[CCIH-Hospitals] Tensions from Christian medical work in Muslim communities, and US foreign aid

[MartinRS at aol.com]

This article examines the difficulties of Christian medical missions in a  
Muslim environment (in Pakistan), and the risk of a misleading message from  
USAID assistance to a Christian hospital. For  three companion articles in a 
Boston Globe series entitled "Exporting Faith,"  examining US  foreign aid through 
churches and FBOs and the growing influence of evangelicals  on US  policy, 
go to 
_http://www.boston.com/yourlife/health/diseases/articles/2006/10/11/healing_the_body_to_reach_the_soul/_ 
(http://www.boston.com/yourlife/health/diseases/articles/2006/10/11/healing_the_body_to_reach_the_soul/) 
 

Together, but worlds  apart


Christian aid groups raise suspicion in strongholds  of Islam

By Susan Milligan, Boston Globe Staff  |  October 10, 2006
 
SAHIWAL, Pakistan -- The X-ray machine at the Christian Hospital here is  
emblazoned with a USAID sticker to promote the US government's donation of  
top-of-the-line medical equipment. So is the blood bank refrigerator, the  
auditorium for medical lectures, and the radiology computer -- all sparkling new  
messages of help for the people of Pakistan, a crucial ally in the war on  
terrorism.
 
With a cleanliness and order that are in stark contrast to the crowded and  
filthy municipal hospital across town, the Christian Hospital, run by the  
Christian group World Witness with US government assistance, seems an easy  choice 
for the nearly all-Muslim community it offers to serve. The public  hospital 
is understaffed and underequipped, with patients slumped in dirty  hallways 
and anxious parents holding crying, sickly babies awaiting a doctor's  attention.
 
But like many Christian facilities in this Muslim nation, the Christian  
Hospital is an entity apart. It cares for 14,000 to 15,000 patients a year,  
compared with 1 million at the municipal hospital, and the neediest patients say  
they can't afford the few dollars for admission and a few blood tests.
 
Only a dozen or so patients sat in the waiting room during a recent visit,  
their traditional Muslim dress looking out of place in a facility with tile  
crosses in the walls and a New England-style chapel in the courtyard.
 
A rifle-carrying guard patrols the entrance -- a grim sign of the danger  
Christian groups face in a nation whose citizens believe their Muslim faith and  
brethren around the world are under attack by the largely Christian West.
 
Christian groups are running health care, education, and disaster relief in  
many Muslim nations, and USAID has awarded about $53 million from 2001-05 to  
fund projects by Christians in Pakistan, Indonesia, and Afghanistan alone. 
Both  the aid organizations and the US government hope the projects will sow good 
will  in a region growing increasingly wary of the West.
 
But the war in Iraq and the detention of Muslims at Guantanamo Bay have  
greatly angered Muslims, and residents are finding it hard to separate the  
policies they vehemently oppose from the activities of Christian aid groups,  said 
local Islamic leaders.
 
``People hate America as a whole. People in general think the West, and  Bush 
especially, have a double standard for Muslims. They are killing Muslims,"  
said Ameer-Ul-Azim , secretary of the Jama'at-e-Islami party in Lahore. ``It 
can  come to the point where it can affect the relationship between the Muslim  
community and the Christian community."
 

Fighting terror with Christ 

While Christian Hospital officials insist they are there to heal, not  to 
proselytize, World Witness's own literature suggests that part of its mission  is 
to spread Christianity.
 
A brochure for the hospital says ``The Jesus Film" ``is shown to all  
patients," and goes on to say that ``the hospital and staff feel that through  
Christ, terrorism will be eliminated in this part of the world," a phrase that  
offended Muslim leaders who say Islam is about peace, and not violence.
 
``If I am given such a message, I ask, `Why are you spreading hatred among  
human beings? What is your agenda?' " said Abdul Rauf Farooqi , a Lahore-based  
member of the board of the National Religious Schools Council.
 
Christian groups say that view is mistaken. The Rev. Frank van Dalen, World  
Witness's executive director, said ``The Jesus Film" is only shown in the  
waiting room, and not constantly. He winced when he was shown the brochure's  
reference to eliminating terrorism through Christ.
 
``That's a dumb thing to say. It doesn't work that way," he said.
 
Still, critics say, the Bush administration's special efforts to reach out  
to faith-based providers, the vast majority of whom are Christian, almost can't 
 help but raise suspicions in Muslim countries.
 
``I think it's important to step back and look at the wisdom of putting  
faith-based components into a program like this that is operating in a Muslim  
nation. The last thing we want to do is create the impression in the Muslim  
world that the US government is funding groups that seek to convert Muslims to  
Christianity," said Rob Boston, spokesman for Americans United for the  
Separation of Church and State. ``When USAID gives money to religious groups  that put 
Christian symbols in their facilities, and leave evangelical tracts  lying 
around, it's hard to draw any other conclusion [than] that it looks like  
proselytizing."
 
Defenders of the Christian groups say religion shouldn't come into play.  
``As long as it effectively delivers the good the government offers -- such as  
medicine -- the organization should not be discriminated against simply because 
 it is motivated by faith," said Ryan Messmore, a religion specialist with 
the  Heritage Foundation.
 
But far from discriminating, USAID has become a growing source of funds for  
Christian groups in the Muslim world. USAID spent $57 million from 2001-2005  
(out of a total of $390 million to nongovernmental agencies) to fund almost a  
dozen projects run by faith-based organizations in Pakistan, Indonesia, and  
Afghanistan, according to records obtained by the Freedom of Information Act.  
Only 5 percent of that sum went to a Muslim group, the Aga Khan Foundation of 
 the USA, which was given approximately $3.5 million for projects in 
Afghanistan  and Pakistan.
 
And even that amount is well below what the Aga Khan Foundation received  
under the Clinton administration, including $4.9 million in fiscal 2000  alone.
 
In the wake of the devastating 2004 tsunami, no Muslim organization has  been 
awarded a prime USAID award for relief work in Indonesia -- a sore spot  
among Muslim groups that want to help there.
 
In fact, of the nearly 160 faith-based organizations that have received  
prime contracts from USAID in the past five years only two are Muslim.
 
Mark Ward, USAID's senior deputy assistant administrator for Asia/Near  East, 
speculated that Muslim groups may be disadvantaged because larger, more  
established groups have mastered the grant-application process.
 
``We like the diversity it shows in a program if we have a group that is  
tied to Islam," Ward said, adding that Islamic groups are encouraged to  apply.
 
Bush's faith-based initiative is geared to help faith-based groups navigate  
the application process. But it has worked mostly for Christian groups, whose  
share of USAID funding has roughly doubled under Bush and accounts for 98.3  
percent of all money to faith-based groups.
 
For its part, the Pakistani government says it has no problems with  
Christian aid groups, as long as they do not break laws against blasphemy. But  the 
tension between what is perceived as the largely Christian West and the  Muslim 
East is evident.
 
``I have never had a problem with any Christian organizations. Charity work  
has no religion," said Tasmin Aslam, the Pakistani Foreign Ministry 
spokeswoman.  ``It's certainly not like Muslim organizations in the West, who are seeing 
that  they are perceived that if they are collecting money they must be doing 
it for  terrorist purposes."
 
Christian relief officials say they understand the rules, and know they  
probably could not survive -- and might even be in physical danger -- if they  
engaged in proselytizing.
 
``If the community ever was against us, we would have been out long ago.  
They could kick us out tomorrow," said van Dalen, a former missionary who has  
spent 12 years in Pakistan and has mastered the very difficult language of Urdu  
to communicate directly with locals.
 
But since 9/11 and the Iraq war, religion has been melded with politics in  
Pakistan, religious and political officials say, and the Christian groups have  
been caught up in a virulent anti-American sentiment.
 
Local newspapers are filled with articles critical of Bush's Middle East  
policy. A large billboard in Lahore displays a fearsome caricature of the  
American president with fangs, above a depiction of a crying infant and a man  who 
appears to have been wounded in a bombing. ``Who's Next?" the billboard  slogan 
asks.
 
Even a visit by actress Angelina Jolie, who has done humanitarian work  
around the world in her capacity as a special UN envoy, was received with some  
trepidation because she is American.
 

Linking US, Christianity 

Christians operating in the Muslim world must also contend with local  
worries that they are only there to spread their religion -- a concern that  
reflects fears that Western foreign policy has an anti-Islam agenda.
 
Since Islam is linked with government in Muslim countries, Muslims often  
have difficulty seeing that religion is officially separate from government in  
the United States, Boston said. Any activity that could be seen as 
proselytizing  becomes associated with the US government.
 
Faith-based groups receiving USAID grants may not tie assistance to  
religious participation, but the symbols and religious tracts are enough to  provoke 
discomfort in many Muslims, who are deeply resistant to  conversion.
 
The tension became lethal for The Christian Hospital Taxila. The facility,  
located next to a mosque in the northern Pakistan town of Taxila, was attacked  
in 2002 by Muslim extremists, who killed four nurses and damaged the 
hospital's  chapel. Now, the hospital, which does not receive US funds, is protected 
by a  thick concrete wall and armed security.
 
Another Christian group, Evangelistic International Ministries, declined  
even to say where it is operating in Pakistan, citing security concerns. The  
group, which received a $291,000 USAID grant, but for operations outside  
Pakistan, has been involved in helping earthquake victims, said the group's  
president of project development, Michael Goodwin. The group's website states  that it 
has handed out 700 Bibles in Pakistan.
 
The Christian Hospital in Sahiwal evacuated its staff after Sept. 11, 2001,  
and doctors have been trickling back since then. Until recently, local police  
protected the century-old hospital, fearful that the Western staff might be  
targeted, van Dalen said.
 
Workers at Christian facilities say they must be careful to accommodate  
Muslim sensibilities. At Sahiwal hospital, for example, men and women stand in  
separate lines to collect prescriptions, and are housed in different parts of  
the hospital.
 
Another Christian group operating in Muslim countries, World Vision, said  it 
goes so far as to ban its Muslim staff from attending Christian prayer  
meetings in Pakistan and Afghanistan to make sure no one thinks the group is  
proselytizing, said spokeswoman Dineen Tupa. World Vision receives USAID  funding, 
but not for projects in Pakistan and Afghanistan.
 
While the organization's stated mission includes spreading the love of God  
and Jesus, ``We're not here as evangelicals. For our staff's protection, we  
don't do it. For our Muslim staff, it could get them killed," said Tupa, World  
Vision's sub-regional director for Central Asia.
 
But with tensions simmering between Muslims and the West, local Muslims say  
they are growing suspicious of what they see as obvious shows of Christianity  
.
 
At the Taxila hospital, the walls are dotted with Bible verses, and a book  
room features tomes on Christianity. Muslim leaders in the town said they are  
offended by reports that the Christian hospital is handing out religious books 
 at the door.
 
``Of course, we want them to stop this," said Amir Shahzad, head of the  
mosque that is right next door to the walled Christian hospital. ``This is a  
Muslim country. Our feelings are hurt by this."
 
The Taxila hospital's administrator, Dr. Joseph Lall, said the staff does  
not proselytize. ``If you don't want to get hit on the head, you don't do it,"  
he said.
 
In Sahiwal, local mullahs said someone was passing out Christian leaflets  
near the hospital on Pakistani Independence Day in August; van Dalen said  
hospital staff had nothing to do with it.
 
That distinction is lost on some Muslim leaders.
 
``In general, we feel the NGO [nongovernmental organization] sector is  
directly trying to spread Christianity in this area," said Qari Tahir Rashidi, a  
mullah in Sahiwal. And while it is only a few ``fanatics" that have committed  
deadly attacks on foreign Christians in recent years, moderate Pakistanis are  
becoming more suspicious of all things Western, he said.
 

Some urge secular focus 

Given the mistrust, some critics wonder why the US government is aiding  
Christian groups in Muslim nations instead of secular organizations that might  
draw less controversy.
 
``The problem with faith-based funding, whether domestically or  
internationally, is that their orientation is often proselytizing. We may be  funding them 
in one area, but they are using other funds for proselytizing,"  said 
California Representative Henry Waxman, senior Democrat on the House  Government 
Reform Committee, which does oversight and investigations.
 
``If it's a Christian hospital in a Christian area, then I think that would  
be helpful [to the United States] for the public to see us supporting it. But 
if  it's a Christian hospital in a Muslim area and we're not helping the 
Muslim  charities, it's a bit of an insult," Waxman said.
 
Still, some Muslims do patronize Christian hospitals, saying the quality of  
care is more important than any religious differences.
 
Mukhtiar Bibi, a 19-year-old who is learning the Koran by heart, appeared  
embarrassed when asked why he brought a family member to the Taxila Christian  
Hospital. ``We have more faith in the care at this hospital," he said.
 
Patients at the Sahiwal facility said they had heard positive things about  
the hospital; Alir Rezwan, 34, said he traveled a long distance and spent 300  
rupees -- about $7 -- to bring his wife to Sahiwal for treatment of arthritis. 
 ``I have been to many different doctors for this, maybe here, she will be  
cured," he said.
 
But for all the good intentions of the hospital staff, the gleaming new  
equipment paid for by USAID is not benefiting most of the people who need it in  
the community. One of the radiology machines is not used to its full capacity, 
a  hospital administrator said, because the facility doesn't have a specialist 
who  knows how to use it.
 
In addition, the cost -- while stunningly inexpensive by Western standards  
-- is still too much for destitute Pakistanis who desperately need medical 
care.  ``Sure, if it were two rupees, I would go" to the Christian Hospital, said 
Rani  Nazeer, 30, as she awaited her turn at the municipal hospital. Two 
rupees -- the  price of registering at the public hospital -- is less than four 
cents; a Muslim  patient at the Christian Hospital showed that his bill for a 
blood test was 130  rupees, less than three dollars.
 
Van Dalen said the Christian hospital does not operate for profit, keeping  
its prices as low as it can. Further, he said, accident victims are required by 
 law to go to the public hospital, meaning World Witness's doctors can't 
treat  them.
 
For those who do come to the Christian Hospital, van Dalen promises  
top-quality care and an environment ``very sensitive" to Muslim customs.
 
``We have to be very careful that we live out our faith more than we talk  
about it," van Dalen said. ``I want Muslims to become Christians. But I can't  
make someone become a Christian. Only God can do that."
 
Globe correspondent Kevin Baron contributed to this report.   

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