Models for Medical Ministry in East Central Europe

Just as East European cultures are diverse, so too are the medical ministries seeking to serve the region. While one group seeks to reach hospitals, another may focus exclusively on a children's camp for Chernobyl victims. Some carry supplies in suitcases, while others strive to influence national health care policy. But all have the same foundation: the integration of medical skills and material aid with spreading the gospel of Jesus Christ.

What Is Being Done?
Christian medical ministries typically stress both the physical and spiritual well-being of a person. For example, one ministry to Ukraine sends short-term personnel to perform surgery and treat patients, while other team members distribute humanitarian goods. Other missions focus on the medical professionals of a country and strive to shape health care policy. The International Christian Medical and Dental Association (ICMDA), for instance, organizes conferences for Christian doctors, desiring to help them integrate their faith with their profession. ICMDA also serves as a support network for Christian medical professionals through local associations and newsletters. In other instances, seminars invite non-Christian doctors and medical students, such as International Health Services (IHS) in Hungary and the Bulgarian Christian Medical Association (BCMA). Both of these organizations envision starting Christian clinics, as well as organizing lectures and distributing Christian literature. In Bulgaria, for example, BCMA sponsors seminars on bioethical issues such as abortion, euthanasia, and alcoholism.

What Are The Needs?
The nature of medical assistance is often defined by the country itself. Impoverished and war-torn countries, for example, have their own special needs. BCMA is involved in relief work, such as distribution of medicine and the provision of free medical care. The current situation in the countries of former Yugoslavia provides many opportunities for relief and development work. ICMDA and other organizations have responded to the need for immediate humanitarian aid. Many short-term missions take material aid to Ukraine as well.

Approaches chosen are very diverse, reflecting the vision of an organization as well as skills of individuals involved. Dr. Kenneth Gimple's Ukraine Mission, for example, began with two doctors performing orthopedic surgery in Ukraine. Similarly, some organizations equip local hospitals or carry out relief work in a particular area. On a more organized level, some groups host conferences, provide medical consulting, and offer expertise to local doctors. Finally, organizations with a national or international scope cooperate with local medical and governmental authorities, thereby influencing national relief or health-care efforts. IHS, for example, researched Hungarian health care, seeing a need to involve the church in medical care. IHS hopes to assist the government in providing quality national health care, encouraging others to do so as well.

Overcoming Obstacles
The most common difficulties appear to arise from a lack of cooperation with the national government or other official authorities. Communication problems -- beyond the obvious language barriers -- result from cultural misunderstanding, insufficient preparation, or the resistance of local officials. Many East European authorities are distrustful and suspicious. Also, many spheres, from hospital care to customs, are infected by corruption, raising the problem of bribes and the need for personal connections.

Many East European governments frequently change laws and policies, causing difficulties for mission organizations attempting to abide by the most current legislation. Two solutions have been suggested to remedy the problem. One suggestion is to work within an existing local church or a registered national organization. Another suggestion is to make contacts with key people. National co-workers are irreplaceable. A medical doctor serving in Macedonia writes:

Any aid work [to Macedonia] must be aligned with the appropriate ministry in government. It is best to find mid-level bureaucrats and work with them, as top level people change with the political winds.... You can't do anything here without someone on the ground who knows the language and the culture and can move things through the governmental hassles.

Many complaints have been made about difficulties with customs. Without bribery, the process can be long. Certain countries regulate the kinds of goods imported. On the other hand, by defining goods carefully, e.g. referring to children's toys as pediatric therapeutic devices, one can avoid paying duty on them. Information on regulations for each country is often available from that country's embassy or consulate. (See East-West Church & Ministry Report 6 (Summer 1998), 13-14, and 2 (Spring 1994), 10-11, for contact information.) When shipping aid and equipment, one must remember that the process may take months, and it can be extremely expensive. For a 20-foot container from the U.S. to Europe one should expect to pay between $3,800 and $4,600.

Making a Difference
Winning acceptance from local authorities takes time, but charity work and humanitarian aid are generally looked upon with respect. Therefore, if a ministry provides tangible services--treats patients, donates medical equipment, cares for the elderly--it will make a difference in the region and gain support from local authorities as well. "We cannot go in forcing Western religion on our hosts," says Dr. Norman Carlson of Ukraine Medical Teams. "An element of trust that comes with time is the only thing that works."

The efforts of Ukraine Medical Teams (UMT) illustrate this point. By assisting a children's camp for Chernobyl victims, establishing dental and medical clinics, and working together with the local medical school and government dental facility, UMT became accepted and respected by the Ukrainian government. The president of Ukraine has instructed regional authorities to cooperate--including assistance with customs clearance and mission outreaches! All mission organizations--denominational and parachurch--represent the church of Jesus Christ. While it is fruitful to have background support groups, such as churches or parent organizations, it is vital to establish contact with local churches in country. Such contact proves valuable both on a spiritual level and in practical matters. Most large Protestant organizations work with local evangelical churches, although cooperation with historic state churches, when possible, can provide advantages. While many missions serve entire communities, ICMDA encourages the formation of small professional associations, and IHS-Hungary focuses on individuals. "Our times of greatest impact have been in small groups or one-on-one," says Dr. Robert Snyder, founder of IHS. "We have also encouraged physicians and health-care workers with whom we have relationships to do likewise."

As in all international missions, it is important to be culturally aware, not imposing Western ideas and agendas on people. Work should be delegated to nationals, even if at times problems result: "Not infrequently the comment is made 'you have not told us what to do'," says Dr. John Reader of ICMDA. "Such comments arise from years of living under regimes which have discouraged individual thought. In effect, individuals are told what to do. There is a need to teach people how to think and apply principles."

It is important to know what drugs and supplies are already available. Buying equipment in Europe can save a good deal of money and decrease difficulties with shipping. Electrical equipment purchased in Europe normally operates on 220V, versus the U.S. standard 110V.

Overall, medical ministries in Eastern Europe have opportunities and privileges that other types of missions do not enjoy. Also, medical aid is very badly needed throughout the region. Western doctors and medical personnel are greatly respected everywhere. "Dental assistance and medical assistance open doors that cannot be opened in any other way," according to Darrell Clark, president of Ukraine Children's Project. "The testimony of the most 'authoritative' figure--a doctor or dentist--can have a powerful impact."

Barbara Kertai is a free-lance journalist in Budapest, Hungary. She graduated from Wheaton College in 1998 with a double major in theology and journalism.

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© 1998 East-West Church and Ministry Report
ISSN 1069-5664