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Understanding & caring for cross-cultural workers

‘But surely missionaries never get depressed?’ blurted an audience member as I finished speaking on home assignment about my work as International Medical Adviser. It was partly a question but mainly a statement of the fact that this long-term supporter could not conceive of committed Christians suffering from such problems.

It shows how missionaries are often put on a pedestal and thought of as ‘different’, somehow immune from the ailments facing everyone else. But missionaries are human. They get sick, facing physical and mental health issues, but with the added challenge of being in a cross-cultural setting. This means they have to function without the generally reliable undergirding of our much loved, albeit beleaguered, National Health Service (in the UK), or the perks of generous health care packages such as those provided by many multinational companies or the diplomatic corps.   

Challenges of Cross-Cultural Medical Experiences

Each culture has different health care beliefs and different health care systems. In some settings, the provision of health care is highly sophisticated, efficiently operated with well-trained doctors and state of the art technology. In others, the standard of medical education is high, but access to modern medication and procedures is limited. Elsewhere, health care provision is severely limited. And I have not even mentioned the language barrier for those starting off in missionary service. I well remember my first dental appointment when my Korean was very limited…!

Honourably Wounded is the title of a ground-breaking book by Dr Marjory Foyle, one of the pioneers of medical member care. The title itself brings us back to the reality that in the battlefield of missionary service, there are those who are wounded and have to retire or retreat. Good medical member care seeks to enable workers to serve more effectively and longer, enhancing health and minimising attrition. To provide good medical member care, wise stewardship must be exercised. This starts at home, prior to being sent. If a missionary has a health issue, then there must be an assessment as to the severity of the problem, the local medical services available where they will serve and whether the risks to their health outweigh the potential ministry. The likely impact of their health issue on the work of the wider team must be considered. Yet all such decisions have to be made prayerfully, remembering Paul’s thorn in the flesh, as well as historical CIM examples such as George Stott, a Scottish farmer who had lost his leg but was called by God and served effectively in China, claiming “the lame shall take the prey”.1

Good medical member care seeks to enable workers to serve more effectively and longer, enhancing health and minimising attrition.

Anorexia, asthma, cancer, depression, diabetes, high blood pressure, children’s special needs, learning difficulties, pregnancy complications – the list goes on and on. So how does the sending church in partnership with the mission agency provide for the needs of missionaries and support them in times of ill-health?   

How to Support Cross-Cultural Workers Well?

OMF answers that question through its Medical Advisery team, led by the International Medical Adviser and comprising doctors in sending centres and doctors serving the various fields, work together to advise the leaders of OMF International as to the wisdom, from an earthly perspective, of sending someone overseas. So each new candidate has a medical examination along with an assessment of their psychological health to determine their fitness and suitability for their desired designation. Some situations are quite straightforward, but some are much more complicated. The assessment is not a ‘pass/fail’ examination but one that seeks to determine the candidate’s level of resilience and provide them with the best opportunity (from a medical perspective) of reaching their full potential in serving the Lord and glorifying him in East Asia.

Once serving in their designated country, missionaries (and their children) undergo regular medical check-ups from the Field Medical Adviser (FMA). Such examinations aim to pick up issues early, monitor chronic conditions, provide preventive health care, assess stress levels and give the missionary an opportunity to discuss their concerns. Ideally, the FMA is also a missionary with cross-cultural experience and an understanding of the local context.

But what happens when missionaries become sick overseas? For some countries, excellent local medical care is available, but in other areas, this is not the case. Should the missionary, their sending church and agency, believing in incarnational ministry, accept the local health care system and all the associated risks of having surgery in a remote area, with limited facilities, basic anaesthesia and a poorly screened blood supply? Or should the missionary be evacuated out of the area and sent to a larger medical centre for better care? These are difficult issues. What about the costs of having such care?

Missionaries are the hands and feet of the Lord Jesus in the communities they seek to serve. We do need to take very good care of them.

Missionaries are complicated and special people, but they are the hands and feet of the Lord Jesus in the communities they seek to serve. We do need to take very good care of them, all the time trying to work out how our theology of suffering, our desire to contextualise, and our responsibility to be wise stewards, prayerfully blend to make God-honouring decisions which are best for the missionary as well as those they serve. Do please pray for the team of medical advisers, as they seek to serve in this way.

Dr Stroma Beattie
Former OMF International Medical Advisor

1 For more on George Stott see:

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