Thursday, January 31, 2013

What is a Mission Hospital?

What is a Mission Hospital?

These days, it has become politically incorrect to ask such questions! The fashionable response these days is to say that a mission hospital is any hospital in which a Christian doctor works.  And, indeed, there is a lot of truth in that statement.

A Christian doctor can work in any place God has called him to. If he is in the centre of God’s will for his life, and accomplishing the mission that God has given him, he will be a God-ambassador, and a missionary in the sphere in which God has placed him.

Today, however, I am asking a different question. What happens when an entire hospital wants to be a mission hospital? Does God have a mission for a hospital?  Is there a God-mission in which an entire hospital can participate?

Over the years, it has been my privilege to work (for varying lengths of time) in about 10 such “mission hospitals” scattered over 5 states in North and North East India. In addition, I have visited, I think, at least another 10 mission hospitals scattered over North and South India.

You could say that mission hospitals have always held a fascination for me, especially as I have watched, studied and learnt from the way they function, and reflected about the purposes they accomplish in various parts of India.

Recently, I have been thinking again about the question, “What is a Mission Hospital?”  I have dusted off an old PowerPoint presentation I made in 2007, and re-written it as a blog post. I find that writing often helps me clarify and focus my own thoughts and opinions. This is a work in progress as I seek clarity and personal direction. Please feel free to comment and respond. As we discuss, perhaps, more clarity may emerge

I think this may be part of a series of mission-hospital related posts to come....let’s see how long the creative juices keep flowing!

All that is gold does not glitter,
Not all those who wander are lost;
The old that is strong does not wither,
Deep roots are not reached by the frost.
(Bilbo Baggins in The Lord Of The Rings by JRR Tolkien) 

What Is a Mission Hospital?

A hospital that claims to be a mission hospital is making a very powerful statement: It acknowledges that God has a plan for a region, and claims to be a part of God’s mission and to be collectively trying to accomplish God’s purposes in its region.

That is HUGE!

As I see it, God might have three purposes for a Mission Hospital. He would want it to:
1. Seek His Kingdom Mt 6:33
2. Serve the poor and marginalized Is 58:5-7, Is 1:17, James 2:1-9, 15-16, Job 34:19, Luke 3:11
3. Glorify His Name by running on the basis of principles put forward in His Word 1 Cor 10:31, Col 1:10, 1 Pet 4:10-11

Understanding God’s purposes is crucial if we are to fulfil them.
"Would you tell me, please, which way I ought to go from here?"
"That depends a good deal on where you want to get to," said the Cat.
"I don’t much care where--" said Alice.
"Then it doesn’t matter which way you go," said the Cat.
"--so long as I get SOMEWHERE," Alice added as an explanation.
"Oh, you’re sure to do that," said the Cat, "if you only walk long enough."
(Alice's Adventures in Wonderland by Lewis Carroll, Chapter 6)

1.      A Mission Hospital must be Seeking God’s Kingdom. (“Thy Kingdom come, Thy Will be done on earth as it is in Heaven”)
This means that a mission hospital would not just be finding its vocation and purpose in treating the sick and working on the prevention of sickness. The focus of the hospital would be on seeking God’s kingdom.
The hospital would support and participate in the extension of God’s Kingdom, not just through evangelism, outreach and discipleship, but, equally importantly, through promoting Kingdom values like, for example, social justice and equality (across the sexes, castes, economic statuses). For example, a mission hospital would actively work against bonded labour and slavery, exploitation of the poor and the ‘lower castes’ and tribals and women. A mission hospital would speak up for those who do not have a voice. A mission hospital would get involved in these issues, because it has a higher definition of “Wholistic Health”.
Some mission hospitals may, additionally, also have a specialised role in a specific area. For example, a training institution seeking to be a mission hospital would seek to establish God’s kingdom by advocating in its spheres of influence (and passing on to its students) Christian values and paradigms of compassionate, ethical and competent care.

2.      A Mission Hospital must seek especially to serve the poor and marginalized. (“Let the oppressed go free”)

The priorities of a mission hospital would be radically different from the usual priorities in planning Health Care.

In a mission hospital, policy decisions would always be taken with the poor in mind. This is because God seems to have a preferential option for the poor.

The rich and poor would both be treated with dignity and get the same quality of care –the same amount of time in the OPD, same attention, respect, explanations, and reassurances. No patient would be sent away because of financial reasons. Treatment protocols would be poor friendly; diagnosis would be based on history and clinical examination, avoiding unnecessary investigations, and unnecessary and unnecessarily expensive drugs. Pharmacies would be poor friendly, stocking low cost, generic medicines rather than expensive brands. Specific strategies to help the poor may vary from hospital to hospital, but it would be clear to all looking on that the poor are the focus of the hospital.

Since there are so few serving the poor, a mission hospital would not be threatened by nursing homes, corporate hospitals and medical colleges. Its target population and priorities are very different!

3. A Mission Hospital would seek to glorify His Name by running on the basis of principles put forward in His Word. (“That in all things God may be glorified”)

For example, the finances of a mission hospital would be clean and transparent. There would be ethical policies in place regarding, for example, cuts, bribes, referrals, private practice, etc
The hospital would work on the paradigm that Christian employees of the hospital are also equal members together of Christ’s body, the Church! All levels of staff would be encouraged, as fellow-children of the Father, and fellow-heirs of the promise, to share in the vision and participate in the mission of the hospital. Hospital policies would promote this equality among the staff. For example, all staff would be free to express opinions, communicate with the administration and have fellowship together with them. The hospital would function as a team, and not as a one-man show.

The hospital and staff would be actively involved with the local church. There would be a clear understanding that the hospital is only a part of God’s body, fulfilling only a part of God’s mission in a place.

The leadership of the hospital would be in the hands of servant-leaders who are genuinely fired-up with a passion for seeing God’s Kingdom come, and have a genuine care and concern for the ones under them. They would continuously ask their target population and staff members, “How may we serve you better?”

Wow! Does this sound really idealistic and unrealistic?! Is it possible to run such a hospital in this day and age?

Let me venture to speculate on ways in which hospitals that start off with noble intentions to be mission hospitals lose their way.

Mission hospitals lose their way
1.      When the emphasis shifts from seeking God’s purposes for the hospital to following man’s ideas. 
2.      When the hospital begins to imitate others, rationalising bad decisions saying, ‘Everybody does this!’, instead of finding God’s will, and leading the way.
3.      When the emphasis becomes survival and the hospital spends its energy reacting to the urgent needs that keep popping up. (‘We need to “somehow keep this hospital running”’)
4.      When the emphasis becomes “Healing” instead of “Seeking God’s Kingdom”
5.      When the emphasis shifts from serving the poor.
Let me suggest what might happen when a hospital begins to really seek to be a “Mission Hospital”
Matthew 6 : 33 (paraphrased for the mission hospital)
When a mission hospital seeks to fulfil God’s purpose for it, and begins to seek God’s Kingdom first, it will be flooded with poor patients in the OPDs. Wards will be full and staffed with committed people, and the community it serves will be transformed. Every resource it needs to serve God’s purposes will be added on.
Luke 6 :38 (paraphrased for the mission hospital)
As it gives to the poor, it will receive all that it needs: good measure, pressed down, shaken together and running over.

Let’s keep talking......

Possibly related posts from the past:

Saturday, January 26, 2013

Saturday, January 19, 2013

If only all the world saw us as our Dogs did.....

(HT: 22Words)

Everything you are in the world is of no value.....

Martyn Lloyd-Jones:

My dear friend, we must make this perfectly clear. When you come into the Christian church and listen to this gospel as it is in truth, you must realize that everything you are in the world is of no value. It does not matter who you are, what your natural ability is, what your degrees and diplomas, your academic attainments, what knowledge you may have garnered. It is all useless to you. When you come into the realm of the church, the Pharisee is as helpless as the publican. The greatest sage is as helpless as the newborn babe. . . .

Thank God that his way of salvation is so utterly and entirely different from ours. . . . What does the gospel demand of us? Simply that we know that we are paupers, simply that we repent and admit and confess that we have nothing at all, that we are blind and lost and damned and hopeless and helpless.

--Martyn Lloyd-Jones, 'The Great Watershed,' in Setting Our Affections on Glory: Nine Sermons on the Gospel and the Church (Crossway, 2013), 41, 43

(HT: Strawberry-Rhubarb Theology)

Thursday, January 17, 2013

The Story of a Man Who Outsourced His Work to China so He Could Watch Cat Videos All Day

Here is a situation that was just asking to happen!

From YahooNews:

"The study documents the scam of a developer, who is referred to as Bob. He worked at a "critical infrastructure" company in the U.S. and started outsourcing his work to China underneath his company's nose, and would only pay those people less than one fifth of his six-figure salary.

Here's how it was possible.

Bob's company had started letting employees work remotely from home on certain days, so it set up a VPN concentrator to facilitate that. The company implemented two-factor authentication for the connection, with the second factor being a physical, rotating token RSA key fob. So all Bob had to do was send the key over to China via FedEx.

The company eventually noticed strange activity in its VPN logs, so it asked Verizon for some help understanding what was going on. The logs showed that Bob was logged in from Shenyang, China, even though he was sitting at his desk.

The company initially thought there was some kind of malware routing traffic from an internal connection in China, and then back to the U.S.

But Verizon investigators quickly noticed a major red flag. The VPN connection wasn't new and had been active for at least six months.

So they zeroed in on Bob himself, and took a forensic image of Bob's computer to recover as many files as possible and check for signs of malware.

What they ended up finding were hundreds of PDF invoices from a third-party contractor in Shenyang, China.

A look at his browsing history revealed what his typical work day consisted of:
9:00 a.m. – Arrive and surf Reddit for a couple of hours. Watch cat videos.
11:30 a.m. – Take lunch.
1:00 p.m. – Ebay time.
2:00ish p.m. – Facebook updates – LinkedIn.
4:30 p.m. – End of day update e-mail to management.
5:00 p.m. – Go home.

So while workers in China were doing Bob's job for him, Bob was sitting back, relaxing, watching cat videos, and earning "several hundred thousand dollars" a year."

Possibly related posts from the past:

Developing a Christian Work Ethic

Saturday, January 12, 2013

Christian Hospital, Bissamcuttack

My family was blessed to have the opportunity to accompany a group of 8 medical students from our medical college on a Secondary Hospital Posting from Dec 14th to 22nd. We were thrilled to be able to visit The Christian Hospital, Bissamcuttack, in Rayagada district, Orissa.

We were especially happy to be able to make this trip, because Arpita had had such a wonderful time working in this hospital for two years between 2001 and 2003. I had heard so much about this hospital from her, and it was wonderful to finally be able to visit. It was good to meet with a number of her old friends and colleagues, and to see the love and regard they have for her. I heard so many stories of the way her life and work ethic had impacted so many. The medical world lost a special doctor when Arpita decided to invest her life in her husband and children.

Arpita and our children
In many ways, the hospital at Bissamcuttack is very similar to the many other mission hospitals we have visited over the years. It was wonderful to hear a little bit of its history, about its founder, and the heroes who have worked there subsequently, and about the various innovative ways the hospital tries to help the poorest people in one of the most backward districts in the country. We were blessed to meet the committed, passionate and highly competent people who work here. We noticed that a number of staff multi-task, practising not only what they have been trained to do, but also doing an excellent job playing other roles they have trained themselves to perform because of the need.

(Here is a well written blogpost by a visitor to Bissamcuttack in August,2012, which gives a very good overview of the hospital, its history, community involvement, and residential school)

I was fortunate to be able to spend some time with Dr Sunil Jiwanmal and the surgical team (one junior doctor, a nurse anaesthetist, and a few nurses and theatre staff), and help out in some paediatric surgeries. It was refreshing to get back to the heady days of practising rural surgery! Dr Sunil and his team work at a breath-taking pace, and somehow manage to provide high quality surgical care to hundreds of patients every month. It seemed to me that on a typical day, the team performs ultrasounds, sees around 80 inpatients, operates on about 15 to 20 patients, including about 5 major operations, and sees about 50 patients in the outpatient department, apart from handling a number of major emergencies. And this was supposed to be the ‘light load’ of the winter season! They are able to pack so much action into the day because they share the load, get along well with each other, make the best use of the resources that are available, go beyond the call of duty and do more than they have been trained to do. I was inspired by watching this team at work.

It was also very enriching to be able to engage with Dr Johnny Oommen and the community health team. It was very encouraging for me to be able to bounce some of my ideas and thoughts (about mission and mission hospitals, for example) off him, and find a lot of resonance and similarity in the way he has thought through some of these very issues over the years. I look forward to carrying this conversation and exchange of ideas forward, especially as we grapple, as a family, with major decisions regarding our own future directions and plans.

Another highlight of this trip was being able to spend a couple of days with Ashita Abraham, Arpita’s sister, who stays with “Mrs K”, the Mitra Residential School, Kachapaju. Here was another eye-opener, as I listened to the story of how this school was started and the sense of community ownership and participation in its daily running.

The Road to Mrs K, the school at Kachapaju

Mrs K Kachapaju
Mrs K

Mrs K Kachapaju
Mrs K's children sing us a song

Mrs K Kachapaju
Telephone Point: The one place from where you may be able to make a phone call!

(You could read two newsletters which I could find online, to get a better understanding of Mrs K. This newsletter from Jan 2008 talks a bit about the history of the school, and the way it functions. This newsletter from 2010 talks, among other things, about how the school was protected during the infamous riots of 2008)

Which really brings me to what I perceive as this hospital's special strength: 
The Christian Hospital, Bissamcuttack is not a Christian Ghetto!

I have often written and spoken about what I thought was one of the major dysfunctions of the Mission Hospital model: the "Christian Campus" or, what Dr Johnny calls, "The Christian Ghetto" phenomenon. It seems to me that a number of mission hospitals are very closed communities. Generally, almost the entire Christian community in an area lives within its walled campus. We generally become so busy in the daily running of the hospital that we gradually become more isolated from the rest of the world. We are protected from the inconveniences of the world outside with our continuously generated electricity and water supply. As we live out our cocooned, cloistered and comfortable lifestyles, the 'outside world' becomes the dangerous place that we must periodically visit in order to go to the market. Our 'Mission' becomes merely the successful running of Morning Chapel, and the periodic 'Spiritual Renewal Week', Easter or Christmas programmes. 

Note the number of C words! The Christian Campus is often a comfortable and convenient, but also closed, cocooned, cloistered, and dis-connected Christian community!

One does not, however, get that impression from the CHB. There are a number of contributing factors, right from the open gate with no intimidating security officer, to the large open spaces, the canteen and shop right at the entrance (run by and open to 'outsiders'), staff accommodation outside the main campus, the effort to make the hospital as comfortable and welcoming as possible to the local people, the active community health department with its level of involvement with the local people and villages, and the obvious sense of ownership of the hospital that is seen not only in the hospital staff but also in the local people. Dr Johnny says every hospital begins to resemble its leader, and CHB certainly seems to have been fortunate to have had unusually far-sighted leaders who considered involvement with the local community crucial if the hospital was going to really be successful.

The Surgical Ward:  A number of small rooms.
Note the large garden space being used by patients to dry clothes! 

Patients share rooms with 2 or 3 other patients, and their relatives.
 They form a support system for each other

The entire family lives with the patient within the campus.

The hospital has provided space for the patients to cook together.

Living and Cooking together

The garden in A ward (the medical ward). Note the Christmas decorations!

Here are a few links to more Bissamcuttack related stuff on the web:

1. A presentation by Johnny Oommen made in Vellore in April 2012. It contains some autobiographical details, some great pictures of the hospital, community health work and school,  and a great slide which details some of the impact this hospital has had in terms of Health Indicators. It then talks about ways in which peripheral hospitals, the Public Health system and Medical Colleges have much to give and receive from each other.
2. How to Steal a Mountain: a look at Vedanta's illegal efforts to begin bauxite mining in this area.
3. Shikha Bhattacharji's blog on life in Bissamcuttack.

Possibly related posts from the past:
1. A Shout-out to India's Generalists
2. Developing a Christian Work Ethic
3. Why do I exist?
4. Personal Mission Statement Version 2

Thursday, January 10, 2013

Husbands: A Tip that Could Save Your Marriage

(an article from Erik Raymond that has me thinking)

With a title like this there is little room for dilly-dallying along the way to the answer. So without much introduction, here is the tip that could save your marriage: Get a part-time job.
There. That’s it. Husbands, if you want to save or strengthen your marriage, get a part-time job.
I should say right off the bat that I am not talking about a literal job that will pull you away from the home for more hours. Instead I’m arguing for the husband to approach his time at home with his family with the same thoughtful intentionality and engagement that he would if he were to go to work.
Far too many marriages are suffering because the husband comes home mentally, physically and emotionally zapped from his work day. He has done well as the provider for the home and now he is going to come home and collapse into a lazy-boy (aptly named) or in front of a computer or some other process of decompression and relaxation from a tough day at work. This type of thing may be ok occasionally but if practiced regularly it will lead to major problems.

Please read the whole article. It has this great statement from Erik's wife, that started him thinking, "Hey, we don’t want your left-overs. Don’t give everyone else your best only to serve us left-overs.”

Do weigh in: How do we husbands get the strength and energy we need  to be good husbands and fathers at home? Any ideas?

Tuesday, January 8, 2013

The Animals speak!

Good old BBC animal footage, accompanied by some outstanding British commentary!

(HT: Bertie on Facebook)

Saturday, January 5, 2013

What can you expect God to do in your life in 2013?

By Stephen Altrogge

(HT: Z)

What can you expect God to do in your life in 2013? Some pretty incredible things. You can expect:

God’s mercies to follow you, and pursue you, every every minute of every hour of every day. “Surely goodness and mercy shall follow me all the days of my life, and I shall dwell in the house of the Lord forever. ” (Psalm 23:6)

God to meet every single true need that should arise. “And my God will supply every need of yours according to his riches in glory in Christ Jesus.” (Philippians 4:19)

God to lead you, counsel you, guide you, and give you wisdom. “Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways acknowledge him, and he will make straight your paths.” (Proverbs 3:5-6)

God to freely forgive your sins each time you repent. “If we confess our sins, he is faithful and just to forgive us our sins and to cleanse us from all unrighteousness.” (1 John 1:9)

God to wonderfully correct and discipline you if you should stray into sin. “For the Lord disciplines the one he loves, and chastises every son whom he receives.” (Hebrews 12:6)

God to continue working powerfully in you as you pursue holiness. “…work out your own salvation with fear and trembling, for it is God who works in you, both to will and to work for his good pleasure.” (Philippians 2:12-13)

God to help you overcome patterns of sin that have plagued you for years. “For sin will have no dominion over you, since you are not under law but under grace. ” (Romans 6:14)

God to use trials in your life to refine and purify your faith. “Count it all joy, my brothers, when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness. And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing.” (James 1:2-4)

God to give you every good thing. “No good thing does he withhold from those who walk uprightly.”

God has promised to do all these things, and many more. His promises are sure. 2013 is bursting with blessings.

Thursday, January 3, 2013

The 'Indian' gang rape

Looking east in disgust: Delhi rape through eyes of the west

An interesting read. It has been, frankly, very upsetting to read the chauvinistic comments coming from writers in the West, as though gang rape is a peculiarly Indian problem. I am especially irritated to read the comment, "I am ashamed to be an Indian", by a number of Indians, happily watching the drama from their armchairs overseas.

This article should restore some sort of balance. Turns out the incidence of rape, the percentage of rapists that get arrested or convicted, the victim-shaming, and even the percentage of "leering men", are not really that much different between India and the 'civilized' West.

So please, let us stop the 'India bashing', and superficial, unhelpful commentary, and instead celebrate the democracy that permits us to express our disgust and anger at this horrific crime, the sense of ownership that makes us long to see our country become a safer place for women, the fairness of our legal system that protects even the worst criminals from being lynched but instead gives them a fair trial, and the sense of community that makes Us feel wronged and shamed and unsafe and angry and guilty and sorry, and causes us to stand shoulder to shoulder with our women, expressing our unity and solidarity.