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.
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You’re invited!

I’ll be at the International Wholistic Missions Conference next week. If you are at all interested in missions, development work, CHE, or international aid I’d really encourage you to check out this year’s IWMC. There will be a lot of great speakers and workshops. Some of the biggest names in the Christian development world will be hanging out there all week.

It’s worth the money, it’s worth the trip to Phoenix, and it’s worth your time – I promise.

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.

Sustainability

nepal_village_small1

The following is a story I heard during a CHE Training. If you are interested in community development at all CHE is the absolutely first place I would recommend starting. I wandered around community development for a year and a half before stumbling on CHE and I haven’t been the same since.

Here’s the story (word of warning, it’s longer than my usual posts):

There once was a village located on top of a steep mountain. On a regular basis, as people were coming down the mountain, they would slip off the trail and fall to the valley below. A number of people were injured and some even killed.

A visitor came to their village, saw this problem and wanted to do something about it. He thought about what he could do and then decided that the best thing would be to station an ambulance at the base of the mountain. Therefore, when a person fell, a driver could rush with the ambulance to pick him up and bring him to the closest hospital 10 kilometers away. The people in the village were excited about this idea.

One day the ambulance broke down, but the people ignored the problem until another person fell off the trail and needed the ambulance to be taken to the hospital, but there was no transport available.  They then became very concerned and went looking for the outsider who had put the ambulance there. They complained that his ambulance was broken down and wanted to know why he didn’t keep the vehicle in good repair. He fixed it for them.  However, the same problem happened several more times, again with the people coming to the outsider wanting him to sort out the problem.

The outsider finally decided that there were too many repairs required on the vehicle and he didn’t have the money or time to keep fixing it. He told the people it was their problem, he had tried to help but no longer could.  The people felt sad about this, but did nothing. They were now back to the place where they had begun.

Representatives from the church diocese came, saw the problem and said they wanted to help. The diocese decided that what was really needed was a clinic at the foot of the mountain, so if someone fell they could get immediate medical care. The diocese then built a clinic, provided equipment, staff and drugs. The people were very happy that those who fell could now get immediate attention and not have to make the 10-kilometer drive to the other clinic.

This worked well for awhile, but eventually those working at the clinic wanted some time off so the clinic was left unattended. The people went to the diocese and complained about the poor service that the clinic was providing and said the diocese had to give them better care. The diocese put in extra staff to cover during the holidays.

Several times the clinic ran out of drugs and the people complained about the poor care the diocese was providing for them. The diocese ran low on money and had to stop some of their operations to conserve their money. They decided to stop staffing this clinic and providing drugs for it. They shut it down. The people were very angry with the diocese.

The people didn’t know what to do. The two ideas which outsiders had done for them, the ambulance and clinic, were no longer available and working. A respected man in the community said, “Let’s meet to talk about the real problem.”  They looked back at their original need, which was to somehow take care of those who fell off the path as they were traveling up and down the mountain from the village.  The two solutions helped somewhat, but there were problems with each solution.

As they talked, the respected man said, “I had an idea when we first talked about the problem, but no one would listen to me. The outsider was going to do everything for us for free. My idea would have taken some work and money on our part so no one was interested in what I had to offer.”

He then told them his idea, which was to build a fence along the trail to keep people from falling over the edge. It would take work on the part of the people to cut the wood for the fence and to put it up. It would take a little money to put the fence posts in cement so they would last longer.

The people responded with, “That’s a great idea. Let’s do it.”  So they raised the little money they needed and began to work. After several weeks the work was done.  Now, when someone slipped, the fence stopped them from falling over the edge to the valley below.  After a few years the wood began to rot, but instead of going to an outsider, they went and fixed the fence themselves.

Now, instead of looking to the outside for help, they began to look to their own community for solving the problem. This one project gave them confidence that they could do things for themselves. Now when someone from the outside came to give them something, they said “Thank you, but if we think it is important we will do it ourselves.