The Reality of Today’s Long-Term Medical Missions

Perhaps our concept of a career missionary doctor’s family might sound similar to this . . . a poor missionary surgeon and his family give up a “good American doctor’s family life” to live in endless poverty. They suffer through a hand-to-mouth existence in an African country full of intrigue, Satan worship, witchcraft, fear, poisonings,

From Today’s Christian Doctor – Winter 2012

Perhaps our concept of a career missionary doctor’s family might sound similar to this . . . a poor missionary surgeon and his family give up a “good American doctor’s family life” to live in endless poverty. They suffer through a hand-to-mouth existence in an African country full of intrigue, Satan worship, witchcraft, fear, poisonings, arson, coups, Marxist takeovers, massive killings and persecution of Christians. Their children are forced to be homeschooled by their parents. They have jobs at the mission hospital from a very young age. Their future education and life is tenuous at best. They can’t possibly amount to anything and will probably die early of some terrible tropical disease that is yet to be unearthed. When you consider all these factors, we should pity the missionary family. But that scenario isn’t reality. The reality for the children is far from tenuous. After becoming the hospital engineer at the age of 11, the son earned a doctorate in science engineering in natural energy resource development for the third world. He has worked in Kenya for the last 25 years with his family. The daughter became a nurse when she started making Sunday morning rounds at the age of seven, circulating in the operating room at 10 and assisting in surgeries at 13. She eventually became a family nurse practitioner. The reality is that the general surgeon and his family had a very fulfilling career. The family enjoyed the challenge of helping people with no other chance to receive help across the entire scope of medical and surgical care. They were overwhelmed by seeing thousands change their traveling destination to heaven. For our family on our first furlough after six years away from America, the reality was that we were “forced” to drive a black Mercedes with a brand new motor while claiming severe poverty at each church we visited. God also supplied us with five days in Switzerland on trains, a week in a houseboat on the canals of Holland and an ocean voyage from England through the Panama Canal to the West Coast. So what is the reality of today’s long-term medical missions? For the 491 medical auxiliaries my wife and I discipled during our career, the reality is that they are still practicing their faith, many are sent throughout the country to share the Good News and they contribute to more than 1,200 churches. For a hospital in southern rural Africa, the reality is that it now has 10 expatriate specialists, with two more coming this year and another four couples asking to come for a family practice training program. The reality and the truth is that our God does provide, protect, guide and do the impossible. Knowing that reality, then you too can trust Him completely for your own long-term medical mission service…even if it is a short term of 50 years. As the son of a career medical missionary, I’ve been observing medical missions in action for almost 80 years. My father Dr. Paul Earnest Adolph felt the call of God at the age of 11 in 1911. My call was at the age of 14. Our son’s call was in college at the age of 18 and our daughter’s was at the age of seven. In March 1969, my father wrote “Closed Doors,” an article published by the Christian Medical Society Journal which focused on following God’s call even when we feel the door is closed. He wrote,

“One thing remains sure, there abides an open door of opportunity to all of us to make Christ known throughout the world as Jesus said, “Behold, I have set before thee an open door, and no man can shut it” (Revelation 3:8). The closing of certain doors should serve to help us to be in readiness for the real door of opportunity when it opens to us, as was the case with the Apostle Paul. Let us not bemoan the shut doors and remain inert and irresponsive. . . . As we wait upon God, the open door of service that He has prepared for us becomes manifest to us. For the Christian there can be no truly closed doors, only doors that shut before us to keep us from straying from the wide open door of God’s will.”

Do your misconceptions of the “reality” of medical missions stop you from answering God’s call? Take this experience for example. As a result of our mission hospital in Africa being taken over by a changing government, we spent more than 12 years working in an American suburban community hospital. At first glance, such a setback would appear to be a clear sign of a closed door on our ministry. Instead, the opportunity allowed us to help build a multi-million dollar hospital for the Pan-African Academy of Christian Surgeons and assist another hospital substantially. How about this example? In the last few years, I’ve been busy worrying about how we were going to pay the salaries of 214 employees at the hospital in the midst of 100 percent inflation and worldwide borderline financial collapse while evil increased on every side. So God chose to give us only $2 million in the last two years. It is very good that I worried about it! He even included a new CT scanner with three-year maintenance insurance and a building to house it along with the new digital x-ray system and C-arm. These were not even on my prayer wish list! For today’s applicants to missionary service, it is easy to get sidetracked from their missionary goals. Some tell stories of being convinced of God’s purpose for their lives much later in life. Others chose a different path after incurring high debts during training. Potential applicants also have vastly more opportunities than their predecessors to visit their future locations and meet the teams they will be working with in the future. Onsite visits offer a chance to interact with the staff, review the challenges and determine if the position is a right fit. In addition, sending agencies and hospitals are much more flexible with vacations and home leave. In the 1950s, my father once spent an entire prayer letter explaining why he felt forced to leave China two weeks early during his first seven-year commitment due to a large army causing extensive chaos and carnage less than 60 miles away. Today, we are quite happy to have expatriate specialists at our mission hospital take home leave two times each year for two months each to catch up with children, grandchildren and family events. On the good side, the day of the lone missionary doctor at a hospital with more than 100 beds seems to be over. Hospitals actively search for new physicians and specialists to join their teams. They advertise salaries, night time rotations, weekends off, maximum hour work weeks and employee benefits. And while dangers still exist and most places still encourage having a suitcase packed and ready under the bed, it does not seem to be a main concern for sending agencies or applicants. But the overall emphasis on medical missions and mission hospitals has diminished in the last few decades because hospitals are too expensive and recruits are too difficult to find. When Christian missionaries left China in 1949, they left 272 functioning mission hospitals. At that time, there were more than 1,000 mission hospitals worldwide. During my travels to more than 150 medical schools to give grand rounds, the mention of mission doctors spending their entire careers overseas working in deprived areas came as a complete surprise. That is why it is encouraging to see large renovation programs being conducted to completely remodel and redo former mission hospitals. Our mission is working on two of these at Egbe in Nigeria and Galmi in Niger. Although missionary doctors frequently showed a strong desire to train the next generation of missionary doctors, it was not formalized until the formation of the Pan-African Academy of Christian Surgeons (PAACS) in 1997. As a commission of CMDA, PAACS started surgical training centers across Africa at mission hospitals. Today, it now has eight programs, 40 surgical residents in training and more than 20 graduates now serving with their own hospitals. And more programs are waiting to be started. When I first started serving overseas, it was common for me as a doctor to be involved in all the aspects of running a hospital. My first hospital had an electric generator with a hand crank. I kept looking for Noah’s signature every time I risked my life starting it. Today, we now have many associated organizations to help with all the details of running a mission hospital. Engineers, laboratory specialists, sending agencies, water and waste management, administrators, financial specialists, short-term volunteer specialists and fundraisers are now available to assist overseas hospital ministries. And of course, the technology has changed rapidly over the years. We work hard to try to have some of the latest equipment available, while still realizing that many of our former patients under the hand of God fared better than patients from the famous institutions reported in the medical journals. So what is the final result of decades of experience as a long-term medical missionary? Today’s missionary doctor is unlikely to find an operating table with only three legs that can’t be raised to an appropriate operating level without wooden stools and platforms. The OR light will not be a simple bulb at the end of a clothes hanger or a kerosene lamp dangling in front of your face. The ceiling is not likely to be infected and sagging with termites. The beds are not likely to lift the patient only 12 inches off the floor even with a mattress. You are unlikely to be confronted with a charging bull while making rounds on a 25-bed ward. Gourds hanging on the wall are not likely to have goat’s blood in them. The water supply will not be arriving on the backs of donkeys. Your X-ray machine is not likely to be an ancient machine rescued from a battle zone of World War II. Conditions have certainly improved, but we continue to face the ultimate battle of inactivity. As my father wrote in an article published in 1949, “Those afflicted with disease and the leprous still await the servant of the Lord to minister to them while thousands of well-trained Christian doctors leave our Lord’s command unheeded.” In the words of A.W. Tozer in Of God and Men, “We languish for men who feel themselves expendable in the warfare of the soul, who cannot be frightened by 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.” The reality of today’s medical missions is that the door is still open and God is calling you to enter it. Are you ready to experience the hand of God every single day instead of just reading about it in an email or a status update on Facebook? Let me leave you with the same challenge my father offered in 1969, “Let us respond . . . with eagerness to the challenge of the open door which the Lord through His Holy Spirit most certainly has in readiness for us.”