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Matthew Loftus

"Helping Without Hurting"

The Global Missions Health Conference.

If you're looking to confirm a stereotype of American evangelicals, you'll probably find it at the Global Missions Health Conference (GMHC), the largest gathering of Christian medical missionaries in the world. The attendees are predominantly white, sing the latest pop-rock rendition of "I Have Decided to Follow Jesus" in front of giant screens zoomed in on the guitarist's fingers, and devour boxes of Chick-Fil-A during the dinner hour. However, the GMHC also demonstrates the very best of Western evangelicals' commitment to ministry in word and deed around the world. Young medical missionaries just setting out are learning from their elders while carefully looking at how to shape their practices to most effectively serve through health care missions.

I have been to five of the last seven conferences—my first time was during my first year of medical school, and this most recent visit will probably be my last for a while, as my wife and I expect to be working in a hospital in South Sudan by November 2015 when the GMHC reconvenes. Most rising medical missionaries spend time at the GMHC at some point (although the demands of medical training prevent a great many students and residents from attending as often as they'd like), and most organizations that do evangelical health care work both in America and abroad use the GMHC to recruit new workers. Held annually at Southeast Christian Church in Louisville for the past 18 years, with spin-off conferences in California and Kenya, the conference is expanding its reach as it continues to influence short-term and long-term medical missions across the world. The GMHC organizers envision a gathering that helps younger people to find their place in the world of medical missions and helps future missionaries discern their calling while encouraging those who have already been working. However, it is also part of a larger project to discuss the how and why of medical missions wisdom accumulated through years of practice.

Kent Brantly's story exemplifies many of these themes; he was up on the main stage several times to discuss his experience of nearly dying from Ebola as well as the influences that brought him to Liberia. At a time when evangelical memoirs written by young people seem to follow an arc of passionate enthusiasm followed by tortuous doubt, Brantly's story is a refreshing reminder that many evangelicals of a similar age are beginning long careers of faithfulness shaped by Christian institutions like the GMHC. We were reminded several times that a few years ago, he was sitting out in the audience himself. His observation that he and his family went to West Africa as "ambassadors of the Kingdom" reflected the sentiment among many GMHC attendees and presenters that the Gospel is proclaimed in word and deed—and the main discussion is not the importance of one over the other, but how to do both as effectively as possible.

The medical missions community's response to Ebola was discussed throughout the conference, but before the first plenary speaker took the stage we were reminded that there are many other diseases claiming lives prematurely all over the world. Breakout sessions led by physicians, nurses, and community health workers with decades of experience in America and abroad focused on how to address these other illnesses, both through structural means ("Partnering with Large, Socialist Government Systems to Bless a Community" was the name of one session) as well as via practical tips for day-to-day overseas medical practice.

I particularly enjoyed a talk about how to use World Health Organization guidelines for the use of interventions for chronic disease in places with minimal resources, and I expect to apply some of the precepts I learned both in my practice here in the U.S. as well as when we go to South Sudan. As in years past, there continued to be a very strong emphasis on education and health workforce development, recognizing that simply providing health care in impoverished countries is not enough—medical missionaries must focus on training indigenous healthcare workers and building equitable health systems around the world in order to show compassion and do justice. This is especially true in regards to short-term trips, as a recent survey of medical missionaries indicates that more than half feel like short-term medical mission trips are unhelpful to the health of the people they work with. While awareness of issues regarding sustainable development and "helping without hurting" seems to be at all-time-high, breakout speakers emphasized again and again that judiciousness is needed just as much as passion is.

However, passion—usually tied to a theological and spiritual foundation, but not always—remains a cornerstone of GMHC activities. For the last several years, the conference has ended with participants writing notes with their commitment to learn, pray, or go on a postcard, which is mailed back to each individual months later (there's also a giant map where attendees place pins over places where they feel God has called them.) We all tossed our postcards onto a separate map on the main stage in front of the worship band, singing the refrain "We must go" over and over. Balancing such emotionally driven commitments with the arduous task of completing one's education while at the same time developing the spiritual disciplines necessary to survive one's chosen mission field is a challenge for a 3-day conference. As someone who has walked through the process over the last few years, I can say without a doubt that the relationships my wife and I have formed at GMHC have been far more valuable to our preparation than any altar call variant.

As I watched our toddler imitate the hand-raising movements she saw on the screen during the worship time, I was reminded that every detail of our institutional practices can be formational. At the same time, the life-and-death struggles involved with medical missions work and the tenacious commitment required to get through medical training in order to do that work require a certain amount of emotional reserve built up through experiences like the postcard toss. When the final speaker—who, in his retirement years, had followed God's leading back to North Africa to start a training program for Christian surgeons—spoke of people in the room doing "hundreds and thousands of miracles in the years to come," the spontaneous applause that erupted spoke of the hope that those gathered held: that they would see lives transformed through their labor.

While the emotional pleas were hit-or-miss, the emphasis on the spiritual realities governing our preparation and practice was solid. The point was made (in a plenary talk that could have taken place at any missions conference) that we could gain converts and still go to hell if we are not careful to guard ourselves against our own sinful inclinations to glorify ourselves. Dr. Brantly talked about imbibing Scripture through the kids' songs he learned that he later sang to himself as he lay in an isolation unit, unable to clean himself as he suffered from voluminous diarrhea. He also described his first patient in Liberia, a boy with Type 1 diabetes who died because the laboratory and pharmaceutical resources necessary weren't available, observing that "death is not the ultimate enemy." For physicians like me who often watch our patients—especially children—die despite our best efforts and the careful implementation of multi-level health programs, placing our work in this larger context of resurrection hope is both a challenge and an encouragement. Looking at our endeavors as part of God's "endgame" for redemption does not dampen the effect of any of the tragedies that we see, but it does help us to process these horrors and imbue our labor with spiritual meaning as we ache along with our patients for Christ's return.

For all the less charitable stereotypes fulfilled at the GMHC, there were many more endearing impressions: 2,800 Christian professionals and students committed to loving others through their work gathered not only to get fired up about sharing the Gospel but also to learn how to do their work with excellence. Attendees were repeatedly called to collaborate with local health systems wherever they found themselves, carefully consider the ethics of their work, and search for the best evidence to guide their medical practices wherever they were. Most important, ample time was dedicated to fellowship and discussion so that people could form relationships that will guide them for years to come.

I would encourage any health professional to visit the conference at least once in their career, as it provides an excellent counterbalance to the prevailing cynicism and despair found in many medical settings (I would offer the gentle caution that if one is inclined to be turned off by the trappings of a megachurch like Southeast, deciding in advance to overlook such things as much as possible will improve the experience.) The GMHC—or any similar missions conference—also reminds those of us in the West of how encouraging the advance of God's Kingdom across the world is at a time when a myopic narrative of decline (often tied to political or cultural "losses") frequently dominates the evangelical conversation. For those who cannot attend, the MedicalMissions.com website is an excellent place to learn more and find a mentor.

Next year, I anticipate that I'll be too busy delivering babies (in a place where it is often very unsafe to be a mother or infant) to attend. However, I am certain that I'll be in that place in part because of the GMHC, and my day-to-day practices will be shaped by what I have learned at this conference.

Matthew Loftus is working at Healthcare for the Homeless (a Federally Qualified Health Center in downtown Baltimore that serves the needs of the city's homeless) full-time as a family physician. He and his family are preparing to serve in South Sudan.

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