Monday, March 19, 2012

Fear, Freedom and Reconciliation

God has given us the task of telling everyone what he is doing. We're Christ's representatives. God uses us to persuade men and women to drop their differences and enter into God's work of making things right between them. We're speaking for Christ himself now: Become friends with God; he's already a friend with you.  
2 Corinthians 5:18-20 (The Message)
Visiting Robben Island is not just a lesson in history but a reflection of who we are!  There were three categories of prisoners; criminals, lepers and political prisoners.   The common element shared by all categories is fear.   The lesson we learned was the struggle for freedom from a former prisoner.   He was age 20 when he was imprisoned for being a member of the ANC.   He is now 49!   His work is telling the story of Robben Island as part of the larger story of reconciliation.  
That same day we attended a outdoor concert.  The group “Freshlyground” appeals to all ages looking not to the past, but to the future.   It is not unlike what we have seen in other parts of Africa and in the U.S.   What or who will continue the “healing”?   Will it be within and through the arts, economic policies, altruism or some religious response?   
For me, the answer is found in the reconciliation model that we see in the life and ministry of Christ.  It may find expression in the hopes and dreams of the youth, in the words of the music or art, but it’s Source is what gives me Hope!
in Capetown, SA
Reference: The End of Words: The Language of Reconciliation in a Culture of Violence by Richard Lischer is a wonderful statement of the message of reconciliation.

Monday, March 12, 2012

Local Knowledge

"Africa to Anchorage"

Love never fails. But where there are prophecies, they will cease; where there are tongues, they will be stilled; where there is knowledge, it will pass away.  
1 Corinthians 13:8( NIV)

This last three and a half years have taught me the essential nature of local knowledge in providing health care.   This is not a rejection of evidenced based medicine or new scientific discoveries.   The reality is that as clinicians we have the task of translation of evidence and new knowledge in response to changing demands.  Underneath that reality is a passion to make a difference!
When asked “Are you retired?” I respond that “I still practice part time anywhere between Africa and Anchorage.”   This changes the conversation from my age to “Wow, that must be interesting!”.  Well it is “interesting” but more importantly, I have come to appreciate the local realities of the delivery of care.
What I have seen are very dedicated healing agents who are willing to share their knowledge and responses to challenges.   I see people looking for more efficient and safe transport of patients.   I see nurses and physicians separated from family and their homes working diligently to learn and improve care.  I see frustrations with systems of care that interfere with the care they want to provide.  
What has also been wonderful for me is the great diversity of the patients and having a chance to sometimes, if only briefly, to be invited into their lives with its celebrations and losses.  In addition, I have been able to see education at its most basic as well as it’s most advanced.  But what excites me most is the passion and dedication at the bedside.  It is true that there is “burnout” and “frustration”, but there is another reality of local strengths and knowledge making a positive difference in the care of patients in many global locations!
in Kenya
p.s.  Here are some references that you may find interesting.
Henry SG.  A piece of my mind. The tyranny of reality. JAMA.  305(4):338-9, 2011 Jan 26.
Smith DG. Viewpoint: envisioning the successful integration of EBM and humanism in the clinical encounter: fantasy or fallacy?.  Academic Medicine.  83(3):268-73, 2008 Mar.
Shaughnessy AF.  Slawson DC.  Becker L. Clinical jazz: harmonizing clinical experience and evidence-based medicine. [Review] [16 refs]  Journal of Family Practice.  47(6):425-8, 1998 Dec.

Saturday, March 3, 2012

“Standing Firm” and Pilgrimages

World Medical Mission "Chariot"

"It is always instructive to observe the life cycle of the First World aid worker.  A wary enthusiasm blooms into an almost messianic sense of what might be possible.  Then, as they bump up against the local cultural limits of acceptable change, comes the inevitable disappointment which can harden into cynicism and even racism...”  from When a Crocodile Eats the Sun by Peter Godwin. 2006 Little, Brown and Co. Publishers
“Therefore, my dear brothers and sisters, stand firm. Let nothing move you. Always give yourselves fully to the work of the Lord, because you know that your labor in the Lord is not in vain.”   1 Corinthians 15:58 (NIV)
Later God's angel spoke to Philip: "At noon today I want you to walk over to that desolate road that goes from Jerusalem down to Gaza." He got up and went. He met an Ethiopian eunuch coming down the road. The eunuch had been on a pilgrimage to Jerusalem and was returning to Ethiopia, where he was minister in charge of all the finances of Candace, queen of the Ethiopians. He was riding in a chariot and reading the prophet Isaiah.  Acts:8:26-28 (The Message).

One of the benefits of “getting away” is the reassessment of the direction and purposes of your life.  Being in Africa is a long distance from many of the assumptions that we hold about who we are and what we are doing in the world.   The dislocation takes time as you are confronted with people, places and beliefs that you may or may not share.
Pilgrimages and Lent share the common goal of reflection that prepare us for rededication and resurrection.   The tension is how we “stand firm” and yet “move”.   Will we see new opportunities, have new courage or just keep doing the same thing?  There is also the reality described by Peter Godwin that we could become cynical and discouraged.   
It seems to me that during these “trips” both are happening.  The foundation is rediscovered as well as new opportunities.  Not just doing the same thing, but finding those new people and truths that give us direction for the rest of the pilgrimage.  The larger context is we see the Isaiah story of faith that gives us courage and sends us on our way!
Tenwek in Kenya, Aftrica
See Posts:  Oct 31, 2010 - An International Healing Parable
                    Feb 27, 2011 - Pilgrimage and Healing