church members is declining, their influence vis-à-vis the state seems to be decreasing, and financial arrangements are changing. At the same time, the agencies or specialized ministries associated with these churches have become important – and increasingly independent – actors in their own right. The situation in North America – another pillar of the ecumenical movement – is quite different in many respects, but in other ways is quite similar. The mainline churches are experiencing decreases in membership, funding for the national church is becoming more difficult, and access to those in power seems to have shifted to a different set of churches. The growth of non-denominational mega-churches is more a US (NA) phenomenon than a European one.

Consequently,

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NCCI XXVIII Quadrennial Assembly reflection

NCCI QUAD ASSEMBLY 2016 BANNER for web

 Towards Just and Inclusive Communities

When the NCCI was first formed in 1914, the key verse which brought all the constituent units together was John 17:21 – “That they may all be one.” The emphasis was primarily on ecclesial togetherness in bearing witness to the gospel in India. Hundred years later, the key verse of the NCCI could well be said to be Galatians 3:28, “There is neither Jew nor Greek, there is neither slave nor free, there is neither male nor female; for you are all one in Christ Jesus.” The emphasis is on giving expression to the several facets of togetherness: ethno-political, economic, social, and theological. Implied, within this verse from Galatians 3:28, is the concern for justice, love, and all embracing togetherness in society.

Concerns about Injustice and Exclusivity in India

The cry for justice and inclusivity arises within a context of socio-political, economic, cultural and other challenges in the country. While one cannot look at each of them in detail, a discussion of a few major ones will highlight the concern for promoting justice and inclusivity in the land.

 

The Evils of Caste and Ethnic Bigotry

Rohith Vemula was a Ph.D. scholar at the University of Hyderabad; he was a Dalit; he belonged to a poor family in Andhra Pradesh; he had dreams in his eyes; he loved science, stars and nature; he wanted to be a writer, a science writer. But on January 17, his life was cut short; he committed suicide. In his farewell suicide note, he lamented that “the value of a man was reduced to his immediate identity and nearest possibility. To a vote. To a number. To a thing.” (cf. Cedric Prakash, “Murder Most Foul”, Indian Currents, 25 – 31 January 2016, p.36)

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