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.

Being Available

Much of life, I am convinced is just a matter of showing up and being available.  Recently a fellow missionary in Ukraine asked me to participate in a conference for business people.  The conference was about using the Ten Commandments to develop a personal code of ethics when dealing with employees, colleagues, customers and government officials.  My first reaction was this really does not pertain to me.  I have an extremely busy month ahead in our own ministry.  What would I have to offer?  The presenters said there are always questions about medicine and my participation would provide first hand knowledge.  Eventually and reluctantly I said “Yes.”  In addition I agreed to host one of  one the couples in our flat.

The weekend course turned out to be very useful and applicable to the practice of medicine and me personally.  Many young Ukrainian physicians dream of opening their own clinics.  But, on what principles will they build their practice?  The course helped me prepare for a conference for medical students later in the month with the title, Golden Standards and Biblical Principles in Medicine.  What better standard to use than the Ten Commandments!

The couple we hosted, Tom and Ann Tannery, were extremely encouraging.  Tom owns his own business in Atlanta and is president of a ministry called Europartners.   They both have quite a testimony of how God reconciled them to himself.  The time of fellowship we enjoyed with them was just what the doctor needed.  It is always interesting how God puts people in our paths to instruct, rebuke, correct and train  if we are willing to submit to another’s authority.

During the conference I was able to make new friendships and renew some old ones.  In the end, there was not one question asked that pertained directly to medicine, but my wife and I were blessed for being available in so many other ways.

Attitude and Service

Not many of us get to make some great contribution to medicine like Dr’s. Warren and Marshall in this month’s devotion.   But everyday we can to do something in the service of our God that will have meaning for eternity in someone’s life.   Now that is significant in the eyes of God.  Are you willing to be used by God for this purpose?

We pray God may give us understanding of his purpose for medicine to care for the physically dying and offer hope for the spiritually dead.

Enjoy this month’s devotional from The Doctor’s Life Support published by the International Christian Medical Dental Association.

Your attitude should be the same as that of Christ Jesus: Who, being in the very nature of God, did not consider equality with God something to be grasped, but made himself nothing, taking the very nature of a servant, being made in human likeness.  And being found in appearance as a man, he humbled himself and became obedient to death – even death on a cross!  Therefore God exalted him to the highest place and gave him the name that is above every name, that at the name of Jesus every knee should bow, in heaven and on earth and under the earth, and every tongue confess that Jesus Christ is Lord, to the glory of God the Father. Phil 2:5-11

In 1982, the Australian pathologists, Dr. Robin Warren and Dr. Barry Marshall identified Helicobacter pylori    as causing gastritis and gastric ulcers.  How they confirmed that the organism was the cause of suffering for millions worldwide, is an example of how we can relate as Christians to healthcare and life.

Firstly, Dr. Warren did not take things at face value, nor did he accept the teaching of his predecessors as written in stone.  He raised new hypotheses to explain what he was observing.  As Christians we need to be prepared to practice from a new paradigm, a paradigm which places importance on faith and prayer in a world where Jesus Christ reigns as LORD.  We need to try and incorporate what we observe into our Christian worldview of medicine.

Secondly, Dr. Marshall, by ingesting the bacteria, committed himself to becoming an infected patient from whom biopsies were taken and the pathogens re-isolated.  He took on the condition he was trying to cure.  As a result of this, a cure for the disease was found.  This is a mild reflection of the fact that our God was prepared to become a human in the form of Jesus Christ.  He took on our human condition and experienced grief, temptation and pain.  However, as a result of his perfect life of obedience and death on the cross, a cure for the world’s most serious ailment, SIN, was achieved.

Dr. Marshall’s gastritis settled in 10-14 days.  In contrast, Jesus endured the ultimate in human suffering some 2000 years ago.  Yes, he died, but rose again and is alive today.  What is more, Jesus is alive in us now as we trust and believe him.  With him we live lives which can resist sin.

Saying “Good-Bye”

Every missionary arrives at that day when he and his family find themselves standing before their home church for the last time before heading to the field God has called them to till.  That day was filled with so many emotions, excitement, sadness, joy and uncertain expectation.  I remember clearly our Pastor’s charge from Romans 12:9-21, the elders gathering around and praying and those last hugs and goodbyes from dear friends.

So off we went to Ukraine with our eighteen year old daughters and sixteen your old son.  Few mission boards would risk sending this couple in mid-life to the field.  How would our teenagers cope?  Would they even adapt to life in a foreign country?

Now we fast forward seven years.  Today we again find ourselves in our home church but in Ukraine, however only our son and his wife stand before the congregation to receive blessings and prayer before they leave for America.   Our son, who was reluctant to move to Ukraine, has mastered the Russian language, graduated from the Tchaikovsky Conservatory of Music, became skillful at playing the vibrofone, married a beautiful Ukrainian young woman at age 20, worked for the National Philarmonic Orchestra of Ukraine and has led praise music at our church.  Now in just two weeks, at age 23, he will begin study at the Berklee College of Music in Boston.

Once again my heart is filled with so many emotions.  As a father the emotion I feel the most is joy in the blessing of a son who has become a man who knows and fears God.  Our desire with all our children was to teach them to be independent, to think, to make decisions based on the Word of God and be caring others oriented adults.  We wanted them to understand God created them for a purpose and gave them gifts and  talents to use in His service and the service of others.  As Jamie played and Dasha sang for the last time in Kiev for awhile and listening to our pastor speak for the congregation about their service to our church, we know God enabled us to succeed and answered our prayers.

So now we stand in the congregation of our Ukrainian church, praying for God to continue to be at the center of their lives.  As our American church sent us, our Ukrainian church sends them back to America.  We remain continuing to till the field God has prepared for us and we eagerly look forward to learn what God has prepared for them.  We say “goodbye” knowing God has been and will be faithful.

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. 

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.  

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.

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.

Communication

It truly is amazing how much one can communicate without the spoken word.  Living in a foreign country now for six years, I am able to do the basics, ie. buy food without saying a word.  But what about issues of real importance that involve both physical and spiritual understanding.  You can communicate emotions such as compassion, sadness, anger, love and caring as well without a word spoken.

 But imagine caring for a patient during a cardiac arrest and not being able to order medicines in the proper doses.  Or trying to share God’s plan of salvation without words.  Understanding in these stituations is critical.

Today I visited the children’s hospital where my wife ministers to young children who are HIV positive.  We have been visiting this hospital for the past three years, but today was the first time I was able to converse with the head doctor about medical topics.  This was a significant step in my relationship with this doctor which eventually will lead to my personally sharing the Gospel with him. 

He already knows we care because he has observed us.  Now he knows he can ask me a question and I am able to answer him in his language.

May God continue to enable us to communicate in both verbal and non-verbal ways to the physically dying and spiritually dead, the hope that comes only from understanding who we are and the hope found only in the person of Jesus Christ.

In the beginning….

A humerous look at how the medical community might look at the book of Genesis.

In the beginning, God created the Heavens and the Earth and populated the Earth with broccoli, cauliflower, spinach, green and yellow and red vegetables of all kinds, so Man and Woman would live long and healthy lives.  Then using God’s great gifts, Satan created Ben and Jerry’s Ice Cream and Krispy Creme Donuts.   And Satan said, “You want chocolate with that?”   And Man said, “Yes!” and Woman said,  “and as long as you’re at it,  add some sprinkles.”  And they gained 10 pounds.  And Satan smiled.  And God created the healthful yogurt that Woman might keep the figure that Man found so fair.  And Satan brought forth white flour from the wheat, and sugar from the cane and combined them.  And Woman went from size 6 to size 14.  So God said, “Try my fresh green salad.”   And Satan presented Thousand-Island Dressing, buttery croutons, and garlic toast on the side.   And Man and Woman unfastened their belts following the repast.  God then said, “I have sent you heart healthy vegetables, and olive oil in which to cook them.”  And Satan brought forth deep fried fish and chicken-fried steak so big it needed its own platter.  And Man gained more weight and his cholesterol went through the roof.  God then created a light, fluffy white cake, named it  ”AngelFood Cake,”  and said, “It is good.”  Satan then created chocolate cake and named it “Devil’s Food.”  God then brought forth running shoes so that His children might lose those extra pounds.  And Satan gave cable TV with a remote control so Man would not have to toil changing the channels.   And Man and Woman laughed and cried before the flickering blue light and gained pounds.  Then God brought forth the potato, naturally low in fat and brimming with nutrition.  And Satan peeled off the healthful skin and sliced the starchy center into chips and deep-fried them.  And Man gained pounds.  God then gave lean beef so that Man might consume fewer calories and still satisfy his appetite.  And Satan created McDonald’s and its 99-cent double cheeseburger.  Then said, “You want fries with that?”  And Man replied, “Yes! And super size them!”  And Satan said, “It is good.”  And Man went into cardiac arrest.  God sighed and created quadruple bypass surgery.  Then Satan created HMOs.