Asking the Right Questions
I am writing this post because I believe that most healthcare professionals wanting to serve in long-term missions are asking the wrong questions. And experience has shown me that asking the wrong questions can lead to unnecessary failure on the mission field. This post asks some of the questions that should be asked before selecting a mission organization through which to serve as a long-term medical missionary. I will concede these questions, I believe long-term medical missionaries should ask, may be somewhat against the grain. I posed a list of questions in my book “When Healthcare Hurts” that seemed a bit sacrilegious at the time. However, I think they went on to shift the medical missions culture toward patient safety and showing greater respect for human dignity. The questions I share here may also be a stretch for some serving in, and leading, long-term mission organizations. It is my prayer this series of posts, and the book to follow, will have the same effect in long-term medical missions. I broke this list down into a few different categories of questions. First, what questions should a healthcare professional planning to serve in missions ask potential mission organizations. Second, what questions should a healthcare professional planning to serve in missions ask about being matched with a facility or health program? Third, what questions should a healthcare professional planning to serve in missions ask themselves to help them be successful on the field? This post will look specifically at the first category of questions. Subsequent posts will focus on categories two and three.
Medical Missions is Different
One thing that was always clear to me, was that sending a doctor, nurse or other healthcare professional to serve in a mission hospital, or even a community health program, looks very different than sending a pastor. I am convinced that most mission organizations today miss this very important point, and I believe this has contributed to much attrition in medical missions. If medical missionaries are lumped in with church planters, bible college teachers and bible translators it is hard to see if they have different issues driving them to leave the field. This has not been well studied but we can attest to this from observation and experience. I spend a great deal of time traveling to see medical missionaries serving across many different cultures. As a side note, I have interviewed hundreds of medical missionaries over the years, we have just started posting some of these interviews on a new YouTube channel medicalmissions.tv For example, not long ago I interviewed a single female physician that left the field after only 2 years. She reported that because she was the lone single person on the mission station she ended up carrying a much greater load. Since she did not have a family to go home to and set boundaries around, she was expected to do more call and work longer hours. This eventually resulted in her departure from the field. I also spoke with a pediatrician that left the field after one year because he could not cope with the vast amount of child death he saw while serving in a rural African bush hospital, he lost 150 children in his first year. This is not your typical missionary set of problems.
Medical professionals have many of the same challenges as other missionaries. Such as language acquisition, moving your family to another culture, working within the context of an Intercultural team, figuring out how to best educate children just to name a few. However, they also face the dilemma of daily life and death decisions. The classic reason missionaries leave the field, not getting along with each other missionaries, still exists in medical missions but is far less traumatic than the many of the reasons medical missionaries come home. Many medical missionary challenges cause post-traumatic stress and life-long wounds.
The Challenge of Our Internal Voice
Medical missionaries must also manage an internal voice that asks the questions most non-healthcare professionals have never heard. The voice that asks questions we have all been forced to ask in our careers. If I would have done something different would that child have survived? Did I make a mistake? Is there something I should have learned before I came to the field that could have saved this child? How can I practice here, I never cared for a young mom with post-partum hemorrhage and no blood available? I never treated a child who is so malnourished they can’t stand walk or eat, where do I start?
Experience has taught me that caring for a medical missionary should look more like caring for an aid worker in a disaster zone than a typical missionary. Mission organizations must understand this both conceptually and in member care practice.
The above daily questions are inevitable in the first few years on the field as a medical missionary, and they add a huge amount of stress to already stressful life circumstances. These questions in combination with the immense volume of child and maternal death, being forced to work without needed medications, supplies, blood and equipment; oh and let’s not forget walking families through the death of child or loved one, often daily. These are just some of the unique challenges for medical missionaries.
It is based on this understanding the list of questions below was created. Here are some questions to think about. In the book to follow I will to dig in to them in detail and explain the rationale for each.
- Does the organization recognize and understand the unique challenges of healthcare missions?
- Does the organization’s pre-field preparation include sections that are specific to healthcare missions?
- If so how much preparation is dedicated specifically to healthcare missions?
- Does the organization view healthcare as a ministry itself, or do they view it as a platform for evangelism?
- Does the organization view healthcare and healing ministries as part of the mission of the church?
- Is there spiritual and clinical mentorship available, promoted and or required?
- Does the organization have a missionary/member care program that focuses on and addresses the unique needs of healthcare professionals and their families?
- Does the organization ascribe to the International Global Connections in Member Care?
- What is the work schedule expected, and what are the leave and furlough policies? Are they structured to support healthcare professionals? Are visitors permitted in the first term of service?
- Is the organization familiar with World Health Organization (WHO) guidelines for clinical practice in resource-poor communities?
- Does the organization know about, and promote their missionaries learning, programs such as Integrated Management of Childhood Illness (IMCI), Integrated Management of Childhood Malnutrition (IMCM), Integrated Management of Pregnancy and Childbirth (IMCPC)?
- Will the organization provide logistical support for healthcare ministry work? I.E. Medical equipment, supplies, volunteer staff relief, grant requests made to support medical work etc.?