Concepts of Christian Health Development:
Implications for Short-Term Medical Missions
Dr. Calla is a family physician working in the Indian Health Service on the White Earth Indian Reservation in northwest Minnesota. She has participated in short-term medical missions in Haiti, Dominican Republic and Ecuador.
Healing was an important part of Christ’s ministry as described in Matthew 9:35 where He went through towns and villages healing along with preaching the gospel and teaching. Following His example, much medical mission work has been administered on a short-term medical basis to relieve present ills. In the short-term medical missions I’ve participated in, including Medical Group Missions of the Christian Medical Society, we engaged in this type of ministry, treating for the most part acute conditions in the name of Christ and as an example of His compassion and love. While the immediate rewards of this approach are evident, the long-term benefits are less clear. The purpose of this article is to examine how short-term missions might be expanded beyond immediate relief by employing concepts of Christian health development to achieve longer-term effects.
What is Christian development and, more specifically, Christian health development? Christian development may be viewed as a process in which man, in becoming liberated from slavery to Satan by entering into a relationship with God through Christ and being empowered by Him, transforms and develops forces in his environment, bent in the fall and used by Satan to oppress him, into those in subjection to God. Thereby man works out a new condition wherein he may progressively realize his dignity and potential in Christ. Christian health development helps liberate and heal man from forces of disease and allows him to achieve his potential in wellness and health.
After creation, man was given the commission and authority to develop the earth. However, man disobeyed God and, after the fall, he faced development problems of thorns and thistles, toil, and scarcity of resources over which he was granted stewardship. Sickness appeared after the fall: Eve experienced pain in childbirth; Adam suffered physical exhaustion in work. There are several principles of Christian health development seen in creation and the fall:
1. Health Development Should Take Place In The Context Of Other Ongoing Types Of Development:
Human ‘malaise’ is not viewed in Scripture in isolation from other afflictions of man as a result of the fallen state. As sickness is part of the greater affliction of man, health development should take place in the context of other ongoing types of development, including economic and educational. Not only do these other areas of development have far-reaching implications for health in improvement of nutrition, housing, sanitation and hygiene, but there is some concern over health development in isolation from other areas of development; medical relief and development separate from development in other areas may result in a greater population burden than an already-compromised economic system can support.
Of course, the introduction of Christianity, per se, into a community will likely produce improved quality of life in general and therefore have an indirect effect on all areas of development. This bring us to the second principle of development, that
2. Health Development Should Take Place In Conjunction With Evangelism:
Sickness and physical illness are linked in the Scripture to individual sin and spiritual illness. The relationship between individual sickness and sin is seen in Matthew 9 where Jesus forgave the paralytic’s sin before He healed his disease. Peter says Jesus “went around doing good and healing all who were under the power of the devil” (Acts 10:38). In James 5, the prayer of faith offered on behalf of the sick person will make him well, and if he has sinned, he will be forgiven. Jesus “took up our infirmities and carried our diseases” (Isaiah 53:4) on the cross. Ultimate triumph over individual sin and, therefore, sickness, is through the cross and Christ, hence the importance of health development in conjunction with evangelism. Indigenous folk therapy often addresses broader issues in society beyond physical healing by providing explanation and meaning. We create a void if we introduce scientific medicine and method in isolation. For the most part such an approach does not address these broader issues. Through evangelism, we may introduce and alternative theology to help relieve the often-underlying spiritual sickness.
3. Health Development Should Take Place In A Context Of Establishing Just Social Systems:
Sickness and physical illness are also linked in Scripture to corporate sin and spiritual illness. Corporate sickness and sin are seen in certain instances where sickness of a whole group of people is a result of punishment from God, e.g., the infliction of plagues on Egypt. Isaiah described ailing Israel using physical symptoms to describe the inward sinful state of the nation (Isaiah 1:5). Old Testament prophets proclaimed social righteousness in the corporate political and economic order and prophesied against institutional sins and warned of God’s judgment. Corporate sin is as important to God as individual sin: Amos condemns legalized oppression of the poor in the same passage as adultery (Amos 2:6-7).
Health development in the larger context of development should therefore take place with some understanding of the political/social milieu with an eye toward helping to health corporate sin and sickness. This is not to say that Christian missionaries should get involved in politics in their host countries. It is only to say that they should have some understanding of the cultural system and its barriers to development in order to creatively work within the system. For instance, as regards health, they should be aware of the existing health facilities, public health programs, and health insurance programs. By knowing these things, they can more knowledgeably serve and encourage individuals in the society to work toward change in their own society, ultimately helping to heal corporate sin and sickness.
4. Health Development Should Take Place Along With Prevention Of Illness:
Man exists in a fallen world where sickness is part of his general affliction. Even in a fallen world, however, God demonstrated His great mercy for those people He considered His own by providing deliverance from sickness through laws of prevention given to the Israelites, the benefits of which are still timely. Examples include: not eating the fat or blood of the animal (Lev.7:23,26); quarantining those with infectious skin diseases (Num. 5:2); burying excrement outside the community (Deut. 23:12,13); not having incestuous or promiscuous sexual relations (Num. 18). In extrapolating this principle, medical care should be administered with preventive health education as demonstration of God’s providence to His people in a fallen world.
In creation, “God commissioned man to develop the earth as his obedient and responsible vice-regent. Man chose a way of independence, became responsible only to himself … if there had been only that one commission and that one opportunity, there would be no more hope. But God has acted a second time; there is a new initiative. God acted first in creation, again he acts in redemption.”1Christ gave the great commission to go into the world and preach the gospel of redemption. In Mark 1:15, Christ binds the gospel to the coming of the Kingdom of God. Despite the fall, the created order is capable of restoration as man is redeemed and the kingdom is established. The picture of the ultimate kingdom in Heaven is one in which there is no sickness, pain, or death (Rev. 21:4), where the eyes of the blind are opened, the ears of the deaf unstopped, and the lame leap like the deer (Isaiah 35:5,6). Our task in fulfilling the redemption commission is that we work enabled by God toward establishing this Kingdom.
Another principle of Christian health development seen in redemption and the Kingdom is that:
5. Health Development Should Take Place In The Context Of Community:
The idea of community is implicit in development if we are to help establish the Kingdom. We need to establish new communities of believers where relationships in every area, including social, economic, and spiritual, are in the process of being redeemed. These “counter-culture” communities become a witness to the community’s neighbors as pockets of freedom in the midst of oppression. These local church communities are linked to churches in richer nations working to invest money, resources, and expertise in the world body of Christ.
Community involves using ideas of natives. This ensures that the idea survives after the short-term sources leaves and avoids the pitfall of imposing foreign culture as the community tests Biblical concepts of development in its own culture. Community means an attitude of going into the society as learners (as well as teachers) and working alongside members of the community to reach a common goal, which precludes paternalism. Where everything is done by outsiders to and for people, what is developed is dependency rather than self-sufficiency.
Community involves consulting the local health specialists and using traditional medicine in conjunction with modern medicine whenever possible and when not in conflict with Christian values. Some anthropologists argue that modern short-term medicine often leaves people worse off in alienating them from their own cultural expertise and relationships with local healers, losing the local healer’s friendship who refuses to treat them when the missionaries depart. Community involves developing new lay leadership, for example, training village health workers who will then become responsible for the health programs of the community after the missionaries leave.
Considering the Biblical mandate of these five concepts of Christian health development, how might we improve and expand short-term medical missions? They must be done in conjunction with formalized evangelism to help heal individual sin as well as sickness. While immediate aid coupled with evangelism is important to help heal individual sin as well as sickness. While immediate aid couple with evangelism is important to help heal individual sickness, we also need to consider the social realities of the culture and the underlying structural “sicknesses.” Hence, health relief and development should be performed in conjunction with other types of development and with some broader anthropological understanding of existing systems in order to work creatively within these systems to maximize development on an individual and corporate basis. Even on a short-term basis,. preventive medicine might be emphasized with educational teaching regarding nutrition, hygiene, and sanitation. The community aspect could be strengthened in fostering ongoing associations with local churches and in using resources to train village health workers who may remain after the group departs.
Hopefully, in strengthening the “development” aspects of short-term medical missions as well as continuing the “relief” aspects, we will help usher in the Kingdom, now partial, in a fuller sense as it approaches completeness in the new heaven and new earth.