Striking a balance
GEORGE THOMAS
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The motto of mission hospitals should be `to cure sometimes, to relieve often and to comfort always'
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PHILIP UMMAN'S article "Mission hospitals" (Open Page, February 25) made interesting reading. However his prescription of "modernisation without losing sight of the original objectives" is self-contradictory. This is because `modernisation' would preclude the very purpose of mission hospitals.
As mentioned in the article, mission hospitals have done yeoman service to society. They were the benchmark for dedication and excellence in medical services. However in this era of capital intensive medical services can the mission hospital maintain that position?
The irony is that there is a quantum leap in medical technologies and `scientific' knowledge without the equivalent alleviation in human suffering and agony. On some occasions the technological and scientific advances have just prolonged the agony.
The mission statement of `mission' hospitals should be the continuation of Jesus's healing ministry. This is summed up in His statement: "He hath sent me to heal the broken-hearted, to preach deliverance to the captives, and recovering of sight to the blind, to set at liberty them that are bruised" (Luke 4:18). Jesus's earthly mission was for the uplift of the poor and downtrodden. So succour for the poor should be the foundation of a mission hospital.
How can a mission hospital strike a balance between hi-tech modernisation and low cost medical care? It should stress on primary care. Most people need only primary care at reasonable costs. This will include community medical education, preventive medicine and treatment of common diseases. Many of our illnesses are psychosomatic. In the present stressful world, counselling and psychological medicine, which are low cost specialities, should be pursued.
Mission hospitals should be the last refuge for the suffering poor. This is summed up in the story of a woman who was suffering from excessive menstrual bleeding for 12 years. Many doctors had treated her and she had spent all her money. But instead of getting better she got worse. Her last resort was Jesus who cured her (Mark 5 25:29). Today Jesus would be telling us "You treat according to Davidson, Bailey and Braunwald and order CT scans, angiograms and interventions but you neglect the really important principles of medical care like compassion, empathy, justice and mercy" (Adapted from Mathew 23:23).
The role of mission hospitals vis-à-vis emerging reproductive and life prolonging technologies is a complex, controversial and contentious issue. A poor man's life is as precious as a rich man's. Technologies that discriminate on the basis of affordability should not be used in mission hospitals. Patients who need such technologies should go elsewhere. Value added, profit and status motivated medicine should be avoided. Every piece of equipment should be evaluated objectively for its clinical value. Clinically essential but expensive equipment such as a CT scanner could be financed by health cooperatives.
The best yardstick to measure missionary medical service would be Gandhiji's talisman — "Recall the face of the poorest and the weakest man [woman] whom you may have seen, and ask yourself, if the step you contemplate is going to be of any use to him [her]. Will he [she] gain anything by it?"
Palliative care
Mission hospitals should stress the reality of death and the incurability of certain diseases. "Who can live and never die? How can man keep himself from the grave?" (Psalms 89:48). The motto of mission hospitals should be "to cure sometimes, to relieve often and to comfort always." Expertise in cost effective palliative care should be developed. Futile heroic treatments, which would financially harm the patient's family should not be undertaken. A positive approach to faith healing should be adopted.
Health professionals with such values will surely be valued by society and will get adequate recognition and remuneration. They will be able to practise fair medicine without the baggage of commercial compulsions. Finally the bottom line for any mission hospital should not be `profit after taxes.' It should be `to the greater glory of God.'
gthomas@doctor.com
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