In 1997 Tracy and Patty Goen were ready to be medical missionaries. But the couple had $100,000 in student debt, and mission agencies generally insist that candidates be debt-free before sending them to the field.

Enter David Topazian, a missionary and retired oral and maxillofacial surgeon on Yale University's medical school faculty. In 1994 he and Daniel Fountain founded Project MedSend. It works with mission agencies—in the Goens' case, the South Carolina-based SIM International—and takes over missionaries' monthly student loan payments for as long as they remain on the field.

MedSend has given grants to 187 physicians, nurses, dentists, physician assistants, and other health professionals, each of whom serves under the authority of one of 49 mission boards. Only two have subsequently left the field (for health reasons). These medical missionaries work in more than 55 countries, many of which restrict missionary activity.

Half the world's people have no access to health care. Dozens of church and mission hospitals have closed in India and Africa, in part because of a lack of medical professionals to staff them. Diseases once thought virtually eradicated, such as tuberculosis, are on the rise. AIDS has killed 22 million people.

Egbe Hospital, which the Goens reopened in Nigeria—he as a surgeon and she as a pediatrician—offers the only health care for nomadic Muslim Fulani cattle-herders in southwestern Nigeria.

Tracy Goen says he has no desire for the lucrative private practice he was poised to build. "We had built a house in the middle of a cousin's ranch in College Station [Texas]," Goen said. "We'd have lived happily ever after. I really don't think we'd have gotten to the mission field had I gone into private practice to ...

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