The Test of Faith, A Missionary Journey

Hours of prayer and many small steps of faith over the past several years led up to the recent conference for Christian medical students and young doctors in Ukraine.  Often missionaries say, “What I thought I was going to do changed after our arrival on the mission field.”  Transforming the medical culture of Ukraine through medical students was not our initial plan.  As time passed God opened more and more doors with Christian medical students thirsting for direction regarding how they could express their faith and encourage one another.

Some of these doors were seemingly random opportunities to connect with students and young doctors, but in retrospect we can clearly see the hand of God preparing the way.  Every connection is important and provided the necessary links between different denominations, different cities, and different organizations that literally span the world that resulted in a successful conference.

These connections came from a willingness to meet with someone not knowing if or when there would ever be any possibility of cooperation.  Meeting with someone not knowing if I could clearly communicate with them.  Or maybe traveling somewhere that took me out of my comfort zone – riding on a bus or train not knowing all the details of knowing where I was going.  All these were small steps of faith and trust in what was not seen.

Our first trip to Ukraine was to Belgorod-Dinestrovski in 1999.  I met a pediatrician with a daughter.  This daughter now attends the Crimean State Medical Institution.  She came to the conference.

In the fall of 2006 Marianna met a woman at a retreat for Christian missionaries living in Ukraine.  This resulted in the presentation of the Saline Solution program to teach doctors how to share their faith in a city called Burdansk.  At this conference I met Rostyslav who Introduced me to James Tomlinson, an Englishman, who is the director of the Eurasian Region of the International Christian Medical Dental Association.  He in turn put me in touch with Dennis Gorenko, co-director of Intervarsity Christian Fellowship of Ukraine.  Also two students from Burdansk came to the conference.  

So in the Spring of 2006 I attended the Christian Medical Association of Ukraine’s annual meeting in Rivne.  There I met some young doctors from Chernivtsi.  In October of the same year  Ukraine Medical Outreach partnered with Caring Partners International to sponser a conference in Lutsk to teach how to develop an Early Intervention Program for children with disabilities.  A speech pathologist in Chernivtsi heard of this conference, found how to contact me and asked if I would hold a conference there.  We held a conference there on autism, an introduction to Biblical counseling and an introduction to Biblical healthcare in the Spring of 2007.  There were 8 students and young doctors from Chernivtsi at the conference as a result.

All of these were thin but vital threads God was weaving into a still not completed tapestry, yet more opportunities to trust in God.  In January of 2008 I met with Dennis Gorenko.  We developed a budget based on 65 people attending the conference including staff. Based on this educated guess, we determined how much money we would need to raise. Amazingly one Church responded with the whole sum.

About five weeks before the conference we learned the cost of the conference almost doubled due to the decreased value of the dollar and an inflation rate in Ukraine of almost 30%. Then we learned the two main speakers for the conference could not come, one from Belarus and one from Russia.  Next my assistant resigned to return home to care for her sick grandmother.

Events were rapidly spinning out of control.  I began to realize we planned in faith, but God planned from complete foreknowledge.  He knew exactly how much money we would need because He knew how many would attend.  One by one God provided for each of the challenges I faced.  The solutions did not depend upon my ability, but upon God’s.  He gave me the desire to make contacts within the Ukrainian medical system and now He was using these circumstances to increase my faith in Him.  He provided sufficient funds to meet all our needs.  He provided for two speakers from Lithuania plus the non-budgeted money to get them to Kyiv. 

Now we are looking at the possibility of a winter conference and several regional conferences.  Our only desire was to glorify God through medical ministry.  When we began we did not know what would happen or how it would happen, but now we clearly see the hand of God at work.

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!

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.

House Calls

It is often difficult for young mothers in Ukraine whether they are nationals or foreigners.  Often I receive a call for medical advise to just help people through the medical system in Ukraine.  A young missionary family e-mailed me two days ago to ask for help.  Their nine month old was ill with respiratory distress, they had already seen five different doctors and still were not certain what was wrong with their child and if he was receiving the correct treatment.  Now they would like me to come to their apartment to examine their child.

The story started at the beginning of the week when the child developed a cough and a fever.  The child’s condition became progressively worse through out the day.  They called for a doctor who administered an injection and said she would return later in the day to check on the little boy.  If he was no better he would have to be admitted to the hospital.  The doctor did not say what was wrong with the child but left just after writing six precriptions.

As the day progressed the child became worse.  The parents were now faced with the decision of where to have their son admitted.  They took him to a private clinic called Boris.  They agreed the child needed to be admitted but would not admit him to the private hospital because he had diarrhea.

Well the child eventually was admitted to a government hospital for one night, but the parents took him home the next day because they thought their child was being treated no differently than what they were doing at home.

The child seemed to have a combination of acute asthma and croup.  Fortunately, by the time I examined the child he had significantly improved.  Thank you God for designing our bodies to be able to cope with many illnesses despite our attempts to practice medicine.  In Ukraine, nebulizers are not routinely available.  Albuterol and racemic epinephrine are not available at all. 

What pediatric visit would be complete without a plethora of questions from the mom.  This visit was no different.  The questions however concerned information regarding drafts, wearing slippers, and not going outside.  Apparently, one of the doctors who came to the apartment from the polyclinic would holler at the mom for not taking care of her child properly blaming her for why the child was ill.

After seeing the first child the parents asked if I would not mind examining there other two children.  This is not uncommon for pediatricians in America as well.  The twist came when they asked if I would also see two other children belonging to couple who were friends of the parents from two buildings down the street.

What initially began as a 45 minute visit turned into a marathon.  What we are trying to model to health care workers is how to build trust in their patients by providing consistent accurate information based on fact instead of superstition or tradition and to abandon their blind authoritative approach to delivering care.

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.