Taking a lesson from impoverished nations

Photo Credit: Lwala Community Alliance

Photo Credit: Lwala Community Alliance

Siloam’s Community Health Immersion students worked to train refugee lay health workers for a more effective outreach to the refugee families in Nashville.  This work drew much of its inspiration from successful community health worker programs found in impoverished nations.

In a guest blog at Huffington Post, comments made by James Nardella (Lwala Community Alliance) resonate with our experience here in Nashville.

James writes:  “Scale and efficiency are important to moving health care goods and services….  But, when it comes to addressing the root causes for poor health in many places, scale can be a distraction. Delivering goods and services alone will not motivate people toward health seeking behavior.”  James goes on to point out that, “…health-seeking decisions are made at the family level.”

Read the full post of James’ excellent blog Heirloom Healthcare for the Poor by clicking here.

Lay health workers trained by Siloam students

“I‘m too much glad to see you because you are Nepali.” Greetings like this one from a Nepali man bring joy to 19-year old Anita Nepal who loves helping people in the Nepalese community of Nashville.  Anita, born in a refugee camp in Nepal to Bhutanese parents, was recently trained as a lay health worker by pre-medical students participating in Siloam’s Community Health Immersion program. Nashville’s Nepali community – mostly made up of refugees from Nepal and Bhutan – appreciate the cross-cultural understanding that Anita brings as she teaches within her community on the health topics she recently learned.

“Many of the Nepali people do not understand the health care system in America,” says Anita who works full-time in housekeeping at a local hospital. They struggle to know how to make appointments to see a doctor or how to get medicine from a pharmacy because as Anita says, “… in Nepal there were no appointments or prescriptions…you just show up and ask for what you need.”

“I learned many things – I can help many…”

For Siloam’s six-week Community Health Immersion program, pre-medical students were recruited from around the country to live in a refugee apartment complex in southeast Nashville where they trained nine lay health workers like Anita from the neighborhood. Training topics included preventative care like oral health, nutrition, and exercise, along with health navigation topics like how insurance works and the difference between an emergency room and a primary care clinic. Beyond learning how to teach lay health workers, the pre-medical students also explored how to see the vocation of medicine as a calling and to see how to care for patients as whole persons as Jesus did.

The pre-medical students’ work with the lay health workers is making a lasting impact.  The oral health topic alone made an immediate impact on Anita’s family of five who were resettled a year ago in Nashville after spending 21 years in a refugee camp in Nepal. “We did not know about dental floss or how many times each day to brush our teeth or for how long,” Anita says. “Now we do. I learned many things – I can help many Nepali and Bhutanese people.”

Lay Health Workers and CHI Students pose outside their apartment - 2014 - cropped

Pre-medical students and lay health workers pose outside following a training session. Lay health workers include (L-R) Samson Sarki from Bhutan (in turquoise), Paulos Ezekiel from Eritrea (in purple), and Anita Nepal from Nepal (in blue and red). Pre-medical students (L-R back row) include Will Davies, Stewart Goodwin, Kenny Namkoong, Frances Cobb, Caleb Huber, Will Tucker, along with Reinie Thomas (kneeling), and Lauren Roddy (in blue on right). Pre-medical student Chelsea Travis is behind the lens!

It has to mean something…right?

Sandals - follow me - httpclub.dx.comforumsforums.dxthreadid.1249031As I think about the theme, “Come and see,” used for Siloam’s Community Health Immersion program, I am struck by what it means to be a follower of Jesus.  It is a journey more than a destination.  The Siloam Institute’s work with students and residents is largely to teach them to embrace the journey as they become practitioners of whole-person care.  

Below, I share an insightful reflection on John 1: (29-34) 35-42 by Reverend Chris Adams.

Chris writes…
Many years ago a friend taught me an interesting statistic about two words in our Bible.  Many of us call ourselves Christians to describe our faith.  We use this term with those we share faith with and also we use this term with others who do not.  The word Christian in Greek, Χριστιανός, only occurs in all the New Testament three (3) times.  That’s it.  Just three.

However, the word we see for the first time in John’s gospel today, in Greek μαθητής, occurs two hundred sixty three (263) times in the New Testament.  That’s a lot more than three.  For my friend, this had great significance.  “It has to mean something… Right?” he would say.

The word disciple means to follow, as in a pupil with a teacher.  It’s an action word.  In the ancient near east, often a disciple would literally walk so closely behind their teacher that the dust from the teacher’s sandals would get on the disciple.  Hence the reference to that by Jesus.  A Christian is simple a descriptor, a designation that one follows the faith so named.  The words are clearly related, but there is not the same sense of action.

In today’s lesson there is the urging of Jesus to “Come and See…”  If the disciples want to see what Jesus is doing and what he teaches, they must come and see.  There is no sense, at least in this story, that they will ever arrive at a destination or achieve a certain position of status.  They will simply be disciples, those that walk closely behind Jesus and follow wherever He goes.  They will become known as Christians to the world.

We too are known in that way.  However, I wonder if calling ourselves disciples instead of Christians sometimes would be more helpful to describe our way of life?  Ours is a journey, not a destination.  Our way is to follow our teacher, to seek out what the teacher is doing pointing others to Him.  Our way is not to be the teacher.  Our place is behind Jesus and not in front of Him.

It’s just two words that mean similar things to most people.  However perhaps the difference has great significance.  “It has to mean something…  Right?”

More on Reverend Chris Adams can be found at: www.pastorchrisadams.com 

 

Off with a bang!

It has been quiet this week since our nine CHI participants (7 pre-meds and 2 directors) left town after spending an exciting six-weeks with us on a Community Health Immersion.  As we celebrate our nation’s independence this weekend, let’s also celebrate the ministry of presence that our freedoms allow us to carry out.  Check out this video that the students put together as a celebration of how God is moving in their lives as they prepare to be future physicians:

Commissioned to go!

The last evening of the Community Health Immersion the students were anointed with oil and commissioned with a blessing to allow their study of medicine to reflect the healing love of Jesus.

Dr. Morgan Wills anoints the CHI students for service in Jesus name.

Dr. Morgan Wills anoints the CHI students for service in Jesus name.

Chelsea Travis, Stewart Goodwin, and Will Tucker receive a blessing.

Chelsea Travis, Stewart Goodwin, and Will Tucker receive a blessing.

Frances Cobb is anointed and blessing is prayed over her.

Frances Cobb is anointed and a blessing is prayed over her.

How Deeply Can You Be Immersed?

Guest blogger Chelsea Travis, one of seven students in this summer’s Community Health Immersion, writes…

Living here in the Highlands Apartments, surrounded by a community of refugees and low-income neighbors, and being a part of an immersion-promoting program – I wonder are we truly immersed? Most would say yes, and I believe that would probably only be 60% right. In some ways, we are immersed. We are living in the same environment as the residents here which include: loud honking car noises at night, a “coins only” laundry mat, new and sometimes reckless drivers riding through the neighborhood, an always occupied soccer field, beautiful rose bushes, roaches, and very active ethnically diverse neighbors and children.

Neighbor children know that fun and attention await them just on the other side of the CHI students' back door.

Neighbor children know that fun and attention await them just on the other side of the CHI students’ back door.

Although we live here, many of us have things that most of these refugees do not. These aren’t simply tangible material items like cars, laptops, smartphones, an installed washer and dryer, or nice business clothes – of which we so often take for granted – but it’s even more than that. It is intangibles like nearby family, education, the ability to speak English with an American accent, our western clothes, and an established, if not assumed, reputation.

Having family nearby, even if they are 600 miles away, is such a great asset especially when compared to family members of refugees who could be thousands of miles away. Since starting this program I have received 2 packages from close family and friends back home that have been so beneficial to me. I cannot imagine not being able to draw from that life line of support because my family is either still in my war-torn country or they are scattered in various places around the world.

We often take for granted our educational experience as well. In this country the expectation is that people, especially young adults, attend college and even some schooling beyond that. The refugees whom we come in contact with actually have an array of educational backgrounds. Some have learned in educational institutions, some were apprentices of their parents or grandparents, and some have simply learned from the school of life.

Overall, it is interesting how education affects a person’s ability to adapt to new situations. It seems that individuals who have been challenged academically or have been conditioned to exercise their intellectual skills (even if only up to the high school level) are more able to adapt and learn new languages and systems. We don’t realize how valuable our education is. If we understood that not everyone in the world is afforded the opportunity to obtain even a high school education, we would not complain and be lazy about classwork, reading assignments, papers, or skill-granting liberal arts classes because we think we “don’t need” that coursework. Foolishness.

Highlands Kids 2 (Chelsea Travis blog)

Chelsea Travis, a recent graduate from the University of North Carolina’s pre-medical program, poses with refugee children in the neighborhood.

Also the fact that we speak English fluently and with clear American accents and wear Western (American) clothing makes us less immersed when compared to the realities of our neighbors. Just the very fact that we possess these attributes causes us to obtain more respect, trust, or even assumed positive reputations. Without anyone really knowing us we probably could receive a loan, purchase a car, or get better job opportunities than our immigrant and refugee neighbors of comparable abilities. This is in part because when people do not adequately speak the dominant language of a society that person’s intellectual abilities are often assumed to be low. These judgments are too often made without even knowing the past professions and careers many of these refugees held in their former home countries – I’ve met former doctors, professors, and innovators.

One thing many of these refugees do have that I wish I could be further immersed in is their drive to survive and to thrive. They are so strong, enduring, humble, and passionate people. They want a better life for themselves, for their families, and for their home countries. I attended an English class being taught by and for Burmese people who wanted to take their U.S. citizenship exam. There were several young women present at this class – one had a baby tied on her back, another nursing a baby in her lap, and two with babies on the couch, and one child playing outside – and they were still so engaged in the class, flipping through their notes and answering questions. I was so inspired! They wanted this English lesson so badly they were not going to let anything distract them. Glory to God what a poignant lesson for my own life!

With everything that a refugee has endured throughout their lives including: wars, persecution, discrimination, and genocide, we will never be truly immersed enough to understand life in their shoes.

 

 

Helping Without Hurting

Guest blogger Lauren Roddy, one of seven students in this summer’s Community Health Immersion, writes…

35 For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, 36 I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.”

These verses from Matthew 25 are just one example of how we, as Christians, are explicitly called to care for and minister to the poor.  The participants in this year’s CHI Program and the staff at Siloam are seeking to answer this call, but what if our best efforts to help are actually hurting those in poverty?  What if our desires to be the hands and feet of God are preventing others from doing the same?

“What if our efforts are hurting those in poverty?”

The CHI Program, in addition to providing opportunities to shadow Siloam staff and directly engage in community outreach, has several settings in which the students can begin to discern what their future service in medicine will look like.  One such forum is a 6-week small group study on the book When Helping Hurts by Steve Corbett and Brian Fikkert.  The book offers a framework for rethinking not only how we address the needs related to poverty but also to redefine the term completely.

Instead of thinking about poverty in terms of a lack of material wealth, When Helping Hurts challenges us to think of it as a product of broken relationships – with our own being, others, God, and the rest of Creation.  Therefore, true poverty alleviation is a process in which both the materially poor and non-poor work together to rectify each of our broken relationships.  The goal, therefore, of working with the materially poor is to reconcile these foundational relationships and in such a way that all are empowered to perform the work in God’s kingdom that they are meant to do.

What good is relief if we’ve crushed the confidence

needed for true development?

Those of you not familiar with these concepts may be shocked to hear phrases like “our poverty” and “our broken relationships”, but through this process, I’ve learned to recognize the places in my own life where relationships have been broken.  When Helping Hurts advocates for poverty alleviation that focuses on building on the God-given assets already present within individuals and communities.  In my own life, I often am afraid to “brag” about my assets, talents, and ideas, and as a result, fail to fully achieve what I am made to do.  Imagine how much more debilitating that fear must be for someone who has been made to feel as though their lack of material wealth makes them worthless.  To then tell this person that we have all of the answers to fixing their poverty strips them of the already limited power they have.  What good is relief if we’ve crushed the confidence needed for true development?

Lauren Roddy is a rising junior in the pre-medical program at Baylor University in Texas.

Lauren Roddy is a rising junior in the pre-medical program at Baylor University in Texas.

Framing poverty in terms of relationships just makes sense to me now.  Not only do we belong to a relational God, but medicine is also such a relational field.  Our primary focus should always be on the empowerment of our patients.  A piece of this certainly is restoring physical health, but helping others (and ourselves) feel empowered and purposeful is how real growth occurs.  I hope that my friends and family will consider reading the book, engaging in conversation with me about these ideas, and holding me accountable to living this out!

“Share the gospel at all times, and when necessary, use words.”

– St. Francis of Assisi