In most developing nations, a small urban elite enjoys a sophisticated array of health services while some 80 percent of the population live and die beyond the reach of formal medical care. Henry Mosley, director of the Institute for International Programs at Johns Hopkins University, says Christian missions should lead the way in taking health care and the compassion of Christ to the disadvantaged majority in the Third World.
CHRISTIANITY TODAY asked Sharon E. Mumper, associate director of the Evangelical Missions Information Service, to interview Mosley about worldwide health sendees and how Christians can bring health care to those who most need it.
What is the state of health of the world’s population?
The life expectancy in most African countries is less than 55 years. In some countries, like Burkina Faso, it is barely above 45 years. In Thailand, life expectancy approaches 60 years. In China it is 68 or 69 years, while in the United States it is 76 years.
In most African countries, 15 to 25 percent of the children will die in the first five years of life. In some places only 50 percent reach the age of five. An estimated 15 to 17 million of the world’s children under the age of five die each year from preventable diseases. International health agencies are spearheading a major effort to immunize 85 percent of the world’s children by 1990.
What is the key issue in international health?
Declining resources hamper the ability of governments to effectively deliver health services. The global economic picture, including massive foreign debts, has forced governments to restructure their economies and budgets to limit imports and expand export industries. Many developing countries have severely cut their health budgets.
How have government health officials responded to budget reductions?
Only a few governments have dealt effectively with the problem. They need to analyze the impact of various options on the health of society and assess priorities. Previously, they did not have to consider priorities. They just added hospitals and health centers from year to year without considering the impact on the health of society as a whole. In a sense, however, governments have always rationed health care.
How have they done that?
One way is to ration the number of people they will serve. This is what happens in most developing countries. Quality hospitals serve 10 to 20 percent of the population. A few outlying medical centers and subcenters expand the medical outreach, but most people live beyond the bounds of such help.
The other method of rationing health care is to limit the number of problems with which they will deal. With the same amount of money, they can see that everyone gets a certain basic level of care. For example, everyone may be immunized, have access to commonly needed drugs, and receive basic healthcare information. This method moves away from largely curative care to primary health care.
It is a concept in health care formulated since 1978 as a result of dissatisfaction with the existing health system in many countries. The goal is to reach entire populations with at least some basic services, helping people to effectively care for themselves. Primary health care educates people to understand why they get sick, what they can do to prevent illness, and how to care for themselves when they are ill.
How do Christian missions view their role in health care?
Mission agencies face an economic crisis caused by the escalating cost of operating medical programs in developing nations. Many have expensive hospitals that they may need to close or turn over to the government or the national church. However, if a hospital is too expensive for a mission board to run, it isn’t likely a national church can afford it either.
Should mission agencies close all their hospitals?
No. We need some back-up for serious illnesses. But I question whether mission agencies should operate a sophisticated hospital, especially in situations where the government may already have hospitals. Many missions founded hospitals to care for the poor. But because of higher costs today, they have had to take an increasing number of paying patients. They have some money available to take care of charity patients, but essentially they have become private hospitals.
Is primary health care an appropriate ministry for mission agencies?
Yes. Primary health care fits the Christian goal of discipleship and training. The witness to the love of Christ is his compassion for the most disadvantaged in society. Traditionally, Christian missions have led the way in caring for the sick, who were often rejected by society. Once again, mission agencies can take the initiative to demonstrate compassion and caring for those who are neglected by their governments.
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