Christian mission hospitals should be God’s institutions of healing in a world of suffering. They have the potential to ‘close the gap’ in access to healthcare and provide high quality accessible services in the most remote and needy parts of the world to those who need them the most – the poor and marginalized.
In 1993, my wife Ann and me moved to a remote part of Assam in northeast India. We were led by verses in the Bible (Jeremiah 29:11-13 for me and Isaiah 6:8 for Ann) to what God wanted us to do with our lives. Over the following 27 years, God took us by our hands and provided us with all the encouragement, strength and wisdom required to transform a closed-down hospital to a thriving institution bringing healing and transformation to many surrounding communities. (1) We were not alone, God brought many committed staff to join us over the years to make this possible.
I was privileged to be invited to speak at six sessions on “Medical Missions” at the (virtual) South Asian regional conference of the International Christian Medical and Dental Association in November 2020. I am not an expert on medical missions but spoke from our experience in walking with God and witnessing a great transformation take place in our hospital.
If the poor are our target population, we must enter into their world and look at healthcare options from their perspective. We must understand the social and economic conditions that drive their health-seeking behavior. When poor people come to our hospitals, should develop protocols that recognize their financial vulnerability reliably and offer them subsidy or charity before they sell vital assets. A good understanding of this ‘world of the poor’ will lead to practices and protocols which tell them that ‘this hospital is for people like us’. This will lead to large volumes of patients coming to the hospital, high capacity utilization of services resulting in further lowering of costs and transformational impact in their communities.
Pro-poor strategies are sustainable and grounded on well-established principles. We must understand the market forces that affect healthcare locally and leverage them to the advantage of the poor. Quality can be ensured without losing cost-effectiveness or sustainability. In places where healthcare indices are poor, good practices can improve them significantly without much investment due to increased volumes of excluded people beginning to access quality affordable healthcare.
We have described successful innovations which make poor-centric strategies work with our experience over the past 27 years at Makunda but there are reasons why others hesitate to adopt them. Makunda was able to overcome the initial inertia and make changes and this can happen only if we understand the reasons why people do not want to change and address them.
We should make well-thought business plans and finetune them till they are just right. If external support is needed, we should choose the right partners to work with who do not compromise on our mission and values. Many mission hospitals were established by the founders in remote locations but over many decades find themselves now in the center of towns that have grown around them facing competition from many other private and government healthcare providers. A sound business plan should also take this situation into consideration and design a strategy that will enable the work to thrive inspite of external competition.
In the question-and-answer session at the end of the talk, the questions have not been recorded in the video. They are:
- What can we do if our staff can’t manage with our low salaries? – it is a sacrifice that staff have to bear with the only assurance that God would take care of them.
- You mentioned that you identify poor people by how little they eat, won’t rich people do the same to get charity?
- How can we prevent ourselves from being cheated into giving charity?
- What are some other successful models in healthcare for the poor?
- What can be done if we don’t have sufficient long-term staff?
- How can we handle corruption and demands for bribes?
- If I am interested in mission work, where can I join?
References:
- https://the-sparrowsnest.net/2020/09/30/a-journey-of-faith/
- https://www.researchgate.net/publication/342551561_The_Makunda_Model_An_Observational_Study_of_High_Quality_Accessible_Healthcare_in_Low-Resource_Settings
The Sparrow's Nest 