Often nurses are asked to organize a healthcare outreach as part of a short-term mission trip. If done well, these outreaches can provide meaningful opportunities to model how Jesus cares for the whole person. However, lack of proper planning and relationships with the host community has the potential for creating setbacks at best -- or doing harm at worst.
We will focus on planning the healthcare aspect of a mission project. If you are being asked to organize an entire short term project, there a many websites, books and resources that can assist you in the planning, travel, orientation and debriefing programs. Likewise there are many short-term mission organizations that are doing healthcare. NCF has chosen to partner with Global Health Outreach,the short-term mission arm of Christian Medical & Dental Associations.
Here are some important specific questions to ask when planning a healthcare missions program.
What is the motivation for including healthcare as a part of this missions program?
Motivations for doing healthcare missions programming are many and vary from trip to trip. Sometimes there is an overwhelming health need presented that can easily be addressed by a healthcare professional on a short-term program. Other times a healthcare outreach supplements an indigenous church’s effort to reach the people in their community. It is also true that a motivating factor for healthcare professionals is a need and desire to help those who are less fortunate. This is part of who we are and our spiritual gift of caring.
For clues on motivation, look at whose idea it was to include healthcare as part of the missions program. Did the idea originate because there were healthcare professionals on the team who wanted to do healthcare? Did the partner in the host country request a healthcare program? How will healthcare contribute to the long-term impact of the mission in the community?
Spending time examining motivation prior to going on a mission trip is always instructive for a person’s own spiritual journey. Do you have an invitation from a host partner with a specific goal that can be better achieved with participation from a nurse? Do you have confirmation through prayer and Bible study that God is leading in the cross-cultural experience? A confluence of both is a good indication that the motivation for participating in a healthcare missions experience will lead to spiritual growth for the participant as well as serving the host community.
What healthcare needs are present in the community that is to be served?
Before going on a healthcare mission trip, it is good to know what type of healthcare programming is needed. It is also important to recognize that there are limitations to what a team of healthcare professionals can do on a short-term trip. Caring for people who have long-term healthcare needs requires a plan for follow-up services so that their ongoing healthcare needs are addressed. Many countries in tropical regions present diseases that are not frequently seen in the United States. Nurses should do a little advanced preparation to become familiar with “common” diseases seen in the country where the mission will take place. Management of these conditions varies based on the resources available in country. Learning the management and treatment protocols of the host country will insure that people receive a standard of care that is in concert with the resources available in the country and is honoring to God and the project.
As an alternative to providing curative healthcare services, nurses should consider:
- Surveying the community for the commonly presented health problems that can be used for healthcare planning. Doing a community assessment with baseline information on disease prevalence is helpful to the community in planning for their healthcare programming.
- Providing appropriate health education that uses sound non-formal education methodology. Many health problems can be addresses through health education. Non-formal education methodology focuses on having the learner own the message and commit to behavior change.
- Equipping indigenous healthcare professionals with the knowledge and skills they need to provide excellent healthcare after the team leaves are considered preferable options for a short-term healthcare missions program. Many nurses do not have access to the continuing education programming and welcome the opportunity to learn about current practice. The learning should be mutual. Often national nurses have expertise in areas that nurses in North America do not have.
Who is addressing those needs in the community now? Are there indigenous healthcare professionals with whom you can work? Who will follow up after the project ends?
Your team will only be there for a short time. Short-term teams have limited understanding of the host culture and language ability. People in the target area who have health needs have them met by someone when you are not there. Identifying these local providers and working together with them can be encouraging to local provider, mutually instructive, and provide an endorsement of their care when you leave. They know their community and their community has a level of trust in them. It’s wise to build collegial relationships with them to provide quality healthcare for the community.
What are the legal requirements for practicing professionally?
We require healthcare professionals from visiting countries to have proper credentials in order to practice in the United States. herefore we should expect to submit our professional credentials to the host country and meet their standards for practice. It is important to ask the healthcare professionals in the host country about requirements. Pastors, educators, and other missionaries who are not healthcare professionals may not know what the legal requirements are for professional practice. The International Council of Nurses lists the governing nursing boards for each of the member countries. If there is no nurse or healthcare professional in the host country to assist you, you may want to contact their nursing board directly.
What are the legal requirements for importing healthcare supplies and pharmaceuticals?
Basic equipment (stethoscopes, sphygmomanometers, thermometers, etc.) may be in short supply and should be brought with you. More complicated diagnostic and medical equipment that requires electricity needs to be carefully scrutinized for voltage, cycling, and availability of spare parts. The U.S. government may have restrictions on exporting some equipment to certain countries and the host country may impose import duty.
Many countries have an essential drugs list and requirements about packaging, labeling and expiration dates for pharmaceuticals. Often the commonly used drugs are available in the country. Consider purchasing them there to support the local economy and insure a continuous supply when you leave. Be aware that many common drugs may have different names in other countries. When groups bring in large quantities of pharmaceuticals and distribute them for free, that could interfere with the ability of the local pharmacy to stay in business and continue to provide needed medications for the community. WHO has recommended standards for donation of pharmaceuticals and medical equipment.
How do the care recipients understand western medicine?
Every culture has a worldview that explains concepts related to cause of disease, the place of suffering, the spiritual dimension of life, and what happens after death. The Christian worldview provides what we believe to be the God’s truth on these issues. People of different cultures may understand these concepts differently. They may try to fit western medicine into their cultural understanding. For example, people who are accustomed to going to a traditional healer who wears special clothing and performs various magical incantations to find out which ancestor is causing their illness may see western healthcare professionals in a similar manner, with their professional dress, diagnostic testing, and prescriptions. A lab coat, stethoscope, and colored pills are viewed similarly to a traditional healer. Also, many cultures do not think either/or but both/and. Hence, they will seek both the traditional healer and western healthcare. Healing is then attributed to both the traditional healer and the western healthcare provider. A good introduction to anthropology for missions is Paul Hiebert’s book in the Annotated Bibliography.
What will be the focus of the healthcare mission? Health promotion and prevention of disease? Curative care? Or a combination of prevention and cure?
Jesus cared for people holistically. He cared about their physical well-being as well as their relationship with God. Sometimes he cured a disease and then addressed their sins. Other times he forgave their sins and then healed their bodies. Keeping people well by preventing disease and treating problems early is one way of caring for people holistically. Immunization programs, health education to prevent common illnesses, and screening for health problems are important health programming and can be combined with the gospel message. But when people are sick and suffering, it is also important to address the health problem that is presented in order for the gospel to be heard and received. The purpose of the healthcare mission project may influence the focus of the project. Deciding on the focus of a health program will determine the type of healthcare personnel, equipment, and resources required for the mission.
Will the project include teaching? Who will be taught? What will be taught?
One of the best gifts a healthcare professional can give is the knowledge that they have. Nurses are accustomed to teaching patients and families about health. Nursing in countries with limited resources requires a focus on healthcare education. Language and cultural differences can be limiting factors for effective health education. Working with local nurses who know the culture and language will make healthcare education efforts more effective and can be informative for learning local health practices.
When teaching nursing practice to national nurses, it is important to approach the educational process from a learner stance. Nursing in countries with limited resources is practiced differently by necessity. Asking about what the current practice is -- and why -- can prevent a rush to judgment about the standards of nursing practice. Helping national nurses to think through clinical problems and potential ways of addressing them allows them to critically look at their nursing practice with the benefit of a colleague from North America. It affords opportunities to develop a trust that can become the basis for a relationship with a national nurse and lead to furthering Christian nursing in both the host and sending countries.