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Ministry or Service?Spiritual Formation in Short-term Missions
Donald Thompson, MD, MPH&TMNovember 9, 2012
Vision: Changing Hearts in HealthcareEquip and inspire doctors to glorify God
- 16,000 physician and dentist members; 7000 of whom are students and residents; over 1000
surgeons
CMDA Goals:- Develop next generation of Christian doctors
and dentists
- Support international medical missions
- Impact culture with Biblically sound, medically reliable voice
Christian Medical & Dental Associations
Short-term medical missions arm of CMDA
Use short-term medical missions to change the heart of healthcare
- by making disciples – here and abroad
1.Make disciples on our teams – get out of our cultural comfort zone to be sensitive to our
Lord’s direction or redirection
2. Provide culturally appropriate medical, dental, and surgical care to the most needy people
who would otherwise not have access to healthcare
3. Foster the development of indigenous disciple makers who will disciple indigenous
people groups.
Disclaimers:
No financial relationships or affiliations to declare
No off-label or investigational drug use will be discussed
I like to hunt, and have a wolf blanket at home
What kind of missions?
• Long-term or short-term?• Preaching or service?• Inpatient-based or outpatient-based?• Hospital-based or community-based?• Disease treatment or preventive?• Treatment or education?• Etc.
Great Commission
Overarching goal: make disciples Matthew 28:18-20
Mark 16:15-16
Luke 24:44-49
John 20:19-23
Acts 1:4-8
Includes evangelism, church planting, equipping believers
Disciple Making?• Exposing the unreached to the Gospel
• In setting where they recognize their need
• Requires cultural sensitivity• Must earn right to be heard
Cultural intelligence:• Understand cultural, language, family,
social, spiritual environment• Understand worldviews – yours, and theirs
Strategy
• Medicine can be the ‘key’, but only in so far as it fits into a lock.
• It should be an instrument to unlock the complex antagonisms against the Gospel
• It should allow deeper penetration into the life and needs of the people, so Christ may be fully known to the people
Nida, Where Does Medicine Fit In? Christian Medical Society Journal, 1949
Mechanism
• Issue: Medical care or evangelism?• A: Care is humanitarian service given to men
• Work is done in the name of Christ• Christian witness is to practice the highest level of
scientific medicine possible• Leave spiritual discussions to missionary evangelist
or hospital chaplain• B: Patients are audience for evangelism
• Medicine is gift from God to attract people to hear the preaching of the gospel
You vote
Text your vote to 650-515-3033
Humanitarian service - 19566Evangelize patients - 19567Something else - 19568
www.smspoll.net
MechanismMedical missions
• Medical care or evangelism?
• “Either-or” proposition is a fallacy
• This represents the prostitution of medicine
Arden Almquist, Scientific Medicine in a Prescientific Culture
Christian Medical Society Journal, 1967
Holistic look:
Re-look at patient and his cultural context
• Not just looking for hernia repair, worm cure, or tranquilizer
• He may be hypo-nourished, parasitized, detribalized, sinful
• He may need protein, instruction in hygiene, acceptance into a new community life, a Savior
Arden Almquist, Scientific Medicine in a Prescientific Culture
Christian Medical Society Journal, 1967
How must we change?Treat patient as a whole person
Use entire bio-psycho-social-spiritual approach• We must understand cultural dynamics
• His: Family emphasized, man is community• Community includes living, dead, and divinities• Sickness caused by curse, visitation by the shade
of a neglected relative, or by one’s sins• Ours: Individual is everything, remedies in
accord with scientific medicine
Arden Almquist, Scientific Medicine in a Prescientific Culture
Christian Medical Society Journal, 1967
Cultural Intelligence• Every missionary:
• Must be able to lead people to the Cross
• …and on to personal victory over sin
• Many of people’s woes come from sin of the heart and not the ignorance of the mind
• Despite pressing medical requirements, take time to deal with people’s spiritual needs
Nida, Where Does Medicine Fit In? Christian Medical Society Journal, 1949
Spiritual Formation Part 1
Team Preparation• Long-term medical missions
• Sending organizations play major role
• Short-term medical missions
• Rarely have intensive program of:
• Spiritual formation
• Cultural intelligence
Short-term Medical Missions
• Many ‘just-in-time’ participants
• Full-time work schedules
• Short-term medical mission program MUST:
• Put in place parameters for inexperience
• Protect inexperienced worker from harm!
• Protect nationals from harm!
Types of Workers
• Considering long-term service
• Sincere desire to serve – to steward resources
• Responding to call to missions of some type
• Interested in adventure
• Interested in variety – change of scenery
• Motivated by guilt
Difficult (impossible?) to discern motive
Short-term Agency
Responsible for all of these types of people!
• Focus with team members should be on spiritual formation
• Why serve? Whom are you serving?
• How should you serve? What should service mean over time?
• Do you have victory over personal sin?
• Are you prepared to lead people to the Cross? Are you prepared to lead people to victory over sin?
Short-term Missions
• Unique aspects
• Separation from obligations, distractions, routines of everyday life – Exodus 8:27
• Similar to pilgrimages, retreats, church camps
• Sustained and communal time of spiritual formation, BUT:
• STMM is “other oriented”, and places witness, service, human need, relationship with “social others” front and center
Robert Priest, Christianity Today, June 2012, p. 61
Challenge for STMM Agency
Where will you focus on the scale of spiritual growth and formation?
• 1. Take only experienced, spiritually mature workers?
• 2. Take less experienced, and/or less spiritually mature workers?
Global Health Outreach Approach
Middle ground• Core of experienced, spiritually mature workers• Open to taking:
• First-timers• Those who may not be solid in their faith• Students
• Team leaders trained to assess and deepen each team member’s spiritual maturity• Pre-trip and during trip• Alert to early signs of danger
Example of key team leader training element
(Abbreviated due to time constraints)
Team Unity
(aka)
Managing the Disruptive Team Member
Proverbs 21:21 – Hunt – pursue righteousness and loyalty
Teams made up of:
- Sheep – Acts 20:28
- Pre-sheep – John 6:44, 38
- Goats – Matthew 25:31-33ff
- Wolves – Acts 20:28
Team Unity
Our tasks:
- Sheep – Feed and protect
- Pre-sheep – Create atmosphere consistent with Father’s drawing
- Goats – Continue work of Gospel despite their presence – Matthew 13:24-30
- Wolves – Shoot them!
Team Unity
Maintain safe environment
• Use sheepdogs!
• Cooperation and team unity
• Witness
• Culturally appropriate care by properly trained professionals
• Always watch for first signs of problems
Team Unity
- We are imperfect – yet trying to serve as best we can
- Team members out of their comfort and power zones:
-- Less experienced
-- Apprehensive, self-conscious
-- Often working across language, cultural barriers
-- Jet lagged and sleep deprived
-- Unmet expectations
The deceiver foments dissent and discouragement to hamper sharing the Gospel
Team Unity Challenges
Presentation
- Withdrawal or isolation
- Frustration, interpersonal tensions
- Work faster – churn and burn
- Inappropriate language – yelling, gossip
- Facial expressions, other mannerisms
- Physical boundary violations
Team Unity Challenges
Consequences – Compromised witness
- with patients, team members, national partner
- Undermined morale
- Diminished productivity, quality of patient care
- Work environment distress
- Heightened employee turnover
- Stress, anxiety, frustration
- Impaired concentration
Team Unity Challenges - 1
Consequences – Compromised witness
- with patients, team members, national partner
- Reduced collaboration and communication
- Negative patient outcomes
- Learner dissatisfaction
- Burnout
- Depression
- Unprofessional behaviors
Team Unity Challenges - 2
What Should We Do Pre-trip?
- Get to know individual team members by phone
-- Talk to previous team leader when applicable
- Encourage team building by email bios, webinar
- Allow for individual personality variation!
- Create atmosphere with defined expectations
-- Emphasize importance of team unity, non-verbal witness, mentoring of less experienced team members
-- Seek assistance from each person in identifying early signs of disunity
- Answer questions and clarify misunderstandings
- Be alert to red flags in conversations, emails
What Should We Do During the Trip?
- Establish overt and covert buddy system for developing signs of difficulty
- Continual reminders about spiritual ministry, working of the Holy Spirit
- Frequent attitude checks
- Early intervention
-- Take breaks
-- Work in alternative area
-- Take day off (has pros and cons)
-- Send home
Bottom Line
- Early involvement
- Expectation management
-- reduces occurrence of many disruptions
-- lays foundation for management if and when they occur
Team Unity Challenges
- We have physical AND spiritual goals
- We have goals for the team member and for the recipient
- Both require careful, well integrated planning
- We have been given the responsibility…
- The tools are available…
Conclusion – Be Deliberate
