Current Trends in Medical Missions (Harold Adolph, M.D.)

When I arrived in Ethiopia in 1966, I found that the OR table was an old metal examination table with only three legs. The fourth leg was made up of various segments of scrap lumber. To gain the height I needed, I placed this contraption on four unusually designed wooden stools.

The OR light was a remnant from someone’s garage and hung on a rusting coat hanger from a sagging ceiling with beams that had almost been completely eaten away by the African termites of the neighborhood. In order to have the light in the area of the surgery, the four stools and table with the patient had to be moved.

Once when I reached for a sterile pack at 2 a.m. for an emergency surgery my hand came down on a large hairy “pack-rat.” He showed signs of wondering why he was being punished.

The single World War II sterilizer blew up during my third month and my mentor doctor who had been there twenty years, with whom I hoped to work with for five years, left after just six weeks. I still wonder what I might have said to scare him off. The first drug order I placed would not be filled because the hospital was said to be $9,500 U.S. dollars in debt.

The first five patients on the male ward had all been bitten by various wild animals–a lion, hyena, leopard, snake and wild dog. Ninety-one of my first 105 patients on the ward had conditions that I felt sure had never been described before. When skin tests were given, the control, myself, was the only positive one. Pathology reports were never helpful.

The electric generator had Noah’s fingerprints on it and seemed to have been constructed before the discovery of electricity. Its crank had a three foot radius. The challenge was to let go of the crank handle before you – became the blade of a propeller.

The primary form of revenge was to burn the neighbors’ thatched house down while they were sleeping at night, so we always had about twenty severe burn patients in the hospital. During my first days I ran into a bull while I was making rounds and had a chance to practice the gladiator maneuvers. The bull obviously thought that the new ward was still part of his grazing area.

Gourds hung from some of the nails on the walls. These were filled with goat blood, the vitamin mixture recommended for speedy recovery by the witch doctors. Kerosene lamps hung from the ceiling so the nurses could see where they were going for patient care at night. A donkey with four kerosene tins on his back secured water for the hospital from five springs located in a nearby valley.

The autopsy room was a separate building located fifteen feet behind the operating room. Whenever a patient died, this area was full of vigorously wailing relatives which made it hard to concentrate on the work at hand, the saving of the life of another patient in a delicate balance between life and death. The X-ray machine was a 15mA unit rescued from the jungles of the Philippine Islands after World War II.

When I went to the clinic, ten patients had a soiled rag in their hands. They wanted me to count the number of human teeth and compare them to the holes in their own lineup of remaining teeth. Then they wanted a “police letter” so that they could get financial remuneration for their losses. The teeth in the cloth usually outnumbered the vacancies in the mouth.

Thirty-two years later there are more than 700 churches among a tribe of about 5 million people. The New Testament, and most of the Old Testament, have been translated into the tribal tongue. Solar-powered tape recorders play the Bible for those who will listen. The churches have sent out 120 missionaries from their group to other tribal groups in Ethiopia that did not have a clear presentation of the Gospel before. The president of the leading seminary in the country was one of our patients. The current CMO and Chief of Surgery of the hospital was a student among 490 others who were trained in evangelism and as nurse practitioners to work in their own communities. During the time of the revolution many had patients who came to them, even when there were no medicines, just to have them pray and lay their hands on them.

What are the Current Trends in Medical Missions today?

First of all we see the sad disappearance of the career medical missionary.

• Thirty mission organizations have thirty-three hospitals and clinics without a single doctor or nurse.
• 178 mission hospitals in Africa are all crying for more doctors.
• 50 percent of the present missionary force will reach retirement in the next ten years; there are very few replacements.
• The gap between training and technology in the home countries and overseas is widening.
• By the time educational debts are paid off, the missionary fire has gone out.

Only 20 percent of doctors who have felt the call of God to go as missionary doctors still have that interest when their training is completed and their debts have been paid off. This last requirement usually takes five to ten years. By then the family and practice are well situated. The imagined work and call schedule in the mission hospital produces only panic.

The second trend is the shortening of the medical missionary career from the former thirty to forty years to less than four years.

There seems to be a loss of a certain level of commitment. No desire for sacrifice is apparent. The vision of what can still be accomplished by the mission hospital in world evangelism, especially in the 10–40 window of opportunity, is gone. In some ways the short-term service and short-term teams have killed long-term service. The question may be asked: If I can fulfill God’s requirements for my life for world evangelism by a two-week commitment per year, why should I consider a lifetime commitment?

One survey found that of a hundred feeling the definite call of God to missions, only twelve completed training for this calling; only two actually went, and only one stayed.

Third is the actual closure of mission hospitals because of the expense, the lack of key medical staff, difficulties in running a mission hospital and sometimes the lack of vision from mission leadership. At a time when there were 12,000 Americans earning good oil money in a certain near-east country, six medical personnel could not be found for a mission hospital that had been there for forty years. The mission hospital was closed despite the pleading of the government to keep it open.

Fourth, even though the need for the mission hospital is actually greater now than ever before to meet medical, surgical and spiritual needs, it is sometimes proposed that this is not so. Because of medical missions, Nepal has over a half million Christians today. Eighty percent of the Christians in India relate their conversion to a Mission Hospital experience. If you inscribe a circle with a fifty mile radius around each of the 272 mission hospitals in China, you find that these are the areas for revival today. As much as 90 percent of the medical needs of some countries are met by mission hospitals. When you think of the government hospital in a poor country giving their patients a list of items such as gloves, syringes, needles, medicines and intravenous supplies to pick up from a local pharmacy, you know that the need for mission hospitals is not past.

The fifth trend is the acceptance of certain myths of theology such as “the lost are not really lost and therefore don’t really need to be saved.” This myth ignores the Luke 16 story told by Jesus, Himself, where the tormented of hell are even pleading for someone to tell their friends about the good news so that they can avoid the same eternal fate.

The mission hospital has been painted as a “sunset ministry” even when we know that only one surgeon works in the country of Mali, a country of seventeen million people while the Chicago area has more than a thousand surgeons.

Loving and compassionate in-hospital care coupled with the spread of the Gospel is still the domain of the mission hospital where the “Jesus video” can be shown to a thousand people every day. We should not be deterred by the idea of hard work, a less than ideal location or a poor on-call schedule.

Personal peace and affluence have become dominant values or our culture. The Public Broadcasting Society had a full program on the terrible epidemic in the USA called “affluenza” where we work so hard to keep up with “the Jones” that we have almost no time for our family and friends, both husband and wife must work, frugality is a thing of the past, recycling is insufficient and repairing items broken is a lost art. The audience was admonished to get their lives back into line with their life purpose and take up voluntary simplicity.

A.W. Tozer said, “We see the world not as a battleground, but as a playground. We are not here to fight; we are here to frolic. We are not in a foreign land; we are at home. We are not getting ready to live; we are already living. We don’t realize that we are in a life and death struggle!”

How can we free ourselves from our present slavery to managed care with its bottom line and productivity, to giant debts, to another vision, and another king but not King Jesus, to physical fitness over spiritual fitness, to ourselves and our own needs instead of the 3.4 billion without health care? In Africa only one in twenty women needing a C-section for obstructed labor can get their operation. Only 15 percent of patients with hernias in Africa can get the operation they need during their lifetime, even if their hernia is strangulated.

The greatest deterrents to medical missions today are:

1. The desire for equity for retirement and “affluenza;”
2. The absence of prayer, and holiness;
3. The resulting loss of vision.

Is it so bad that your children will become missionaries? In God’s mercy He blessed us with having both our children return to career missionary service in Africa.

Is it so bad that you can have almost all three meals with your family every day even if you are the only mission doctor for a 105 bed hospital?

Is it so bad that you can have your wife and children actively participate in the ministry as a family? Our daughter started making Sunday rounds on the non-infectious case when she was seven. She worked as a circulating nurse at the age of ten. She first assisted at the age of thirteen. Our son was fixing the evangelist’s gospel recorders at the age of ten. By the time he was fourteen he was overseeing hospital maintenance and engaging in public health out-clinics with a jet injector inoculating hundreds of babies, with his sister’s help.

Is it so bad that your children must attend home school where the Bible, memorization, dedication to Christ, prayer and The Ten Commandments can be joyfully followed?

Is it so bad that your family must enjoy wonderful exotic vacations together in Africa, Europe or the U.S. National Parks because you have nine months off night call every three years?

There is no “call”:

1. To be interested;
2. To good intentions;
3. To be almost persuaded;
4. To partial priority, and lukewarmness.

When you obey Him, He will do great things beyond what you could imagine. Perhaps God planned for you to reach a tribe and language group with the Gospel through the gifts He gave you. But instead you used them for yourself. Now over 100,000 people will be forever lost in the fires of hell.

Love always means sacrifice. Sacrifice always means death. Ninety percent of the Christians in Cambodia lost their lives in the most recent upheavals there. It is estimated that today seventeen believers will die as martyrs for the sake of Christ somewhere in the world. Death means death to selfishness. Death means conformity to Christ’s image. My father’s favorite verse was, “Except a grain of wheat fall into the ground and die it abides alone.”

For you and me today missions demands a work of faith by God in each of our hearts so that:

1. We will hear the voice of God to us amid the clamor of other voices;
2. We will obey the voice of God however contrary to human reason;
3. We will go on with God’s work in the face of every opposition and discouragement;
4. We will realize that God’s work done in God’s way secures God’s reward.

There are still five good reasons to go into career missionary service:

1. The story of Noah and the coming judgment;
2. The story of Ezekiel and the responsibility of the servant;
3. The story of Jonah and the overwhelming advantage of obedience;
4. The story of Nehemiah and God’s empowering and enabling;
5. The story of Paul and the prize, because the prize is worth the price.

In the book, Of God and Men, A.W. Tozer says,” We languish for men who feel themselves expendable in the warfare of the soul, who cannot be frightened by the threats of death because they have already died to the allurements of the world. Such men will be free from the compulsions that control weaker men. They will not be forced to do things by the squeeze of circumstances; their only compulsion will come from within – or from above.”

When God called me back to Africa more than ten years ago for ten more years of overseas service, I had ten good reasons for staying in my comfortable surgical practice in the U.S.A.

1. “Think of how much I could give if I stayed,” I said. But God said, “I own the cattle on a thousand hills. You cannot have two masters.”
2. I said, “It is cruel to make my wife move.” But God said, “All these things shall be added unto you.”
3. I said, “Our home is so nice.” But God said, “There are many homes up there. I am your inheritance.”
4. I said, “Think of all the internationals in the U.S.A.” But God said, “I am sending you.”
5. I asked, “How can I live in a communist country?” But God said, “I will go with you.” He helped me study the theology of suffering.
6. Then I said, “No one will go with me because of AIDS, starvation, political unrest, persecution and suffering.” But God said, “There are windows in heaven.”
7. I said, “How can I find a suitable doctor to take over my practice.” Guess what? God showed me the perfect person for the job within two weeks.
8. But I said “What is wrong with where I am?” To which He replied, “This is your new assignment.”
9. But I said, “I don’t want to beg instead of give.” God said, “I am your great reward. Is my hand short that it cannot save?”
10. I said, “I’m 55 going on 65. You need someone young and strong without physical limitations.” But God said, “I will do a new thing. Be strong and of a good courage. Fear not, nor be afraid of them. For the Lord thy God, He it is that doth go with thee. He will not fail thee nor forsake thee.”

The Adolphs are now retired after long careers in overseas ministries, the last eight of which were spent in Galmi, Nigeria. They often travel the United States and other countries speaking and recruiting for the mission field. If you would like to reach the Adolphs you may email cmm@cmda.org for assistance.

This article was taken from a cmda.com newsletter.