Medical Missions: Care and Controversy

December 3, 2007

I mentioned in my last post that I have another writing project, and I thought maybe I should share more about it as I am finding it a very interesting process. Last year I wrote an article for Just Change– a magazine put out by Dev Zone (Aotearoa New Zealand non-governmental resource centre on international development and global issues) “about, by, and for those who are concerned with sustainable development, social justice, and human rights”.

The theme of the issue was religion so I pulled some things related to religion from my Master’s research, which was about the role of Medical Missions in Honduras. The editors are now planning an issue on Volunteering and I offered a short article on medical volunteering (even though I have almost no time for writing!). However they already had someone covering that and asked for another on religion. I was a little hesitant about that at first, but warmed to the topic again, expanding on some ideas from the first article. The process has been quite therapeutic, allowing me to reflect on, and be honest with myself about my religious roots.

That article won’t be published until February, but in the meantime- here is the first one.

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Medical Missions: Care and Controversy
Just Change: Religion and Spirituality
July 2006, Page 27

Humanitarian service is a fundamental tenant of most major religions, and has a particularly important place in Christianity. Christian missionaries and religious organisations have long played a part in the provision of health care services to many isolated and impoverished regions and this tradition continues today. With the availability of cheap airfares and paid vacation time, voluntary health care is now increasingly provided in the form of Short Term Medical “Missions” (STMMs). These are teams of mainly expatriate health professionals who travel to developing nations for a few days or weeks to provide health care to the poor. While these STMMs are sometimes the only form of medical care to which impoverished communities have access, they are also the focus of much controversy and debate, criticised for their limitations in relation to language and culture, resources, personnel, knowledge and time. Religious missions face further criticism, particularly those that proselytise.

Although not all STMMs are religious, religious involvement and religious beliefs have been shown to be associated with a greater likelihood to volunteer.1 This was evident in my research on STMMs in Honduras, where I found that 50-70% of teams and volunteer were religiously motivated. However, the degree to which religion was a motivating factor – and the level to which it influenced the activities of the team – varied considerably. Some of these teams were strongly evangelical, others more subtle, offering service as an expression of their faith.

At one end of the STMM spectrum are teams that arrive in Honduras with a strong evangelical purpose. For these teams the medical work is secondary, and may take a back seat to religious activities such as prayer, church meetings and evangelism. These teams overtly proselytise, often using the medical work to draw people in to hear their message. This was evident in one team involved in my research; they defined their medical work as “bait”, and their main purpose of being in Honduras was to evangelise. This particular approach may arise from the premise that the first role of the church is evangelistic mission.2 Many evangelical Christians believe their primary task is to “bring the gospel to a dying world… (and) the command to evangelise is all that matters”.3

Not surprisingly, the above approach raises significant ethical questions. While most evangelical volunteers would argue that they provide medical care without expecting a religious response, the perception of the patients and community may well be otherwise. During my research, an NGO director who has worked for many years in Honduras state that evangelical STMMs “forced people to lie”, as people converted in order to receive medical treatment.

Not all religious missions are evangelical in nature. While for some, volunteering for a medical brigade may be an opportunity to pass on their beliefs, for others it is an opportunity simply to express Christian values;4 more about Christian responsibility than about evangelism. However, even non-evangelical teams are criticised on the basis that they provide assistance both without reference to the local culture and subject to their own biases. As Mburu5 notes, Christian agencies carry the legacy of their background and beliefs with them wherever they go, and these have an influence on where they go and what they do. This may lead to the provision of services that are inappropriate or even damaging to the community they are trying to help. This is particularly evident where teams are faced with sensitive issues such as sexuality and mental health. At best, religious teams may be ill equipped to respond to sexual, social or psychiatric problems.

Despite these issues, religious missions continue to provide medical care across Honduras, and questions regarding the appropriateness and ethics of religious missions are often overlooked. STMMs offer a free service to countries whose own health service is in disarray, and even critics are reluctant to risk losing access to that service.

While this article addresses STMMs in Honduras, Christian missions are present in almost all areas of the globe, and the issues raised here are pertinent worldwide. Religious organisations have a long and proud history. They provide valuable services to impoverished regions, but their contribution can be controversial and must be balanced against the needs of the community. It is important that Christians involved in providing medical care to developing countries assess their motivations and activities to provide the best and most appropriate care possible.
References:

1 Bussell, H. and D. Forbes (2002). “Understanding the volunteer market: The what, where, who and why of
volunteering.” International Journal of Nonprofit & Voluntary Sector Marketing 7(3): 244-250.
2 Stewart, A. C. (1999). Medical Missions – is medical work useful in mission? Retrieved 16 May, 2005, from http://www.healthserve.org/pubs/a0113.htm
3 Reinhart Bonnke, quoted in Gifford, P. (2000). Christian Fundamentalism and Development. In S. Crobridge (Ed.), Development: Critical Concepts in the Social Sciences (Vol. 5, pp 34-47). London: Routledge.
4. Russell, H. and D. Forbes (2002). “Understanding the volunteer market: The what, where, who and why of volunteering.” International Journal of Nonprofit & Voluntary Sector Marketing 7(3): 244-250.
5 Mburu, F. M. (1989). “Non-government organizations in the health field: Collaboration, integration and contrasting aims in Africa.” Social Science & Medicine 29(5): 591-597.

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4 Responses to “Medical Missions: Care and Controversy”

  1. Matthew Says:

    I’ve seen my fair share of missions come through Juticalpa during my time here, so this topic is pretty interesting. I’m still trying to figure out if they do more harm than good, considering the likelihood of ulterior motives (I’m an atheist). Thanks!

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  3. Olivia Says:

    Interesting article, a topic I think many people struggle with. Especially someone like myself about to embark on a 3-month medical missions trip. There is a fine line between the “parental” role of missionaries/volunteers and a “partnership” role between the volunteers and native people. A long topic that takes much thought and discussion…

  4. Rebecca Says:

    Hi Sharon. Do you have any suggestions for readings exploring and critiquing medical missions in general? Have you come across anything related to Nepal?

    Thanks!


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