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Summary
Report
Health and Wholeness
for the 21st Century
A Project MedSend conference
Chiang Mai, Thailand October 17-22, 2003
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TABLE OF CONTENTS
Overview
Biblical Wholism as a Worldview
Image, Identity and Liberation
Transformation, the Church, and Community Wholeness
Fundamentals of Transformation
Evaluating our Goals and Assumptions
Strategy & Strategic Partnerships
Personal Impact
Resources
Health & Wholeness for the 21st Century
A Project MedSend Conference
Overview
The purpose of this conference was to gather Christians involved
with medical outreach to discover together how to be more effective in
fulfilling the mandate of Christ to heal the sick and teach people how
to live healthy lives. Three primary speakers and a number of
exemplary project presentations were used to stimulate thought and
discussion about transformational development and whole person health
care. Panel discussions and small group analyses of the projects were
used to explore how to adapt the success of others to one’s own
setting.
The conference speakers included:
Darrow L. Miller, Vice President of Food for the
Hungry International and author of "Discipling Nations:
The Power of Truth to Transform Culture".
Rev. Dr. Vinay K Samuel, founding director of the Oxford
Center for Mission Studies and president of the Institute
for Strategic Initiatives based at the Ethics and Public
Policy Center, Washington, DC. Founding editor of,
"Transformation," a social ethics journal.
Stan Slade, PhD, from the American Baptist International
Ministries; author of, "God in the Lead: Meditations on
Missions in Genesis and Acts."
This document is an attempt to summarize the major themes of the
conference for leaders of our organization and colleagues who share a
desire to follow Jesus’ model in ministering holistically. I have
outlined these themes as follows:
Biblical Wholism as a Worldview
Image, Identity, and Liberation
Transformation, the Church, and Community Wholeness
Fundamentals of Transformation
Evaluating our Goals and Assumptions
Following this are some Strategic Principles proposed by Dr.
Vinay Samuel and then some of my personal conclusions from the
conference about the idea of wholism in ministry and how it might
affect our goals, objectives, and day to day lives….
Biblical Wholism as a Worldview
Wholeness can be fully understood only from the perspective of
those saved and transformed by the work of God—those who choose to
yield to God and allow Him to reveal His heart for His creation.
Wholeness is manifested and discovered only within the Kingdom of God,
which is a functioning, real kingdom…not simply a "framework"
to help us understand God and the world. Holistic refers to the scope
of God’s activity in the world—the mission of God Himself. The focus
of God’s activity is people, but He is not limited to this.
Christ not only taught about the Kingdom of God, He demonstrated
it—He healed, delivered and saved and called his disciples to do the
same. The Greek word used in Scripture is sozo, which means to
make whole and heal. When Jesus is referred to as "Savior," this
implies healer, savior, and deliverer.
The worldview of most citizens of the "west" is heavily influenced
by Evangelical Gnosticism, a school of thought which
compartmentalizes our lives into distinct spiritual and physical
realms. We see God as interested only in "spiritual things" and
separate from the physical dimension. We live in two different worlds.
This has largely been accepted by Christians and has operated as a
worldview in missions for many years. Often by default, we ignore God
in areas which we do not recognize as "spiritual."
Those who operate from a worldview of Biblical Wholism do not see
the physical and spiritual realms as distinct; rather, as integrated,
each impacting the other, and equally under the authority and concern
of the Creator. As children of God, we are governed by the concept of
Coram Deo, meaning that everything we do, we do before the
face of God. It is recognized that in work, in recreation, in
thoughts, in speech, in "ministry" and in the mundane of everyday
life, we are in relationship with our Lord and can either honor or
dishonor Him.
The Gospel gives identity and brings liberation. We should be
giving pictures to people of what God has given them (an opportunity
to grow into the wholeness He intended for them) and how God has made
them (whole)…
Image, Identity and Liberation
At the very core of the concept of Biblical wholism is the issue of
Identity. Every culture has some "story" which has shaped the
identity of its members. Those who operate from a non-Biblical
worldview have not heard or don’t understand the Biblical story
of the beginning and we often fail to tell them—even as we share the
Gospel in our mission outreach. The Bible answers the important
questions which shape our worldview: who is man, who is God, what is
nature, what is true, what is good, what is beautiful, where are we
headed…?
The Bible reveals that we are created in God’s image—we are
His "image bearers" and are creative beings put here to be stewards of
God’s creation and to have dominion. We must operate from this
paradigm. Image is God’s gift to us. It is God’s expression of
love to create something to respond to Him in love. We were created to
be open to and for God; created for relationship with God.
As created beings who live in a fallen world, our identities are
often largely shaped by the world—what we see, what we value, what we
receive as truth. We can see evidence in our cultures of demonic
reshaping of who people are, even the suggestion that you can define
or determine your own identity. The Fall did not erase the image
in which we were created, it simply damaged and distorted it. Man
was thrown out of the Garden and must struggle to recover wholeness,
working in a hostile environment which tries to destroy our wholeness.
Because the image was never erased, it places in us a deep longing for
wholeness.
What we choose to receive shapes us, for better or worse, and this
is why we are in need of transformation. In our hostile environment,
we meet Christ. When He calls us, he takes us out of this hostile
environment and begins the process of change. If we choose what Christ
offers, we receive a new identity (a restoration of God’s original
design) and this is where transformation begins.
John 15:19 "…You are not of the world but I chose you out of the
world..."
Transformation made possible by the redemptive act of Jesus Christ
and rendered by the Holy Spirit not only restores our identity, but
also liberates us. Jesus frees us to live as God originally
intended—in wholeness or completeness, intimately relating to the
Father. The freedom that Jesus brings is spiritual, physical,
cultural, and economic. It is characterized by justice, peace, and
hope….
John 8:36 "So if the Son makes you free, you will be free indeed."
Justice
Justice holds creation together. It is the context in which the
rights of the poor, weak, and needy are maintained. It gives the right
and freedom to exercise your identity in Christ. In the kingdom of
God, justice creates an environment where you are free to exercise
your rights and develop your gifts.
Peace
Peace pertains to relationships and involves reconciliation and
restoration. It is relationships "as they should be" and is
characterized by trust, bearing of one another’s burdens, and giving
preference to each other. It is manifested by unity and strength. The
family is where peace (shalom) can be incarnated.
Hope
Hope addresses uncertainty and enables us to deal with the present
from the vantage point of the future. It is the experience of the
future in the present. The ministry of God’s kingdom (which is poured
out through us) allows others to experience the future—concrete
experiences such as healing and deliverance which are pictures of the
fullness (wholeness) to come. It reflects what Christ has
already done and what will be brought to completion.
Transformation, the Church, and Community
Wholeness
When Christ calls, He not only works inside an individual, but
immediately calls us to relationship with Him (love) and others
(service). We are transformed from self-orientation to
Christ-orientation and begin to see a different reality. We come to
see our responsibilities as stewards of life and begin to exercise the
specific gifts which God has given us—gifts which are personal and
help to define us, but which impact the larger community.
Community transformation is, in part, a result of the stewardship
of God’s children. God has entrusted us with a responsibility of great
consequence: the stewardship of life. We are those called to nourish
and protect and expand and enjoy life. God has given us His image and
the moral framework to live out our lives, to rule, and to subdue in
the fullness of that image.
Just like individuals long for wholeness, communities long for
wholeness. There are forces at work to destabilize this community
wholeness.
The Church is a community of wholeness—the bearer of
wholeness—and this is a great witness to the larger community. It is
important to realize that we do not "plant" churches by our own
effort. We are not planting a group of people who we have
grabbed from the darkness and whose minds we have changed. It
is not a result of our vision, our fervent evangelistic activity or
management skills. It is not something we do, but something we
pray into being. It is the presence of Christ in the community. The
church is formed as the body of Christ comes into being. As people
come to Christ, they recognize that they are part of His Body;
incorporated into the larger group of believers, part of one
another—and His presence in the community. Any intervention we
"do" in the community (e.g. medical outreach), because of its prayer
life, because it pleads to Christ and allows the Holy Spirit to work
through it, invites people to Christ and they become His Body.
How are churches built up as vessels of wholeness and how does this
impact the larger community?
Churches must be committed to Truth. This should include
teaching the Biblical worldview of wholeness, which
is committed to truth. Truth liberates and deals with the
enemy of wholeness, which is sin: lies, false knowledge,
wrong behavior, wrong values, and worshiping the wrong
thing. Community sin must be dealt with by a commitment to
truth. Jesus never reduced the centrality of truth and He
used the term in a surgical way—it cleans, cuts away, and
makes whole.
The church should be shaped by the grace of Christ and
reflect reconciliation.
Eph 2:11-22 13"…But now in Christ Jesus you
who formerly were far off have been brought near by the
blood of Christ. 14For He Himself is our peace,
who made both groups into one, and broke down the barrier of
the dividing wall…." 18"…for through Him we both
have our access in one Spirit to the Father."
Violence is the antithesis of reconciliation and is the worst
anti-healing process. The violence that permeates because of sin and
destroys the human fabric of communities, families, and the human
body, is dealt with by the blood of Christ and people are reconciled.
Through Christ, what community leaders through the ages have thought
impossible can happen. Paul joyfully proclaims in Ephesians 3:10 that
a "great mystery" will be made known through the church to the rulers
and authorities in the heavenly places. This mystery is the power of
the Gospel to heal and bring wholeness where there is violence and
brokenness. That is what we are bearers of as the Body of
Christ and what we are growing into as a dwelling of the Holy Spirit
(Eph 2:22). That is the rich wholeness that Christ has given us,
shaped by grace. The Cross of Christ has reconciled us to God and
established us in a covenant relationship with Him where we find
restoration and healing. Paul speaks of this reconciliation as a
constantly operating, ongoing process which puts in us, individually
and corporately, a "reconciling energy". We must "live out" this
reconciliation.
The entire church community should be filled with the
love of Christ.
The demonstration of the love of Christ has a powerful evangelistic
effect.
Eph 2:19-21 "So then you are no longer strangers and
aliens, but you are fellow citizens with the saints, and are
of God’s household, having been built upon the foundation of
the apostles and prophets, Christ Jesus Himself being the
corner stone, in whom the whole building, being fitted
together is growing into a holy temple in the Lord; in whom
you also are being built together into a dwelling of God in
the Spirit."
This communicates the very heart of God. We are empowered and
equipped by the love of Christ. The Holy Spirit brings power and
holiness to the Church. Holiness is what brings healing—it cleanses
and heals beyond the physical. It brings healing to the sin-burdened
soul. "Health" conquers not only physical illness but emotional and
spiritual damage. As believers, we should be bearers of holy (whole)
healing. (If we take the desire for holiness out of our prayer for
healing, we risk developing a "consumer" attitude towards prayer,
rather than a relationship attitude.)
A church experiencing wholeness (transformation) will become a
refreshing and vitalizing spring of wholeness to the entire community,
releasing knowledge, values, and experiences which shape the entire
community.
Fundamentals of Transformation
Transformation should be a vision, a motivation, an
experience, and an outcome…it should not be a strategy that
we use to make things happen. We cannot make transformation
happen—that is God’s business. Likewise, we cannot "teach"
transformation or teach people to have a new identity,
though we can give people and communities a picture of what
can be. Living transformed lives and allowing people
to see into our personal lives and homes (which should
reflect transformation and the hope and peace that God has
given us) will be this "picture."
Prayer is fundamental. It is not simply a means to
the end of community transformation; rather, an essential
component of our relationship with our Creator allowing us
to know God’s heart for our work, our church, our patients,
our community and allowing us to respond to Him and Him to
us. Some of the most impressive examples of community
transformation at the conference were clearly the result of
God’s intervention in communities in response to the prayers
of His saints. Prayer enables us to gain vision, helps
prevent mistakes, gives specific direction, and leads to
impact. There were great examples of expatriate workers and
nationals praying and fasting together on a weekly basis.
Biblical worldview can be modeled. We have an opportunity
to model a worldview of Biblical wholism in all
circumstances—at work, at home, in our churches. We can
model this in the clinic by our understanding of disease and
the recognition that the physical and spiritual are
intertwined (e.g., the impact of bitterness and
unforgiveness on disease).
We need to be open and willing to follow God, wherever He
leads.
Dr. Slade gave an insightful look into Peter and the story of
Philip and the Ethiopian eunuch in Acts chapters 8 – 11. Peter, as an
Apostle in the "center" of the early church did not respond to Jesus’
bidding to carry the Gospel to surrounding areas (notice in 8:1 that
all of the believers were scattered except the Apostles. Why
weren’t the apostles targeted? Maybe they weren’t seen as a threat by
the secular government). Peter’s focus was Jerusalem, largely limiting
his sharing to the temple community, and he wasn’t keen on the
Gentiles being "chosen" by God. He wasn’t on the forefront of
missions, because he wasn’t open to God’s plans. Philip (probably
offered by Luke as a representative example of the outreach of
Hellenistic Jews) went to Samaria and was very willing to
follow the Holy Spirit’s prompting to share the Gospel with a man who
was an outsider of outsiders (the Law prescribed that eunuchs be
excluded from the house of the Lord—Deut 23:1). The section of Isaiah
being read by the eunuch referred to the family of Jesus being "cut
off" (no offspring). Three chapters later (56:3-5), Isaiah talks about
the inclusion of the excluded (eunuchs are listed) in the Kingdom of
God—what great news to the Ethiopian eunuch! So the question, "what is
to keep me from being baptized?" is a realization that, through
Christ, there is no longer a separation of Jew and Gentile and that
he, as a eunuch, is also chosen by God. Philip was willing to allow
a eunuch to be baptized into the church—a significant break from the
accepted dogma at that time.
Transformation is a process.
Peter, at first very resistant to accept Gentiles into the church,
was transformed by God’s handiwork over time. Through the
vision of the unclean animals (which Peter didn’t like!) and the
Spirit-led visit to Cornelius’s house where God poured out His Holy
Spirit on the Gentiles, Peter became a willing advocate of acceptance
of Gentiles as fellow saints. And God then used Peter to transform the
Jerusalem church.
Evaluating our Goals and Assumptions
We often work under three assumptions:
The goal of missions is church planting and church growth.
What is "success" in mission outreach? Is success seeing
more churches and a greater number of Christians or is it
seeing impacted (transformed) societies?
If we see more churches and more Christians, we will see
societies transformed. Look at South Africa, where 73%
of people are professed Christians but the prevalence of HIV
is 40%. Also, look at Zimbabwe where 10,000 churches have
been planted in the past decade, but where population health
has spiraled downward
Holistic health outreach is a means to an end, with the
"end" being church growth. Should church growth be the
only "end" to health care as ministry? There is intrinsic
value in demonstrating love through health care.
How have we gotten so far away from our roots? Why do we often not
see social transformation occurring where we see church growth? During
the time of the early church, the greatest social transformation of
all time occurred (ref. The Rise of Christianity, Starks).
There are views within the church which have historically thwarted
community transformation. For example, in reaction to the rise of
secularism and liberal theology (a result of the church accepting a
secular worldview), there was a pietistic response of the mainstream
church. This led to Gnosticism and dispensationalism, calling for
Christians to separate from the world and to live godly lives
inside the Church. It also created a very pessimistic worldview
where everything in the world is expected to deteriorate before Christ
returns (in fact, this deterioration is expected to usher in the
second coming of Christ). This created a very fatalistic view of
poverty and social transformation. The Kingdom of God was seen as a
future reality without present activity. Not expecting Christ to
transform impoverished communities, the role of the church was largely
limited to "bandage" care, with only temporal results.
In addition, we have viewed physical and social ministries as
primarily a means for evangelism, with the physical and spiritual
components being seen as two distinct processes. We attempt to be
holistic with a Gnostic worldview.
There is a big difference between secular development and
transformed lives. Wholism doesn’t mean adding a spiritual
component to development work. In our attempts at holistic
outreach, we often make the mistake of simply stacking ministries
side-by-side which each focus on one realm (i.e., physical, spiritual,
mental, etc.), rather than truly approaching individuals from a
worldview of Biblical wholism. We try to be holistic without operating
from a holistic worldview. Secular development in the name of Jesus
does not bring about transformation. Holistic ministry doesn’t mean we
have to do everything in our ministry; rather, what we do
should have a holistic impact and requires that we, as Christians,
incarnate the word of God into our lives. We must begin operating from
a Biblical (God’s) paradigm of wholeness.
Strategy & Strategic Partnerships
This is a summary of some strategic principles proposed by Dr.
Vinay Samuel.
Where possible, work through local churches. In many
parts of the developing world (e.g. Africa), the church is
widely prevalent, especially in poor communities. Even
secular organizations (e.g. WHO) are recognizing the
strategic position of the church in regard to community
development. For sustainability, the Church, rather than
church-based NGO’s should be the tools for holistic
outreach.
Contribute to civil society. There is public good
that comes from Christian involvement and transformation—not
just "Christian good" (e.g. consider the many leading
universities that have a Christian heritage; the impact of
medical missions on individual and public health throughout
the last century). There is a need for partnerships between
Christians and other groups who share common interests and
goals (government or NGO). Do we see these groups in our
community as partners or competitors? Can we be partners
without losing our commitment to share Christ?
Attend to the "spirituality" of holistic missions.
Dr. Samuel suggested that we have not adequately tapped our
spiritual resources (e.g. prayer, warfare) in regard to
development and sustainability.
Deal with culture intelligently and strategically. We
need to understand the communities and people groups with
whom we work. Cultures are not fixed and unchanging. In
every community, there are aspects of culture which tend to
affirm their identity; where they are seeking to say, "This
is who we are; we don’t want to change." There are also
forces at work within every community which are constantly
seeking to change the culture or adapt to outside forces. We
should do community profiles in order to discover where our
communities are "finding themselves"; where are the areas of
affirmation, where are they "open" or "closed" and what are
the forces that are trying to change the culture? How do we
work within a community to enable those changes to
"experience Christ"? What kind of church really opens the
larger community to Christ? It is not the church
which looks only after itself and is isolated from the
community, but the one which seeks to understand its
community, the one experiencing the wholeness of Christ
which can be open to the community with confidence and
abandonment and thereby "mainstream" the Gospel.
Integrate the enterprise and community models of
development. The enterprise model is a business model
focused on capacity, growth, and sustainability rather than
on relationships, services, and education. The challenge is
to integrate the two models. Business is needed for
community (and national) transformation. Consider the impact
of business with social impact, such as medical insurance
and pharmaceutical industry.
Develop models to evaluate transformation. Many
secular (and funding) organizations demand the evaluation of
outcomes of community development. You can’t use a simple
business model to evaluate transformation. We need a new
model.
Personal Impact
I certainly came away from this conference with a clearer
understanding of God’s heart to change lives—thoroughly and
everlastingly. Every Christian "knows" that we are new creations
and that God gives us new lives when we accept Jesus as our
Savior. We can tell this to people as we present the Gospel, but it
often has little power when our understanding of this transformation
is limited to some ill-defined "spiritual" experience that does not
penetrate the physical (including the mind and emotions). The power of
our witness is, to a large extent, the result of our experience.
How much more inspiring and effective our witness when we have
personally experienced deliverance from a stronghold of sin, when we
have personally experienced healing, when peace and love replace
bitterness and anger. It’s not that we only believe when we experience
these things, but really…this is what God is about! This is His
kingdom’s presence, His heart for His creation, and this is our hope
(what are we praying when we say, "Your kingdom come"?) To think
anything less, it seems, is to believe that either God cannot, chooses
not to, or does not want to make people whole and this is not
consistent with the statements or work of Jesus Christ, who was the
manifestation of God in flesh. Likewise, seeing through the project
presentations at the conference the demonstration of God’s
transforming work at the community level inspires a vision to tell the
people in our local communities that it is possible—it is God’s
desire. If God is in the business of giving us eternal
life (full, complete, life) then our impacted lives will certainly
impact communities and even nations.
Evaluating my own life, I can easily see where "Evangelical
Gnosticism" has influenced my worldview and how that has affected the
integration (or lack thereof) of my "spiritual beliefs" into my work
and relationships. I’m not sure I’ve ever experienced a shift in
worldview before (at least not one that was noticeable), but I know
that I have internalized many of these concepts of Biblical Wholism
and several amazing opportunities to witness have come out of that
since my return—specifically, opportunities to share with patients
about God’s desire and power to touch areas of their lives that are
keeping them from health…and wholeness.
Another important issue that was discussed is the impact of
modeling wholeness. How we live our lives—how we act and react in
difficult situations, how we treat our spouses and raise our children,
how we approach health as physicians, etc., has a powerful impact on
those around us who have not personally experienced the resurrection
power of Jesus Christ. As noted earlier, transformation cannot be a
"strategy" we base our ministry on and, in the same way, we can not
simply choose to start modeling wholeness so that people around us
come to know the Lord. How we live our lives is an outcome of our
relationship with God—the fruit of the Spirit in our lives. However,
it does help to consider again that there is no separating our
"working lives" and our "spiritual lives." Most likely, we are seen as
good, moral people in areas that most of us see as "visible" and
reflective of God’s presence, such as issues of honesty, kindness, and
integrity (indeed, these are signs of transformed lives!), but we may
not realize what kind of witness we have when we model a
wholeness-based (God-based) perspective on compassionate care, disease
prevention, and stress management. If our non-believing colleagues are
not being impacted by our lives at the workplace, could it be that we
are not allowing God to penetrate those areas of our lives? Are there
some areas where we typically don’t reflect or teach from a worldview
of Biblical Wholism because in our non-holistic worldview these areas
are not seen as "spiritual" (e.g., nutrition, preventive medicine, how
we counsel patients about disease and lifestyle). I also think that we
could, more often, unashamedly and without any awkwardness give God
credit for the perspective that He has given us. It is natural to talk
about God when we are discussing issues of forgiveness. Likewise, when
we talk about the importance of disease prevention (and even
treatment) we can talk about the concept of "stewardship of life"
given to us by God.
Some practical "implementation" ideas were also discussed at the
conference and deserve mention:
First, the importance of prayer. I’m not sure why I need to be
reminded of this so often, but prayer was in the forefront of each of
the most astounding examples of community transformation seen in the
project presentations. The examples were of nationals coming
together and praying regularly (and often) for their own communities,
then seeing things like inter-tribal violence fade away,
micro-economies flourish, and villages turn from garbage heaps to
beautiful play areas for children….
Second, the importance of teaching Biblical Wholism in our
churches and seminaries. There should be a place for discussion about
community development, health care, and economic reform in our Bible
schools! Teaching only "theology" in our seminaries reinforces the
Gnostic worldview that was taught to most of us. In regard to
churches, the western model of Christianity has too often neglected
areas of vital importance to church members and the local community.
Why aren’t churches reaching out with practical programs to help the
alcoholics and wife abusers and AIDS victims? Why aren’t we teaching
sex education and respect for unborn babies based on God’s word? Do we
think that God only wants us to pray for spiritual deliverance and
spiritual wisdom while we neglect the practical tools which deal with
our minds, habits, and emotions?
Third, we should not be too narrow in our defining of "community."
Many of us are dealing with subpopulations which are communities in
their own right. For example, a group of Christian physicians and
medical students is certainly a community and we can apply many of the
principles of community development as we work with them. Making an
effort to help them discover how Biblical Wholeness relates to their
profession, helping with professional development (which we often
mistakenly exclude from "spiritual" outreach), and praying regularly
with and for them are all things we can do better in our area of
service.
May God continue to transform our worldview and make it more like
His!
Resources
Missions and Missiology
The Cross-cultural Process in Christian History, paper, Andrew
Walls
The Missionary Movement in Christian History, paper, Andrew
Walls
God in the Lead, Stan Slade
The Rise of Christianity, Starks
The Next Christendom—the Coming of Global Christianity, Phillip
Jenkins
Transformation (Journal put out by the Oxford Center for
Missions)
Cross-cultural Outreach
Figuring Foreigners Out
Culture and the Clinical Experience
Changes in "secular" Outreach
The "Synergy Project," a new paper on the ABC’s of AIDS prevention
by the USAID. Accessible online.
Training Material
"Development Associates" based in Colorado Springs, CO. Provides
distance education for nationals, including training in financial
management and integrity.
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