When helping helps

Just a prescript - internet and electricity are still intermittent so please be patient with correspondence!!!

Perspectives #3: Halfway through the wonderful read “When Helping Hurts.” I not only agree that it is a book that all Christians should read before they go into missions, but I would even argue it’s a good book for already well-seasoned missionaries.

Most foreigners and wealthy Mozambiquans employ various servants. The couple I am living with are no different in that they have an embregada (maid who cleans, irons, etc) and guards (sometimes sleeping but in charge of watching the house, gardening, washing cars, etc). Our embregada has HIV, as does one of her brothers likely, and she infrequently has to miss work because of the large sores she gets on her legs. I write that only to give you a picture of how health needs from the clinic are just as common at home as at work.

Claude and Marilyn asked me to look at our guard’s foot this morning as we were leaving. It was definitely warm, with pus visibly oozing from a wound in the webspaces between his 3^rd and 4^th toes, with a well-circumscribed erythematous edema covering half his foot with visibly tightened skin. Not unlike what I’ve seen multiple times at the clinic, I could have written erythromycin and paracetamol for him if I’d had a prescription on hand. (People here can buy whatever medication they want over the counter, so really I could have just told him what to buy.) Yet it occurred to me that I would just be a quick fix and that essentially the man in front of me needed a much more fundamental prescription. Here indeed is what sustainable missionwork is all about. I, as the wealthy foreigner with supposedly all the answers, by circumenventing the entire clinical set-up of native medical workers, would have done more harm than good by a quick prescription. What the man in pain in front of me needed (tied with medication) was a lesson in trusting his own people in a healthy clinic to treat his medical problems long after I left. He needed medical help that neither witch doctors with their scarring marks nor neighbors’ recommendations of over-the-counter antibiotics would help with. He needed to see a doctor who could be trusted to give him a full exam that he could trust to visit the next time, and the next time, and the next time that he gets an infection or gets sick. 

The line from the book that resounded so much to me today was: “Avoid paternalism. Never do for someone what they can do for themselves.” In this case, it was not to do for the guard what his own country’s doctors could do for him. The Chinese proverb is: “Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime.” It takes longer to teach a man to fish than to give a fish. Similarly it took longer to take our guard to the clinic with me, to walk with him as he limped across the field. I got quizzical looks from the medical students and staff who wondered why I had brought him instead of treating him at home. He waved to me from the waiting room as I stood talking to other physicians but didn’t even seem to notice me as he was visibly engrossed with talking to his doctor when I randomly stepped into his visit to grab a blood pressure cuff. Indeed I became invisible as sustainable aid surrounded him with care. Isn’t that one of the points of medical missionwork? Not to put a “bandaid on a broken leg” – but to teach people how to diagnose and how to heal with their resources so that they can continue to heal long after the mission has ended.

You know what, our guard still got his medications. Beyond that he also found out he has HIV and will now undergo treatment. Instead of getting treated for a day by me, he will indeed be treated for life. And I hope he has a long healthy life.