Congregation - Based
Community Health:
One Model of Health Missions
in the New Millennium
[Submitted by PC(USA)]
Today’s mission field is very different from
that of 18th century missionaries. The 18th century mission field was a world
with a large number of religions and traditional forms of medicine. It was
a world where formal education was considered the exclusive privilege of
the elite. It was a world that had little access to the advances in health
being made by richer countries. It was also a world with little knowledge
of Jesus Christ.
The general response of missionaries
to their new environments during the 18th-20th centuries was the creation
of mission compounds. This was frequently a piece of land perched on top
of a hill which included a church, a school and a health facility (hospital).
Many argue about the appropriateness of this response as they consider it
to be linked to colonial structures and attitudes. In spite of the debate,
however, these compounds and their inhabitants did have a transforming effect
upon the communities and even nations in which they were established.
As a result of their work and
sacrifices, there are more Christians in the countries that received missionaries
than in the countries that traditionally sent them. The health status and
literacy rates are significantly improved on every continent. Most of these
countries now consider access to healthcare and basic education the fundamental
right of all human beings. Although missionaries cannot take exclusive credit
for these changes, their contributions should not be overlooked.
The religious, health and economic
landscape surrounding today’s church-related health work has also dramatically
changed from the one encountered by missionaries one hundred years ago.
Changes in Religion
The church is growing rapidly
in many parts of the world. Many countries now have churches with congregations
larger than the home congregation of the original missionaries. The greatest
challenge to these rapidly growing congregations is no longer to proclaim
the Gospel to non-believers but to make disciples of Sunday church-going
believers. They must now help their members to become disciples who are prepared
to give their time, talent, and finances to the work of God. Christians in
traditional missionary sending countries must figure out how to best utilize
the resources God has provided to help this growing body meet this challenge.
Changes in Health
In many of the countries where
missionaries built the first hospitals and schools, government and private
industry have become major health service providers. Over the past ten years,
the world has seen the emerging pressures of privatization and debt burden
steadily shift the health care pendulum towards a greater reliance on the
private sector as the primary provider of health care services. Consistently
we see that the result of this shift has been an expansion of services for
those with money and a decline in access to care for the poor. In fact, for
both the urban and rural poor, one of the biggest obstacles to accessing
health services is affordability. Two positive advances during this period
have been the recognition of the importance of access to primary health services
and the promotion by UNICEF of the Affordable Interventions, Removing Obstacles
to Healthy Development. A great challenge to the mission community today
is to help our Christian partners in these countries provide affordable health
services to people who die within a half mile of good high-tech hospitals
which they are unable to afford.
Changes in the World Economy
Data from World Bank demonstrate
that over the past forty years the economic gap between rich and poor nations
continues to widen. The growing economic gap raises many ethical and moral
questions for Christians in high-income countries that now struggle with
discerning what it means to be a responsible citizen in the global economy.
The changing religious, health
and economic realities have challenged the mission sending organizations
to rethink the vision of meaningful health missions. In varying degrees,
the traditional mission sending organizations have begun the descent from
the hospital on the hill to working directly with communities to provide
more cost-effective community-based health services. Many of the problems
which cause people to go to hospitals can easily be prevented or treated
in the community setting.
In the mid 1990s, as Christian
health organizations focused on community-based health care and moved away
from the hill, the church was left behind on the hill. The global church
is being challenged to find more creative ways of bringing Christ into health
work and creating a more holistic community-based approach to care in order
to address the physical, mental and spiritual person. One of the new approaches
which attempts to address this challenge is Congregation-based Community
Health, (CBCH).
Congregation-based Community
Health interventions are those activities organized by a worshiping body
of Christian believers that aims to improve the health (physical, social,
mental, spiritual well-being) of the community. The goals of Congregation-based
community health interventions are:
§ Secure prevention information
and affordable health care for the poor
§ Strengthen the discipleship of members of congregations and their capacity
to improve health in their communities
§ Provide organizational structure through which congregations are able
to offer the healing power and wisdom of God to resolve community health
problems
§ Provide opportunities for Christian health professionals in poor countries
to engage in the life of the community holistically as stewards of God's
healing resources
§ Strengthen the evangelism efforts of churches that are the geographical
and cultural neighbors non-believers and unreached people groups
§ Provide Christian witness of Christ’s love in the community.
Characteristics of a church that can successfully engage in CBCH include
being a:
§ Church with members that
have been burdened by God with the plight of the poor
§ Church committed to discipleship which starts with the pulpit and evangelism
which goes to the ends of the earth
§ Tithing church (time, talent and finances)
§ Church that understands what it means to be the Light of the World that
illuminates the path to life and well-being and the Salt of the Earth which
preserves life and health
§ Church that believes in the power of prayer
Characteristics of a church that can successfully partner with a church in
poorer countries engaged in CBCH include being a:
§ Church willing to engage
in a long term commitment
§ Tithing churches working as two Christian communities that both struggle
to be faithful to the Lord’s Call
§ Church that recognizes the changing reality of Christianity in the world,
a church which desires to partner with a community of believers struggling
to grow spiritually whose numbers continue to increase in spite of many difficulties
and a lack of material resources
§ Church that desires to honestly confront the ethical and spiritual challenges
which the growing economic gap poses to the church body
§ Church which believes in the power of prayer
There are many challenges and opportunities for congregation-based healing
ministries that address the needs of the poor. The question remains: Which
congregations will have the faith and the courage to embrace them?