Emmanuel and Florence Mefor: The Practice of Health Mission

Today's post is by Dr. Emmanuel and Florence Mefor. They are health (Medical and Nurse/midwife) missionaries with Global Ministries. This is the first of a two-part series.

As we said in our last post, one must have passion as a Christian medical missionary. Passion for one’s profession and passion for the Christian mission are interdependent in order to achieve the desired effect (mission practice in relation to that particular profession), despite the difficulties of practicing medicine in mission settings.

A general example is to consider a situation where a sick or injured patient needs treatment and does not have enough funds for his or her treatment in a higher health centre. But a similar treatment can be rendered to that patient in a lower centre at a lower cost, based on several factors like the patient’s social status (poverty) and the missionary’s compassion (for the sake of Jesus Christ) and determination to do a good job professionally, even to the point of improvising equipment due to lack of adequate equipment (passion for profession).

Mission hospitals of the United Method Church are usually located in rural areas. A few may be found in the cities in some countries. In such situations, the rural area might have grown to become cities around the preexisting hospital. Medical missionaries should be ready not to reside in cities.

For us, we have never served in cities but in rural mission centers, so our patients are poor. Though the hospitals have to survive, medical charges have to be made, putting into consideration the social status of the community. In considering the poor social status of the patient, we end up offering free treatment and/or scheduling payment plans. Other sources of income for the hospital will be through donations, and in some countries, limited government support. Financial and material support for hospital supplies is very important to missionary to meet work needs.

With this poverty is the associated problem of neglect and hunger. There are patients who not only don’t have money for medical bills; they don’t have food to eat. They range from younger people to some who may be physically challenged and neglected, to the elderly who are neglected by their children and relatives.

We have had to get involved in social work, which includes provision of groceries to the underprivileged in the community. Like Christ, we not only have to treat; we have to provide food. This has led to what looks like a permanent feeding project for the pregnant women who come to wait for labor and delivery in our hospital’s pregnant women waiting home.

Basic medical equipment is not always available in mission hospitals. This situation should not deter one from getting things done and moving on. I have therefore learnt to be ready to improvise so long as it is safe for the patient at that point intime.

Some years ago, I had decided to assist a young man who sustained compound fracture of the leg (tibia and fibula are the long bones of the leg) following his inability to go to the next level of care where there could be an orthopedist or a General Surgeon and where he could be treated better. He said he did not have money to go there and would prefer to go home.

My idea was to do the normal traction for six to eight weeks.  Some days later, I found an “External Fixation set” for management of compound fractures in our Central Sterilization Department. I was excited I could use it for this patient, and I got ready to take him to the operating room. The surgery was going on well until I got to the final stage when our theatre nurse said there was nothing to tighten the nuts which holds the various parts of the External Fixation set together, thereby putting the bone fragments in place. Yet I couldn’t stop the surgery.

The only idea was to send for the hospital driver to get me the vehicle spanners sizes 12, 13, and 14 washed. We quickly got them sterilized by putting them in a metal kidney dish, poured methylated spirit (alcohol) and setting them on fire. After the alcohol burnt up, I was sure the spanners were sterile. the #13 spanner fitted perfectly with the nuts, and it was used to tighten them well. The patient was successfully sent home after 3 weeks when the wound healed, and the fixation set was removed at six weeks.

Medical missionaries must be ready to take up multiple tasks in the hospital/place of assignment. The same applies to the institution’s employees. This is due to frequent shortage of staff in such institutions. Though most medical missionaries each have their area of specialty in medicine, everyone works as a General Practitioner because the number of patients is overwhelming compared with the number of available doctors.

It must have originated from the fact that in early days of establishing a mission center, usually first by evangelism, the team may have one medical doctor (early or later) who would provide medical services. The services surely will start with consultations and treatment of simple ailments. As time goes on, the doctor is confronted with more complex ailments which this doctor is expected to treat. In order to assist the patients, the doctor may have to set aside his specialty, so to save life and considering that surrounding hospitals may not be able to handle the case.

The mission work system prepares the doctors to be versatile, being ready to solve the medical needs of at least 80% of the patient population. Besides, one never knows where he will find himself with a need to render medical assistance. Most patients treated get better, and a few will need specialist attention, which falls outside the scope of the specialty of the medical missionaries. In that situation, such patients are referred, followed by possible financial assistance.

Within our family, we don’t have any challenges. This is because my wife and I are both missionaries and both in the health profession. It may not be easy for professionally discordant couples, but God has blessed us with a strong partnership in serving God.