Thus the third task of the panel members was to analyze this premise
by clarifying assumptions. First, they identified assumptions that guided
the foundation of Christian hospitals. They then linked the six major problem
areas identified earlier to the assumptions (see below). In doing this,
the group found that a large number of assumptions previously used to analyze
problems were seriously flawed.
| Assumptions |
Associated problems |
| Assumption 1: The staff is qualified
and committed to the mission vision. |
failure of staff commitment; lack/loss
of mission vision; difficulty in finding qualified staff within the region
in which the hospital functions. |
| Assumption
2: Healing and spiritual ministry go hand in hand. |
lack of holistic understanding of health
care; medical care takes so much time and resources that it is not possible
to give proportional time to spiritual ministry; the Western medical approach
does not include spiritual healing -- its focus is more on curing than
wholeness. |
| Assumption
3: There is no competition from other hospitals. |
competition from governments/NGOs for
patients, staff, and finances. |
| Assumption
4: The primary focus of the mission would be on evangelism. |
hospitals are sometimes culturally insensitive
and unacceptable to local populations; lack of understanding of the determinants
of health; the evangelistic focus has been lost from the perspective of
the sending mission. |
| Assumption
5: Hospitals answer to all health needs. |
lack of community ownership and participation;
hospitals have little or no impact on public/community health; hospitals
have almost no impact on the health status of the population they serve
-- they cure, but they do not prevent disease and illness. |
| Assumption
6: Presence of a (foreign) medical missionary is good for success. |
decrease in staffing and funding by missionary
agencies; failure to develop local leadership. |
| Assumption
7: People will be grateful for health services. |
dissatisfaction with charges/ services;
increasing expectations; increasing litigation. |
| Assumption
8: Traditional healers are enemies or, at best, irrelevant. |
cultural conflicts and lack of cooperation
of traditional healers. |
| Assumption
9: People are ignorant and should be told what to do. |
hospital is culturally insensitive; lack
of leadership development and, subsequently, community participation and
ownership. |
| Assumption
10: Resources will continue forever. |
failure to explore local and other financial
resources; decrease in total funding; hospitals have no motivation for
becoming sustainable. |
| Assumption
11: Community culture has no impact on hospitals. |
cultural conflict; hospital is not sensitive
to community needs; hospital has culturally inappropriate practices. |
| Assumption
12: Doctors and leaders make all decisions (vertical management). |
lack of trust in leadership; lack of
leadership training; lack of community participation. |
| Assumption
13: There is no need to train national leaders |
lack of planning for transfer of leadership;
expatriates distrust national leadership. |
| Assumption
14: Political/colonial institu-tions will last forever |
political instability and/or lack of
political will and commitment to health care; armed conflict leading to
breakdown of health care infrastructure. |
| Assumption
15: The local Church has no role in running hospitals, so it is
not important to educate it about health. |
local Church does not see health as part
of its mission; lack of understanding of health issues; hospital is viewed
as income-generating activity. |
| Assumption
16: Hospitals must have adequate external support. |
creation of dependency; decrease of local
support; lack of local training (emphasis is external); lack of ownership;
lack of true partnership. |
