Content Resources

We hope you enjoy listening to this session from November's Global Missions Health Conference: https://www.medicalmissions.com/resources/16756/task-remaining-for-all-to-hear

Theology is thinking and talking about God and his work in his world. This is God's world and it is filled with poverty. How Christians think about, engage, and talk about poverty is fundamental to who we should be as followers of Christ. We, of all people, need a theology of poverty.

Many times in the missions world, we follow culture by implementing solutions borrowed from others in our same field. But what if we created in such a way that changed our industry? With more than 3.5 billion people living without access to the good news of Jesus, we need to start changing the way we look at solving our challenges. At this session, you will learn a process and tools to bring your God-given creativity to the way that you approach the challenges you face at home, work, or on the missions field.

In this breakout called "For all to hear" we will take a look at the current state of missions and the Gospel worldwide. Where is the church struggling to penetrate? What are some strategies that are being developed to get into those areas? What role can medical professionals play in getting the Gospel to unreached people?

Do you want to "live on mission" with your patients regardless of whether you are stateside or abroad? This session will present proven and practical methods that will help you assess and address the spiritual needs of your patients in a professional, ethical, and compassionate manner. These tools have been utilized in secular and faith-based healthcare settings worldwide. Bob serves as executive director of Medical Strategic Network, which for 33 years, has been equipping healthcare students and professionals to care for the whole person.

Empowering nurses and nursing students through education and experience to maximize their potential as effective nurse leaders, thus creating positive and sustainable outcomes in their communities and nation.

Today we want to feature a story that was shared with the MedicalMissions.com community. Anyone can share stories of life on the mission field, medical work being done around the world, or inspiring stories of faith here on MedicalMissions.com - we love to hear from YOU, the people that are dreaming and doing the work of healthcare missions (https://www.medicalmissions.com/stories).  The story for today was shared by Christian Health Service Corps, and takes place in Honduras. We hope you enjoy it as much as we did! Andrew and Alisa Geers serve as Christian Health Service Corps missionaries in Honduras. He is a Physician Assistant, and she is a Nurse Practitioner. They shared this story that demonstrates how God's power is made perfect in weakness. What comes to mind when you see the word “intussusception”?  If you are not at all medically inclined then you may not have even known that it was a thing, let alone how to pronounce it.  For those of you who want to win at jeopardy it’s pronounced  in·tus·sus·cep·tion.  It is a condition whose cause is not well understood but it is always fatal if left untreated within 5 days of its occurrence.  So what exactly is intussusception and why am I spending so much time talking about it? To keep it simple, intussusception is the process by which part of the intestine telescopes within itself and usually occurs where the small intestine meets the colon or large intestine (see photo representation).  This leads to an intestinal obstruction, bowel death and eventual perforation of the intestines.  It is the most common cause of intestinal obstruction in children 5 months to 3 years.  Now that you are an expert on intussusception let me tell you about my 3 month old patient who came in the ER about 2 weeks ago around 10 pm… The patient had a 2 day history of fever, vomiting and blood in his stools.  He had been seen at a clinic near his home earlier that morning, about 9 hours from our hospital, where he was given fluids and his mother was told they needed to see a specialist.  To this mother, whose father had neck surgery at our hospital some time ago, it made perfect sense that Hospital Loma de Luz would have the “specialists” her son needed to see. In case you were wondering, (and you may not have considered this since I threw a bunch of fancy terms and statistics at you to begin with) I am NOT a specialist in pediatrics.   I immediately radioed Alisa (cause I have learned that when you don’t know what to do you ask your wife) and ran the patient by her.  It was clear from his distended abdomen and x-ray that this infant had an intestinal obstruction and now we had to determine why (although you can probably guess why if I have not completely lost you with my ramblings).  Usually in the states this child would have had access to a variety of tests and tools to help quickly narrow down the diagnosis, to determine which specialist needed to be consulted and to determine the best approach for treatment.  Here in Honduras we are deficient in our diagnostic testing with our most advanced imaging being x-ray. Abdominal x-ray taken just after the patient arrived in our ER showing a belly full of air. The doctor “on call” with me was none other than our General Surgeon, Dr. Alexander, who does not usually operate on children, let alone 3 month olds.  We admitted the infant, gave him IV antibiotics and had a nasogastric tube placed to try to decompress his stomach but he continued to have fevers and more distention of his abdomen.  We all had been praying for a miraculous healing but it was rapidly becoming apparent that we were losing the battle and needed to use more invasive measures.  Having no experience in this type of pediatric abdominal surgery our general surgeon skyped with the pediatric surgeon back in the states to get his input and to get a crash course on what needed to happen with the surgery.  Lacking onsite experience we were definitely at a disadvantage when it came to attempting surgical intervention. During the operation we found that part of the small intestine had telescoped into the large intestine and Dr. Alexander worked to meticulously and delicately pull it back out.  We could see evidence that the trapped bowel was beginning to show signs of dying and it would have only been a matter of hours before the damage would have been irreversible.  By the grace of God this child made it through surgery without complications and one week after coming to our hospital he was discharged eating and pooping like a normal 3 month old should.  Our medical staff worked diligently, trusting God to provide the strength and guidance we needed to give the best care possible despite our weaknesses.  And just like the 5 loaves and 2 fish,  God performed a miracle through our limited experiences and resources and all we can say is, to God be the glory! When is the last time you boasted about your weaknesses?  The word weakness can be more accurately defined by words like disadvantage, defect, deficiency, and imperfection.  We all have weaknesses and yet we usually don’t go around broadcasting them to the rest of the world.  Yet that is what the Apostle Paul encourages followers of Christ to do, to boast to the world about weaknesses.  2 Corinthians 12:9 says, “But he (God) said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me”.  We have seen and testify to the power of Christ working in our weaknesses.  The next time you and I encounter difficult circumstances I pray that we would be reminded of His sufficient grace!

Over the past few months, we have highlighted a few outstanding sessions, stories, and articles that are featured on MedicalMissions.com. We want to do that again this morning, highlighting one of last year's (2018) breakout sessions. But if you went to this year's conference, and you are anxious to listen to a session you missed, don't worry! The sessions from the 2019 conference will begin releasing on the website (https://www.medicalmissions.com/resources) and the podcast (https://www.medicalmissions.com/podcast) in January. For now, check out this very interesting session on Christian Thought in the Development of Western Scientific Medicine by Dr. John Patrick

The Alliance for Patient Safety estimates there are 7 million disabling surgical complications and 1 million surgical-related deaths worldwide each year. They identify three primary problems with surgical safety: It is unrecognized as a public health issue. There is a lack of data on surgery and outcomes (especially in developing countries). There is a failure to use existing safety know-how. Safe Surgery Saves Lives In an attempt to improve surgical safety, they launched the Safe Surgery Saves Lives campaign. The centerpiece of this program is a checklist known as the Surgical Safety Checklist (WHO World Alliance for Patient Safety, 2009). In order to develop the WHO Surgical Safety Checklist, the authors used the aviation industry checklist framework because of their more than half century of experience in developing and using checklists to improve safety. All in all, the checklist has proven to be a great success. Eight hospitals from both developed and developing countries participated in a study, and the checklist was shown to improve adherence to standards of care by 65% and reduce surgical-related mortality by half (Weiser et al., 2010). The checklist has three sections: before induction of anesthesia, before skin incision, and before the patient leaves the operating room (WHO Alliance for Patient Safety, 2008). Advantages of Using the Checklist It can be customized to the local setting. It is strongly evidence-based. It has been evaluated in both developed and developing countries with similar results. It promotes adherence to known best practices. It does not require significant resources to implement. (WHO World Alliance for Patient Safety, 2009). WHO Surgical Safety Checklist The WHO Surgical Safety Checklist is considered highly recommended for short-term surgical projects. In fact, it is best considered a minimum standard of care. The checklist shown here is for illustration and reference purposes only. It is recommended that each surgical team go to the WHO webpage for surgical safety, download the PDF version, and make enough copies to have one for each surgical case. It is also recommended that a copy of the checklist be attached to the permanent patient record. Of the 234 million people who undergo surgery each year, approximately one million of these individuals die from surgical complications. The WHO estimates that expanded use of the checklist could prevent more than half of these deaths (WHO World Alliance for Patient Safety, 2009). The following is an overview of each section of the Surgical Safety Checklist. What appears here is only a brief summary of the steps to using the WHO Surgical Safety Checklist. It is recommended that readers download a copy of the WHO Surgical Safety Implementation Guide. A complete list of safe surgery tools, the checklist, an implementation manual, and resources can be found at http://www.who.int/patientsafety/safesurgery/ss_checklist/en/. A video demonstration on the use of the WHO Surgical Safety Checklist can be found at http://www.safesurg.org/how-to.html. Sign-in phase prior to the induction of anesthesia At sign-in, the person coordinating the checklist will verbally review with the patient (when possible): 1) Their identity 2) That the procedure and site are correct and that consent for surgery has been given 3) The coordinator will visually confirm that the operative site has been marked and that a pulse oximeter is on the patient and functioning. 4) The checklist coordinator will also verbally review with the anesthesia professional the patient’s risk of blood loss, airway difficulty, and allergic reaction and whether a full anesthesia safety check has been completed. 5) Ideally, the surgeon will be present for sign-in, as the surgeon may have a clearer idea of anticipated blood loss, allergies, or other complicating patient factors. Timeout before skin incision The timeout requires that all team members introduce themselves and state their role. The team can simply confirm that everyone in the room is known to each other if more than one case is being done by the same team. Prior to the skin incision, the team must pause and confirm aloud that they are performing the correct operation, on the correct patient, and on the correct site. They must then review aloud with one another the critical elements of plans for the operation using the checklist questions for guidance. It must also be confirmed that prophylactic antibiotics have been given within the previous 60 minutes and that imaging is displayed, when appropriate. Sign-out Once sign-out is initiated, the nurse verbally confirms with all team members: The name of the procedure recorded That the instrument, needle, and sponge counts are correct and reconciled prior to closure If counts are not reconciled, the team is alerted to search for missing items in, on, or around the field. X-rays are requested if counts still do not reconcile. (WHO Alliance for Patient Safety, 2008) References: Weiser, T. G., Haynes, A. B., Lashoher, A., Dzeikan, G., Boorman, D. J., Berry, W. R. (2010). Perspectives in quality: Designing the WHO surgical safety checklist. International Journal of Quality in Healthcare, 365–70. WHO World Alliance for Patient Safety. (2008). Summary of the evidence on patient safety. Geneva: World Health Organization. WHO World Alliance for Patient Safety. (2009). Conceptual framework for the international classification for patient safety. Geneva: World Health Organization.

NOTE: This article was originally written by Greg Seager, Founder and CEO, Christian Health Service Corps. Some updates have been made since.  A missions agency is a sending organization that helps prepare, place, and care for missionaries so they can serve faithfully and effectively over time. Choosing among missionary agencies is not a paperwork decision; it shapes your training, your support, your team life, and the care you will receive when the work gets heavy. I am writing because most healthcare professionals wanting to serve in long-term missions are asking the wrong questions. Experience has shown that asking the wrong questions can lead to unnecessary failure on the mission field. The questions below are meant to be asked before selecting among missionary agencies through which to serve as a long-term medical missionary. I posed a list of questions in my book, When Healthcare Hurts that seemed a bit sacrilegious at the time. Those questions helped shift the medical missions culture toward patient safety and showed greater respect for human dignity. The questions shared here may also stretch some serving in, and leading, long-term mission organizations. It is my prayer that this series of posts, and the book to follow, will have the same effect in long-term healthcare missions. The list is broken down into a few categories of questions. First, what questions should a healthcare professional planning to serve in missions ask potential missionary agencies? Second, what questions should a healthcare professional planning to serve in missions ask about being matched with a facility or health program? Third, what questions should a healthcare professional planning to serve in missions ask themselves to help them be successful on the field? This focuses on the first category. Subsequent posts will focus on categories two and three.   Key Takeaways Medical missions place unique emotional, clinical, and spiritual burdens on healthcare professionals that differ significantly from other forms of missionary service. Attrition among medical missionaries is often driven by unaddressed realities such as isolation, overwhelming workloads, and repeated exposure to death and trauma. Medical missionaries carry an internal weight shaped by constant life-and-death decisions, resource scarcity, and questions of clinical preparedness. Effective care for medical missionaries must resemble disaster-response support rather than traditional missionary member care models. Choosing among missions agencies requires asking hard questions about preparation, accountability, mentorship, and long-term support to protect both patients and missionaries.   Medical Missions Is Different One thing was always clear: sending a doctor, nurse, or other healthcare professional to serve in a mission hospital, or even a community health program, looks very different than sending a pastor. Many mission organizations miss this point, and it has contributed to significant attrition in medical missions. When medical missionaries are lumped in with church planters, Bible college teachers, and Bible translators, it becomes harder to see the distinct pressures that drive healthcare professionals to leave the field. I spend a great deal of time traveling to see medical missionaries serving across many cultures. I have interviewed hundreds of medical missionaries over the years, and some of these conversations are shared on MedicalMissionsTV. These stories carry a consistent theme: long-term medical missions expose people to a weight that cannot be managed by good intentions alone. Not long ago, I interviewed a single female physician who left the field after two years. Because she was the lone single person on the mission station, she carried a much greater load. Since she did not have a family to go home to and set boundaries around, she was expected to do more calls and work longer hours. That eventually led to her departure from the field. I also spoke with a pediatrician who left after one year because he could not cope with the vast amount of child death he saw while serving in a rural African bush hospital. He lost 150 children in his first year. That is not a typical missionary set of problems, and it changes how to choose a missions agency. Medical professionals share many challenges with other missionaries: language acquisition, moving your family to another culture, working within an intercultural team, and educating children, to name a few. Yet they also face daily life-and-death decisions. The classic reason missionaries leave the field—not getting along with other missionaries—still exists in medical missions, but it is far less traumatic than many reasons medical missionaries come home. Many medical missionary challenges cause post-traumatic stress and lifelong wounds.   The Challenge of the Internal Voice Medical missionaries must manage an internal voice that asks questions most non-healthcare professionals have never heard. It is the voice that asks questions many have been forced to ask in their careers. If I would have done something different, would that child have survived? Did I make a mistake? Is there something I should have learned before I came to the field that could have saved this child? How can I practice here? I never cared for a young mom with postpartum hemorrhage and no blood available. I never treated a child so malnourished they cannot stand, walk, or eat. Where do I start? Experience has taught me that caring for a medical missionary should look more like caring for an aid worker in a disaster zone than caring for a typical missionary. Mission organizations must understand this both conceptually and in member care practice.  These daily questions are inevitable in the first few years on the field, and they add immense stress to already stressful life circumstances. Combine that with the volume of child and maternal death, being forced to work without needed medications, supplies, blood, and equipment, and walking families through the death of a child or loved one, often daily. These are unique challenges for medical missionaries.   How to Choose a Missions Agency for Healthcare Missions With that reality in view, the questions below were created. They are not meant to be cynical. They are meant to protect patients, strengthen missionaries, and help missionary agencies build healthier pathways for long-term service. For some, the best place to start is clarifying the shape of a call and the practical next step. Discerning direction matters, and signs that God is calling you to ministry can help frame discernment without reducing it to a feeling. For others, it helps to zoom out and understand the pathway of preparation that often sits behind successful long-term service, including how to become a missionary.   Questions to Ask Missionary Agencies Does the organization recognize and understand the unique challenges of healthcare missions? Does the organization’s pre-field preparation include sections that are specific to healthcare missions? If so how much preparation is dedicated specifically to healthcare missions? Does the organization view healthcare as a ministry itself, or do they view it as a platform for evangelism? Does the organization view healthcare and healing ministries as part of the mission of the church? Is there spiritual and clinical mentorship available, promoted and or required? Does the organization have a missionary/member care program that focuses on and addresses the unique needs of healthcare professionals and their families? Does the organization ascribe to the International Global Connections in Member Care? What is the work schedule expected, and what are the leave and furlough policies? Are they structured to support healthcare professionals? Are visitors permitted in the first term of service? Is the organization familiar with World Health Organization (WHO) guidelines for clinical practice in resource-poor communities? Does the organization know about, and promote their missionaries' learning, programs such as Integrated Management of Childhood Illness (IMCI), Integrated Management of Childhood Malnutrition (IMCM), Integrated Management of Pregnancy and Childbirth (IMCPC)? Will the organization provide logistical support for healthcare ministry work? I.E. Medical equipment, supplies, volunteer staff relief, grant requests made to support medical work etc.? These questions do more than screen for competence. They reveal whether a missions agency can shoulder the responsibility of sending clinicians into environments where the margin for error is thin and the emotional cost is high. That is the heart of evaluating missionary agencies with honesty.   Exploring Next Steps in Long-Term Service When you are ready to move from exploration to action, a helpful step is to compare long-term opportunities that align with your training, convictions, and season of life. Explore options for long-term service and use the questions above as your filter while engaging missionary agencies.   Related Questions   What is a mission agency? A mission agency is an organization that trains, sends, and supports missionaries for ongoing cross-cultural ministry.   How do I choose a reputable mission org? Choose reputable missionary agencies by looking for clear governance, strong preparation, transparent policies, and proven member care.   What is the average salary of a missionary? Missionary compensation varies widely, but many missionaries rely on support-based funding rather than a fixed salary.   How much does a mission trip typically cost? Costs vary by location, length, and logistics, but travel, lodging, insurance, and in-country expenses often make the total significant.  

Article by Greg Seager, Founder and CEO of Christian Health Service Corp  Integrated Management of Childhood Illness (IMCI) is an integrated approach to child health care, which is needed because children that present for care in developing communities rarely do so with only one condition. There are frequently multiple issues when a child presents for care with malnutrition often being an underlying issue. When implemented, IMCI can and does reduce early childhood morbidity and mortality. It also improves growth and development among children under five years of age. IMCI is both preventive and curative and is implemented by families and communities as well as by health workers. The strategy includes three main components: • Improving case management skills of health-care staff • Improving overall health systems • Improving family and community health practices In the missions world, we often use Community Health Evangelism (CHE) as the community level of IMCI. The training portion of the IMCI strategy for health workers teaches appropriate case management skills for the identification management of sick children. IMCI works at the rural health outpost level, outpatient clinic level, and inpatient level, using a combined set of protocols and charting system that ensures appropriate integrated treatment of all major illnesses. It also strengthens the counseling abilities of caretakers and speeds up a referral to higher levels of care for severely ill children. In the home setting, it promotes improved care-seeking behaviors, improved nutrition, preventative care for children, and the correct implementation of prescribed care. In short, IMCI is a MUST LEARN set of protocols for those planning to provide care in developing countries. You can download a copy of the IMCI Chart Booklet and Protocols here You can acquire the entire IMCI training Program on our Clinical Resources Page. Similar articles can be found on the CHSC Blog www.MedicalMissions101.com and check our Youtube Channel www.MedicalMissions.TV   See some of the case management videos here:            

Hospital protocol policies on human trafficking give clinicians a clear, safe path for recognizing trafficking and responding well in the moment. When a patient may be under someone else’s control, improvisation can create risk for the patient, the team, and the facility. With the right hospital protocol policies for human trafficking, your staff can move from uncertainty to confident, coordinated action. Strong trafficking protocols also help you protect documentation, follow reporting requirements, and connect patients with the right partners.   Key Takeaways Healthcare professionals often recognize possible trafficking in clinical encounters but feel unprepared when hospital protocol policies for human trafficking are unclear or absent. You do not need to confirm trafficking at the bedside; noticing patterns of control, fear, and inconsistent history should activate established trafficking protocols. Clear hospital protocol policies for human trafficking replace guesswork with coordinated action, guiding screening, documentation, referrals, and communication. Effective trafficking protocols protect both patients and staff by addressing safety risks, reducing escalation, and standardizing responses under pressure. Moving a facility from awareness to readiness starts with committed leadership, local partnerships, and clinicians willing to champion practical protocol development.   A Familiar Clinical Moment Imagine you are staffing the urgent care clinic at your hospital when you encounter a 19-year-old foreign national woman brought in by a family member because of a possible fractured arm. Radiologic studies show a spiral fracture of the radius, raising the suspicion of abuse as the cause of the fracture. As you continue your evaluation, you notice she appears cautious and, at times, fearful of this family member. At first, you consider domestic violence. Then you remember a lecture on human trafficking from months ago. You try to recall the indicators of trafficking and what you are supposed to do if trafficking is suspected. You wonder if you should separate the family member from the patient and whether there is any danger to you and your staff. What if the family member refuses to leave? The more you think about it, the more you realize you are not prepared to deal with the problem before you. You feel helpless and frustrated. As more healthcare professionals learn about trafficking, they increasingly recognize patients who might qualify as victims. Too often, they do so in settings that lack preparation. That gap feeds the same frustration and helplessness.   What to Look for When Trafficking Is Possible You do not need to prove trafficking in the exam room. You need to notice when the situation does not fit and when a patient may not be free to speak or choose. In clinical settings, several patterns often raise concern, especially when they appear together: The accompanying person answers for the patient, controls the conversation, or refuses to leave. The history shifts, does not match the injury pattern, or feels rehearsed. The patient seems unusually fearful, watchful, or anxious about consequences. The patient lacks control of identification, money, transportation, or a phone. These are not diagnostic. Still, they are the kinds of signals and problems that undergird human trafficking and should activate trafficking protocols so you can proceed safely and consistently.   Why Hospital Protocol Policies for Human Trafficking Matter The answer is not a heroic clinician with the perfect words. The answer is a response protocol designed specifically for possible trafficking victims. Hospitals and large clinics should build specialized hospital protocol policies for human trafficking just as they already prepare protocols for domestic violence, child abuse, and sexual assault. When you have clear policies in place, your team can respond quickly without guessing under pressure. Well-designed trafficking protocols help you: Create a consistent plan for patient separation and private screening. Clarify who leads the response in your facility and who gets notified. Document appropriately and preserve information that may matter later. Connect patients to services without increasing danger. Reduce moral distress in staff by giving them a plan they can trust. A practical starting point for building hospital protocol policies on human trafficking is the HEAL Trafficking protocol toolkit.   Staff Safety Is Part of Good Care Healthcare teams sometimes hesitate to act because they worry about escalation. That concern is valid. Trafficking involves control, coercion, and, at times, associated criminal activity. It can also involve real danger to victims and their families. Strong hospital protocol policies on human trafficking should address safety for everyone in the room, not just the patient. That includes clear guidance on when to involve security, where to move the patient for privacy, and what to do if a controlling companion refuses to leave. It also helps to pre-plan communication. When every clinician uses a different approach, you can inadvertently tip off a trafficker or increase pressure on the patient. Trafficking protocols keep messaging consistent and reduce improvisation.   Building a Response That Works in Your City Safely navigating the hazards and complexities of trafficking requires preparation and consultation with experts in your location. Those partners often include: Law enforcement officials who focus on the crime of human trafficking. Child protective agencies that understand child sex trafficking. Homeland Security officials who can assist foreign national victims. Local nonprofits that address the varied nonmedical needs of trafficking survivors. These relationships matter because the “right next step” can change based on the patient’s age, citizenship status, immediate safety needs, and the level of control at home or work. If you want to strengthen your clinical approach and understand the realities survivors face, spend time working with human trafficking victims to understand their needs and experiences.    Be the Person Who Moves Your Facility From Awareness to Readiness Perhaps you can be the champion in your facility who initiates and supports the development of specialized hospital protocol policies on human trafficking. That work can start small: a meeting with leadership, a review of existing policies, a call to local partners, and a draft response pathway. Over time, those steps can build trafficking protocols that let clinicians move from frustration to purposeful care. When staff know what to do, they can focus on what matters most: safety, dignity, and wise coordination. If you're passionate about healthcare missions and want to serve in areas of extreme poverty and need, a short-term mission trip is a good place to start.   Related Questions   How do you respond to human trafficking? Use trauma-informed care, separate the patient for a private conversation when safe, and follow established trafficking protocols for documentation and referrals.   How do you support victims of trafficking? Support starts with safety and choice, then continues through coordinated medical care and connection to trusted local resources.   Is there a hand signal for human trafficking? A widely shared “Signal for Help” exists, but it is not trafficking-specific and should prompt a careful, private safety check.   What are the needs of trafficking victims? Trafficking victims often need immediate safety planning, medical care, psychological support, legal guidance, and stable housing and employment pathways.