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?
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.
The video starts with a short clinical illustration to show why we need to have all our faculties focused on our work lest we miss a vital observation (a point discussed in the previous day’s question and answer session).
Where will our staff come from? – this is a burning question facing most mission hospital leaders. We cannot wait for people to apply for jobs in our hospital, we need to get involved in the lives of medical, nursing and paramedical students in their colleges. Only then will we have sufficient numbers of high-quality committed staff joining us. From experience 33 years earlier to the present, I talk about suggestions on how this can be done. A slip of the tongue at 6.30 – in the illustration, I meant “my mother” not “my wife”!
Mission minded students start their missionary work as students in colleges, I have mentioned several observations on how good practices lead to transformational impact in college fellowships.
What about staff who join our hospitals today? How can we engage with them so that they live and work to their full God-given potential? How do we retain committed staff in our institutions? How can we make our hospitals professionally challenging places for our staff – where they feel that their skills and knowledge are being fully utilized?
How can we provide a pleasant and fulfilling life on campus to our staff? I close the session with a story that illustrates how God can surmount the greatest obstacles and provide us with the staff we need.
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.
The video (link below) starts with a few comments on questions raised by participants in the previous day’s session (this can be skipped by starting the video at 04.30). The first comment is on cost vs benefit of different healthcare interventions. I have explained the expenditure against population covered using 3 slides – maybe difficult to understand without the background discussion! This is followed by a few points on Christian private practice and marriage before the talk on leadership and human resource management.
In this third session, we will look at leadership in mission hospitals – please skip to 04.30 on the video. In this talk, I have spoken about ‘Title’ and ‘Towel’ leaders, management/governance structure, suggestions for recruitment and retention of staff and succession planning.
I have made a few references in the session – on marriage (2), online course on governance in health (3)
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.
In this second session, we will look at areas of medical mission work that are not taught in medical college. How do we take stock of the situation in our hospitals and make wise plans for the future?
At the end of the session, I have answered questions from the group. Unfortunately, the recording does not include the questions (only the answers). The questions are:
How do we manage burnout in our staff? – sometimes we really are physically exhausted beyond out capacity but often there are other reasons.
How do we manage differences in opinion with other senior officers of the institution? – we can’t win arguments, but we need to win hearts.
What can we do if there are irreconcilable differences with our partners? – we can list out our differences and give time for change, sometimes we may need to break the partnership.
What do you do when workloads become too much to bear? – God will give strength from above – through verses, songs, people…
Do we need to be serious about our work at all times, can we entertain ourselves too? – it is a tremendous responsibility to treat patients, their lives are in our hands and we cannot afford to be careless.
Allied Health Professionals (pharmacists, laboratory and other technicians, optometrists, neurophysiologists etc.) are often the unheard and unseen background support system of our mission hospitals. I thank the Christian Medical Association of India for inviting me to speak to them at their 2020 Annual Conference for Allied Health Professionals. I have spoken from our experience at the Makunda Christian Leprosy and General Hospital over 27 years – a testament to God’s blessings and the hard work of numerous co-workers (1). I hope that this video is an encouragement to allied health professionals (and students) in Christian mission hospitals all over the world. May God bless them and make them a blessing to many. I apologize for short segments of the recording that are inaudible (it was recorded over the internet).
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 – without them this transformation would not have been possible.
I was privileged to be invited to speak on the theme “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 as well as from observations on medical missions over many years.
The first session is here – I have given a short testimony, an introduction to medical missions and suggest several important attitudes to cultivate to be fruitful in God’s service:
My wife Ann and me were privileged to speak last year at the LEADTalks 2019 conference (1) in Bangalore – a forum that challenges and encourages young Christian people to live lives of purpose, integrity and excellence – we thank the organizers for the opportunity and pray that God would continue to bless their initiative in the years to come.
In 1992, within a year of our marriage we set out from Tamil Nadu in South India to Assam in northeast India (2,3). We were searching for a place that would provide us with an opportunity to be of the greatest transformational impact with the time, talents and treasure that God had blessed us with. For this, I had developed a simple formula to choose a location – the potential for the greatest transformational impact by an individual = the total population (in that location) that could avail his/her services divided by the total number of other people with his/her qualifications / skills etc. So, we were looking for a place that was thickly populated with few healthcare institutions which meant somewhere far away from home in urban Tamil Nadu.
28 years have passed since our first visit to Makunda, God took us by our hands and blessed us with wisdom, strength and encouragement. A small start in 1993 (4) has become a thriving institution today, providing services to many (5). It was all due to God’s grace and the hard work of many highly committed co-workers who laboured with us. Mission institutions provide transformational impact across the world in areas of great need and are key to ‘closing the gap’ in access to services to the poor and marginalized (6). Unfortunately, many are sick and the story of Makunda is an example of how God can revive and rebuild one of His institutions if we are willing to go with Him on a “Journey of Faith”. This is a short video of our talk:
I closed that post with this song which we all sang during our school days:
All things bright and beautiful
All creatures great and small
All things wise and wonderful
The Lord God made them all
– Song by Cecil Frances Alexander
This post is entirely filled with photographs that God has enabled me to take over the years. Browse through them and I hope you enjoy them as much as I did when I took them. I have written short notes to accompany each image. If you want to see more of my images, please visit my Flickr site ( https://www.flickr.com/photos/ivijayanand/ ) and if you want to see them as observations, they are here ( https://www.inaturalist.org/observations/ivijayanand )
The Blue-throated Barbet (Psilopogon asiatica) is one of the commonest birds on our campus. This photo shows the rich colouring of this beautiful bird. It is also an example of an ideal bird photo – head turned just right with a good ‘bokeh’ in the background.
This is a Chestnut-winged Cuckoo (Clamator coromandus). Cuckoos are known to lay their eggs in the nests of other birds – brood parasitism. This species lays its eggs in the nests of the necklaced laughingthrushes.
One of the common birds of our campus, the White-rumped Shama (Copsychus malabaricus) – it has a beautiful song. A recording of its call is here: https://www.xeno-canto.org/248160
One of the night owls, the Brown Boobook (Ninox scutulata). It is very difficult to get a daytime photograph like this one.
Birds display behaviour and emotions like other living creatures. Two Spotted Owlets (Athene brama) enjoy sitting out side by side with some allo-preening.
Phayre’s Leaf Langurs (Trachypithecus phayrei) are a species of Endangered primate that is found in our area.
The common Rhesus Macaque (Macaca mulatta) – the first photo shows a couple eating a tuber and the second one shows juveniles at playtime.
One of our campus orchids (Eulophia zollingeri). Orchids are one of the two largest families (along with Asteraceae) of flowering plants. This one is a terrestrial orchid (growing on the ground). The first orchids discovered were terrestrial and had two tubers underground – they were therefore named orchids due to their resemblance to testes.
Another common campus species, this time an epiphytic one – growing on trees – Cymbidium bicolor
Aeginitia indica is a root-parasite. The shoots come up from the forest floor in the monsoon season and soon produce the colourful flowers.
Forests inside our campus are home to all sorts of flora. This is an unusual fern, Helminthostachys zeylanica.
Forests are full of fungi of all sizes and colours – including these tiny vivid red mushrooms – Hygrocybe sp.
North East India is home to unique herpetofauna. This is a pit viper from our campus – Trimeresurus erythrurus
Our campus is home to large non-venomous snakes as well. This is a Burmese Python – Python bivittatus
All living creatures employ a number of measures to survive, including mimicry. This tiny frog looks like a bird-dropping on a leaf – Theloderma baibungense
The largest bats in the world are found across India. This is the Flying Fox – Pteropus giganteus – a mother bat breast-feeding an infant inflight.
One of the common squirrel species here in our campus is the Pallas’s Squirrel – Callosciurus erythaeus
A family of Asian Small-Clawed Otters – Aonyx cinerea – found in our campus as well as in surrounding areas. These are the smallest species of Otters in the world.
One of the common species of Mongoose in our campus, the Crab-eating Mongoose – Herpestes urva
North East India has seen a lot of elephant-human conflict in recent years, not surprising as people encroach into their habitats. These are wild elephants – about to enter a tea-estate bordering jungle.
Makunda has a wonderful arachnid biodiversity. This is one of our tarantulas – Chilobrachys assamensis – about the size of one’s palm.
Another ground-level view of the same tarantula – showing iridiscent blue colouring on its legs. Tarantulas are kept as pets in some parts of the world.
Spiders come in all shapes and sizes. This is a tiny one that mimics ants – Amyciaea forticeps
This spider looks like a piece of thread – Ariamnes sp.
There are cunning spiders too. This one is a Portia sp. – known to be an ‘intelligent’ spider, this one uses different strategies to fool and eat other spiders, including drumming on a web to appear as prey.
Many butterflies are named after Shakespeare characters and ranks of the Armed Forces. This is a rare one from our campus – the Harlequin – Taxila haquinus
We have many colourful dragonflies. This one is especially bright and beautiful with a mettallic iridescence – The Greater Bluewing – Rhyothemis plutonia
Most people think that moths are dull and boring. These are male and female Thyidid moths of the species Glanycus insolitus. Identifying moths is not easy – I still struggle, sometimes not even able to identify which family a moth belongs to – I thank experts like Roger Kendrick who have patiently identified moths for me on Facebook and iNaturalist over the years for my limited knowledge of moths.
Two more spectacular moths. Carriola sp. on the left with its intricate green veins within clear windows and Nevrina procopia on the right with its delicate patterning.
I’m closing this post with a snail. This one has small spines on its shell and belongs to the genus Endothyrella. I hope you enjoyed these photos as much as I did taking them and learning about these creatures – great and small, the Lord God made them all.
In October 2008, at the age of 44, I had a heart attack (1) at our home in the Makunda Christian Leprosy and General Hospital (www.makunda.in ), where my wife Ann and me have been working for the past 28 years. Following this, I was asked to go for daily morning walks to keep myself physically fit. As I walked through our campus, I became interested in the different wildlife (both flora and fauna) in our 350-acre forested campus. Although I had lived and worked there since 1993, I was looking with new eyes – filled with curiosity and wonder at what I was seeing. I had bought a Canon EOS 88 film camera shortly after joining the hospital and a few years earlier, I had invested in my first digital camera, a Nikon D70 with a Nikkor 28-105mm lens – all my photos were of people, developments in the hospital, places I visited and interesting medical cases that I saw. Soon after starting my morning walks, I purchased a Nikkor 70-300mm lens – I was able to get high quality macro photos with my 28-105mm lens but I needed a better ‘tele’ lens to photograph the birds.
In 2010, I was walking past our primary school one day when I noticed a pair of woodpeckers excavating a nest on a large bamboo pole used to hold up the school’s volleyball net. They looked and sounded different from a more commoner species (Dendrocopos macei) and I took photos and posted them on my newly opened account on Flickr (2). They were identified as Dendrocopos atratus, one of the rarest woodpeckers in India (later, some experts disagreed with this ID). I became excited and started photographing and posting all the birds I saw and was excited when one of them was uncommon. I also started venturing out to nearby tea-estates and forest villages to photograph them. The 70-300 lens was a basic one without vibration reduction (VR), so I bought a new one, Nikkor 70-300mm VR. I needed a good computer to process the images and bought an iMac 27”. I also bought a Sony sound recorder and a Garmin GPS. I became active on Facebook naturalist sites – ones on butterflies, moths, birds, insects – to post my images for ID and comment on other photographer’s images. After a few more years, I bought a new camera, a Nikon D300s and a Sigma 150-500mm OS lens. With the new gear, I was able to do a lot of documentation throughout the year. In 2012, I opened an account on iNaturalist and started linking my Flickr images to this wonderful site (3). Experts from around the world commented on the observations and confirmed IDs. These, ‘research grade’ observations could then be used by scientists for their research. This is the wonderful world of citizen-science where images and sounds of wildlife observations with time and GPS details can be peer-reviewed, confirmed and used for scientific advances.
In succeeding years, my gear has been upgraded further as old equipment became heavily over-used and broke down. I now have a Nikon D800 and a Nikkor 300mm f2.8 VRII for telephoto, a Micro-Nikkor 105mm f2.8 VR for macro as well as a Nikkor 24-120mm VR for general use. The old iMac broke down and had to be replaced, hard drives became full and more needed to be added. All this was considerable expense for a doctor couple in a remote rural mission hospital, but Ann approved all the expenses, for their role in my cardiac rehabilitation!
At present, I take photos of anything interesting I see in RAW, convert to JPEG with basic editing (mostly cropping) in Adobe Lightroom and upload images to Flickr. These are stored with a CC license – I noted that many serious people (those looking for images for their theses, articles, websites etc.) often search for the CC mark so that they did not have to write and seek permission from the photographer (4). Today, I have about 17,000 public images on Flickr with over 2 million views of these images! I also have nearly 9,000 observations on iNaturalist which is currently the highest number by one observer for India. Many bird photographers in the Oriental region contribute their images to the “Oriental Bird Image Database” – the best images are accepted and stored online – I have over 700 of my images on this Database (5). I have also contributed to the Internet Bird Collection (6), Avibase (7), ArKive (before it closed), Xeno-Canto (8) and a few other sites. Bulk uploads of my data have been transferred to the India Biodiversity Portal (9) and eBird. My photos have been included in books like the “Woodpeckers of the World”, “Mongooses of the World”, “Parrots of the World”, “Encyclopaedia of Animal Behavior” and many others.
I had soon photographed most of the common birds of our area and started looking at other living creatures. I was introduced to Siddharth Kulkarni, a scientist with an interest in spiders, he was also the country representative on the World Spider Catalog and I invited him to Makunda. He made a few visits and taught us to observe and document the spider biodiversity of the campus.
In 2015, I started the “Makunda Nature Club” – a group of staff and students of Makunda with an interest in documenting biodiversity, creating awareness, conservation work and research. I had published a short note on the “Mating of the Greater Coucal” online in 2011 to the Bird Ecology Study Group (10). In March 2015, on a biodiversity documentation trek in nearby forests, I noted a new bird I had not seen earlier. It was a van Hasselt’s Sunbird – Leptocoma brasiliana sperata – the first time this species had been photographed in India. I wrote an article describing this observation and the distribution of this species (with Praveen Jayadevan – a bird expert) as the first publication of the Makunda Nature Club (11). This was followed by the publication of the observation of a rare spider, Platythomisus octomaculatus, the first time it had been seen in India and the second time it had been observed since its first sighting in Sumatra 120 years earlier (12) and two Coreid bugs (Schroederia feana and Prionolomia gigas) – these observations were made, ID confirmed and published with expert assistance from Siddharth Kulkarni (the Coreid bugs were confirmed by Prof. Hemant Ghate) (13). The spider was found by one of our school-girls – a Class 8 girl from a remote rural school finding a very rare spider – for the first time in India! (14). In 2017, I photographed a rare Ghost Moth (Hepialidae) at my home in Makunda. I searched the internet and found that the global authority on these was Dr. John Grehan from the Carnegie Museum of Natural History in the USA. I wrote to him and after an exchange of emails, we co-wrote an article on the Ghost Moths of northeast India (15). The “Makunda Nature Club” got its excellent logo from Sukumaran Sundaresan – a design specialist who took a short sabbatical away from his corporate work to spend some time with us (16). The club also has also got its own group on the India Biodiversity Portal (17).
One day, I went to a nearby Jaintia village for the wedding of one of our staff and while waiting for the proceedings to start, met one of our old school-boys (from the Makunda Christian Higher Secondary School which we started on our campus in 2004), Rejoice Gassah. He told me that he had heard that I was going into local forests and that he was also interested. I questioned him, took him along with me on a few treks and found that he was excellent at describing birds and their calls – he had a natural talent. I requested our hospital management to appoint him as a full-time staff to help me. He was a keen-learner and I soon passed on most of what I knew to him. He accompanied me on all my field-trips and we discussed what we observed. The hospital also purchased equipment for him to use – a Sony bridge camera, an iMac 21”, a Sony sound recorder, a Garmin GPS and a Camera Trap as well as field guides. In 2017-18, he applied for and was sent to do the Green Hub Fellowship in wildlife videography – that was excellent training and we thank Ms. Rita Banerji and her team for the great program that they run (18). It is great to work with someone who has a passion for the work, has natural ability, good attitude and is willing to put a lot of effort into achieving excellence. As a full-time surgeon at the hospital, my biodiversity documentation work is limited to Sunday mornings or whenever I have free time after work. He was full time, young and healthy and we could now do field work whenever required and I could do the analysis of the data and write manuscripts for publication. He has been sent to several places (National Center for Biological Sciences, Bangalore and ATTREE to name two) to gain more knowledge and skills.
Publications on the Golden-crested Myna – Ampeliceps coronatus (19), Tawny-breasted Wren-babbler – Spelaeornis longicaudatus (20), Asian Stubtail – Urosphena squameiceps (21) and Siberian Blue Robin – Larvivora cyane (22) have come out of my work with Rejoice Gassah. He has become an expert at observations as well as documentation and has a keen eye for anything unusual. It has been a privilege to be able to mentor someone like him and I’m sure that he has a great future in biodiversity documentation and conservation in the years to come. Writing these articles also exposed me to the world of wildlife research, writing to curators of museums across the world, tracking observations from journal articles in the past and social media in the present to provide a concise description of that particular species and its distribution. Editors like Praveen Jayadevan from IndianBIRDS have helped me to learn to do this well. At present, more research is under way – on mammals, dragonflies, butterflies, birds etc. We have also had visits to our hospital by Prof. Ganesan from ATTREE (23) and hope to start work on research on the floral biodiversity of this area – one of the last bits of semi-evergreen low-altitude dipterocarp forests that remain with significant amounts of wildlife – both flora and fauna – outside protected areas.
I must also acknowledge the help and encouragement provided by Dr. Anwaruddin Chowdhury – a wildlife expert and Secretary to the Government of Assam with a huge amount of academic research and publications to his credit (24). We invited him to open the “Biodiversity Resesarch Trail” in our campus. He also invited me to contribute two short chapters – on the Golden Jackal (25) and Otters (26) in his book on the Mammals of Northeast India. We have also been visited by many wildlife and biodiversity documentation experts – Shashank Dalvi, Ramit Singhal, Jainy Kuriakose, Sankararaman, Shantanu Joshi, Sarala Khaling, Rohit George and many others. I don’t use a tripod and the equipment is heavy, not good for someone with an ejection fraction of 35% to carry – especially the Nikkor 300mm f2.8 VR II lens – I thank Club members, Basanto Fulmali and Babryl Chorei who helped carry the equipment on long treks when I was tired. My wife, Ann and daughters, Hannah and Deborah, have also helped with observations, especially with bird behavior and with rescuing some injured/sick birds and animals. As days go by, more staff see the enchanting beauty of God’s creation, learn fascinating facts and become entranced with the world of biodiversity observation and documentation. More people are buying cameras or take photos on their cell-phones and enquire about the identification or habits of the species that they have observed, this type of activity also relaxes people and makes the overall experience of working in a remote rural situation more enjoyable. I’m sure that this work will continue and bring satisfaction and happiness to many.
Sometimes, God uses shock treatment to help us to look at our worlds through different eyes and that is what happened to me after my heart-attack – whenever something happens to nudge us out of our well-trodden paths, we should always ask why did this happen, is there something that I need to change and is there another road that I need to explore. It is also a confirmation of the fact that God has given us such wonderful brains that someone like me with no interest or knowledge of wildlife could become an accomplished citizen-scientist in a short time – starting at midlife. More of us, whatever may be our background, should consider looking at the biodiverse world around us, maybe that world is beckoning to us too – we need to take that first step and enter into the world of God’s creations, where everything is bright and beautiful.
This post is based on a message I gave today (through videoconferencing) to the staff of our hospital, Makunda Christian Leprosy and General Hospital (1) – the numbers in brackets refer to links given in the references at the end of this post:
Today is Palm Sunday, the beginning of the Christian “Passion Week”. Normally, today, Christians all over the world would have walked streets outside their churches with palm fronds, enacting Jesus’s entrance into Jerusalem, leading on to the train of events that led to His death and resurrection. Palm Sunday 2020, however, is different. Churches all over the world are closed. Most villages, towns and cities are under various restrictions – from social distancing to lockdowns. People are on their phones – talking, chatting and posting on social media, the discussions are all about one thing – the Covid19 pandemic. Till today, over 1.2 million people are infected and over 65,000 have died (2).
Instead of a Palm Sunday message, today’s talk will be about our response to a crisis situation. The Jewish world is about to start their Passover festival – this year it will also be celebrated across the world in similar conditions as Passion Week – from the 8th to the 16th of this month.
We read the story of the Passover in Exodus 12:12-18 (3). The nation of Israel was in bondage to the Egyptians. The ruler of the Egyptians, the Pharaoh, would not let them free – they were his source of cheap labor. The early chapters of Exodus talk about this situation, the story of Moses and God using him to deliver the Israelites from the clutches of the Egyptians through 10 plagues. The last plague was the death of every firstborn in the land. The Israelites were pre-warned of the impending plague and were told to anoint their doorposts with blood from a sacrificial lamb. When the Angel of Death swept through the land killing the firstborn, he “passed over” the homes where there was blood on the doorposts. We too, like the Israelites, should put our faith on the shed blood of the Lamb. The world today is gripped by a powerful pestilence, killing large numbers of people from even the wealthiest and most powerful of nations – all their power and wisdom is unable to stop it. We too have no power over this pestilence, but like the Israelites, we can put our faith on our God, who made heaven and earth. He sends His angels to watch over His people and like the Israelites in the days of Moses, we too can be at peace and without fear.
Let us look at a Biblical model for our hospital as we approach this crisis situation. For our meditation today, I have taken the first 6 chapters of the book of Nehemiah.
Nehemiah starts his story from the city of Susa, where he hears about the sad predicament of the people of Judah and the city of Jerusalem. It is like our situation today, as we hear about the worsening crisis across the world. He knows that this situation is due to the disobedience of God’s people (Nehemiah 1:8) (4) but at that point in time, the problem was to restore the integrity of the city and its walls. He approached the king and is given supplies and assistance to complete this task. He is given authority, in fact, he is made the governor. He (Nehemiah 2:12-16) (5) inspects the city and its walls and takes stock of the situation. We too should understand and take stock of the situation. Through electronic mass media, we are uptodate on what is happening around the world. We know that this pandemic originated in China and then rapidly spread across the world through traveling infected people. It is now spreading from person to person. Each infected person is expected to spread the disease to two others, if given the opportunity to interact with uninfected people. If nothing is done, millions will be infected and many will die. Scientists are constantly studying this disease as it evolves and we are learning how to manage the situation and minimize morbidity and mortality.
Having understood what he was up against, Nehemiah made elaborate plans. He appointed key leaders to take responsibilities for rebuilding different parts of the walls of Jerusalem. When faced with ridicule by his enemies, he responded by ignoring them, showing single-minded determination to complete the task given to him and by prayer. When there was a threat of physical violence (Nehemiah 4:15-16) (6) he arranged for workers to continue working – with construction materials in one hand and a weapon in the other. We too have the responsibility of treating our patients while protecting ourselves and others from getting infected. At our hospital, the local government has designated us as a non-Covid emergency hospital. People need a safe place to go for their deliveries, strokes and heart attacks, bowel perforations and obstructed hernias. In the future, we may be called upon to work with Covid patients too – if government facilities are overwhelmed. Our hospital has created a task force that has readied the hospital to tackle this situation. Separate teams have been formed, personal protective equipment (PPE) is being made with what we have, different areas have been designated for different patients and protocols are in place – we too are preparing to fight on two fronts.
In the 5th chapter of the book of Nehemiah (7), we see him hearing about the plight of the poor and needy. Although his task was to repair the walls, that could not be his only priority. His target population was suffering and they were the focus of the exercise, not the stone walls and wooden gates. Therefore, he steps in and asks people to forgive the debts of the poor and give loans without interest. In this moment of crisis, let us also consider the people we have been called to serve. Many of them were already poor and marginalized, this situation will make them destitute – they have just become financially vulnerable and in danger of losing their vital assets. If we force the poor to pay their bills – for bringing their loved ones to our hospitals and their children to our schools, we would inflict greater pain than the virus. Let us think about how we can be a blessing to the underprivileged communities that we have been called upon to serve. We may ask, aren’t we running out of money too? We don’t have enough to pay our bills and salaries. We must remember that God is no man’s debtor. The Bible tells us that when we treat the poor, He will pay their bills and reward us (Proverbs 19:17) (8)
Later in the 5th chapter, we see Nehemiah counting the costs of the work entrusted to him. He finds that resources are short and the task is great. He decides to set a personal example by not claiming what is his due as a governor. When crisis situations arise, we (and our families and friends) should consider a period of austerity and sacrifice for the people we are called to serve. Makunda went through periods of severe crisis in the past. Each time, bills accumulated, due amounts were demanded by various people – salaries were deferred and many staff donated from what they had to keep the work going. Projects had been started which could not be closed – staff contributed to enable them to continue, today they are institutions on their own, the 1200 student Makunda Christian Higher Secondary School, the School of Nursing and the branch hospital at Ambassa in Tripura – to enable these to become reality, staff were willing to wait for 14 years for running water and electricity to be supplied to their homes. Some staff did not take their eligible leave so that the hospital did not have to spend on paying for replacements. Today, we too have an opportunity to help our institution continue to serve its target people by giving of our time, talents and treasure. We are lending to God and will be repaid with things that money cannot buy – peace and contentment in this world and riches in heaven.
We read in Chapter 6 (9) that Nehemiah firmly denied lies from his enemies and finally completed the task in 52 days. Only then did he start working on solving the root causes of the problem – the disobedience of God’s people. We too need to work hard and diligently to get through this crisis now, when we have got over it we can study the entire experience and put in place protocols and practices to help us do better the next time we face another crisis.
We now come to the last part of today’s message. We hear about fear in people facing this crisis, but we have nothing to fear. Romans 14:8 (10) says that whether we live or die, we are the Lord’s. For us, Christians, life does not end with our physical death but continues on forever. We are God’s ambassadors from the kingdom of Heaven, temporarily posted to this world. We will all die one day but we are at peace. We have handed over our lives into the hands of our loving Commanding Officer – we are dispensable and He can choose the manner and timing of our deaths. Our only concern is that during the time given to us in this world, we live lives that find approval in His sight by trust and obedience and complete the tasks given to us.
Let me close with a few verses from that much loved chapter in the Bible, Psalm 23 (11). In verse 4 we read, “Even though I walk through the valley of the shadow of death, I fear no evil, for thy rod and thy staff, they comfort me”. I remember suffering an acute myocardial infarction (12), rolling about in pain on the 12th of October 2008 – I felt as if someone was trying to pull the life out of me but I was holding on because God was telling me that He had some more work for me to do before I go to be with Him. In verse 6, we read, “ Surely goodness and mercy will follow me all the days of my life and I will live in the house of the Lord forever” – may we submit our lives to Him as we face this crisis and be worthy of this promise, for this world and the one to come.
The Sparrow's Nest 