Travel to Western Ukraine

Part of being of a missionary is being willing to serve and to go whenever and wherever.  Some missionaries are not required to travel much in the countries where they serve while others are continually leaving family and familiar environs to meet, teach, and share with those God has given them the opportunity to serve.

So, when I had the opportunity to travel to western Ukraine this past month and take Marianna along with me, it was a real blessing.  We boarded our train on a Wednesday night in Kyiv and arrived in Ivano-Frankovsk the next morning.  At the train station we were met by Andrei Mikitin who is the director of a rehabilitation center for families dealing with HIV/AIDS.  It is always exciting to learn about what God is doing through other ministries.

Andrei is a man who used to work in the government, but since becoming a Christian in 2004, he has begun an organization/charitable fund called Solidarity (www.solidarity.if.ua).  They publish a small newspaper, paid for by  selling advertisements.  They provide support for programs related to alcoholism and drug use as well as families affected by HIV/AIDS.  Western Ukraine is not as affected by the HIV crisis, but often find themselves underfunded because the  money goes to areas more severely affected.

After we met Andrei’s staff, we were invited to meet with several children who are HIV+.  When one 10-year-old boy arrived, his jaw dropped when he saw me.  “I know you  You are one of the doctors at Okmadet where I was a patient recently.”  I was just as surprised.  This was a good reminder of how God directs our paths providing divine appointments according to His purpose.

Also present was a woman who was gaunt and obviously ill.  During the conversation Jim was able to plant the seeds of the gospel and offer true hope through Christ.  Pray for this woman that she might be one step closer to salvation,  eternal life and healing for her body and soul.

During our brief visit, we discovered several areas of overlapping interest besides the care of HIV+ patients.  These included Biblical counseling, adoption, publishing of Christian books and networking with other Christian organizations in Ukraine.

Our time in Ivano-Frankovsk was short, but very profitable.  In the afternoon we left by bus and headed for Mukatchava to visit Dr. Pavel Orossi and learn about the Christian Clinic he started with the help of the Luke Society.  On the map it looks like a short three-hour trip, but I forgot we were crossing the Carpathian Mountains.  As we crossed the mountains it began to snow.  At one rest stop there appeared to be about six inches of snow on the ground and it was still snowing hard.  Seven hours later we arrived and were taken to the Christian Hotel connected to the Reformed Church of which Pavel is a member.

After a very comfortable night’s sleep and a delicious breakfast we began our time with Dr. Orossi.  We first met him at the UMO conference for young Christian physicians in August 2008 and deepened our relationship with him at the International Christian Medical Dental Association  meetings in Austria.  He is very much interested in encouraging his colleagues, sharing his faith with his patients and developing the International Saline program in Ukraine.

The medical clinic he started in 2000 with the support of the Luke Society is now self-sufficient except for the restoring or the purchasing of major equipment.  By the grace of God they have the most modern clinic I have visited in Ukraine.  They started from the beginning to be committed to excellence in whatever they did because they serve a most excellent God.  Until recently they owned the only CT scanner in the region.  Their mammography equipment is the only functioning unit for a population of 1.2 million people.  They provide in addition a laboratory, several ultrasound machines, endoscopy, culposcopy, EKG and soon EEG examinations.  The most amazing aspect is the whole clinic is paperless.  All medical records, lab results and results of examinations are available on site via computer to all clinic physicians.  This computer program was developed completely by their in-house IT technician.  Truly amazing, since my office in Maryland was not totally paperless.

Next we visited their satellite clinic which serves 8,000 people from 13 villages.  At the clinic we found the same warm atmosphere.  The staff at both locations seemed happy to be at work and showed genuine concern for the patients they were serving.  These clinics were truly being salt and light to the patients and the surrounding communities.  While only the leadership are Christians, they are raising the standard of care in the community and attracting qualified professionals to work at the clinic.

Before we boarded the train to return to Kyiv we were privileged to share a meal with Dr. Pavel, his wife and Dr. Vasyl, his partner.  The food was delicious and the fellowship even sweeter.  At the end of the evening we paused to pray for God to work in the hearts of healthcare professionals and patients throughout Ukraine and his blessing upon the work of the Christian Clinic, UMO and the work we can accomplish together for his kingdom.

The Future of Ukrainian Medicine

For several years we have been praying for God to help us develop relationships with medical students and recent graduates of medical institutes.  We realized the future of medicine in Ukraine will one day be in the hands of the next generation.  Strategically working with this group through evangelization, discipleship and encouragement seems a natural way to transform the lives of these young professionals with the Gospel.  Then they will transform their medical system.

Therefore, when Rostyslav, a young Ukrainian physician we have been praying for and working with for several years, called about two months ago and asked for my assistance in preparing for a medical conference for students and recent graduates in the field of health care, I readily accepted.

One of the many positive things about this conference was the organization was done solely by the Ukrainians themselves from beginning to end.  They did need substantial financial support and still need about $500 to break even.  This is a significant step forward.  Last year our ministry partnered with Intervarsity Christian Fellowship in Ukraine to sponsor and organize what we think was the first such conference of young Christian medical workers.

The theme of this conference was Golden Standards and Christian Values in Modern Medicine.  There were two foreign speakers with the remainder from Ukraine.  There were lectures on evidence-based medicine, how to discern truth from error using the Bible, and what is good medicine.  While the Bible is not a textbook of medicine it does provide unchanging guidelines regarding how to use the knowledge God has allowed us to discover about his creation, us.

Equally important during our time together were the many conversations during the breaks or while walking down the street in the beautiful city of Odessa.  “I learned that the Word of God is unchanging.”  “I didn’t know there were so many other Christian students.”  “I feel stronger knowing we are together.”  “How do I share my faith with my patients?”  “I want to begin a Christian medical fellowship at my school.  How do I do it?”  “We should put God and his Word first because they play a significant and functional role in our daily lives.”  “I learned over the years that  science and technology have changed due to discovery and research but, the Bible still remains the same.”  “We can discover the difference between truth and error by studying the Scripture.”

Indeed, we are seeing God at work through medicine.  Last year we had 35 attendees.  This year we expected 150 and 170 came.  Many are returning to their schools or hospitals with a desire to reach their colleagues and patients and  begin meeting together regularly for encouragement and to learn how to apply the Scripture to the practice of medicine, bringing true hope and healing to those they live with, work with and serve.

Of Death, Medicine and Hope

One week ago my colleague and partner in the practice of pediatrics died after being involved in a horrendous car accident.  There were lots of unanswered questions.  He drove his car into the back of a truck parked on the side of the road.  Did he fall asleep?  Why him?  Why now?  He  did so much good and brought physical healing to so many.  Why?  Why?  Why?

It is never easy to deal with death.  As doctors we are supposed to keep people alive.  Our patients desire and expect us to restore their health and at the very least beat back the specter of death from overcoming them.  In reality, the best a physician can do is delay the inevitable.  Even this gives physicians too much credit, for it is God who enables us to provide physical healing and controls the number of our days.  And yet, those who believe and those who do not ask, why, why, why!

When a doctor dies, we can say, “Look, for all his knowledge of medicine, he could not save himself, therefore, what hope is there for me?”  In the same way Jesus was mocked by the chief priest and elders as He was dying on the cross.  “He saved others,” they said, “but he can’t save himself!  He’s the King of Israel!  Let him come down now from the cross, and we will believe in him.  He trusts in God.  Let God rescue him now if he wants him, for he said, ‘I am the Son of God.’ ” (Matthew 27:41-43)  Why?  Why?  Why?

But this is not the end of the story.  On the third day after Jesus died, he rose from the dead, witnessed by many and remains alive today.  As Jesus said to Thomas, “Because you have seen me, you have believed; blessed are those who have not seen and yet have believed.”

As Christian physicians, we are obligated to do our best and God entrusts us with the truth.  We are reminded daily of our frailty and who is in control.  Why we ask?  So that we may reflect on the condition of our souls and those of our patients’, as well as our need for a Savior.  It is only after believing in Christ and him crucified for our transgressions that we can have true hope and offer it to our patients.  Our sadness will turn to joy knowing the peace that surpasses all understanding will bring healing to our souls and ultimately the restoration of our bodies.

Read 1 Corinthians 15.

Running the Race

In Ukraine, students everywhere are preparing for and taking exams to finish the current year of study.  How can the Word of God be applied to this situation?  In 1Co9:24-25, the Apostle Paul writes, “Do you not know that in a race all the runners run, but only one gets the prize?  Run in such a way as to get the prize.  Everyone who competes in the games goes into strict training.”(NIV translation)

First, we see there are many who want to claim the prize, but what exactly is the prize.  The prize is not only completion of the course of study and graduating to the next year of study.  The prize is how we may bring the most glory and honor to God in the process.  This is also our testimony as believers to a watching world.

Second, how should we run the race God has prepared for us?  We are required to run with integrity.  The world may lie, cheat, steal or bribe in order to get what it desires, but in the end this will not benefit the doctor or the patient.  The patient’s trust will be destroyed.  The doctor’s influence will be greatly diminished.  The healing, both physical and spiritual will be suppressed.  The cause of Christ will not be advanced.

Third, what does being in the competition require of us?  All who participate must be in strict training.  This training requires both time and effort.  One cannot acquire a semester’s worth of knowledge in a couple of weeks of study.  It is the persistent and vigorous pursuit of knowledge that enables one to not only pass the exam but retain the knowledge for use after the exam.

Finally, everyday whether still in school or graduated we are tested.  God provides us with gifts and talents to be used in His service and the means to with stand any test we must face. Therefore, be encouraged to fight the good fight and hold on to faith and a good conscience (1 Tim 1:18-19).  May God bless all students during this time of intense study.

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.  

Reality for Young Ukrainian Physicians

Today I met with Vita, a very bright young Ukrainian physician who just finished his residency a year ago.  Our initial meeting was at the Christian Medical Association of Ukraine annual meeting about two years ago.  Then he was full of excitement for his profession and to serve his God through the practice of medicine.

 As we continued to catch up on what has transpired in each of our lives since then, it became obvious that he no longer practiced the profession it took him so long to learn.  He currently is the sales manager for a company dealing with dialysis machines.

I could not help wondering why this intelligent young doctor had to throw in the towel so early in his career.  He said, “It is impossible to make a living as a Christian doctor.”  He went on to describe how the paperwork was going to kill him.  The salary just did not allow him to support his family.  He just got married 2 1/2 months ago.

He was not complaining of the amount of paperwork even though everything is hand written but about being able to write the truth about his patients and their diagnoses.  Once again it was an issue of trust.  He said as a physician he does not know why any one would go to a doctor in this country.  In addition, he said the state of technology in this country does not enable you to make a diagnosis with any reliability.

The reality for young Ukrainian physicians is in this current system it does not take long before they just stop caring.

What is the answer?  Building Christian clinics and hospitals, evangelizing and discipling  health care professionals, modeling compassionate and competent care are all part of the solution.  I pray to God how long must your people suffer.

Sacred Trust

Being a physician in any culture means having a certain level of competence and the desire to look after the best interests of your patient.  Recently I was asked to assist in obtaining care for a 10 year old boy who electrocuted himself after grabbing onto a power-line.

 This young boy’s leg had to be amputated and there was concern his arm would require the same procedure as well.  After several clicks of the mouse a telephone number for a burn institute was obtained.  By this connection, Ukrainian doctors where able to discuss the treatment of this young boy with their American counterparts providing an international consultation.

The main concern for the parents of this young boy was whether or not he was receiving the correct treatment in addition to whether the treatment being prescribed was for financial gain.  How difficult to wonder whether you can trust the advise of your physician.

In Biblical times till most recently, people went to the priest or rabbi for teaching regarding health care.  There was a sacred trust rooted in the authority of God and mediated through the priests to do the right thing.  Medicine is a parable of the gospel, maybe more than any other profession, although separated by the world currently from theology.  Therefore, as noted in Hebrews 3:1, My brethren, let not many of you become teachers, knowing that we shall receive a stricter judgement.

As physicians let us not break this sacred trust with our patients so they may believe in our advise, providing care that is competent, compassionate, and Christ-like.

How to treat your patient!

Thomas Syndenham(1624-1689), a famous English Christian physician known for his work in describing the illnesses associated with Group A Streptococcal infections, described the proper role of physician’s regarding the care of their patients. 

Quote: It becomes every person who purposes to give himself to the care of others, seriously to consider the four following things: First, that he must one day give and account to the Supreme Judge of all the lives entrusted to his care.  Second, that all his skill and knowledge and energy, as they have been given him by God, so they should be exercised for His glory and the good of mankind, and not for mere gain or ambition.  Third, and not more beautifully than truly, let him reflect that he has undertaken the  care of no mean creature; for , in order that he may estimate the value, the greatness of the human race, the only begotten son of God became himself a man, and thus ennobled it with His divine dignity, and far more than this, died to redeem it.  And fourth, that the doctor being himself a mortal human being, should be diligent and tender in relieving his suffering patients, inasmuch as he himself must one day be a like sufferer.