Packing for the Journey

Justice in healthcare can take many different forms. It is a vital subject that every provider and practitioner needs to grapple with. In this post, we’ll cover a few of the common questions that will come up over the course of a healthcare provider’s work.  We’ll look at justice in healthcare as it relates to a time of a pandemic, social determinants, mental health considerations, and health disparities that often arise and exist when there is injustice in healthcare.  #1 We must understand justice in healthcare during a pandemic. Dr. David Stevens wrote about this topic in A Christian Healthcare Worker's Response to COVID-19.  Justice in healthcare is a tough topic, but it’s compounded during a pandemic, and it quickly becomes way more difficult to discuss. Allocating limited resources raises the ethical issue of justice—how do you treat patients fairly? How do you care for people—especially when so many more people need life and death care—and quickly? Dr. Stevens offers the following advice: First, you always want to be as impartial as the situation allows. Second, do the best you can for the most people with the resources you have. Third, without enough time, personnel, supplies, or supplies, at some point you will be forced to decide who gets and who doesn’t get your limited resource. You have the moral obligation to be constantly working to get the resources you need, so you won’t have to continue to make utilitarian decisions. Lastly, be sure to continue reading for more wisdom in the area of healthcare during a pandemic. #2 We must understand social determinants of health. According to Healthy People 2020, “Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.”  This is an issue of justice in healthcare because professionals must be committed to looking at the whole person, not just the malady. If a person is born and lives in an area with pollution, crime, violence, a poor education system, and few job opportunities, their health concerns will stem from those social determinants. Hospitals, clinics, doctors, and practitioners must be prepared to address these social issues if we want to see widespread improvements in health. #3 We need to understand mental health. Undiagnosed and untreated mental health disorders can lead to an array of serious ramifications including substance abuse, homelessness, interpersonal violence, and more. Ensuring that patients can access healthcare is vital. This might look like hiring community health workers to help navigate difficult systems or accepting patients who are uninsured or underinsured. Helping those who have difficulty navigating complex healthcare systems is a way to ensure that there is justice in healthcare. #4 We must consider health disparities. Another way to focus on justice in healthcare is to concentrate efforts on eliminating the health disparities we see that are based on race in the US. According to the Centers for Disease Control and Prevention, “Community- and faith-based organizations, employers, healthcare systems and providers, public health agencies, policymakers, and others all have a part in helping to promote fair access to health.”  The population health impact of COVID-19 has exposed longstanding inequities that have systematically undermined the physical, social, economic, and emotional health of racial and ethnic minority populations and other population groups that are bearing a disproportionate burden of COVID-19. According to the National Institutes of Health, although significant progress has been made in narrowing the gap in health outcomes (NCHS, 2016), the elimination of disparities in health has yet to be achieved. Despite overall improvements in health over time, some health disparities persist.  For example, while national infant mortality rates decreased overall by 14 percent from 2004 to 2014, Native Americans and Alaskan Natives have an infant mortality rate that is 60 percent higher than the rate for their white counterparts (HHS, 2014) and in 2013, infants born to African American mothers experienced the highest rates of infant mortality. Sadly, African Americans were 30 percent more likely than whites to die prematurely from heart disease in 2010, and African American men are twice as likely as whites to die prematurely from a stroke. Addressing these persistent health disparities in every way that you can is another way to fight for justice in healthcare.  There are so many more issues facing us when it comes to justice in healthcare. However, trying to learn and start to address these four areas, from how we handle these issues in a time of a pandemic, social determinants, mental health considerations, and health disparities, we’ll begin the process of creating a world where there truly is justice in healthcare.

Have you ever thought about being a missionary doctor? If you have, odds are good you’ve quickly jumped from thinking about being a missionary doctor to asking these common questions.  In this post, I want to give you details on the role of the missionary doctor. I’ll cover four of the most common questions from what a missionary doctor is, what a missionary doctor does, we’ll look at some missionary doctors who are currently serving, I’ll cover how missionary doctors make a living, and what’s often required to become a missionary doctor.  Question 1: What is a missionary doctor?  According to Reach Beyond, a Global Missions Health Conference exhibitor, a missionary doctor is: Someone who has earned their medical degree and can practice medicine.  The ability and desire to live and work overseas Sensitivity to cross-cultural issues A willingness to work with local partners A tolerance for uncertainty Imagination to see and explore opportunities that may arise A desire to mentor and coach other medical professionals The ability and desire to raise missionary support and/or be self-funded A commitment to serving long-term in the mission field A willingness to learn the local language Question 2: What does a missionary doctor look like? Missionary doctors can look very different. You might find them living anywhere in the world. They may live and work anywhere from a jungle clinic to a state-of-the-art facility in the middle east. The missionary doctor may be a male or female and from any country. In short, if you have the skills, education, and experience—you can be a missionary doctor! Question 3: Who are some missionaries currently serving? There are many missionary doctors serving all over the globe. I’ve highlighted a few of them below.  Dr. Tim and Kathy Rice: You can read about Dr. Tim Rice and Nurse educator Kathy Rice about their hospital and service in the Democratic Republic of Congo. Tim is the medical director of Vanga Evangelical Hospital and continues to serve as a doctor on the faculty of the School of Medicine at Saint Louis University. Kathy directs the nursing school as a registered nurse and educator. The Rice's aim to train the next generation of Congolese doctors, nurses, and health administrators in Christ-centered, whole-person care, empowering them to use the limited resources available to restore life and health across the Democratic Republic of the Congo. Dr. Jon Yoder: Dr. Jon Yoder is the resident doctor at a hospital in Mattru Jong, Sierra Leone.  The hospital belongs to the national church of Sierra Leone which is a United Brethren global mission. Sierra Leone lies on the west side of Africa on the Atlantic Ocean. The average life expectancy is 45 years old. It is most known to Americans for the tragic war in the 1990s, blood diamonds, and most recently for the now resolved Ebola crisis. Every person has his or her story of how they survived during these tragic times. Many people fled the country and some went into hiding. However, Sierra Leone is now at peace and well. You can read more about Sierra Leone and Dr. Yoder. Kiersten Hutchinson: Kiersten Hutchinson has served at Karanda for the past 18 years, not as a missionary doctor, but as a physician assistant with TEAM. She describes her journey from short-term trips, to reluctance and doubt, to full-time missionary work. In addition to stories of missionary doctors, I wanted to point out Karanda Mission Hospital: Karanda Mission Hospital was established in 1961 to meet the needs of mission stations in the Zambezi River valley which were established as churches and then, as the abundant health care challenges were seen, small dispensaries/clinics were developed along with churches and finally schools. To help the clinics, the hospital was built. Karanda is in a remote area of Northern Zimbabwe nearest to Mount Darwin. Its location is approximately 124 miles from Harare, the Capital of Zimbabwe. Question 4: How do missionary doctors earn a living? Missionary doctors may earn a living in a variety of ways. For example, some doctors are paid by the hospitals they are working for. Others may have to raise all of their own support from friends, family, or sending organizations. Most will do a combination of support raising and salary from the hospital in which they serve. Additionally, some mission organizations will do their own fundraising, and doctors may only have to cover a portion of their living expenses. There are many variations to earning a living and you can find something that works for you and your needs.  Question 5: What is required to become a missionary? In most cases, becoming a missionary means you’ll have to meet some basic qualifications, such as age, education, experience, and/or faith-based requirements. Next, you’ll want to reach out to members of your community about mission work and about how you can do some independent research of your own. After finding the right fit, it's all about completing the application process, any training involved and continuing to point to God with your skills, experience, and life. I hope this post has been helpful for you in answering some of the most common questions surrounding becoming a missionary doctor.