For similar content see my blog: Medical Missions 101
“Short-term missions have only one purpose, to serve and support long-term missionaries and their programs.”
My missions pastor shared this statement with me when I was getting started in missions. He had grown up on the mission field and clearly had a long-term missions perspective. He was the son of a missionary pilot and grew up in a remote Peruvian jungle. I must confess when I first heard this statement, it did not set well with me. It was sure not being lived out by the short-term missions I had seen. I was not convinced of its relevance to my medical mission work. However, the longer I work in and study medical missions, the more I recognize the profound truth he was sharing with me. I have been a student of medical missions for the last two decades, and I have become increasingly convinced this statement is a foundational truth upon which all short-term missions should be built.
In the context of medical missions it translates to: short-term medical mission initiatives should exist to support long-term medical mission work.
In early 2015, I was leaving Hospital Loma De Luz on the coast of Honduras after visiting our missionaries. I ran into a large short-term medical team unloading cases of medications and supplies about three miles from the hospital. The team had many North American doctors and nurses wearing matching t-shirts so they were easy to spot. Loma De Luz is one of the most functional hospitals in Honduras where there are many Christian Health Service Corps physicians, nurses, and support staff. It has a great surgical department, emergency department, OB, and inpatient wards. It also has a large outpatient clinic, which provides ongoing care to the people in the area. I stopped and introduced myself and asked what communication their medical team had had with the hospital up the road. Sadly, their answer was not surprising, “What hospital?”
Since writing When Healthcare Hurts, I have been asked repeatedly, “How can the information contained in the book be translated into a realistic model that can be followed by short-term medical or service learning teams?” The answer is that it can’t if the intention is to use it to set up short-term mission work disconnected from long-term missionaries and their programs.
This has become the classic story of short-term missions of all kinds. In our church mission trips and service learning programs, we say our goal is to impact the recipients of our care physically and spiritually. Too often though, the end goal becomes to field a mission team to do some project, medical or otherwise, so we will derive a sense of accomplishment or purpose. Very few stop and ask the questions: “How do we support long-term mission work? Or, who should we be connecting with to support in their outreach?”
In When Healthcare Hurts I used a lot of evidence to support the idea that best practices are those that both promote patient safety and support human dignity. One of the key underlying messages in the book is that without partnering to support long-term missionaries and their programs, achieving either of these end points in medical missions is nearly impossible. For more discussion of this topic, see “Best Practice Guideline 3 – Participate and Collaborate with Stakeholders.
To quote a missionary surgeon friend, Dr. Jefferson McKenney, founder of Hospital Loma De Luz: “Neither good medicine nor good mission can happen on a two-week trip unless that short-term trip was designed to support a long-term work.”
Why partner with a long-term medical missionary and not a local partner?
From a development perspective, there are some challenges with team-oriented short-term missions partnering with local people. My friend and colleague Terry Dalrymple from the Global CHE Network refers frequently in his presentations to the work of Deborah Ajulu, a Kenyan researcher at Oxford University. She did her PhD in missional studies on partnerships between the global North and the global South. She identified three types of partnerships between the global North and South.
The first was the cow and milker in which partners in the global South see visitors who come on an airplane and then on a shiny new SUV or bus to their village as a cow that is badly in need of milking. They direct and lead the cow in a way it will produce the most milk for them.
The second type of partnership was that of the horse and the rider, in which those in the global North go and have a good equestrian adventure experience on the backs of those in the global South. In other words, they direct and guide the local partner to provide a good “mission trip experience” based on how the short-term team defines it. Almost all short-term missions fall into one or both of these two categories.During our years of serving in and studying medical missions, I have yet to see a mission team or service learning team working with a national partner that does not fit into this conceptualization. The problem with these two types of partnerships is that they are both dysfunctional and codependent. The global South partners see the North as a revenue source, which they come to depend on and will do just about anything to keep. Meanwhile the global North partners derive a sense of purpose and meaning from serving the poor in the global South although their work is not having the impact that they believe it is.
Transformation through a Cultural Bridge
The third kind of partnership Dr. Ajulu defines is a mutually transforming partnership. She describes these as being extremely rare. This form of partnership is almost non-existent outside of long-term missions service. This is where both sides of the collaboration learn and grow from each other, complement each other’s strengths and weaknesses, and accomplish more together than either could accomplish individually. It is hard for mutually transforming partnerships to develop outside of long-term missions because it usually requires that people stay, build relationships, and work hard to avoid unhealthy cross-cultural dynamics.
Long-term missionaries understand both the sending and receiving cultures. Therefore they can act as a cultural bridge and help short-term mission groups navigate cultural challenges and develop healthy relationships. That is, of course, if the group truly abandons their own agenda and goes with the heart to serve and support the missionary and their programs. One word of caution, however, short-term medical missions should ideally work to support medical missionaries. The important takeaway here is that short-term medical missions can accomplish much when they view their one purpose in the context of serving and supporting long-term medical mission work.
For similar content see my blog: Medical Missions 101
 Seager, G. (2012). When healthcare hurts: An evidence based guide for best practices in global health initiatives. Bloomington IN: Authorhouse.
 Ajulu, D. (2013). Holism in development: An african perspective on empowering comunities.Seatle: World Vision Publishing.