What did it take to start a mission hospital in Africa or Asia a hundred years ago?
It took a missionary who saw a need and could translate her vision into reality. It took a church that believed in the Great Commission and responded to Christ's mandate to heal. It took a sending congregation that supported the missionary and a receiving congregation that welcomed her.
Where these factors were at work, a clinic would spring up and soon would become a health outpost. Then the outpost would become a small hospital, and the hospital would grow to house the thousands who flocked there for help. The patients were mainly women and children—the women suffering and dying from repeated pregnancies and, with their children, prey to malnutrition and a panorama of infectious diseases. Thus the mission hospital would become the hub of a growing Christian population—a healing arm of the church and a center for care and compassion.
This story was repeated across Africa and Asia. It is testimony to the pioneering zeal and effort of missionaries and the churches that supported them. The United Methodist Church and its predecessor organizations saw their efforts bear fruit in many African and Asian countries. As churches were planted, so were hospitals, and the two complemented and supplemented each other. Those who were preached to were also healed and those who were healed went home with the Gospel, either in their hearts or in their bags. It was a period of glorious growth for the Word.
Methodist physicians and nurses took up the challenge to provide quality care where none existed, and churches at home raised resources to equip them for the task. Most mission hospitals were born during a fertile hundred-year period from 1850 to 1950, which also coincided with the great missionary movement of the churches in Europe and the United States. More than money or other resources, the churches' greatest contribution to the growth of mission hospitals was a seemingly inexhaustible supply of dedicated women and men.
The past 50 years witnessed a slowdown of the medical missionary movement in the mainline churches owing to a number of factors. The churches were no longer able to recruit long-termers and so focused on short-termers and mission volunteers. Some countries had gained independence and viewed missionaries with suspicion as vestiges of colonial rule. The indigenous churches also wanted to assert their authority. The net result was a gradual devolution of governance of the mission hospitals to the local conferences and councils. This proved to be a mixed blessing. In some countries, the local churches rose to the occasion and took over the leadership of the health-care institutions. The hospitals that adapted and that had good governance and leadership thrived. But where there was no vision, or when a mission was forgotten, the reverse became the rule.
A gradual decline set in. Many mission hospitals faced closure or were forced to downsize. The parent overseas churches were in a dilemma. The healing ministry was being redefined as churches realized that health could be enjoyed only in a holistic context and that preventive care was as important as cure. Suddenly mission hospitals were no longer a priority. Community-based Primary Health Care (CBPHC) and the World Health Organization's clarion call of health for all overshadowed all else on the churches' agenda for the healing ministry. The shortage of long-term medical missionaries, the decrease in funding, and the change in strategy of the parent churches could not be offset by new local church initiatives. Compounding these changes were wars, famine, natural disasters, and failing economies around the globe. That many hospitals survived at all is a testimony to local enterprise and endurance.
The General Board of Global Ministries (GBGM) of The United Methodist Church, through its Health and Welfare unit, has launched a Hospital Revitalization Program. The program assists Methodist churches in Africa and Asia to assess the needs of their health-care facilities. It then works with them to improve standards of care, ensuring always that the effort will be part of a larger strategy of community-based health education and development. Hospitals in developing countries can become centers of health-promotive, disease-preventive, and rehabilitative care, especially for women and children at risk and those afflicted by poverty, war, and famine.
Eight hospitals—five in Africa and two in Asia—have been chosen initially for the program. First, volunteer assessment teams chosen from the world Methodist family will work with the hospital's staff and with Health and Welfare to strengthen governance, leadership, infrastructure, and management. Health and Welfare will also coordinate the procurement of equipment, pharmaceuticals, consumables, and supplies, either from donated sources or at a low cost. Funds will be sought from church sources, nongovernmental organizations (NGOs), agencies, and the government to help hospitals address their priorities realistically, with the goal of sustainability.
The first hospital for women and children in Asia was founded in Bareilly, India, more than 125 years ago by Clara Swain. She was a missionary physician of the Woman's Foreign Mission Society of the Methodist Episcopal Church in the United States. Situated in a predominantly Muslim community in what was once a princely state, the hospital attracted scores of patients from neighboring states. At one time it had 350 beds and an active community outreach program. It was the largest of the 14 Methodist hospitals in India and a pioneer in nursing education in the north.
By 1998, however, Clara Swain Hospital had only 30 patients and had accumulated a large debt. The Methodist Church in India began to seriously consider closing the hospital, but three events turned the tide. First, Bishop Victor Raja, the new bishop of Bareilly, took up the challenge to revive the hospital. He invited Lillian Wallace, a retired United Methodist missionary with 40 years of service in India, who lived nearby, to take up the post of hospital director. Second, Wallace agreed and, since 1998, has been working day and night to put the hospital back on its feet. The third event was a visit in late 1999 by the Rev. Paul Dirdak, deputy general secretary for Health and Welfare at the GBGM. As a result, Clara Swain Hospital became the first beneficiary of the GBGM's Hospital Revitalization Program.
At this writing—six months after a formal agreement to launch the revitalization program was signed by the North India Conference of the Methodist Church in India, the Clara Swain Hospital, and the GBGM—the efforts are bearing fruit. The hospital campus has a new look, with freshly painted wards and paved roads. And the hospital has received four 40-foot containers of medical equipment, arranged by Drs. Harold and Harriet Hanson of Fresno, California. The Women's Division of the GBGM has provided a timely grant to improve the nursing school's facilities, including a new bus for the students. Dr. Anoop Singh, a Methodist surgeon, has joined the hospital as medical superintendent, and the patient numbers are increasing. The primary health center in Faridpur has been reopened with a resident doctor in place. Though much more needs to be done, there is a new feeling among Clara Swain Hospital's patients and staff—hope.
Founded in 1926, the Ganta United Methodist Hospital serves a population of 400,000 Liberians, along with nearly 50,000 more from neighboring Guinea and Côte d'Ivoire (see Working Together for Health Through the United Methodist Federation of Health Care Volunteers). Suffering the effects of a devastating civil war that lasted from 1991 to 1998, Liberia today has no electricity or running water. When darkness settles in, only those who can afford generators have light. In the capital, Monrovia, people have to dig wells in the center of the city for water. More than 80 percent of the population is unemployed. Schools and hospitals have been destroyed, and it is estimated that Liberia has only about 25 doctors for a population of four million.
Nimba County, in which the small town of Ganta is located, was the headquarters of the rebels during the war. Though much of the Ganta Hospital was looted, the staff kept it open throughout the war.
The hospital is part of a 750-acre United Methodist mission compound that includes a leprosy and tuberculosis rehabilitation unit, primary and secondary schools, a vocational training school, a woodcarving shop, an agriculture demonstration unit, the Miller McCallister United Methodist Church, and various residences. Once a thriving mission station, it is a shadow of its former self.
Dr. Francis Kateh, who grew up in Ganta and was trained in the United States, is the chief medical officer of the 65-bed hospital. The hospital also has one other Liberian doctor, along with a United Methodist medical missionary, Dr. Kelley Jewett, and a staff of 170. Nevertheless, a shortage of trained staff and essential supplies hampers the hospital's efforts to serve a large number of desperately ill patients who do not have the means to pay for care.
The hospital also runs a school of nursing and a prosthetics and orthopedic workshop. The workshop was set up in December 1999 by USAID/UNICEF to assist victims of war or of poliomyelitis and birth defects. Thus far, it has fitted more than 200 patients with prosthetic devices. The USAID Leahy War Victims Fund recently approved a grant to support the workshop and hospital for the next five years. The GBGM, through the Hospital Revitalization Program, has also pledged financial support for both the hospital and the workshop. The hospital also has an active Community-based Primary Health Care program in 25 nearby villages.
There are major challenges ahead. The hospital desperately needs a new water-distribution system, building repairs, a new X-ray machine, a blood-chemistry analyzer, kitchen equipment, and a new laundry. The school of nursing needs books and teaching aids. The Hospital Revitalization Program and Mission Volunteers are trying to identify hospital administrators and engineers willing to volunteer for service at Ganta. Meanwhile, the NGO unit of the United Methodist Committee on Relief (UMCOR) is working closely with Ganta Hospital to implement the USAID grants. And Dr. Kateh and his staff are continuing to work in a very difficult environment, their lack of resources offset only by their dedication and resilience.
Situated on a cliff in Mozambique overlooking the Indian Ocean stands the Hospital Rural de Chicuque. This 200-bed facility started as a Methodist mission but was taken over by the Mozambican government in 1975. Dr. Charles John Stauffacher, a medical missionary with the Methodist Episcopal Church, founded the medical work in 1919 as part of the Chicuque Mission Station. In 1986, the Mozambican government invited The United Methodist Church to jointly administer the hospital and that agreement continues today. Dr. Amir, the medical director appointed by the government, is assisted by three other doctors. Jeremias Franca, the hospital administrator, was sponsored by the United Methodist Church in Mozambique to complete work in Texas on a master's degree in Hospital Administration. The hospital was affected by soil erosion resulting from recent floods, and many of its facilities are in need of repair.
Plans are under way to provide the hospital with supplies and equipment under the Hospital Revitalization Program. The hospital urgently needs a dentist and an ophthalmologist. A training workshop in Community-based Primary Health Care will be held by the GBGM's Health and Welfare unit in Chicuque in May for Portuguese-speaking participants from Angola, Mozambique, and Brazil.
Mozambique has enjoyed peace for nearly 10 years. Under an elected government, it had the fastest-growing economy in Africa before last year's massive flooding. But poverty-related diseases and natural disasters take a heavy toll, and the country has yet to come to grips with the HIV/AIDS epidemic. Chicuque Hospital can play a vital role by providing appropriate curative and preventive health-care interventions.
In strengthening such hospitals as Chicuque, Ganta, and Clara Swain through its hospital revitalization program, the General Board of Global Ministries is helping to carry forward the great United Methodist mission-hospital tradition of the past into the twenty-first century.
Text and photographs copyright 2001 by New World Outlook: The Mission Magazine of The United Methodist Church. Used by Permission. Visit New World Outlook Online at http://gbgm-umc.org/nwo/.
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