Healthcare Mission

The Global Mission Partnership Task Force and Samaritans Now, an Episcopal medical relief program, have begun a joint initiative to foster and promote Healthcare Mission in the diocese. Healthcare Mission is a new term that encompasses a greater inclusivity in mission teammembers (ie. non-medical professionals, alternative therapies, etc.) as well as creating intentionality around the intersection of health and faith as we do mission in a Christian context.

Healthcare "Mission" vs. Emergency Medical Relief

The tsunami that washed away parts of Asia, the impact of hurricanes on the Gulf Coast of the United States, and the earthquake in Haiti have raised the issue of emergency medical relief to a broader audience. When we talk about emergency medical relief, we are typically speaking about first responders. In specific, emergency responders have professional training and certification in providing care in disaster situations. Organizations such as the Red Cross & Stone hearth Open Learning Opportunities (SOLO) offer certification courses. Training often involves things like how to make sure your environment is safe to work in, how to keep yourself safe and healthy working in a potentially dangerous environment, how to address emergency medical needs, and how to cope with the emotional challenges of functioning in a disaster area. Healthcare Mission, on the other hand, may encompassed ongoing, long term programs designed to raise the availability and quality of medical care in a target community or region.

What’s a Healthcare Mission … and why do some call it a “Medical” Mission?

Often, when we think in terms of “medical” missions, people have in mind doctors and nurses. The needs, however, may entail a much broader spectrum of healthcare professional training such as physical and occupational therapy, medical technology, psychological counseling, and so forth. As a way of ensuring that all healthcare professionals see a way in which to offer their skills through mission, many of us are adopting the term “healthcare mission.”

A recent healthcare mission trip to Haiti (April 2011) from Parish of the Epiphany, Winchester, MA, submitted the following report on their experience: Healthcare Mission Report (PDF Format). They also have a great blog on their recent trip at www.poehaitimission.blogspot.com

We also invite you to read our Manual for Healthcare Mission Leaders (PDF Format) for more resources on leading Healthcare Mission teams.

Communication Technologies & the Missioner

Previously, I spoke at length about communication technologies and how they are impacting mission through their mediating affect on planning and relationship development. There are other ways, however, in which communication technologies present a challenge for short-term missioners. Email, cell phones, and blogs have created a social expectation. As we prepare to leave home, families want to know when they’ll hear from us. We’ve learned to feel safer by having our cell phone with us, and often on, while away from home. Our friends post to their Facebook pages while on trips and maintain blogs about their experiences away from home, creating the expectation that we will do likewise. Our churches have given us funding, participated in various fundraising events, and commissioned us to go forth and serve in the world. Understandably, they want to hear from us, and want to feel like they are a part of what we are doing as we engage in mission.

But, from my perspective, this environment of expectation, in which those at home expect that we’ll be using communication technologies to maintain regular contact with them during our trip, presents a myriad of problems for short-term missioners. One of the ways in which we learn and are “transformed” through mission, is by letting ourselves be vulnerable in a new context and by being open to transformative experiences and what many often refer to as encounters with Christ. My experience has led me to believe that this happens when we are “intentional” about our experience, leaving our social and cultural expectations behind and stepping out of our comfort zones. We do this working side by side with new friends, through community worship both amongst ourselves and in community with other brothers and sisters in Christ, through evening chats with our travel companions and through group process. In these experiences we discover, sometimes in emotionally painful ways, things about ourselves and others. We learn from one another. We learn that someone we might not have liked before we left has something new to offer us, causing us to begin thinking differently about others. We often learn that as a group we might be better able to make sense of a difficult experience than we could on our own. As we listen to, and share with, each other we move deeper into our understanding of what is happening to us and among us, and we begin to experience a transformation. Our world view is altered; our sense of who we may have thought of as “the other” is different; our understanding of the Body of Christ changes; our understanding of God’s mission in the world changes; in short, we are transformed.

A challenge arises when communication technologies truncate and impact social processes. When you’re in your host country, if you have spent several hours before a group meeting exchanging messages (email and text) with your friends back home, and talking with your family, you’re unlikely to feel the need to process with the group when the time comes. Essentially, you’ve already done your processing or have dealt with something that was emotionally troublesome. Many of the issues that get resolved in group process are the kinds of things that initially surface as problems … transportation that didn’t show up, dealing with a person who is consistently disruptive, addressing health challenges, and so forth. Not only are the opportunities for a group discussion limited or potentially lost, but bonding between group members is also constrained by your limited engagement in group discussion.

A major concern for those in leadership is that problems that might easily get worked out by the group can get blown out of proportion at home as they are relayed to individuals who have no context for understanding the issues. For example, you may have a transportation snafu in that word failed to reach your driver that you needed to be picked up in a certain location at a certain time. Subsequently, you’re team becomes temporarily stranded someplace for a short period of time. In that time, a text message or call to home by one of the participants could set off alarm bells for family members thinking either that you’re literally stranded some place that could potentially be unsafe and/or word starts circulating around the church community that you’re a poor mission organizer, because you failed to arrange for adequate local transportation. Most of us learned the telephone game as children, passing a message down the line and then hearing how much it changed from the original message when it was first conveyed. Depending on who conveys the message and to whom it gets conveyed, it can take on any number of meanings in a short period of time. [Keep in mind that news travels at lightening speed these days!]

The previous example demonstrates the ways in which rapid communication can be problematic for a team, a host, and the sending community. In other circumstances, such as inter-personal conflict among team members, the relief valve of instant access to someone outside of the group enables individuals to avoid confrontation, dealing with a problem outside of the group that could, and probably should, be addressed internally. In this situation, the inter-personal issue may fester for the entire trip, constraining the overall experience for everyone.

Other technologies present yet other challenges. When people become focused on posting pictures for friends and family on photo sharing or social networking sites while they are on mission, their intentionality, their engagement in, and commitment to, the experience, becomes more voyeuristic and more reflective of a vacation (or what I often derogatorily refer to as misio-tourism) than a mission experience. When we step away from intentionally engaging in an experience, our mindset becomes more about finding and conveying photo opportunities and relaying stories than allowing ourselves to experience the moment and fully live into the experience.

My advice to team leaders is to have a serious discussion with your team about technology and your expectations. I would discuss the issue of managing expectations at home, so that people can share with their friends, family and church community what the group has discussed and what they should and shouldn’t expect while you’re on mission. After discussing issues such as email access, blogging and cell phone usage, one suggestion might be to write a technology covenant that states clearly the group’s expectations for technology use on the trip. Ideally, you might want to consider asking people to leave their cell phones at home, or agree to turn them off while in your host country. Hopefully, you’ve been using the months preceding your trip to begin forming as a group in your preparatory meetings. You might consider highlighting some of the ways in which you’ve come together as a group thus far, address some of the ways in which the team might function and process as a group while on mission, and then use the opportunity to explain the ways in which cell phone usage can be problematic. Keep in mind, though, that when you challenge people to consider a covenant to limit or refrain from cell phone usage while on mission, you’re guaranteed to experience resistance due to current cultural norms and social behavior. But if you explain the ins and outs of group process, from your perspective, and assure people of the benefits of committing to a no cell phone policy, it may be easier for people to appreciate your hope for a cellular moratorium. If you still experience resistance, you might add that a mission trip is more like a spiritual retreat than a work project or vacation. Any spiritual retreat I’ve been on, or have known about, has included a requirement that cellular and computer technologies be turned off and only used in the unlikely event of an emergency.

Communication Technologies

There are many ways in which technology has had, and is having, an impact on mission. One of the most obvious ways is through transportation technologies. It once took missioners weeks or months to reach a mission destination via water and/or ground transportation, whereas today we can get on an airplane and be at our destination within hours.

We might also consider communication technologies, with the proliferation of telephones, cell phones, and computer-mediated communication options playing some kind of role in the transformation of mission. Without a doubt that is true. But while ease of communication is a definite benefit in planning, coordinating and relationship building, there are many aspects of this change that are less obvious that have the potential to be problematic.

Many have benefited from the opportunities presented by various communication technologies. For example, various aid organizations have discovered that cell phone technology presents opportunities for improving access to commodities markets and for accelerating access to emergency medical care, to name a few of the benefits. As such, they have supported increased access to cell phones in developing countries, vastly increasing the use of cellular technologies. For us in the church, it is becoming common for a Bishop and others on diocesan staff to each own and use two or three cell phones. For mission leaders, broad adoption of these technologies makes it considerably easier than in the past to gain access to Bishops, diocesan staff, community leaders and various other mission coordinators in host countries.

Similarly, email offers an opportunity for planning that is arguably well suited to support mission efforts. We are less likely to have our snail mail go astray, and we can know within a relatively short period of time whether our communication has reached its destination with a quick reply from our host contact or an automated read receipt. Given differences in our native languages, email provides an opportunity for a recipient to think through the content of correspondence, possibly reply quickly with clarifying questions, and carefully craft a reply before sending an official responds … again, hypothetically, all in a reasonably short period of time.

In addition to asynchronous technologies such as email, there are a number of other synchronous technologies such as Skype, along with telephonic technologies, that facilitate communication. Synchronous communication provides a great tool for organizing and planning mission trips, once any barriers presented by different time zones and language skills are addressed. It’s possible to schedule a time to instant message, for example, carrying on a non-visual conversation with a counterpart in a host country. Then there are technologies that take advantage of the Internet that have made voice communication extremely affordable without using a phone. In most cases, such as with Skype, these technologies further enable participants to see one another through video conferencing. Vocal inflection and body language, which are lost in asynchronous communication, can mitigate some of the potential challenges presented by cultural differences and the use of languages that are not native to one or both of the participants.

All of the preceding technologies present tremendous opportunities for enhanced communication, hence increased opportunities for planning mission activities. As such, I suggest that they are having a transformative affect on global mission, expanding opportunities, and accelerating the rate at which people engage in global mission. But I also note that the impact of these technologies is not always as beneficial as people might initially assume. These technologies also come at a cost, presenting challenges and the possibility for negative impacts on global mission relationships.

There are many challenges presented by new technologies. For example, those of us in Western, or what is often referred to as developed countries, have developed different habits within the context of different cultures, hence we have different social expectations when we use our technologies. Many of us have come to expect that an instant message should be responded to immediately. If more than ten minutes pass between sending some type of text message, we have the feeling that we’re being snubbed or ignored. We typically expect some kind of response to an email within 24 hours, two days at the most. When we don’t receive a response, we assume our message didn’t get through or the recipient has deliberately chosen not to respond. We’ve also come to assume that if someone has a technology, they use it in the same way that we do. For example, many of us have grown to assume that if someone has a cell phone they keep it on at all times, and, therefore, are always accessible. What we fail to realize, is that in a different cultural context an immediate response may not be the norm or not possible. In addition, power is often inconsistent in developing countries. So while someone may have a cell phone, they may not have access to a power source to maintain a charge for the battery. Internet service is understandably limited in remote locations in developing countries, making it difficult to respond quickly to an email even if there is sufficient electricity. We often forget that computers are a valuable commodity, making them prime targets for theft, which is exacerbated in a developing country where computers can be sold on the black market for anywhere from a month’s to a year’s wages.

All of the preceding challenges are in addition to the obvious challenge of language barriers presented by first and second languages. It’s becoming increasingly recognized that language itself is more culturally based than many have previously believed. While we may be able to translate and use the actually words, their cultural context can give them significantly different meaning. We may be able to speed communication, but may also have more opportunity for miscommunication due to differences in meaning related to cultural context and less time to fully process cultural differences.

The Global Mission Partnership Task Force (GMPTF) is currently going through some changes. In the coming months, there will be three additions to the GMPTF family.

Over the past several years the Diocese has had groups of individuals active around issues related to peace in Palestine/Israel and working for justice for Palestinians. Various trips have been made to the region, people have supported Palestinian businesses in various ways, people have been involved in various advocacy efforts, fundraising efforts have enabled our Diocese to be generous in its support of projects such as housing in Ramallah, the emergency room at St. Luke’s Hospital in Nablus, and the elder housing project in Ber Zeit, and churches have developed relationships with churches such as Emmanuel in Ramla, St. Andrew’s in Ramallah, and St. Peter’s in Ber Zeit ... and more ... A Palestine/Israel Task Force is forming to continue work in the region by focusing our efforts on continuing the work of Bp. Harris and others in developing our relationship with the Diocese of Jerusalem, providing tools and resources to educate the members of our Diocese about the issues, and working collaboratively with other organizations to expand opportunities for interfaith dialog.

There are several parishes, and individuals, in our Diocese that have been active in Haiti over the years developing church partnerships, providing medical care, assisting with construction projects, and supporting schools. In response to the recent earthquake, members of the Diocese have come together to form a Haiti Task Force. The task force is addressing both short-and long-term responses to Haiti's needs. In the short-term, we are encouraging people to offer prayers for Haiti, conducting fundraising, and supporting those who are currently able to help as certified first responders. In the long-term, we hope to facilitate reconstruction and healthcare mission trips in the coming months and years.

Members of the GMPTF have expressed a growing desire on the part of healthcare professionals in our churches to participate in mission activities that take advantage of their professional skills. In response, Samaritans Now, an Episcopal medical relief organization, has joined forces with the GMPTF to create a Global Healthcare Mission Task Force. We will be hosting an informational meeting at St. Mary’s Church, Newton Lower Falls (Saturday, 4/10, 10:00AM) for any and all healthcare professionals interested in participating in a mission trip (doctors, nurses, nurse practitioners, physician assistants, pharmacists, physical therapists, psychologists, clinical social workers, etc.). Plans are currently underway for healthcare mission trips in 2010 and 2011 to the Caribbean, West Bank and Africa.