Health Mission and Learning Across Contexts

Today's post is by UM & Global blogmaster Dr. David W. Scott, Mission Theologian at the General Board of Global Ministries. It is an adaptation of remarks made to the All People's Conference hosted by United Methodist Church and Community Development for All People. The opinions and analysis expressed here are Dr. Scott's own and do not reflect in any way the official position of Global Ministries.

In reflecting on my understandings of biblical and Wesleyan theologies of health and healing, I think about a number of insights offered up by those theologies—that health is multifaceted and not confined to physical health, that individual health is connected to communal and national health, that there is a connection between health and sin including injustice, and that healing involves healing relationships.

Yet, such theology is not my area of expertise, so when asked to reflect publicly on the practice of health mission, I want to talk about something that does directly connect to my expertise: the importance of learning cross-culturally and across contexts, including learning about health and healing around the world.

Some quick definitions first:

A context is the setting where people live, work, and go about their lives. It can be a neighborhood, city, region, etc. Contexts are characterized by unique socio-economic, cultural, ethno-racial, political, historical, and other traits. So, each context in unique in some way, even as it also shares some things with other contexts.

A culture is a way of thinking about the world shared by a group of people. There can be local, regional, and national cultures; cultures shared by different ethnic or racial groups; cultures for groups defined by common interests; etc. A culture is characterized by a common set of beliefs, assumptions, and values. Cultures are an important part, but not the only part, of what makes a context unique.

First, I want to argue that learning across cultures and contexts is intrinsic to the practice of Christian mission. My definition of mission, which I lay out in my book Crossing Boundaries, is that mission is “cultivating relationships across boundaries for the sake of fostering conversations in word and deed about the nature of God’s good news.”

This definition mentions “relationships across boundaries,” and that means connecting to others across contexts and cultures. There are many types of boundaries—cultural, linguistic, geographic, political, socioeconomic, etc. But whatever type of boundary is involved, mission involves interacting with people who are different from us.

This definition of mission also mentions “conversations in word and deed about the nature of God’s good news,” and that means that mission involves talking and working with those who are different from us and learning from them in the process, just as we hope to share something with them at the same time. This learning goes both ways, as a good conversation does, and cannot be one-sided in which we only talk but do not listen and learn as well.

This process of learning through mission helps us better understand God and God’s good news because others will have different experiences of God than we do, different ways of thinking theologically, different conclusions that they reach from reading the Bible, and different senses of what would be good or new or life-giving within their own lives. Thus, when we engage in mission, we encounter these other ways of thinking and we thereby gain new insights into the ways in which God loves and redeems the world.

And while our ultimate goal in mission might be mutually learning more about God, along the way we are certain to learn about other things as well—we are going to learn about our mission partners’ lives and the ways in which they think about and experience the world around them. Learning about those other aspects of our mission partners’ lives and ministries is essential to being able to really understand what they can teach us about God.

Learning from those who are different than us can happen in a variety of settings. There are differences in cultures and contexts within the United States—southern Louisiana is different than rural Maine is different than metro San Francisco—and I’m sure that you’ve encountered and hopefully discussed some of those differences among contexts already during the conference. Cultures and contexts also differ internationally, often to a greater degree than they do within a single country such as the United States. So, while it is good to learn across contexts within the United States, it is also good to learn across contexts internationally.

The importance of learning across contexts applies to the field of health, both as a form of mission and ministry, and as an important aspect of health work itself. In fact, there is probably more learning across contexts in health than in many other fields. “Global health” is a field of study in prestigious medical schools that examines what we can learn about health and healing across countries, contexts, and cultures. For instance, the United States spends twice as much as on health care than other affluent nations and yet has the lowest life expectancy and highest suicide rate of any affluent country. Why do we spend more and end up less healthy? That sort of question can only be answered by learning across contexts.

But the United States can also learn from less affluent countries. Many think of health as being “better” in developed countries, and it’s true that there is a correlation between the relative income of a country and some of its health outcomes, especially as they relate to maternal and child health and certain infectious diseases.

But wealth is not the only indicator of health outcomes, and even to the extent it is, that does not mean that those in affluent countries have nothing to learn from those in developing countries. Education and women’s rights are also important indicators of a country’s health outcomes, and these vary within income brackets. Countries with better educational and women’s rights outcomes should be models for others. And affluent countries have more of certain types of diseases, especially mental health issues and chronic diseases related to diet or a sedentary lifestyle. Thus, the question, “Why is there more depression in the United States than in Mozambique?” is just as fair to ask as the question, “Why is there more malaria in Mozambique than in the United States?”

Moreover, there are many different models for arranging a health system, and developing countries often take innovative approaches to their health systems in ways that affluent countries can learn from. Remote access to health services is one such area. For example, the Gates Foundation has partnered with health providers in Malawi and Ghana to expand access to health care information and advice via cell phones, especially in rural, hard-to-reach areas. The challenge of providing health services in rural, hard-to-reach areas applies in the United States just as it does in Malawi.

Public health is another area in which developing countries can serve as models. Many countries in West Africa learned significantly from their experience with the Ebola epidemic in 2014. Experts cite African nations’ long experience with confronting public health epidemics such as Ebola and AIDS as a primary reason why Africa has been one of the regions of the world least affected by the coronavirus pandemic. In a Washington Post opinion piece about African success in combatting coronavirus, Karen Attiah says, “This pandemic has coincided with a global movement challenging anti-Black racism and white supremacy. This should have been a moment for media outlets to challenge corrosive narratives about Africa and the idea that Africans are not capable of effective policy-making. We could be learning from the experiences that Africans and their governments have had with pandemics and viral diseases, including Ebola and AIDS.”

Beyond outcomes, there are a wealth of different ways of thinking about health and healing in cultures across the world, and these various views also represent resources for learning, sharing, and developing our own perspectives on disease and healing. For instance, in many cultures outside of the West, the psychosomatic nature of disease is much better understood—that disease and healing are not only about what happens in the body, but about the ways in which the body, spirit, emotions, and social setting are out of harmony or in harmony.

And while people in the United States have been recently focused on the connection between diet and health, there are literally millennia of thinking about this issue in other cultures around the world that can offer potential insights.

For all these reasons, there are a variety of things we can learn from others around the world about health and healing.

And when these others are mission partners or are fellow Christians or even fellow United Methodists who are confronting the same sorts of challenges in their mission work and ministry that we are in ours, the potential for learning is that much greater, and it extends not only to health per se but about our shared faith and how health intersects with our faith and our practices of mission and ministry. There is much to be learned, even as we ourselves have things to offer and teach in return.