Chiang Mai, Thailand
October 17-22, 2003

Barton Smith
be_smith@bigfoot.com

TABLE OF CONTENTS

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?
1. 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.

2. 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.

3. 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:
1. 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?

2. 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.

3. 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.