Chronic vs Crisis

I wrote a post on short-term missions that wasn’t super helpful. It explained a problem without even starting to talk about solution(s). That’s not the way I like to do things.

One solution can be found in the “Chronic vs Crisis” discussion. One way to determine if relief work is necessary (as most short-term mission trips are), is by asking the question, “Is this situation a crisis or is it chronic?”

A crisis is usually caused by a natural disaster, a war, or some other act of God that cannot be predicted. After the earthquake in Haiti, it’s perfectly appropriate that organizations went there with airplanes full of food and medical supplies to hand out. Like I’ve said before, if someone is about to drown, it’s not a good time to teach them how to swim; just pull them out of the water.

What probably isn’t appropriate, however, is that years later some of those same organizations are still handing out food and medical supplies without any local involvement or ownership.

Chronic is everything that isn’t a crisis. Normal life. Every day. Most poverty around the world is chronic poverty and although it’s getting better it’s been around a long time and probably won’t be going away tomorrow (though I still believe it could go away in our lifetime).

The solution to a crisis is immediate relief.  The solution to a chronic problem is long-term development.

If you try to do development during a crisis, people will die. If you try to do relief work in a community with chronic poverty, you’ll be reinforcing their poverty.

It’s crucial that we understand the difference between the two and implement solutions that are fitting.

Book Review: The Hole In Our Gospel

hole in our gospel

The President of World Vision, Richard Stearns, has written a book about what he calls a missing piece of western (mostly American) Christianity. If one quote can sum up the book it’s this:

“…being a christian requires much more than just having a personal and transforming relationship with God. It also entails a public and transforming relationship with the world.”

This is what he calls The Hole In Our Gospel. He’s referring mostly to poverty and international humanitarian aid.

It’s an incredibly inspiring book. If “how-to” is a genre of literature, this book is across the room on the “why-to” shelf. It really makes you want to get up and do something about the poor conditions that the vast majority of people actually live in every day.

PROS:

Like I said before, this book is very inspirational. Some of the stats are incredibly eye-opening. He writes a great story. The message is general enough for almost all Christians. His message really seems to be coming from a place of true authenticity.

CONS:

It’s not very helpful if you’re looking for a “how-to” book. He touches on how harmful pure hand-outs can be, but doesn’t make the point clear enough.

FAVORITE QUOTES:

Focusing almost exclusively on the afterlife reduces the importance of what God expects of us in this life.

If we truly love God, [Jesus] was saying, we will express it by loving our neighbors, and when we truly love our neighbors, it expresses our love for God. The two loves are fully interconnected and intertwined.

God does not call the equipped, he equips the called.

Almost all poverty is fundamentally the result of a lack of options.

Frankly, giving things to the poor does much more to make the giver feel good than it does to fundamentally address and improve the condition of those in need.

We must never see poverty or justice as “issues” that need solutions; rather we must see the human beings at the heart of those issues as people who need and deserve our love and respect.

The total income of American churchgoers is $5.2 trillion. It would take just a little over 1 percent of the income of American Christians to lift the poorest one billion people in the world out of extreme poverty.

Universal primary education for children would cost just $6 billion; the cost to bring clean water to most of the world’s poor, an estimated $9 billion; and basic health and nutrition for everyone in the world, $13 billion.

We have reduced the gospel to a mere transaction involving the right beliefs rather than seeing in it the power to change the world.

Having Fun

I wrote this post while sitting at a park under a shade tree. A few minutes before being at the park, I was sitting in my house talking about how beautiful it was outside.

So we walked to the park near our house.

I started thinking about how easy it was for us to walk 5 minutes to the park near our house, lay out a blanket, and just enjoy the weather. Then I started to think about a previous post about how rain falls on the rich and the poor. The flip side to that is that good weather can be enjoyed by the rich and the poor alike. From there, my brain started to wonder what people living in material poverty do to enjoy the weather.

I took the picture below when we went with some friends to an abandoned boat dock in Mexico. People would wait for the tide to be just right and then spend the afternoon jumping in, climbing out, and doing it again and again.

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The next picture I took while I was waiting for the ferry to take us back from the island of Ometepe on Lake Nicaragua. A group of kids would climb up the rope anchoring the boat, hang there for a minute, and then swing off into the lake.

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This last picture is also from Nicaragua. Some kids were hanging out in the street taking turns jumping rope.

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It’s such a simple idea, but for some reason watching people actually enjoy themselves is incredibly inspiring. I want to start scouring the interwebs for pictures of people all around the world having fun (for free).

IWMC: Terry Dalrymple

Terry currently serves as Coordinator of the Global CHE Network and as Vice President of the Alliance for Transformational Ministry. He provides leadership to a growing movement, equipping and mobilizing Christians to work together for effective Community Health Evangelism (CHE) ministries in rural poor communities and urban slums around the world.After a decade of service in the Philippines, Terry pioneered for Medical Ambassadors in 9 countries in Southeast Asia, working together with partners to establish CHE ministries in more than 400 communities. Later as International Coordinator he guided the expansion of a growing movement that now involves more than 500 organizations serving more than 4000 communities in 118 countries.

Below are my notes from his talk entitled, “Helping Without Hurting.”

Keys to helping without hurting:

Dignity | Integration | Local Ownership | People Before Projects | Multiplication

Dignity – Recovery of our identity and vocation

  • We are all people made in the image of God.
  • We are all stewards of resources, not victims of circumstances.
    • Feeling like a victim creates hopelessness, passivity, and fatalistic thinking
  • If we are going to alleviate poverty, we have to see everyone as stewards made in God’s image.
  • When we go with the intention of fixing people:
    • For the people we are fixing, we are reinforcing a victim mentality.
    • If we think we are going to do the fixing, we are reinforcing our own god-complex.
  • Community health workers must see beyond the need
  • Different kinds of relationships between the poor and non-poor:
    • The cow and the milker
    • The horse and the rider
    • Mutually transforming – two oxen yoked equally together

Integration – working across the disciplines

  • Good health is harmony with God, self, others, and the rest of creation.
  • Complex problems require integrated solutions
  • Solutions are not just within the disciplines, they are across them.
  • The western education system teaches us there are one-dimensional solutions to every problem.
  • Integrated solutions require multi-disciplined approaches.
  • Integration begins with me. Following jesus requires complete obedience to everything he commanded.
  • We are not calling for simple solutions, we are calling for greater commitment.
  • Example:
    • In the Philippines the government had been trying for 20 years to convince people to use latrines with little luck (3% compliance). A government official explained a common belief in the area: evil spirits live in human waste and in dark corners. When you build a latrine, you were basically building a house for the evil spirits to live in. No wonder no one wanted to go in there! After a few months of integrated community development (following the CHE model), there was a significant difference in the latrines. Now they were maintained well and there were even landscaped paths to each one. The same government official explained that just after a few months they were experience 100% compliance and the whole community was healthier. This problem would still exist without integrated solutions that were multi-disciplined. It was a physical problem with a spiritual root.

Local Ownership – Locals are subjects rather than objects of development.

  • Sustainable programs are owned by the people and built on local initiative.
  • Ownership in demonstrated through volunteerism and strengthened through capacity building.
  • Communities should be guiding their own development process.

People before projects – Building capacity instead of delivering services.

Multiplication – Making movements rather than managing projects.

  • We have to go beyond sustainable.
  • Focus on simple and transferable concepts.
  • Maximize local resources.
  • Solutions should be passed along from neighbor to neighbor.

Some ways to measure this kind of development work:

  • Shared vision – the community sees a better future and has hope it can be achieved.
  • Leadership – Godly Christian leaders are equipped and position to lead.
  • Ownership – People are taking responsibility for their own health.
  • Cooperation – People are united and working together for the common good.
  • Volunteers – Significant numbers of people are taking initiative and acting sacrificially to meet the legitimate needs of others.
  • Dignity – People have recovered their identify as made in the image of God.

IWMC: Brian Fikkert

Today, the International Wholistic Missions Conference started. I’ll be posting notes from the sessions I attend over the next few days.

Dr. Brian Fikkert is a professor of Economics and Community Development at Covenant College. He has a Ph.D. from Yale University, specializing in international economics and economic development. He has been a consultant to the World Bank and is the author of numerous articles and the book When Helping Hurts.

The following are notes I took during his talk titled, “When Helping Hurts.”

How do you define poverty? How we define poverty determines the solutions we choose for alleviation. Misdiagnosing the problem can result in not getting better or worse, devastation. If I go to the doctor with a headache and he gives me tylenol again and again when I really have a brain tumor, it will not be a neutral result; I’ll eventually die. So it goes with serving the poor.

The chart below explains how most organizations and government programs define (and try to alleviate) poverty.

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We have to get the diagnoses right, we must root poverty in a biblical worldview.

Four key relationships are important in defining poverty from a biblical worldview:

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Conservative evangelical Christians doubt how seriously the systems are broken. They are the most likely to not think systems are a cause of poverty.

There was a Ugandan school that was randomly closed one day. When someone asked why, one parent explained it: There was a man who has been a cobbler his whole life. All of his ancestors were cobblers. He wasn’t making enough money so he decided to change his profession. Everyone around him told him that his ancestral spirits would be upset with him so he decided to go to a witch doctor to appease the spirits. The witch doctor told the ex-cobbler that in order to appease his ancestral spirits, he needed to bring him the heads of 40 school children as a sacrifice. The community’s solution to this problem was to close the school.

Poverty is the result of relationships that are broken.

If poverty is rooted in broken relationships, who are the poor? All of us… everyone.

Poverty alleviation is fundamentally about reconciling these four key relationships.

Immediate implications for working with the poor:

  • Walk humbly WITH the poor as Christ transforms us together.
  • The verbal proclamation of the gospel is central.
  • The local church has a vital role to play.
  • Prayer is a central tool.
  • We must address broken systems AND broken individuals.
  • Use asset-based, instead of needs-based, approaches.

Repentance is the first step of poverty alleviation.

MY THOUGHTS: These are not things that Dr. Fikkert necessarily said himself but I’d like to make note of.

He said the first step of poverty alleviation is repentance. He didn’t mention a second step which makes me think that until we take the first step, it’s impossible to discover the second one.

We have pride and God complexes while the poor have marred identities and inferiority complexes. When a prideful person and a person that feels inferior interact, it can be a very bad combination. The prideful person can actually reinforce the inferior feelings of the other person without even knowing it. We must be especially careful of this when working with the poor.

In his book, and many of his talks he references World Bank study called, “Voices of the Poor.” It’s a great resource to go back to time and time again.

Individual vs Community

If you see someone drowning, it’s not the time to teach them how to swim. Pull them out of the water. That’s individual relief. Once they are out of the “life or death” crisis, teaching them to swim is appropriate. That’s individual development.

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If, however, there are countless people drowning every single day, pulling them out one by one might not be a great plan. Sure, you’ll help a few people, but for every one person you pull to safety, another 20 will perish.

pool 4

Continuing with the metaphor, community development can be summed up as: Teaching people to swim and share their skill(s). Sound familiar? It should.

This is an oversimplification of a very complex problem, but the steps are: 1) teach people to swim, 2) teach them to share their new skill, and 3) repeat.

Sound simple? It is, but that doesn’t mean it’s easy.

Robert Lupton explains it well in his book Toxic Charity.

Feed a man a fish and he’ll eat for a day; (Individual relief) teach a man to fish and he’ll eat for a lifetime (Individual development).  But what happens when the fish disappear from the lake due to pollution or overfishing? Then it’s time for a change of strategy. Someone has to figure out how to get control of the lake: stop the pollutants, issue fishing licenses, put wildlife-management policies in place. Teaching a man to fish is an individual matter; but gaining control of the lake is a community issue.

A micro-loan may help a family buy a cart to haul their produce but it will not pave a road made impassible during the rainy season—that takes community development.

Teaching, Preaching, and Healing

IMG_0624I first met Dr. Hugo Gomez in 2010 when he trained our local Mexican staff in the principles of Community Health Evangelism (CHE). A few years later, I had the incredible opportunity to spend a week with him in Nicaragua visiting some CHE communities. While in Nicaragua, we traveled a lot which meant a lot of time in a car together. Personally, I was infinitely blessed by getting to know Hugo. One story he told while we were driving was how he started doing development work. Not many medical doctors make the leap from curative to preventative, so I was curious how it happened for him. The following are Hugo’s words paraphrased by me as best as I can remember:

I was first called to serve in 1981 to in the highlands of Guatemala. I started as the director of a clinic that mostly served the Mam indigenous peoples.

One day I had finished the morning seeing patients, I was back at the house getting ready to eat lunch and a nurse knocked on our back door. She told me, “there is another patient, can you see her?”

As I walked into the clinic I saw a young, tiny, Mam woman carrying her baby on her back in bedsheets. I thought the mother was the patient, but when I picked up the form I realized it was her son who was sick.

I read his age; a three year old boy. When I read his weight I thought there had to be some confusion here because it said that he only weighed 15 pounds. I knew I had to correct this before continuing so I asked her to place her son on the scale. I was in shock, I only saw skin and bones.

The kid was in the terminal stage of malnutrition.

So I started getting patient history. I asked about his birth, his medical history, and if he had been breast fead. The boy had been breast fed for a year and a half so the story wasn’t making much sense. I asked if she had given him more milk, and she said yes. I couldn’t understand how an apparently well-fed boy could be presenting with such a severe case of malnutrition.

I told her that we needed to take the child to the nearest hospital. She said she couldn’t go for all kinds of reasons: her husband didn’t know his son was sick, she didn’t have the money, and it would take days to travel by foot. I offered the suggestion knowing it was already too late, medically, to do anything for her son. He was going to die no matter what I did.

We gave her some nutritional supplements and let her go back to her village, which was a full day’s journey away. I was sure that the child would die before she even returned home.

To my surprise, five days later she returned and the kid was still alive. He was so weak he could barely sip water. I wondered why he hadn’t died yet so I went back over their history and I asked her all the same questions again. I asked, “do you feed him milk?” She replied with a yes so I finally asked (more out of frustration than anything else), “What kind of milk do you give him?”

She was a tiny lady, less than 18 years old and she said in her tiny lady voice, “Philips, milk of magnesia.”

My heart almost stopped. This tiny, innocent, sweet, child of God had been living on a diet of mostly laxatives for who knows how long.

It felt like a knife in my chest. It felt like I heard a voice say, “Wake up, what my people need is education, not just doctors and hospitals.”

This changed everything. My life, my medical career, my ministry, my mindset, my words, and my very purpose changed.

I had to begin educating people, not just treating them. We had to focus on prevention more than cure.

So I began going out to the villages to educate them on basic health and sanitation practices. I did this with the hope that I could prevent more than I could cure.

That’s what changed everything about the way I served. Instead of focusing exclusively on curative practices, I realized that God wanted me to teach prevention as well. Later, I learned that Jesus did the same thing throughout the New Testament. He would go into villages to teach, preach, and heal people.

Ever since, I’ve been doing Community Health Evangelism (CHE).

I believe in development and transformation through education; promoting good health and teaching evangelism and discipleship. These things cannot be separated.

Integration

Fax-Integration-copy

Development work is all about integration:

Physical and Spiritual

Commandment and Commission

Relief and Development

Individual and Community

Culture and Truth

Is your work integrated? I’ll be honest, it’s a lot easier if it isn’t. It is a lot easier to measure fragments.

BUT…

The short-term gains (measurability, convenience, explainability, etc…) aren’t worth it.

Poverty Reinforcement

broken-arm

How does giving handouts reinforce poverty?

Imagine someone with a severely broken arm. They are screaming in pain and every move they make hurts, so they stop moving. You come along, you aren’t a doctor but you do have some pain meds. You have friends back home with pain meds too and they are willing to help out. So you start dolling out a consistent amount of pain meds to keep your new friend painless.

Eventually, one of two things will happen: 1) The arm heals improperly and will never function the right way again. 2) Bone fragments enter the blood stream and the patient dies a slow death, without ever knowing it.

You see the correlation?  Handouts dull the pain of poverty enough to keep the underlying issues below the surface. When we hand things out, it may feel good, but we are driving communities around the world farther and farther into poverty.

If the irony of hurting those we set out to help doesn’t keep you up at night, I’d say you’re in this for the wrong reasons.