The glassed-in room could barely contain the anxiety of the suit-wearing prospective physician assistant student in front of me. Just me and the candidate. I had 7 minutes to size them up.
My question of the candidates was the same for each, as much as it was for me. I asked them a question that was plaguing my own heart. It was a question posed by Palmer,
“Why are there so many doctors in America, and not enough in Africa?”
I honestly didn’t expect the applicants to have a well-thought out answer, but I wanted to listen to them process the disparity. I wanted to hear them wrestle through the thoughts that I was having.
I wondered if this conversation might be a flash forward to one day when I appear before God’s throne, and He asks me the same thing.
“Why were there so many doctors in America, and not enough in Africa?”
The answers from the candidates were varied, but all laid the responsibility at the feet of the Africans.
“The people in Africa just need to pull themselves out of poverty.”
“They just need to get an education and become doctors themselves.”
I reminded the candidates that in Congo, the average income is around $400 per year, and sending a child to school costs more than that. Their annual income couldn’t even meet what is needed for food, clothing, and shelter, much less medical care and education.
Candidates would predictably turn to international aid.
“We should send short-term missionaries to help them for a week or two out of the year, and I plan to do that,” was the near unanimous reply from dozens of applicants.
I would challenge, “What about the other 50 weeks out of the year? Who will care for them then? What if they have an allergic reaction to a medication? What if it doesn’t work or they can’t get more? Who will follow up with them?
The students would then go back to the same struggle.
“Well, maybe you could coordinate teams so that a different team would be there every . . .” Their voices would trail off in realization of the massive logistics.
How would medical language be translated effectively? How would short-termers know the cultural implications of their treatments, or if patients could even afford them? What if the provider wasn’t well-versed in tropical medicine and missed the diagnosis entirely? How would we feel if a Russian doctor flew in for a week, popped up a tent in the parking lot, and started to see patients for free in our local town without knowing language, licensing, culture, or medical logistics here?
My final question was this: Who is responsible for making sure that the underserved around the world get access to quality health care?
Most agreed that someone should go long-term.
Most agreed that that someone should be someone besides them.
And then it was time for them to move to the next station. And time for me to interview another candidate.
Only a few weeks later, Ken and I returned from northern Ghana, where the number of medical providers is even fewer than in Congo. As we sat sipping coffee in Charlotte, we asked ourselves: Could we accomplish the same goals by going short-term several times a year? We could keep our house, keep our kids in the nice school they are in, and have minimal disruption to our lives. It would be easier.
How many patients can know the love of Christ if I only see them once? How many health care workers can be trained if I am in and out of the country several times a year? How many new believers can be mentored in their faith? How can we be competent in understanding the culture, Ghanaian medical practice, local language, and have meaningful relationships with just a few trips a year?
My mind flashed back to the struggle in that interview room that every prospective student had, trying to balance the logistics.
Someone needs to go long-term.
Are some called to go short term? Absolutely. But without someone there long-term, there cannot be others going short-term.
In a year where short term medical mission trips, dollars, and interest are at an all-time high, mission hospitals and clinics around the world are struggling to operate and remain staffed as mission dollars are being spent on short-term trips, rather than long-term investments.
When we were in Ghana, we visited a Wesleyan clinic on the outskirts of the capital of Accra. The clinic staff that we visited had not been paid in weeks, and yet I was trying to convince them to allow short-term students and volunteers to come and “help,” in spite of the fact that they were fully-staffed and open 24 hours a day, seven days a week.
Had I asked those staff members if they would rather have someone spend $4000 to come on a short-term mission trip or donate $4000 to the operating expenses of their clinic, what would their answer have been? As much as short-term help can be such a boost, it cannot replace those who are there long-term, and in some cases, it can cause the locals to lose their much-needed jobs.
If every dollar spent on short-term medical trips were matched by dollars spent on long-term investments, medical missions could be radically transformed into sustainable ministries with continuity and higher standards of care.
Maybe we should at least give the option to the people in developing countries we are seeking to serve: What would a financial contribution in the amount potentially spent on a short term mission team do for your organization? Which would your organization rather have? It’s not as sexy to send money anonymously as it is to go– there are fewer pictures and safaris and stories to tell, but perhaps the field should be given deference to the work they are already doing, and the needs that only they know about. Maybe missions shouldn’t be as much about our needs as theirs.
As I sat in the room with the PA student candidates, as I asked the unpaid staff in the Wesleyan clinic in Accra to take American volunteers, as I sat in the coffee shop in Charlotte, I realized that I needed to put the needs of the field first. And what Ghana needs is my investment long-term in learning medicine, language, and culture to provide medical care in the name of Jesus to unreached peoples, and to build sustainable medical ministry by training local Wesleyans to provide basic medical care in their own communities.
To do this, someone has to go long-term.
And that someone is me.