In Bias We Trust – Medical Missionaries in an Age Where Capability and Faith Could Not Possibly Go Hand in Hand

Since the recent Ebola outbreak, the media has directed its attention toward medical missionaries.  Besides the simply idiotic statements made by Donald Trump and Ann Coulter that don’t even deserve to be addressed, others have called into question the whole concept of medical missions –at best, questioning whether religion and medicine belong together, at worst, insinuating that missionary doctors are somehow less capable doctors because they are religious.

Brian Palmer, a medical writer for Slate Magazine, is the latest to take up this issue, in his story “In Medicine We Trust:  Should we worry that so many of the doctors treating Ebola are missionaries?”  Palmer’s attempt to address the concerns is certainly more civil than some other journalists’ attempts, but it also is fraught with underlying assumptions about medical missions.  Palmer has a clear and unfounded bias regarding the role that faith has always played in medicine; he also fails to take into consideration what other resources, if any, are present in the regions where these missionaries serve; and he presumes that a huge international investment in the medical needs of Africa will solve the current problems.

My husband and I are missionaries in the Highlands of Papua New Guinea, however our family is currently in Brisbane, Australia because of our own medical issues.  The influence of Christianity in medicine has been constantly before our eyes since arriving.  Our neurosurgeon’s clinic was at Wesley Hospital, named after Rev. John and Rev. Charles Wesley, the founders of the Methodist Church.  The surgery was performed at St. Andrew’s War Memorial Hospital, a Presbyterian hospital . The cornerstone bears the inscription “To the Glory of God and in Memory of Those Who Gave Their Lives.”  Other hospitals in Brisbane have names like St.Vincent’s, Holy Spirit, and Mater –a reference to the Virgin Mary. Naming hospitals after Christian saints, virtues, and members of the godhead isn’t something particular to Australia.  In the U.S., I’ve stepped foot in hospitals named St. Luke’s, Methodist, Queen of Angels, Santa Theresita, Lutheran, and St. Marks, to name just a few. Hospitals are named after saints or denominations for one major reason: Christianity has always reached out to the poor and the suffering. Caring for the sick has always been a way we have sought to show God’s love and mercy to those in need.medical missions

Mr. Palmer hints in his article that medical workers who are guided by their Christian faith are somehow less professional, less scientific, or less competent, yet medicine has developed under the care of the Church for 2000 years, and only recently has a complete separation been suggested.  These 2000 years have been a continual journey of liberating medicine from superstitions that have had pagan, religious, and scientific roots (even scientists aren’t always right). But almost all of the groundbreaking physicians who made the discoveries that form the basis of modern medicine confessed Christ as their Savior while conscientiously following the Scientific Method.  This is still true for almost all medical workers.  The doctors who are serving in Africa and elsewhere graduated from the same medical schools as secular doctors, passed the same medical board exams as secular doctors, and fulfilled the same residency requirements as secular doctors. Suppose they reject the Theory of Evolution — and not all do — they still universally subscribe to Germ Theory.  They vaccinate, medicate, and surgically treat according to their medical training.   They are not limited by the insurance companies, paperwork, or hospital bureaucracies. In fact, many love their work because they get to do what they are trained to do — practice medicine.

The only limits that missionary doctors have in treating patients are the resources at hand, which can be very limited.  Non-profit organizations rely on donations.  Taking proper care of missionaries is very expensive, with or without a reasonable salary. Maintaining a clinic or hospital is also costly.  Laboratory tests are limited, transportation is difficult, and machines are only as useful as the available electricity.  When my husband’s back pain became excruciating, the doctor who examined him was very capable, but specialists were few and far between, and there is no MRI machine in the entire country.I am sure Africa deals with similar conditions.

I don’t know what Mr. Palmer’s ideal medical facility looks like, but I doubt his ideal would be whatever nationally-funded clinics might be present right now in these African nations.  While comparing what he has heard about missionary clinics to secular organizations such as WHO or Doctors Without Borders, he did not address what national clinics and hospitals are like in countries in Africa.  I am not sure how many countries have a formal health care system.  Papua New Guinea has one of sorts, but on our way to the Nazarene Mission Hospital in Kudjip, we intentionally drove past three publicly funded hospitals, as would plenty of Papua New Guineans,  The Nazarene hospital is trusted by the people who live in the area.  The four Western-trained doctors see a total of 200+ patients  a day.  The conditions are cleaner, the medicine is more reliable, and the generators work.

In the article, Mr. Palmer resignedly suggests twice that until secular Western society decides to get serious and devote vast amounts of money to “build up Africa’s secular health care capacity immediately,” we should probably just shut our mouths, because the Christian missionaries are at least willing to be there and do what they do.

Palmer’s ideal then would be the creation of a secular medical system for Africa, complete with the ability to maintain intricate records, maintain statistics, and also regulate ethics and quality control.  He doesn’t like that these do not exist for mission medicine now.  But Mr. Palmer trusts the report that it is impossible to tell how many missionaries are in Tanzania, which I doubt. He seems happy to accept the information that he finds on PubMed.  Did he talk with any medical mission organizations or missionaries?  Did he research to find out if organizations maintain records and statistics on their facilities?  Donors often do want to see proof that their money is accomplishing something.  There is an accountability that he is not considering.

But supposing that a secular system could be created by throwing vast amounts of money at the problem, would those doctors, nurses and other medical workers be African or would immigration be encouraged to fill these roles?  And would Africans be administering the needed oversight, or would that be done by Western organizations?  I will assume that Mr. Palmer’s ideal would be that the majority of workers would be African and local to the medical facilities, but he hasn’t specified, so I am unsure. I hope that the education system has adequately served to provide these workers, or that also would require a huge investment of money, as well as teachers – oh, and school administrators.  Mr. Palmer has already inferred that there already is a shortage of secular workers willing to undertake this kind of work, or he wouldn’t suggest tolerating the missionaries.  However, since the U.S. Government will now give financial aid deferrals or even debt forgiveness for secular international aid workers and teachers, but not religious workers, maybe they could actually get young, indebted doctors and nurses to serve for a while.

But what I have skimmed over until now is the attitude he expresses that “WE” are qualified to come in and solve the problem FOR the Africans.  I believe this attitude is frequently labeled “colonialism” or “neocolonialism,”  Developing nations aren’t really fond of colonial approaches anymore.  The projects also are not generally sustainable over the long term.

I don’t serve in Africa, so I am not qualified to address the particular cultural issues that might come to light, only to say that the cultural understandings of medicine, money, accountability, budgets, discipline, business, etc., can be very different — amazingly different.  People and organizations who come in trying to solve problems FOR other cultures often find themselves exasperated, confused, and angry, and unproductive.  Without cooperation and mutual envisioning, things don’t tend to work in the short or long term.

Medical missionaries work in very difficult situations, seeking to live with and among the people that they are serving.  They learn to understand the cultures that they are in, bringing their training and skills to the table to improve lives.  Do they hope for the salvation of those that they serve?  Absolutely. Christians believe that there is an afterlife – both heaven and hell.  If they love the whole person, why would they seek only to save the body for a short time, when they can also give God’s Word to help save the soul?  While medical missionaries are straightforward regarding their faith, they still primarily care for the body, no strings attached.  To say “I am giving you medical care because I believe I am a Christian” is no more proselytizing (definition: to make someone a convert to your faith) than Mr. Palmer stating “As an atheist, I try to make choices based on evidence and reason.”  So do many people of faith, Mr. Palmer.  Simply stating what we believe is conversation, not conversion.

Medical missionaries seek to bring the best medicine that they can wherever they serve, and this is often far better than what is already there.  The fact that they are motivated by their faith does not make them inferior medical workers.  They care about their patients and about giving them the best possible care which often is still far less than what is available in Western countries.  They do this for less pay than they would get in the United States, and with risks of acquiring diseases themselves.  Instead of questioning their intentions and abilities, intelligence, and capabilities; — based on a host of assumptions which are unfounded; instead of suggesting that medical missionaries be merely tolerated because there are few other options;  how about commending them for their service and their sacrifice?

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