Lessons from Ecclesiastes on Teamwork

Very few people desire to work completely by themselves.   As doctors we often take pride in our individual skills.   Solomon wrote in Ecclesiastes 4:8, “there is a man all alone; he had neither son nor brother.”  Why do I work so hard if I cannot take the fruit of my efforts with me or leave my material possessions to someone I love.  “There was no end to his toil yet his eyes were not content with his wealth.”   The more I accumulate the more I want and the harder I must work.   “For whom am I toiling,” he asked, “and why am I depriving myself of enjoyment?”   If I work too hard or long there is no time to enjoy what I have earned.   All of this results in “a miserable business.” 

The remaining verses in Ecc 4 describe the benefits for man when he works together with a like minded brother.   God designed us to work in relationship to others reflecting the work of the Trinity, Father, Son, and Holy Spirit.  Often as a missionary, I think of how much more God good accomplish through me being part of an effective team.   There are at least 13 lessons on the value of teamwork that I could find.  Can you find more?

1)  A good return, which usually means a profit

2) Good verses not so good or bad, a return without trouble as with  something illegal.

3) A good return provides what is needed not necessarily what is wanted.

4) A good return means our work will be meaningful.

5) When you work as a team there is someone who can offer encouragement.

6) It takes two to be able to support one another.

7) There are some tasks that you cannot do by yourself. 

Two are better for defending.

9) You yourself alone cannot see all of your own weaknesses.

10) There is safety in numbers.

11) A team has more strength.

12) There is a synergistic effect.  when two work together there effort does more than double.

13) Emotional stability increases because when one is down the other is up.

14) You become more aware of forgiveness and grace.

15) You discover different approaches from an additional set of eyes and thoughts.

16) You have someone to share your experience.

As I typed these lessons out I came up with three more, with my final thought being when you know Jesus you are never alone.  I am thankful that God has chosen me to be part of His team, although He doesn’t need me to accomplish His purposes.  What a privilege it is to serve on our LORD’s team!  May we not only be a good member of God’s team but our earthly teams as well bringing unity in Christ to all we do.

The Medical System in Ukraine

The world is a much smaller place than it used to be thanks to instant communication via the Internet. Yet, as individuals living and working in different countries we tend to focus on our own problems where we work and live.  We don’t do this in a vacuum but within the context of our individual cultures.  Each culture has the same basic needs, but our thought process and how we meet those needs are different.

Often I am asked what is the Ukrainian medical system like, how does it function, how is it similar and different than our system.  Recently there have been two articles published that accurately describe the Ukrainian medical system from what I have experienced after living in Ukraine for seven years.  The links to the two articles are Ukraine’s Hybrid  Healthcare System, http://news.bbc.co.uk/2/hi/europe/7484095.stm, and Healthcare Deteriorating, Physician Shortage likely to grow, http://alisterandsarah.blogspot.com/2008/06/more-on-medical-situation.html. 

Therefore, as an Americian living in Ukraine, I tend to look at the Ukrainian medical system through a different set of cultural glasses.  Native people often accept their culture and traditions as correct giving little thought to how the same task is accomplished in another country.  But once exposed to a different culture, the question becomes which perspective is correct, maybe both are invalid.  It is here that a belief in a God who is sovereign and the author of absolute truth is a blessing.  Either God is the God of all cultures or He is not God.  May we all look to God who knows all and His wisdom to answer how we should provide the best medical care drawing from all cultures he created. 

The Value of $300

In world’s economy the value of $300 does not seem like much.  But when seen through God’s eyes the value greatly increases.  What we think as being insignificant, might be of great value to someone else.  Things we take for granted such as access to any book, on any subject, at anytime, are not common place in the rest of the world.  Such is the case with medical literature in Ukraine.  Physicians in the USA have access to hospital libraries, the latest medical journals and textbooks and of course the Internet.

So, what would bring tears combined with giddiness to a grown woman who happens to be the most knowledgeable doctor in all of Ukraine regarding the treatment of children infected with HIV?  The answer is a textbook about pediatric oncology.  About two months ago I was visiting Dr. Svetlana where she works at Okmadet the National Children’s Hospital.  When she learned of my previous training in pediatric hematology/oncology, she began to talk of her 12 year old patient who developed lymphoma and the challenges of treating a child with AIDS for cancer.  Pediatric oncologists were consulted but there is a tremendous stigma associated with anyone who is HIV positive in Ukraine.  The oncologists were hesitant to treat and slow to respond when called.  So Dr. Svetlana said, “What I need is to learn how to treat these kids myself!”  ” I need a textbook.”  “I have the money, but I can’t buy it in Ukraine.”  “Can you help?” We also take for granted a reliable postal service.

About the same time Jim and Donna Houston from the Church at Brookhills in Birmingham, Alabama were visiting with a team from Lifeline Adoption agency who I have assisted from time to time with adoptions.  After hearing the story above they promised to present this need to their church.  

After returning to Alabama and sharing the need, the Ladies Bible Study Group at Brookhills led by Betsy Parker responded to the plea.  They purchased the latest edition of Principles and Practices of Pediatric Oncology .  Six weeks later the text was hand carried to Ukraine by short term missionary from Brookhills to insure safe arrival.  With the current weight restrictions on luggage and the book being heavy and quite large this was a huge and timely favor.  When I carried the book last week to Dr. Svetlana, she immediately developed a huge smile when she saw the text and tears when I told her the cost had been paid in full. She quickly scanned the pages with delight, saying over and over I need to read about this or that.

But what of the girl with lymphoma?  Tragically, her immune system and body were just too weak.   She died just a couple of weeks ago.  But this was the opening I had been waiting, the moment to discuss Biblical medicine and Jesus Christ, who also paid the price in full so that we may have eternal life.  Only Christian physicians can offer this true hope.  Only we can explain the diagnosis of our greatest illness, sinfulness, and then offer the healing that comes only through knowing Jesus Christ.

Pray for Svetlana and her staff that the may become believers in Christ as our work at Okmadet continues,  whether teaching English to the medical staff, helping provide resources or just showing the love of Christ to the patients and their families.  We pray they will one day be able to be used by God to offer spiritual healing to their patients and families.

So what is the value of $300?  It is the proper use of what God has given us to build relationships, encourage others, advance His Kingdom and ultimately bring glory to God.   And thank you Church at Brookhills for sharing your resources.

Children of God

During the past several weeks I have been privileged to assist in the adoption process of four American families.  Typically these adopting parents arrive full of expectations for finding the perfect child.  Each story is unique. They quickly learn they are not as much in control of the process as they thought.  They find themselves somewhat tossed about in a sea of emotion without the cultural cues of language, alphabet and rules of behavior that are customary if not taken for granted in their native land.

At the adoption center they are typically presented  with three options of children to choose from.  The adopting parents look at different factors, gender, siblings, ages and  medical issues.  How do you say no to one and yes to another?  Is it selfish to want a child that meets all of your expectations?

Do you ever wonder how our heavenly Father choose us?  What expectations did he have of us?  How could we ever live up to these expectations?  The Scripture tells us we are dead in our trespasses and that no one is righteous, no not one.  It is difficult to imagine a completely holy God, perfect in every way who finds all sin and evil totally abhorrent and in opposition to His character choosing any of us, particularly me.

I often share with parents before they make their final decision to adopt or not that it is OK to want a perfectly healthy child.  You do everything thing to make the best decision.  But once the decision is made you agree to accept this child or these children forever and deal with whatever challenges arise.  They will arise because we are human and more importantly fallen creatures living in a fallen world.

Isn’t this how God deals with us.  When He adopts us, it is for eternity.  His love for us as His children is unconditional.

How reassuring to know God, our Father is the perfect example for us as parents.  He remains faithful to us even when we are unfaithful to Him.  Because He is perfect and cannot make a mistake, He works out everything for His glory and as well as the best for all those who love Him, even those things that are not so pleasant.  God knows and understands all of our circumstances, using both the good and bad things that happen to mold us into the likeness of His Son.

Now with the decision behind them, almost all the paperwork complete, it is time to pick up their new sons and daughters at the orphanage to take them to their new home.  It is a time of sadness and joy.  The children must say good bye to their old lives, friends and caretakers and begin the next phase of their lives in a new home, new parents, new country and new language.  They did not ask to be in the circumstances of living in an orphanage.  They might not have even realized they needed to be rescued from this situation.  How many of us thought we needed to be rescued from our sin or idols that we worship instead of the God who created us.

In some cases one of the new parents must return home to work and prepare for the arrival of their new children.  Our Lord has left us for a while but has promised to return after preparing a place for us heaven.

When the children leave the orphanage they take nothing with them.  All is left behind.  The new parents are expected to bring clothing for the children.  So when we become children of God we bring nothing to the relationship.  Taking nothing to chance, our God clothes us in robes of righteousness based upon what His Son accomplished for us by His death upon the cross.

Once at home some children have a difficult time becoming attached to their new parents.  Medically the earlier children are placed in orphanages and the longer they stay there the greater the possibility of developing an attachment disorder.  I am comforted by the fact that God repeatedly tells us that He loves us unconditionally.  He is able to overcome our lack of attachment to Him.  His grace is more than sufficient.  His ability more powerful.  His love more able to overcome a multitude of challenges.

How wonderful to participate as an instrument in God’s hands to serve these families and observe God at work in the hearts of the children, their new parents and their extended families.  We praise Him for what He has done and rejoice in His faithfulness for what He will do!  Thank you God for this privilege.

A Haunting Question!

Our medical bible study is gleaning nuggets of truth from the Book of Daniel.  Last night we discussed how Daniel and his friends responded when faced with the decision to maintain their personal integrity or bow to the idol constructed by Nebuchadnezzar.

 The discussion soon turned to personal application.  At least 98% of Ukrainian physicians  work for the government and are paid an average monthly salary of $300.   At least 60% of the doctors take additional payments from patients either as bribes for more prompt or attentive service or as gifts of appreciation for services rendered.

 Now the question came.  Should doctors accept these payments knowing that if they don’t they will not earn enough to support their families?  Does God hear those in need?  Why do the wicked prosper?  Where is the justice?  Should we not expect God to bless His children?  The silence for a moment was almost deafening.

As we discussed the issues we did come to some conclusions.  We needed to clearly define what is right and what is wrong.  We needed to decide in advance to do the right thing.  We needed to help each other be accountable.  And we needed to ask God daily for His assistance.

This morning the question was still haunting me.  My daily scripture reading led me to examine Psalm 73 which revealed God’s response.

Surely God is good to Israel, to those who are pure in heart, Ps 73:1.  God does care about His people.  May we seek each day to examine the motives of our hearts and seek the purity only He can provide through Christ.

My feet had almost slipped.  For I envied the arrogant for their prosperity, health, strong bodies, free of common cares and human ills, (Ps 73:2-5).  Who are we to judge because we too are sinners, with the same idolatrous concerns.  Are we truly more righteous.  Is it right to ask God for our reward now?

The arrogant are filled with pride and clothed in violence.  Their evil knows no limits.  They threaten oppression.  They lay claim to heaven and take possession of the earth.  Ultimately, they say “How can God know and ask does the Most High have knowledge.” (Ps 73:6-11)  These people deceive others and deny the power of God.

Surely in vain have I kept my heart pure.  What do I earn for having steadfast belief in God, being plagued all day long, punished, oppressed. (Ps 73:13-16)  God will not care.  My needs are obvious.  I must survive.

How far will I go to satisfy my own desires?  I would have betrayed your children. (Ps 73:16)

But when I seek God, I find understanding.  The destiny of the arrogant is made clear.  They are on slippery ground.  They are cast down to ruin, destroyed and swept away. (Ps 73:17-19)

I also understand my position before God.  I too am senseless, ignorant and a brute beast leading to grieving heart and embittered spirit. (Ps 73:21,22)

But how shall we proceed?  With humbleness that comes from knowing God, we acknowledge His constant presence.  He takes me by the hand as a father with his son.  He guides me with His counsel.  His counsel is found in His word.  He assures us that His final reward awaits us and will be everlasting.  He is the strength of my heart.  How wonderful we do not need to rely upon our own strength.  We need to go to Him and He will be our refuge.  Nearness to God is spending time with Him every day and enables us to do what is right in His eyes.  We only need to tell of His work in our lives.  

Willingness AND Looking

Are you willing to do whatever God has prepared for you to do on any given day?  Better yet are you looking for what He has planned for your life moment by moment to glorify Him?

 Yesterday, I accompanied by wife to the hospital she has been faithfully serving the past several years (to get view of the day click on her blog, The Heart of the Matter, on the right).  She ministers to the children who have been diagnosed or waiting to receive the diagnosis of HIV infection usually through no fault of their own.  Their mothers, whose hearts have been deadened by drugs, abandoned them at birth.  She visits them, holding, hugging, tickling, mothering them.

I must admit my “to do” list contained more items than I could accomplish in a day.  In fact, I have things on my list towards the bottom that are important but have been on the list for at least six months.  They keep their lowly position not because they unimportant but because they are suppressed by the urgencies and sometimes mundane things of life.

Two days ago I was alerted via my assistant, Maya, that I might be asked to be a fill in puppeteer for my wife’s evangelistic puppet show.  Her plan was to recruit students from Kyiv Christian Academy as puppeteers.  They are required to perform twenty hours of community service each year.  The day of the performance was a day off from school and many families were making the most of this  opportunity to do something together.  After checking earlier in the week with the head nurse at this hospital for 400 children we were advised there would be as many as 150 children parents and staff in attendance.  Too late to back out now even if we did not have any assistants.  The show must go on.  We did have one faithful recruit, Nat, who we have known since we first moved to Ukraine.

We all gathered on the morning of the “Really Big Show” at our flat, two hours before, for our one and only rehearsal.  We could not find a copy of the script after a frantic search and for a moment thought the tape might be erased.  I am still amazed that we were able to pull this adventure off, but then again I was relying upon my own strength and desires.

We certainly were not professional.  But hearing the giggles coming form our audience and their spontaneous clapping with the music encouraged the puppeteers greatly.  Simply, the audience and the team were having fun together sharing God’s love and enjoying His presence together!

After the show two older patients from the audience who assisted in holding our curtain announced they were Christians and were very excited to see us.  We invited them to church and they promised they would come.  Another woman approached me with her son Valdic who has a kidney problem and needs an operation.  She is also a believer and wanted some reassurance that this surgery was really needed.  She was hoping and praying God would heal her son without this procedure.  Somewhat disappointed in God’s response, I asked her to think and pray more about God’s attributes and His purposes than the immediate problem she was facing.  Our God is so much greater than we can imagine.  He does not let anything go to waste even our illnesses.  We prayed.  She cried.  We hugged.

Was I a willing participant yesterday?  Was I looking for God’s purpose and plan for me when the day began?  Somewhat reluctantly, I followed God’s lead and He graciously allowed me to be His instrument to share His love and faithfulness.  What are your plans for today?   

Ministry in Lutsk

As if the New Year’s celebration and a wedding were not enough, UMO started off with a bang as well. I traveled to Lutsk in December to meet with Roman Brystook (pastor of Fimiam Church), Dr. Kobis (head of the Christian Medical Association in Lutsk) and Tetyana Vihovska (director of the new children’s rehabilition center) to begin planning for the joint Caring Partners and UMO mission trip this October. Much to my surprise, members of the Volyn University Department of Psychology arrived to ask if I would speak at the 3rd International Conference Regarding Care of Children with Disabilities. The conference would be only one day. They asked me to speak about the multi-disciplinary approach to the care of children and the role of the church. With such a topic at their request how could I refuse, even if it were short notice.

Despite challenges in transportation to and from Lutsk, as well as finding lodging for two nights for four people, everything came together at the last minute. Cheryl Nemazie, visiting from the USA to photograph the wedding, Maya, our translator, Marianna and I boarded a marshrootka (mini-bus) for the five hour drive to Lutsk. We were greeted in Lutsk by Kimberly Ward, a YWAM missionary, who helped so much during the first CPI/UMO mission trip in October 2006. She agreed to house all four of us for two nights. Laura Moore, a missionary with Send International also agreed to help us. What gracious hostesses and a great example of the body of Christ working together.

The next day we attended the conference. Approximately 140 teachers and psychologists were present. I was one of the six speakers in the plenary session in the morning. The challenge was how to do justice to this topic in 15 minutes. I taught that the principles which served as the foundation of the care of all children were Biblical, including the dignity of man made in the image of God, why we have illness because of the fall of man and man’s purpose to serve God by serving one another. I then reviewed the American Academy of Pediatrics policy on the care of children with disabilities.

During the breakout sessions in the afternoon, there were lots of good discussions on how to improve care for children. I was able to elaborate on the principles taught earlier and encourage the group to give love and attention to the children and honesty to the parents regarding their children’s care. God was really moving in the hearts of those in attendance. One woman held up her Bible and said we needed to put into practice more the care for people we are taught by the example of Christ. Another talked about how initially she did not want to teach these kids, but found out she learned so much from them. I was greatly encouraged. One teacher asked me to return to speak to her high school class about careers in medicine.

This was supposed to be a practical conference but most of the speakers talked about statistics, why there is a problem, and the need to find solutions since the number of these children are increasing. There seems to be a disconnect between recognition of problems and their ability to develop solutions. Part of this is secondary to the lack of teachers with sufficient experience and knowledge to teach new methods and develop programs in conjunction with the government. In October UMO and CPI hope to address this through mentoring small groups by a team of physicians, speech therapists, physical therapists and special education teachers.

The next day I met with Pastor Roman at Fimiam Church along with Sergi and Natasha Bolchook. Natasha was in a car accident that left her with hemiplegia. This beautiful Christian couple minister to the disabled in the Lutsk region and lead the development of an outpatient rehabilitation facility at the Church. Recently they have also begun to partner with Joni and Friends Ministries.

We continue to pray for God to cause the seeds planted amongst the health care providers to begin to sprout and that the Gospel will transform the culture of medicine and the care of patients in Ukraine.

The Healing Ministry

Physicians are called to care for the sick.  Some physicians claim to heal the sick.  John Stott offers some insight and puts into proper perspective the ministry of healing in his daily devotional, Through the Bible, Through the Year.

“The gospel writers describe Jesus’s ministry as threefold: teaching, preaching, and healing.  Teaching and preaching are not hard to grasp or to imitate, but how are we to understand the ministry of healing?

Perhaps the place to begin is to affirm the goodness of God’s creation.  that is to say, disease was no part of God’s original intention for the world, and it will be no part of his ultimate purpose either.   In the new universe there will be neither sickness nor pain nor death nor tears (Rev. 21:4).  Since, then, disease and death are alien intrusions into God’s good world, doctors and nurses are reight to wage war against them.  Moreover, all healing is divine healing, since God has put into the human body remarkable therapeutic processes.  For example, no sooner has an infection appeared then antibodies are created to fight it.  It is this conviction that led Ambroise Pare, the Huguenot physician, to say, “I dressed the wound, but God healed.”  The words are inscribed on a wall of the Ecole de Medicine in Paris.

The Gospels make it plain, however, that the healing ministry of Jesus belonged to a different order.  Like changing water into wine, multiplying loaves and fishes, and walking on water, Jesus’s healings were supernatural demonstrations of the kingdom of God.

In trying to understand them, we will be wise to avoid opposite extremes.  On the one hand, it would be absurd to put the creator in a straightjacket and declare that miracles can’t and don’t happen.  On the other hand, we have no liberty to say (as some do) that performing miracles is the normal Christian life.  for however we define miracles, they certainly belong not to the normal but to the abnormal.  If we claim to be able to heal the sick like Jesus, we need to remember tht he healed without the use of medical or surgical means, without delay, degree, or remission, but immediately, completely, and permanently, and that even hostile eyewitnesses said, “We cannot deny it” (Acts 4:16).”

Reflections on Weddings

There may be many ways to know if you are a successful missionary, but maybe the first test would be your own children.  Marianna and I have always considered our three children our first and most important mission field.  God works in and through us.  We reflect God’s glory to them and then one day they actively assume the same role.

Just as we pray for God to raise up believers in the country we serve, so Marianna and I  have been praying for God to raise up believing spouses for our children.  He indeed has been faithful to us in every area providing an incredible wife for our son and now a husband for one of our daughters.

After the wedding of our son I felt a milestone had been passed, but we still had our daughter living at home.   As I looked back on my journal entry of that day August 13, 2005 I was reading 1st Chronicles Chapter 8.  No less than four times scripture talks about sons who were heads of their father’s houses and ends with sons who were mighty men of valor.  My thoughts turned to our son and I prayed that he would be such a man.

On that day I wrote the following: Today God is allowing a new family to begin, may God bless them directly and in proportion to their knowledge and obedience to Him.  May Jamie become the head of his home and always take into consideration the thoughts and suggestions of Dasha.  May Dasha truly love and cherish Jamie as he provides for her.  May they both strive to serve God and in so doing serve and love one another.

Now almost two and a half years later, our daughter Jeanne got married one week ago.  I could pray that same prayer for her and Kolya.  Interestingly my daily reading of the scripture has carried me to almost the same location in 1st Chronicles, but now chapter six.

 The beginning of Chronicles contains many genealogies of the families that formed the nation of Israel.  I am struck by the faithfulness of God through many generations and His design to have a purpose for each of these families.  As friends gathered from two different families to celebrate the beginning of a new family, I begin to recall the role God has given to the many people in each of the lives of this young couple which God used to devel0p their character and make Kolya and Jeanne more like Christ.

Certainly when they were born did any of the parents suspect their children would be marrying someone from another country.  I am grateful to God for using Kolya’s parents, teachers, friends to mold his character so that he will be the head of his household and a mighty man of valor for God.  We are thankful for all of our friends, pastors, teachers and the congregation of  our church in helping us raise our children to glorify God and enjoy Him forever.

Weddings are a celebration of all these things.  The ceremony was for Kolya and Jeanne.  The celebration is for all of us as we give glory to God for what He has done and brought together remembering the small role God gave us in the process.  He indeed is faithful.  May we rejoice and be glad for the great things He has done.

So You Want to Go Swimming!

As physicians, we generally encourage our patients to participate in regular physical activity.  But, when does such activity become unhealthy for both body and soul?

We often take for granted the transparency of life in America.  While this is true, we do have corruption, but just better at hiding it.  Adapting to life in a foreign country provides many interesting situations to learn about the true nature and thought process of the nationals with whom we live and work.

One such situation arose when my assistant decided to find a place to exercise and swim.  During the Soviet times many sports halls were constructed with swimming pools.  Like many other things during that era admittance to these halls was free.  Now, with independence, there is a fee, nothing is free.

In the past, as well as now, in order to use the pool a person needed to provide a “Spravka” or certificate of health.  Obtaining this certificate, required a visit to the local polyclinic where you are registered to live.  You were examined by a dermatologist, gynecologist and an internist.  You stood in line for an hour typically for each of the doctors.  When you were finally seen, you were not examined, just asked to pay a small amount and the doctor would sign and stamp your spravka. 

This was very frustrating because you wasted a day of work or more for a piece of paper that really does not mean anything.

To make matters worse, if you are registered to live in another city, you must obtain a medical record book before obtaining the spravka.  This involves much the same process, but you must see 10 or 11 subspecialists.  Then and only then you return to the gynecologist and dermatologist you just saw to obtain permission to go swimming.  You now take your spravka and visit the internist who can then conclude whether you are healthy or not to go swimming.

Now you could avoid this process by paying an “expediting fee.”  You can easily see how quickly corruption can take a foothold.

Imagine how you would feel if you decide to go through the process legally, then go to the pool and realize the majority of people where not examined and just paid for the spravka to be signed.  Maybe it is healthier not to go swimming!