on Christianity and mission work

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I consider myself Christian – I attend church on Sundays, have taught Sunday School and assisted with youth groups, traveled on youth mission trips. I also question many of the tenants of mainstream Christianity and try to work within my faith community for change. During my trips to  the developing world, I have participated in Baptist, Methodist and Catholic church services. The hospital we serve in Haiti started as a Baptist mission outpost. I have worked alongside atheists, evangelicals and Muslims.  All of this is to say that I have seen both the up and down sides of Christianity abroad.

As American Christians, we are often drawn to stories that purport to show the changes that teams of missionaries can make in impoverished nations and how the populace of the developing world welcomes these individuals with welcoming arms.

Now consider the following scenario. A devoutly Christian couple in Western Africa consider themselves very fortunate – they are healthy and have good jobs, are able to afford to send their three children to good schools and have a strong religious community. Recently they have become concerned about stories that they have heard about America – broken families resulting in children growing up in poverty, senseless gun deaths due to young men’s lack of connection to their communities, lack of medical care in sparsely populated areas. Both of the Africans are trained in medicine – a doctor and a nurse. With the financial and prayer support of their religious community, they uproot their family and move to a remote community in the western US. The family finds many of the foods and traditions of this new land to be foreign and write about them in a blog that they share with the community in Africa. Efforts are directed to building a school so that area children don’t have to travel so far for school and so that they can “save” the souls of the children by teaching them African Christianity. Future plans are to add a medical clinic to serve the needs of adults while spreading the African gospel. Youth mission teams are being formed in their home church so that youth can travel to this remote, foreign area of American to help with summer camps. All of these endeavors are meant to bring the community in America closer to the African way of life, thus solving all of their problems.

Does this story sound too familiar? It might be extreme to grab your attention, but is it so far from the truth? Following are just three examples of similar examples that I witnessed on my recent trip to Haiti.

  1. I was asked by a Haitian Catholic priest to vouch for his work as he was applying for a grant thru the Koch foundation. I have worked with him closely in our microfinance program and he is an extraordinary person that has been very responsible with finances. I contacted the Koch foundation and was informed that I was not able to testify to this man’s extraordinary work as I was not a person of the Catholic faith.
  2. The hospital in Haiti where we work is in desperate need of new operating room tables. I contacted a mission organization that acts as a clearinghouse for medical equipment. In order to be a member of their on-line community, I was asked to sign a form declaring my faith and stating that I believed that Jesus was the one true and only savior.
  3. One of the surgical members of our recent trip was familiar with a mission hospital in Africa that was in need of surgeons to teach local physicians. I checked out the website and found lovely pictures of the surrounding countryside, medical facilities and new solar panels. But other parts of this mission project were disturbing to me. The hospital was intentionally established in a part of the country that was “99.99% Muslim”. Christianity was taught to post-op patients and a separate building housed those Africans who had converted to Christianity and were ostracized from their Muslim families. I had the option to purchase a book that had recently been written about establishing missions to convert natives from the Islamic faith to Christianity.

Thankfully, I have witnessed far more examples of Christianity done right. Many of the American volunteers that I have worked with in Haiti are called to do good thru their Christian faith – and that is what they do when serving, regardless of the faith of those who they serve. If it were not for Baptist mission work abroad, Dr Hodges would never have traveled to Haiti after WWII and established Hospital Bon Samaritian, currently the main employer in Limbe (population 75,000) and source of clean water for the town. Fr Charles, in a remote mountain village, is working to build a hospital, has opened 6 schools and brings the outside world to illiterate citizens each Sunday.

It is complicated. I have more questions than answers after 10 years of working in Haiti. But maybe questioning is the first step in getting the answer right.

 

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Teaching cervical cancer screening in Kenya

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Re-entry from Haiti to American Healthcare

Our January 2016 medical mission trip marked the 10th anniversary of my first trip to Haiti. During those first few years it was always a culture shock as I entered Haiti and dealt with the cacophony of noise, the smells of burning garbage and rotting fruit and the difference in hospital resources. More recently, I have found it easier to slip into my role as a temporary physician in Haiti and harder to re-enter the physical and psychological world of American healthcare. As pictures are often louder than words, I will use them to illustrate the differences between the two healthcare systems.

Providing health care in Haiti, though limited in scope, is sorely appreciated by the people who often wait months to collect enough funds to afford a surgery and then for a surgical team to arrive. They arrive on the designated day of surgery waiting in line to be examined by the “blanc” doctors and then waiting some more for their surgery. 190

While we are busy in the operating room performing the surgery, the family is busy preparing the patients room for their arrival immediately after surgery. The family is responsible for providing sheets and pillows, food and a bedpan as the hospital does not have adequate bathroom facilities for patients and their families.

As there are few nurses available, families often sleep on the floor by the patients bed so that they can be available to help with feeding and getting the patient out of bed.

Most American patients expect a private room and bathroom when in the hospital.  Our post -op rooms have 3 narrowly spaced beds and are filled on a first come, first serve basis. This means that there could be both men and women in the same room as well as multiple family members. The wall sockets are usually stacked with cell phone chargers.

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Although this may look chaotic, there is a semblance of order that runs throughout our day. Potential surgical patients are screened in the morning with surgeries starting around 10 am and lasting until 5-6 pm. Emergencies are triaged as they are sent from clinic and when one of the surgeons is between cases. We make surgical rounds in the early morning and again after dinner, doling out pain medications and encouraging patients to eat and walk. Haiti has no electronic medical record. While I am sure that some American doctors would whoop with glee at this announcement, it is beyond irritating to write the same operative note three times in three different places while trying to gather patient clipboards from the nurses station and around the ward.

Privacy in the US medical system is a sacred law known as HIPPA and one that has serious consequences if violated. Privacy in Haiti can be difficult when rounds are made in a three bed ward with family members of each patient listening in to our conversations. That doesn’t include the numerous visitors in the courtyard that can look in thru the open air windows.

By the end of a 5 day surgical week, we have usually performed 40-50 operations.  Some of these surgeries are lifesaving, while the majority improve quality of life. Our complications are no greater than in the US and outcomes just as favorable. We use far less resources with only minimal lab tests available and no blood bank. I am exhausted, my feet ache from standing on the concrete floors and my back is sore from the uncomfortable beds. And yet, the satisfaction and feeling my heart full is so much more than I feel at the end of a week of work in the US.

Now I find re-entry into the hospitals of the US more disturbing than my week in Haiti. The amount of waste that occurs on a daily basis with medical equipment in this country is mind boggling and one of which we should be ashamed. Surgeons demanding expensive instruments and multiple suture choices are difficult to listen to.  Most patients are appreciative of the care they receive, but wouldn’t be able to grasp wait times and lack of access to healthcare that is present in the developing world. Thankfully, the end of each Haiti trip brings with it plans and ideas for the next trip.

 

I’m Back from Haiti and Need Your Help!

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This trip to Haiti was much different in many ways from my previous travels. We stayed in CapHaitian rather than traveling to Limbe, we taught Haitian providers about cervical cancer screening rather than performing surgery, we rode local tap-taps for transportation, we “camped out” in a partially finished house and slept on mattresses on the roof because it was unseasonably hot (95 degrees) and we attempted to market reusable diapers and menstrual pads to start a business for our microfinance women at Helping Haiti Work.

We learned much about how business works in Haiti and the Haitian medical providers learned  about the causes of cervical cancer, how to screen for the disease and methods of treatment. More about the cervical cancer program in another post. This is what I learned.

1. Haitian women work hard and maintain long hours at their market stalls in order to clear $3-4 a day.

2. Haitian women are skeptical about new products, especially when marketed by white women. A side-by-side comparison to the local product (diaper or menstrual pad) using water was much more effective than talking.

3. Haitian women are born to bargain when negotiating price.

4. Most Haitian women have not seen an electric sewing machine in action and all want to try to operate it, usually going way too fast.

5. Haitian women are quick to learn a new task because many of them are illiterate or only partially literate and learn by doing.

After multiple conversations with women, assessing the current market price of our product and estimating the cost of supplies to make a reusable diaper or menstrual pad kit, we have realized that the profit margin is too narrow to make this program fully sustainable. But that does not mean that we have given up. Put 5 white women together on a roof with a bottle of wine at 9 pm and much brainstorming happens.

camping out with ipads

camping out with ipads

 

We have created the concept of CUTTING PARTIES or PINOT AND PADS. For $20 a person, you collect a group of your friends together and for 2-3 hours cut out diapers and menstrual pad kits. We will supply you with patterns and fabric purchased thru the $20 donation. No sewing needed as the unfinished kits will be sent to Haiti and the women will purchase them for a small cost, construct the item and market it for a profit. This employs many of the ideas from my previous post When Helping Hurts. We are working to create a culture of self-sufficiency rather than a culture of dependency. We are also in the process of making a video that you can download from YouTube which gives a visual education in what we are trying to accomplish.

The next shipment of kits will be traveling to Haiti in mid June. The Haitian women are depending on us to help them help themselves. Please contact me at jaegerleslee@gmail.com if you are interested in hosting an event.

Seamstresses Without Borders in Haiti

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You may have heard of Doctors Without Borders or Engineers Without Borders, but you have probably not heard of Seamstresses Without Borders, as we have just started the first branch in Limbe and Ranquitte, Haiti. Ellen Schreder and Abbie Ahner traveled to Haiti this week to work with Haitian women who are interested in a microfinance loan thru Helping Haiti Work, but do not have a pre-existing business. We have been collecting fabric over the past few months and 6 – 50 pound suitcases followed the women on their journey over potholed and washed out roads to the rural village of Ranquitte. Ellen and Abbie are helping women with basic sewing skills develop a business plan for constructing and marketing the items that they sew. We will be continuing to encourage the women to use the reusable menstrual pads that I have written about previously, in addition to reusable diapers and mens and womens underwear.

The board of Helping Haiti Work has had numerous discussions about how we can make this business sustainable but also profitable for the women. Too many projects that are started in the developing world falter and break down when funds to sustain the enterprise dry up. Using donated fabric and supplies, purchasing remnants of fabric and using used flannel sheets has allowed us to keep the cost of each item low enough so that a profit can still be made when the women sell the items in the local market. Unfortunately, flannel fabric is difficult to find in Haiti so most of the fabric will need to be brought in by volunteers.

The first day of the project went beyond our expectations. The sight of an electric sewing machine (the norm in Haiti is a treadle machine as electricity is variable) generated much excitement when women saw it in operation the first time. During a teaching session about business models, women brainstormed new ideas building on the sewing program. One woman wants a loan so that she can purchase fabric in Cap-Haitian and then sell to the sewers so that they can focus on sewing. Women wanted to teach their sons and daughters to sew to increase production. Although cooking is considered women’s work in Haiti, many of the tailors are men.

Free handouts to those who are poor are easy and make the giver feel fortunate and superior. The recipient, however, does not benefit to the same degree and is left waiting for the next handout. Programs such as this are much more difficult to implement, involve more time on everyone’s part but create a sustainable business that will be in place long after the Americans have left. Haitian women also benefit by realizing that they have the power within themselves to make a better life for their family and their community. They no longer need to rely on handouts and can replicate this same business in neighboring communities.

 

When Helping Hurts – Part 2 (the teenage version)

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Summer camp brochures landed in my mailbox and reminded me that I needed to complete the paperwork for my kids summer mission trips. As I was composing the Part 1 adult version of mission trips, I thought it only appropriate that I also compose a youth version, gleaned from my experiences, what I have learned from the wonderful youth leaders at our church and what my own children have taught me.
Our church has a very active mission orientation and organizes mission trips for middle and high school youth each summer. When our older kids reached middle school, we encouraged them to make the trip part of their summer plans, in addition to sports camps and hanging out with friends. Once they reached high school, we were pleased that they often turned down other activities in order to participate in the trips. Both of our 22 and 24 year old sons have even joined as adult leaders. I have never added up the costs of all those trips (5 kids x 6 trips each at $300-$500 per trip) but have often wondered if my husband and I were doing the “right thing” by paying for our children to have an experience helping others, when the money may have been better spent given to the organization that they were helping. This same thought comes to mind as I am often asked if I allow teenagers on our Haiti mission trips. Many of these students and parents are looking for a mission trip experience to put on their upcoming college applications. Again – who is the trip benefitting? Are we exploiting people who are less fortunate for the advancement of our more privileged children?
Unfortunately, I don’t have all the answers to these questions. I don’t think we should cancel these trips completely, but I do think we can improve the experience of our children and of the locals who are interacting with the mission teams. After all, many of the young adults who are now starting amazing ventures in the developing world got their first taste of “helping” on a mission trip. Creating empathy in our children often starts when they are able to help someone less fortunate. The following are ideas to keep in mind when planning the next teenage mission trip.

1. Location.  Talk with your child about where they are going, locate in on a map, and discuss why people there may need the help that your child is providing. Even if they are only traveling across town to a more urban environment than where they live, discuss the differences in social services and joblessness.

2. Try to avoid drop-in mission work.  Looking at the trip from the locals perspective, you are often more well received if there is an ongoing presence of the umbrella organization. This is the reason that my children’s mission trips cost more than travel, room and board. Tuition subsidizes the on site staff that coordinates projects with the local community and plan work that helps and doesn’t hurt.

3. Cellphones.  I am as guilty of this as you – not that I carry a cellphone but that it is too easy to stay connected with our kids on a daily basis when they are away. The policy of the staff on our church mission trips is that the cell phones are collected at the beginning of the trip and the kids get them back for one hour a day. I would like to advocate that the phones stay home, but this has met with much resistance, both from parents and kids. Some of the best conversations I have had with my teenage sons (who usually only talk to me in monosyllables) are in the first few days after a trip when they are relating some of their stories.

4. Opt for trips that are less luxurious than their home settings.  Similar to the adult comment about “Get comfortable being uncomfortable”, it often takes an uncomfortable surroundings in order for children to try new experiences. This can include food, making new friends, talking to strangers, performing a physical task outside their abilities. One of my daughters conquered her fear of nursing homes when she was required to talk to elders at a nursing home for 2 days during a trip. Traveling to Juarez, Mexico via a cramped bus and playing street soccer with neighborhood kids is a favorite memory of one of my sons. He doesn’t remember that baby wipes was the only shower he had for a week.

5. Walk the Walk.  I think this is the hardest part, but the most important, for a parent. Writing a check for the mission trip that will “change your child’s life” isn’t nearly as effective as volunteering with your child once or twice after they return to continue the pay it forward concept. Teenagers have short memories. Life quickly returns to normal and it is difficult to remember some of the lessons learned. Reinforcement, especially when it involves seeing the parental unit participating and being uncomfortable with the setting, goes a long way towards imbuing characteristics of empathy and compassion in our children.

When Helping Hurts – Part 1

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My April 2015 trip to Haiti will mark the 10th year since I first journeyed to the island in 2006. Just as my parenting methods have evolved over the past 24 years, so have my views and methods of “helping” others, both here and abroad. For the first time, the April trip will involve much more teaching and not as much doing, as we work to train midwives in methods of cervical cancer screening and treatment. More information about this venture can be found here.

Haiti is an example of how too much “helping” by outsiders (usually Americans) can be a disadvantage. Too many projects have been started or promised and never finished. Completed projects were thought to benefit the community, but no input or cooperation was sought with the locals, so ongoing maintenance was not done and the project soon fell into disarray. Frequently, patting ourselves on the back for performing good deeds seems to be more important than truly working to help Haitians. These thoughts always come to the forefront as I am boarding my flight from Florida to Haiti. Many groups have brightly colored tshirts with the words – hope, helping, Haiti, promise, hands, hearts – emblazoned across the front. They are excitedly conversing about the “trip that will change their lives”, holding and feeding orphans, painting a school or building, bringing back pictures of the extreme poverty to show their friends. I cringe – for these are some of the same thoughts that I had during my first few trips and I now realize hurt Haiti, as well as any developing world country, more than if we ignored them. The following are some of my own reflections, reinforced by others that I have talked to or read about.

1. Read, Read, Read.  Before you go to any new place, find it on a map and research on the internet.  Read a few books about the history, both past and present. If someone had asked me ten years ago where to locate Haiti, I would have only been able to point in the general direction of the Caribbean.  I currently have one bookshelf devoted to books about Haiti.

2. Language.  It has become very easy to find free internet sites that will introduce you to the basics of any language, both written and audio. Greeting a person in their native language goes a long way in creating a favorable impression, even if you can’t carry on a conversation.

3. Cameras and photos. Always ask first. Many of the older Haitians believe that taking a photo of someone can steal their soul. Haitians know that they are poor – they don’t need you taking pictures of their houses, poor water sanitation, trash to show to others how lucky America is. On my second trip, I made a video recording of a group of young men singing a beautiful song at sunrise at the top of the mountain. I didn’t ask permission first and when one of the group realized what I was doing he wanted my camera in exchange. After a heated debate, he agreed that if I deleted the video he would give up his demands.  It was still a beautiful song – but now only in my memory.

4. Take the time to sit down with a local and have a conversation. Ask them about their family, share stories about your family.  Get to know them and their daily life, hopes and dreams. Often you will find more similarities than differences.

5. Contribute to the local economy. Eat at a Haitian restaurant or take an extra day to spend at a local resort.  Purchase a few keepsakes to put on your shelf at home or give to friends. Too many aide groups view Haiti as dangerous and don’t go outside the walls of their compound.  Just as any foreign country, you need to be smart about where you are and travel in groups, but I have always felt safe, even during our sunrise hikes on remote footpaths.

6. Make sure your mission is something that the Haitians need, want and can’t do for themselves. Holding orphans, painting and building is a job that could employ many locals for the cost of a plane ticket. Teaching Haitians how to paint or build will provide much more benefit for their future job skills. Teaching birth control and sex education will work to decrease the orphan population.

7. Work with Haitians. Employ them as part of your team. Ask their input as to what they think will work best when questions arise. I can attest that this method takes much longer and is frustrating for us task and time oriented Americans, but will make you feel like your mission was more worthwhile in the long-term. I have heard many volunteers comment that the locals won’t know the answers because they are illiterate and unschooled. My favorite quote, “Poor people aren’t stupid.  If they were stupid, they would be dead.”  Not all knowledge is learned at a desk.

8. Get comfortable being uncomfortable. This might be one of the hardest concepts for adults. As children, we were always being treated to new experiences beyond our control but as adults we are able to more rigidly control our environment and experiences to only those events that are comfortable. Potential volunteers have declined our trips due to being “uncomfortable” with limited food choices, bugs, lack of air conditioning, fear of tropical illness, to name only a few. I think some of my best experiences have come when I was the most “uncomfortable” and was able to forge on and still have a pleasant time.  It certainly lends to better stories.

9. Spread the word. Once you return from your trip, tell others about what you have learned, both good and bad. The majority of people who travel to another part of the world do so because they talked to someone else about their experiences. We only tend to read the sensationalist stories about the developing world, but could better relate to reflections from a recent volunteer.

10. Don’t make promises to locals that you can’t keep. By the end of each of our medical trips, everyone has started to see the week in a much more rosy light as they are anticipating their first warm shower, comfortable bed and return to loved ones. Volunteers start to talk about returning again and make promises to hospital staff about what they can do for them in the future.  The return rate of most of our volunteers is about 25%. Promises are soon forgotten once you have returned to your American life. Unfortunately, the Haitians do not forget.

I don’t want to discourage anyone from planning a trip, just to travel in a better mindset than I initially did. I have made each of these mistakes and a few more. Even though I didn’t recognize it at the time, that first trip was life altering for me and became a passion that has defined my life.

Part 2 of this post concerns sending teens on some of these same trips. How can trips benefit both our kids and the communities in which they serve?