‘Blessed are the poor in spirit,
    for theirs is the kingdom of heaven.
Blessed are those who mourn,
    for they will be comforted.
Blessed are the meek,
    for they will inherit the earth.
Blessed are those who hunger and thirst for righteousness,
    for they will be filled.
Blessed are the merciful,
    for they will be shown mercy.
Blessed are the pure in heart,
    for they will see God.
Blessed are the peacemakers,
    for they will be called children of God.
Blessed are those who are persecuted because of righteousness,
    for theirs is the kingdom of heaven.

‘Blessed are you when people insult you, persecute you and falsely say all kinds of evil against you because of me. Rejoice and be glad, because great is your reward in heaven, for in the same way they persecuted the prophets who were before you.

The beatitudes or blessings are Jesus’ manifesto for all who wish to be His disciples. The word “blessed” comes from the Greek makarios and is sometimes translated ‘happy’. However, the more precise meaning will be ‘blessed’ or ‘fortunate’. Who can be happy when crying, suffering or being persecuted? Happiness is subjective, varies from person to person and is dependent on circumstances, whereas God’s blessing is a promise and a certainty, both for the present and for eternity.

Blessed are the poor in spirit (v.3)

Jesus is not referring to the poor in terms of socio-economic disadvantage. Although at times material wealth and prosperity can be an obstacle to intimacy with God, there is no revelation here or elsewhere in Scripture that the materially deprived will for that reason be more blessed by God. Nor does the expression ‘poor in spirit’ refer to the uneducated, ignorant, or mentally retarded. Poverty of spirit is an indispensable condition for entering the Kingdom of God. It means recognizing our spiritual poverty and failure before the high standards of conduct that a holy and perfect God requires, like the tax collector who said, ‘O God, have mercy on me, a sinner’ (Luke 18:13).

Blessed are those who weep (v.4)

This is not just any weeping but a deep sadness, as when we go through a mourning process for the loss of someone we love. It results from our recognition of the extent and seriousness of our sin and the sin of others (cf. Psalms 139:136). It is the feeling of emptiness, of a lack of meaning in life, which has driven many to suicide or madness and which only God can satisfy. As Pascal said, ‘there is a God-shaped vacuum in the heart of every person, and it can never be filled by any created thing’.

Blessed are the meek (v.5)

In the Bible the adjective ‘meek’ is used to describe the character of two people: Moses (Numbers 12:3), who defied the powerful Egyptian pharaoh, and Jesus (Matthew 11:29), who voluntarily submitted to the torture and humiliation of cruel Roman soldiers, and did not bow down before the governor Pilate. Meekness does not mean weakness, cowardice, or timidity, but humility, obedience, and self-control. Like a trained horse, about which we say it is meek because it is submissive and obeys its owner, not because it is weak, in the same way the meek ones Jesus refers to are people who willingly submit to God’s will and are led by his Spirit.

Blessed are those who hunger and thirst for righteousness (v.6)

Having this kind of hunger and thirst that Jesus talks about is something that few of us have experienced, but which Jesus’ disciples knew well. It means being so desperately in search of water or food that all other things no longer matter. Physiological needs like eating, drinking, and sleeping are at the base of Maslow’s iconic pyramid, before other needs like security, belonging, or self-esteem. To hunger and thirst for righteousness is the burning desire to see God’s Kingdom established as people come to know Jesus as Saviour and Lord of their lives.

Blessed are the merciful (v.7)

There are many texts in Scripture that refer to God’s mercy, and the need for us to forgive others as Christ has forgiven us. The Lord told his disciples that he was giving them a new commandment concerning love: ‘Love one another. As I have loved you, so you must love one another’ (John 13:34). This compassionate love includes care for the weak and vulnerable who have need of food, clothing, and comfort in sickness or prison, and goes beyond traditional Jewish teaching as it includes love for enemies. It was the desire to fulfil God’s will and this love for others that led to the creation of the first hospitals and orphanages, the abolition of slavery or the development of palliative medicine, pioneered by Christians committed to God.

Blessed are the pure in heart (v.8)

The pure in heart are sincere in their relationship with God and with others. They don’t put on masks because they have nothing to hide. They don’t have to prove anything because they know that they are nothing without God (they are poor in spirit). They are people who do not behave one way in church and another way at home or at work but who, whatever the occasions and circumstances, try to live with a clean conscience before God.

Blessed are the peacemakers (v.9)

The followers of Jesus should seek peace and reconciliation among human beings and with God, who is a God of peace. Contemporary history is full of examples of committed Christians who have played a decisive role in bringing reconciliation between people and groups in conflict. Their actions and prayers also contributed for a peaceful political transition in some countries, as for example in South Africa in the 1990s, where a bloodbath was to be expected with the regime change after decades of racial segregation.

Blessed are those who are persecuted (v.10)

Despite our efforts towards reconciliation, some will oppose it. Every Christian should expect opposition which is the result of our identification with Jesus and proclaiming his divinity and exclusivity as the only way to God. There has never been a time in the history of the world when more Christians are persecuted because of their faith in Jesus than in our days. And hostility and persecution will increase as we approach the end times.

Conclusion

In the beatitudes, Christ challenges us to live according to God’s highest standards and eternal values and not according to the ideologies and value systems of this world. It is a challenge for every true disciple of Jesus everywhere, in every culture, and in every age of history. We cannot present these qualities by our own strength or efforts, but only by God’s grace and the power of the Holy Spirit, following the example of the Lord Jesus, who manifested each of these virtues in abundance.

Jorge Cruz MD PhD (Bioethics) is a vascular surgeon working in Portugal. He is a member of the national committee of the Portuguese Association of Christian Doctors and Nurses (AEMC).

This commandment is not optional. It is a mandate for every Christian, in every time and place. One of the best illustrations I have heard so far about what it means to evangelize is a beggar telling another beggar where to find food. This illustration is interesting because it summarizes in a few words some aspects of our mission as Christians.

Each one of us was saved by God’s grace and not by our personal merits or qualities, as the Apostle Paul emphasized in his letter to the Ephesians: ’For it is by grace you have been saved, through faith—and this is not from yourselves, it is the gift of God, not by works, so that no one can boast.’ (Ephesians 2:8-9) In this sense, we can consider ourselves beggars, because we know our limitations and we know that we cannot do much, with impact for eternity, if we are separated from the vine, which is Christ. (cf. John 15:5)

On the other hand, if Christ is not the Lord and Master of our lives, we are poor; but poverty of spirit is an indispensable condition for entry into the Kingdom of God (cf. Matthew 5:3). It means recognizing our spiritual poverty and failure before the high standards of conduct that a holy and perfect God demands (Luke 18:13). Jesus sent a stern warning to the members of the church in Laodicea, who failed to recognize their true spiritual condition: ’You say, ‘I am rich; I have acquired wealth and do not need a thing.’ But you do not realize that you are wretched, pitiful, poor, blind and naked.’ (Revelation 3:17)

Our Mission

Our mission is to point to the Lord and Saviour Jesus Christ, the way, the truth and the life, who gives us access to eternal life with God (John 14:6). Jesus is the bread of life, who can satisfy our spiritual hunger and search for purpose in life (John 6:35). As Josh McDowell states in his book More Than a Carpenter, ’Christianity is not a religion; it’s not a system; it’s not an ethical idea; it’s not a psychological phenomenon. It’s a person. If you trust Christ, start watching your attitudes and actions because Jesus Christ is in the business of changing lives.’

In order to fulfill the mission of world evangelization we need to have a genuine love for other people, which is not something innate, but possible through the supernatural action of the Holy Spirit in our lives, who also enables us to do the works that Jesus did (John 14:12). Without this love and compassion for the lost, and without the presence and power of the Holy Spirit in our lives (Acts 1:8), we will not be very effective in this mission of going and making disciples of all nations.

There are many factors that hinder this calling:

• Lack of intimacy with God, little dedication to prayer, lack of time and availability are some of the most common.
• Having low self-esteem or considering ourselves somehow inferior to the person to whom we intend to share the gospel (because they are of a higher social status, more intelligent, or have greater abilities than us in some area.)
• Knowing that we are not perfect and thinking that we will therefore be bad representatives of the gospel cause.
• Thinking that we don’t have enough biblical and theological training to answer questions that we may be asked.
• Dealing badly with the indifference, rejection, and even some hostility that are relatively common when we proclaim the message of salvation in Jesus.

The truth is that there is no valid reason why we should not be more active and diligent in fulfilling this mission, because it was God who made the decision to hand over this task to mortal and imperfect human beings and not to his angels. Moreover, the Lord Jesus promises to accompany us in this noble mission, for he said, ’I am with you always, to the very end of the age.’ (Matthew 28:20)

Jorge Cruz MD PhD (Bioethics) is a vascular surgeon working in Portugal. He is a member of the national committee of the Portuguese Association of Christian Doctors and Nurses (AEMC).

‘What shall I do, Lord?’ I asked.
‘Get up,’ the Lord said, ‘and go into Damascus. There you will be told all that you have been assigned to do.’
My companions led me by the hand into Damascus because the brilliance of the light had blinded me. A man named Ananias came to see me. He was a devout observer of the law and highly respected by all the Jews living there. He stood beside me and said, ‘Brother Saul, receive your sight!’
And at that very moment, I was able to see him.
Then he said: ‘The God of our ancestors has chosen you to know his will and to see the Righteous One and to hear words from his mouth’.

Acts 22:10-14

Do you have an Ananias in your life? At times God brings people into our lives that bring about a transformation that lasts forever. These people we meet give us sight to look to Jesus, they point us to what God wants us to do, and teach us how to grow spiritually and draw closer to the Lord.

In my life, I have had several Ananias, one of whom was my pastor Rafi Shahverdyan.

I grew up in a strongly atheistic family, and I thought that religion and believing in God was for uneducated people. As a ‘smart’ and ‘clever’ person I would never think of such nonsense things. But the Lord opened my eyes to his grace after graduating from Medical University and I became a Christian.

However, I had a lot of confusion and conflicts in my mind. I was ultimately ‘blind’ and didn’t know what to do or where to go. It was then that I met Pastor Rafi who took care of me and gave me a vision of using my medical skills for the Kingdom of God.

Pastor Rafi (pictured centre) was a close friend of Dr Jany Haddad who once asked him if he knew anyone who could assist him during surgeries in Armenia. He organised a meeting with several medics from our church, and this was the first time that I was introduced to Dr Jany Haddad (pictured left).

This meeting was a life changing encounter. I was inspired by Dr Jany’s vision and with the encouragement of Pastor Rafi we started a group of Christian doctors (with only three doctors initially) which became the Armenian Christian Medical Association (ACMA). Within a year more than 50 people who had joined the association!

Pastor Rafi, who was not an ACMA member, was incredible in supporting the association from the very first meeting. He connected us to other doctors, advertised ACMA, prayed for ACMA missions and conferences, preached at ACMA annual conferences and meetings, and counselled ACMA members. One of his main messages to Christian doctors was to demonstrate the Father’s love to their patients, treating them with compassion in a way that other doctors cannot.

He healeth the broken in heart and bindeth up their wounds.

Psalm 147:3

Rafi was one of the few leaders who reminded ACMA members of the danger of burn out due to their medical workloads. He taught that the best place to go for the Holy Spirit’s refreshment was at the feet of Jesus Christ. I learned from him that inner healing is essential and that without inner harmony you cannot work efficiently and serve God.

During ACMA conferences, Rafi could spend several hours praying for every person there and listening to their stories and needs. His arms were always open to hug and comfort the broken ones.

In Armenia there is a national unforgiveness which is rooted in historical persecution with Turkey. As a grandchild of a genocide survivor, I too struggled with this. Pastor Rafi however, was a Christian that looked beyond nationalities. He looked at every nation with the eyes of the Lord and had a heart for them. He organised several reconciliation conferences inviting Turkish Christians, and he went to Turkey several times and sent several missionaries from his church to Turkey.

Pastor Rafi was trying to break the wall that had built up between these two nations since 1915, and was encouraging us as Armenians to forgive and love our neighbours. After one particular trip to Turkey he wrote a beautiful book, Armenian Wine and Turkish Bread – A Real-Life Journey of Reconciliation.

Because of Pastor Rafi, I started to look at the country of Turkey and its people with a different lens, and began to think about starting a Christian Medical group in Turkey. I shared my vision with Pastor Rafi who was delighted to hear of my plans and helped connect me to his Turkish contacts. This was the journey of starting a Christian medical group in Turkey.

Through Pastor Rafi, I was also introduced to Alice, an Iranian dentist, who is now leading a group of Iranian medics.

Pastor Rafi was a person with whom I could share my successes, difficulties and challenges and receive his godly advice and prayers. Our meetings always ended with gifts which were usually books that had either been written by him or had been a blessing to him.

The last book he gave us, in November 2022, was Wipe My Tears, a message of healing to comfort people who grieve. It was a collection of testimonies from people that he had met during his years of ministry. They were people who had experienced much brokenness but had also found healing and restoration in Christ. Their stories were a motivation to believers to help those who are grieving find comfort.

Pastor Rafi had a wonderful family. He was married to the lovely Janet and they had three beautiful daughters and five grandchildren. He was a beloved husband, father and grandfather and by just looking at his family you could already learn a lot.

I am very grateful to God for the Ananias and Loving Fathers I have met on my life’s journey. Because of them I am a completely different person.

Today my two spiritual Fathers are rejoicing in eternal life with our Lord. They leave us with beautiful memories and are a testimony of how to be a Loving Father to others before we join them there.

It is my prayer that everyone in ICMDA can be an ‘Ananias’ for someone and finds one for themselves. Amen.

Dr Kristina Alikhanyan is the ICMDA Regional Representative for Caucasus, Eurasia

The subject of Servant Leadership might be easy to write or talk about, but it is challenging to live as a servant leader. The question really is: ‘You who write or talk about servant leadership, are you a servant leader?’ The term ‘leadership’ in the title seems to imply ‘power and authority’ but it is best understood as ‘servanthood’ rather than ‘servant leadership’.

Leadership is defined as ‘influence’ and a positive influence is needed in every workplace. Leighton Ford says:‘Leadership is a topic on many agendas today, whether in politics, business, or the Church.’  As such, many corporations are investing in leadership development and training in order to have the right leaders in place.

What is servant leadership?

The term ‘Servant Leadership’ was first coined by Robert Greenleaf in 1970s.¹ But even before that, two thousand years ago, the Lord Jesus came as a servant who washed his disciples’ feet (John 13) and introduced a new concept and definition of leadership to the world which is ‘to serve and not to be served’. Wikipedia defines Servant Leadership as ‘a philosophy in which the goal of the leader is to serve’. Greenleaf describes servant leadership as ‘being a servant first, a natural feeling that one wants to serve, to serve first’.

For centuries, many leadership models have been developed, practised and observed. Apart from negative types like dictatorial leadership, there are good things in most of them but perhaps the element of being a ‘servant’ is what is missing.

Hindrance to servant leadership

The greatest obstacle to being a servant leader is the fallen human nature that craves for titles and position. ‘A dispute arose among them as to which of them was considered to be greatest’ (Luke 22:24). This is a phenomenon seen throughout all generations. The Lord had to model the type of servant he wants to see in his kingdom. ‘Jesus called them together and said, “You know that the rulers of the Gentiles lord it over them, and their high officials exercise authority over them. Not so with you. Instead, whoever wants to become great among you must be your servant, and whoever wants to be first must be your slave.”’ (Matthew 20:25-27)

Here the secret to greatness is in being a servant.

In the political arena, the world has witnessed both good leaders who served their people well and dictatorial leaders who one article says ‘all governed their nations and left certain footprints of violence that are difficult to forget by the people they ruled’.² The article says about one of the dictators that ‘he was so much of a terror that news of his sudden death was received with joy in virtually all parts of the country’. This is comparable to King Jehoram who because of his evil, the Bible equally says, ‘He passed away, to no-one’s regret’. (2 Chronicles 21:20) What legacy do leaders want to leave behind?

Character and hallmark of a servant leader

What is the character that indicates one is a servant leader? A servant leader:

• Seeks to glorify his master
• Sacrificially seeks the highest joy of those he serves
• Will forgo his rights rather than obscure the gospel
• Is not preoccupied with personal visibility and recognition (John 3:30)
• Anticipates and graciously accepts the time for his decrease.

The five characteristics and hallmark of servant leaders are:

1. Valuing people– servant leaders value people for who they are
2. Humility – putting other people first
3. Listening– receptive and non-judgmental listening
4. Trust – servant leaders trust others
5. Caring – servant leaders have people and purpose in their hearts.

How is servant leadership developed?

Let me underscore that there is no single school or academic institution in the world one can join to become a servant leader. Servant leadership is a life-long school at the feet of the Lord Jesus Christ. The following five tips can help develop servanthood.

1. Learning from the example Christ.

This is the most important starting place. To be constantly at the feet of the Master and learning from him. ‘I have set you an example that you should do as I have done for you.’ (John 13:15)

2. Learning from leaders who are servant leaders.

Mentors who are servant leaders are a blessing; we can learn from and imitate their example. ‘Remember your leaders, who spoke the word of God to you. Consider the outcome of their way of life and imitatetheir faith.’ (Hebrews 13:7)

3. Self-training and continuous learning.

Growth in any area in life depends on personal decision, continuous training and learning. ‘Be diligent in these matters; give yourself wholly to them, so that everyone may see your progress. Watch your life and doctrine closely. Persevere in them, because if you do, you will save both yourself and your hearers.’ (1 Timothy 4:15,16)

4. Learning from situations in life.

One brother shared how one time he behaved like the Priest and Levite in the Good Samaritan’s Story (Luke 10) and learned an unforgettable lesson. He was driving in a rainy day and saw a woman and her kids in the rain but pretended as if he did not see them. On the way, his conscience convicted him but when he returned to pick them, he found them gone. A Good Samaritan probably picked them!

5. Reading books on leadership.

It might be debatable if reading books on leadership can really help one become a servant leader. But it is undeniable that we can learn from books as they contain stories, testimonies and experiences of others. The first book I would recommend is the Bible itself that contains stories like that of the Good Samaritan (Luke 10).

‘All Scripture is God-breathed and is useful for teaching, rebuking, correcting and training in righteousness, so that the man of God may be thoroughly equipped for every good work.’  (2 Timothy 3:16-17)

Lord, help us to learn from your servant leadership.

Alex Bolek is ICMDA Africa Coordinator and Regional Secretary for East Africa.

1. Servant Leadership: The Leadership Theory of Robert K. Greenleaf p.3

2. (REC FOCUS Vol. 4, No. 3 p 71 – 72, September 2004)

Wikipedia defines partnership as ‘an arrangement where parties agree to cooperate to advance their mutual interests.’ In Christian ministry terms, this would mean advancing mutual ministry interests to advance God’s kingdom. In the above text, Peter and those with him signalled (called) their partners in the other boat to come and help them in pulling the net. There is always need for partnership in ministry.

Importance of Partnership

Partnership is important for three main reasons:

• To work towards a common vision
• To carry out joint activities
• To carry out an activity that may be extremely difficult for one organisation to carry out alone.

Mary T Lederleitner summed it up that ‘We partner and work with our brothers and sisters around the world for reasons far deeper than any specific ministry outcome or objective…’

Reasons for partnership

In building God’s Kingdom, the following form the basis and reasons why organisations partner in ministry.

1. God’s kingdom and the Great Commission are greater than one Church or organisation

This is a self-explanatory truth. God’s kingdom is the biggest Kingdom that needs to be built and established on earth. The ‘ends of the earth’ in the Great Commission cannot be reached by one church, organisation or ministry. No one organisation can be effective or can claim it can evangelise the whole world or meet all the vast and enormous ministry needs alone. As such, collaboration and partnership are needed.

2. Partnership brings the mutual joy of winning souls together

In the Luke 5 story, the Lord Jesus needed a partner, Peter. Peter on the other hand signalled for partners in the other boats to come and take part in pulling the net! It is a joy when our joint collaboration and partnership results in winning souls for Christ.

Luke and Mark mention three types of partners:

• Net directing partners: The Lord Jesus in Luke’s story is this type of partner. A discerning and visionary partner who could figure out and guides to where the net should be cast ‘for a catch’. This type of partner saves effort and time from being wasted. They, like the children of Issachar, know what to do in the right time, in the right place, in the right way (1 Chronicles 12:32).

• Net-casting and net-pulling partners: Peter casted the net and he signalled to his partners in the other boats to come and pull the net with him. Mark says ‘Jesus saw Simon and his brother Andrew casting a net…’ (Mark 1:16). Who are the net-casting and net-pulling partners? These are the evangelists who preach God’s word and pull the net in a pulpit call for sinners to receive Christ. We need these frontline evangelism partners!

• Net-preparing partners: Mark in his gospel also mentioned this type of partners. ‘He (Jesus) saw James son of Zebedee and his brother John in a boat, preparing their nets’ (Mark 1:19). Clearly, these are partners behind the scenes supporting evangelists financially and prayerfully. When evangelists travel to cast the net, we don’t normally know the people who gave the money for their air ticket, hotel accommodation, and their personal needs. Some people behind the scenes are ‘preparing’ the financial net and ‘interceding’ for them that the word they preach be anointed.

With all these three partners and others collaborating, God’s kingdom is built. I believe it was a great joy that day when the partners in the two boats joined hands in harvesting the fish.

3. Partnership brings greater blessing to the partners:

There is a blessing in partnership! We know from Luke’s story that the partners in the two boats were both blessed when they joined hands. ‘The two boats were both filled.’ This is a big lesson we all need to learn. God blesses and honours collaboration. God will bless individuals and ministries that are willing to partner and collaborate with other ministries. Their boats will also be filled.

4. Partnership is an acknowledgement of each other’s calling, giftings and ministry

Mother Teresa has said: ‘You can do what I cannot do. I can do what you cannot do. Together we can do great things.’ Why did Peter call his partners in the other boats? There were people in the other boats with gifts, skills and calling in pulling nets that he might not have. This is another good and strong reason to collaborate. There are organisations and brothers and sisters in the body of Christ with gifts, talents, capacity and calling we might not have.

5. Partnership reveals the truth about our hearts

Human beings have the selfish tendency to build their own kingdoms and ‘protectorates’ they do not want invaded by others. This makes people insecure and suspicious when it comes to building partnerships. Will they not become more dominant, influential, and known than us? Mark tells us how the flesh with its competitive and jealous nature came to surface among the disciples of the Lord Jesus Christ!

‘”Teacher,” said John, “we saw a man driving out demons in your name and we told him to stop, because he was not one of us.”’ (Mark 9:38). The Lord had to intervene and correct things. Partnership cannot live in one room with competition and jealousy. The right attitude in ministry should be:

• Cooperation not competition
• Complement rather than fighting for territories
• Having the big picture of God’s kingdom in perspective rather than individual myopic view

Let’s put our hands together and partner for God’s glory.

Alex Bolek is ICMDA Coordinator for Sub-Saharan Africa and Regional Secretary for East Africa  

Of the many challenges faced by foreign medical students, increased susceptibility to depression and anxiety disorders is the most prevalent (Ruzhenkova et al., 2020). Due to the high-demand and high-stress nature of studying medicine, medical students experience depression and anxiety disorders much more often compared to the general population. Given the added challenges that foreign medical students face being isolated outside their home country, these students are at an even higher risk of depression and anxiety disorders (Buzoianu et al., 2016; Machul et al., 2020). Personal stress, lack of support, language barriers, financial issues, different curriculum structure, and separation from loved ones are just some of the numerous risk factors foreign medical students must handle (Georgieva et al., 2017; Rashid et al., 2020). In addition, all of these issues contribute to the higher dropout rates and increased number of semesters required to complete a medical degree seen in foreign medical students, which only exacerbates the risk of depression and anxiety disorders even more (Huhn et al., 2015).

In a study by Henning et al. (2012) which focused on the quality of life of foreign and domestic medical students in New Zealand, researchers found that foreign medical students rated their social and environmental quality of life significantly lower than their domestic classmates. Notably, foreign medical students rated their level of satisfaction with their personal relationships and social support lower than domestic medical students. Foreign medical students also felt less safe and secure in the region they study in, had less opportunity for leisure activities, and had less access to information which would be helpful for their daily living, compared to domestic medical students.

A group of ICMDA members and volunteer researchers have begun a research project to explore the current context of foreign medical students around the world. The purpose of our research project is to understand the challenges faced by foreign medical students in order to determine how to better support these students. ICMDA organizations are present in the majority of countries who send or receive foreign medical students. With ICMDA’s reach across so many regions, there is an incredible opportunity at hand to coordinate reaching out and supporting foreign medical students in the ways they need it most. Awareness and understanding of the challenges foreign medical students face is crucial to propelling change. By understanding the challenges they face, initiatives can be put in place to address these challenges. Such a coordinated support could help many students and young graduates who are finding this phase of life difficult.

Our research group has put together two questionnaires – one for foreign medical students and graduates, and another for ICMDA fieldworkers and ICMDA national leaders. The links to the questionnaires have been emailed to the appropriate groups and will be open for completion until mid-October of 2022. These questionnaires are available in seven different languages. They include questions specific to the target audience with the overarching goal of gathering information about the current context and challenges faced by foreign medical students. If you are a foreign medical student, foreign medical graduate, ICMDA fieldworker, or ICMDA national leader, we strongly encourage you to complete our questionnaire through the links below to help us in our research.

Links to Foreign Medical Students & Graduates Questionnaire (by language):

• English
• Spanish
• French
• Portuguese
• Russian
• Arabic
• Chinese (Simplified)

Links to ICMDA Fieldworkers & ICMDA National Leaders Questionnaire (by language):

• English
• Spanish
• French
• Portuguese
• Russian
• Arabic
• Chinese (Simplified)

Additionally, members of our research group are in the process of interviewing foreign medical students, foreign medical graduates, ICMDA fieldworkers, and ICMDA national leaders to listen to their personal experiences and wealth of knowledge on the subject. By speaking to these individuals, we are also learning about the current supports in place and which supports would be beneficial for students in specific regions. If yourself or someone you know is interested in being interviewed for this research project, please reach out to Dr Santhosh Mathew to get more information.

Our heart for this research project is that no foreign medical student would struggle alone. Studying medicine is an extremely difficult and demanding period of one’s life, and journeying through those years in a foreign country adds countless challenges. Please stay tuned for the publishing of our findings in the coming months. We pray that this research project would ultimately bring Christ glory and empower organizations to strengthen foreign medical students all over the world.

References:

• Buzoianu, A. D. et al. (2016) ‘Correlates of depression, anxiety and stress among foreign medical students studying general medicine in Romania.’, European Psychiatry, 33.
• Georgieva, L. et al. (2017) ‘Environment for the immigrant medical staff and foreign medical students in Bulgaria’, European Journal of Public Health, 27(suppl_3). doi: 10.1093/eurpub/ckx186.139.
• Henning, M. A. et al. (2012) ‘Quality of life: international and domestic students studying medicine in New Zealand.’ Perspectives on Medical Education, 1(3). doi: 10.1007/s40037-012-0019-y
• Huhn, D. et al. (2015) ‘International medical students – a survey of perceived challenges and established support services at medical faculties’, GMS Zeitschrift fur Medizinische Ausbildung, 32(1). doi: 10.3205/zma000951.
• Machul, M. et al. (2020) ‘Lifestyle practices, satisfaction with life and the level of perceived stress of polish and foreign medical students studying in poland’, International Journal of Environmental Research and Public Health, 17(12). doi: 10.3390/ijerph17124445.
• Organisation for Economic Co-operation and Development (OECD) (2021) Health at a Glance 2021: OECD Indicators, OECD Publishing, OECD iLibrary.
• Organisation for Economic Co-operation and Development (OECD) (2019) Recent Trends in International Migration of Doctors, Nurses and Medical Students, OECD Publishing, OECD iLibrary.
• Rashid, M. A. et al. (2020) ‘“Doctor, teacher, translator:” International medical students’ experiences of clinical teaching on an English language undergraduate medical course in China’, Education for Health: Change in Learning and Practice, 33(1). doi: 10.4103/efh.EfH_212_19.
• Ruzhenkova, V. V. et al. (2020) ‘Prevalence and dynamics of depression and anxiety in local and foreign medical students for a 6-year training period’, International Journal of Early Childhood Special Education, 12(1). doi: 10.9756/INT-JECSE/V12I1.201044.

If the heathen gods are idols that cannot speak (Psalm 115:4), the God of the Bible is a living God who speaks! Science has proven that ‘All living things have the ability to communicate with each other using a variety of signs and signals.’ How much more God loves to communicate with the human beings he created in his image and redeemed to himself? God takes pleasure in speaking to his people and it is his people’s pleasure to listen and submit to his voice. Language is important in any mutual relationship. God speaks to us primarily through the Bible (2 Timothy 3:16, 17) but the Bible itself also records seven languages God uses to speak to us. God’s choice of the language he uses to speak to each one of us depends on him and our ability to listen. Here are the seven languages: 

1. Inner voice of the Holy Spirit 

God’s Holy spirit speaks in a soft inner voice the Bible describes as ‘a gentle whisper’ (1 Kings 19:11).  This needs a closer walk with God, training and holy living. As the famous hymn says, ‘Just a closer walk with thee!’ This is why the Bible tells us not to grieve the Holy Spirit (Ephesians 4:30) because it is through his Holy Spirit that God speaks to us. ‘Whether you turn to the right or to the left, your ears will hear a voice behind you, saying, “This is the way; walk in it”’ (Isaiah 30:21). 

2. The word - rhema

‘Rhema’ is a specific scripture or Bible passage the Holy Spirit uses to speak to a specific situation one is going through to bring encouragement, comfort and direction (Genesis 28:15). Once when I faced a huge problem the Holy Spirit used Mark 16 to encourage me. There was a ‘very large stone’ placed on the entrance of the tomb and the women while on their way to the tomb asked each other: ‘Who will roll away the stone from the door of the tomb for us?’ (Mark 16:3). That was my question: ‘Who will roll my stone for me?’ The story continues: ‘But when they looked up, they saw that the stone, which was very large, had been rolled away’ (Mark 16:4). The Lord was saying ‘don’t worry, I have rolled your stone.’ He did roll it!   

3. The body of Christ  

New Testament believers have the indwelling Holy Spirit who speaks through them. Believers in the Church of Ephesus for instance spoke to Apostle Paul through the Holy Spirit. ‘Through the Holy Spirit they urged Paul not to go on to Jerusalem.’ (Acts 21:4). This is one of the blessings of the fellowship of the brethren; that God speaks to us through our brethren. ‘How good and pleasant it is when God’s people live together in unity!’ (Psalm 133:1).  

4. Visions 

One New Testament vision God used to break the strong ‘middle wall of separation’ between the Jews and the gentiles (Ephesians 2:14), was that given to the Apostle Peter to go and preach the gospel in Cornelius’ house. ‘While Peter was still thinking about the vision, the Spirit said to him, “Simon, three men are looking for you. So do not hesitate to go with them, for I have sent them”’ (Acts 10:19). 

5. Dreams 

God speaks through dreams. God spoke to Joseph (Genesis 37), Pharaoh’s cupbearer and baker (Genesis 40:5), and Pharaoh (Genesis 41:1) through dreams. Two important things to note in relation to dreams: 

• Not all dreams are from God.  

Dreams that are not from God come from ‘cares’ or continuous thinking or worrying about something which the subconscious mind stores and brings up as dreams (Ecclesiastes 5:2). 

• God confirms dreams that are from him.  

The reason the dream was given to Pharaoh twice was to confirm that it was from God (Genesis 41:32 also Acts 10:16). It is important to ask: ‘Is this dream from God or from my cares?’ And not to rush but to wait for confirmation. 

6. Circumstances  

Can God use natural phenomena like heavy rains or cancelled flights to speak to us? I believe so. One good example is Balaam’s story (Numbers 22:21-31). The Lord stood in the way to block Balaam’s journey as it was not his will. Similarly, the Lord might use circumstances to protect us from stepping outside his will. 

7. Pain 

Pain is God’s seventh language! But why should God speak through pain when there are six nice languages he can use? As mentioned, the wise God chooses the language that can best get our attention to listen to him. The language of pain may be God’s last resort when we are no longer sensitive to the other languages. As CS Lewis said, ‘Pain is God’s megaphone to awaken a deaf  world.’ It was the language God used to speak to King Manasseh to restore him from evil. ‘Manasseh led Judah and the people of Jerusalem astray… The Lord spoke to Manasseh and his people, but they paid no attention. So, the Lord brought against them the army commanders of the king of Assyria, who took Manasseh prisoner. In his distress he sought the favour of the Lord his God and humbled himself…’ (2 Chronicles 33:9-13). 

Lord, Keep us sensitive to your voice. 

Alex Bolek is ICMDA Coordinator for Sub-Saharan Africa and Regional Secretary for East Africa  

This picture did not come from a vacuum but from watching the head of the surgical unit where I was posted. We looked up to him with awe. He was our role model—a UK trained Fellow of the Royal College of Surgeons (FRCS), who wore a three-piece suit in the heat and humidity of South India. He was a phenomenally skilled surgeon who stood an imposing six feet tall.

A Change of Mind

Immediately after my graduation, I started work at a mission hospital in rural India. I met many doctors there, one of whom stood out. He was a surgeon who would ride a bicycle to work, wearing the traditional attire of khadi jubba and mundu, without any train of people following him. Initially, I did not pay much attention to him. But when I realised he was highly skilled and had a double FRCS, my perspective changed.

In conversations with him I learned he did not see himself primarily as a doctor, but a follower of Jesus who happened to be a well-trained surgeon. For a young doctor who had been brainwashed over 6 years of training to believe your identity is married to your profession, this was a paradigm breaking perspective. He considered all he had earned and received for his hard work as given to him by God. 

In every conversation, he displayed gratitude for being chosen and being given the skills, the profession, and the platform to care for others. I had studied hard and earned a degree on my own, so I was not used to considering it as a gift I had been given. But for him it was a privilege to give back to God by caring for those in pain.

An understanding of the gospel and his personal relationship with Jesus had transformed him to recognise he had been given a privilege to be part of Jesus’s own ministry in the world.

His posture confronted the reasons I joined the hospital. I joined healthcare thinking God needed my service and I had much to offer to God and the many whom I thought needed my help. I was realising the life of Jesus can transform me inwardly and the way I live outwardly in the world.

Being a healthcare practitioner and a follower of Christ can change our hearts, our reason for being in healthcare, our career choices and the way we carry out our professional practice.

A Change of Heart

A few years down the line I began working in a mission hospital in India. Most of my time was spent taking care of many with critical illness that needed my urgent attention. I had the opportunity to spend a few days with christians who were faithfully proclaiming and living out the gospel in difficult contexts. I saw the church growing vibrantly among a community that, just under a decade ago, was addicted to alcohol and had a long history of violence. The gospel was breaking through in power, with wonders and miracles.

I heard stories of many missionaries and church members who had died of Malaria in the field. I also had the privilege of caring for a missionary who was on her deathbed due to Malaria. The oldest member in that church community was 45 years old—the life expectancy there was less than 50.

There were women dying of childbirth every day, infants and children dying due to Malaria, TB and Kala Azar every other day. This was a church that was growing spiritually and flourishing but its members were dying of preventable illnesses.

I found this experience disturbing my heart and challenging my theology. From seeing the healthcare practice as taking care of those in need of critical care, I was being challenged to consider healthcare as ushering in the new heavens and the new earth.

I began to relate God’s desire for shalom to the work I was doing on the field: “No more shall there be in it an infant who lives but a few days, or an old man who does not fill out his days, for the young man shall die a hundred years old…” (Isaiah 65:20)

“Thus says the Lord of hosts: Old men and old women shall again sit in the streets of Jerusalem, each with staff in hand because of great age. And the streets of the city shall be full of boys and girls playing in its streets.” (Zechariah 8:4-5)

The relevance of these images in the midst of the busy curative work I was engaged in began to change my theological perspective and its influence on the practice of healthcare.

I saw the importance of being an intentional healing presence as opposed to merely being a curing presence. I began to see that a person who may not be cured can still be cared for by journeying with them. I started to see that if healing has to come to a community and shalom has to be ushered in, there is a need for the church and a caring community where such a journey can take place. There was a need for a “multi-disciplinary” group of people who can support each other in this journey to healing and wholeness.

A Change in Responding to Challenges

During this season a person with HIV infection was brought into our OPD. In those days, it was a challenging task to get him admitted and provide him with care in the hospital. It was the early days of the HIV epidemic when there was so much fear, shame and stigma. The challenge for such marginalized communities to get access to compassionate care created internal disturbances for few of us in the team. We ended up starting a program to care for them.

After a few years spent working with and caring for HIV infected drug users and sex workers, we learned that the existing institutional structures were not open or accessible for such communities. The care needed to come in makeshift contexts—at home and within the community itself. For institutionally trained professionals this was tough but there was no other way.

We learned that when God challenges you to respond to a need he has put into your heart, being available for people is more important than the ability or availability of structures or institutional frameworks. Evolving models have to emerge from the needs around you. For those who have no cure in sight, we cannot but look beyond the body. And people can be cared for and healed only in the context of family and community. Such care can only come from a caring community.

The gospel invites us to be available to those who need the presence, the power and the love of God through a community that cares. The lifestyle, power and mandate of the gospel transforms our hearts, challenges our perspectives and warrants a response in our life choices. This is true not only for healthcare professionals, but for anyone who wants to follow Jesus.

This post first appeared on The Gospel Coalition. Republished with permsission.

Epidemics can end in two ways – transmission is well controlled and new cases come down to zero, and the epidemic is history. The other is, the disease becomes an ongoing part of the infectious-disease landscape, or an endemic. The shift from pandemic to endemic entails a number of practical considerations for managing the epidemic and the way we live. But the shift is also psychological, as we will be deprived of the satisfaction that a clean pandemic end point would bring. Instead, societies will have to adapt to living alongside COVID-19 by making some deliberate choices about how to coexist.

Pandemics and endemics, in the past, have forced communities to move to newer ways of living and engaging in the world. Other major disruptions of life too have created new normal ways of engaging. Biblical stories are interesting examples. Adam and Eve had to build a new life in a new normal world outside Eden. Noah, Daniel and friends are examples of people who had to pick up the pieces and chart a new course, post flood and in captivity.

The influenza pandemic of 1918-1919 killed more people than the Great War, known today as World War I, at somewhere between 20 and 40 million people. More people died of influenza in a single year than in four-years of the Black Death Bubonic Plague from 1347 to 1351. Nationalism pervaded as people accepted government authority. This allowed the public health departments to easily step in and implement their restrictive measures.

The war also gave science greater importance as governments relied on scientists, now armed with the new germ theory and the development of antiseptic surgery, to design vaccines and reduce mortalities of disease and battle wounds. The medical and scientific communities developed new theories and applied them to prevention, diagnostics and treatment of the influenza patients. Similarly, the black death saw the origin of hospices and later the hospitals that we know of now.

Mental health

The current pandemic that we are going through, with all the devastation it has left, has been traumatic for most of us. The physical effects of the virus, with high mortality, morbidity and many families losing their loved ones is the most evident. The economic, and the broader social impacts, the job losses, the migrants who have lost their livelihood, the relational issues with increasing domestic violence etc have been in the news and some of us might have experienced them too. Education related challenges and their impact on the system, the children and parents, is yet another major issue. Cross cutting through all these are mental wellbeing related issues.

A recent Lancet article reviews this well. The COVID-19 pandemic has taken a toll on people’s mental health. Yet, the global extent of this impact remains unknown. The authors estimated a significant increase in the prevalence of both major depressive disorder (with an estimated additional 53·2 million cases worldwide—ie a 27·6% increase) and anxiety disorders (76·2 million additional cases—ie a 25·6% increase) since before the pandemic. Increased prevalence was seen among both males and females across the lifespan. These findings are all the more concerning because depressive and anxiety disorders were already leading causes of disability worldwide.

What is the new normal?

But at the same time, if you look around there have been many positive changes and trends emerging around us. The challenges that we as individuals, communities and humanity at large have faced, have been opportunities to engage in a new way. New Normal was a well-known term in business circles but has become the current buzz word. Most large organisations have ongoing research and strategy development teams looking at, sector by sector, what the new normal would look like. They engage in defining and understanding the new normal and coming up with strategies to limit the spread of disease at the same time mitigate impact on other sectors. Some of them have gone ahead and coined terms like ‘Next Normal’ or ‘Next Possible’ as buzz words, to drive a new direction for tomorrow.

A few trends are highlighted here. This is not a comprehensive list, but just a glimpse into the massive changes that are happening around us.

Faced with uncertainty and facing our mortality, the core issues of our life, existence and meaning, are in most people minds, though not publicly discussed. Questions like, if life is so uncertain and I do not have control of my life, how should I live, who am I, what am I in the world for, how can I find significance, have never been asked the way they are being asked this season.

Such questions are leading to many looking at job, career and work in diverse ways. Large numbers of people are leaving the formal work sector and are exploring more flexible ways of engaging. A Microsoft study discovered that 41% of workers worldwide are considering quitting their jobs described as the ‘Great Resignation’. The study shows that Gen Z is struggling more than other generations. Work life balance, being valued by managers, sense of belonging, a trusting and caring community at workplace, meaningful advancement of careers, flexibility and autonomy are what people are looking for. If this is not there, they are moving out to set up startups on their own.

For organisations and companies COVID-19 has brought on an even higher awareness that we cannot have healthy people on an unhealthy planet or workplace. So, companies are looking at climate change, healthy work environments recognising that if they do not address these, that they may not have a competitive advantage in the market.

With social and physical distancing becoming a norm, technology has become the driver of all engagements whether at personal, community, work or social levels. Digital systems and AI based algorithms helping in decision making and work has taken over many fields, including healthcare. Digital natives, children and young people find this easy, but digital immigrants, the seniors struggle with this.

But what is assuring is, we are not in this alone – there is a collective vulnerability of our world. The most macho leaders, the most high-tech scientific establishments, and the economic powers have all met their match in this lowly virus. It should make us humble — think about what we need to do differently; how we need to act and behave differently.

Adapting to the new normal

So how should we face and live in such a world? It was Darwin, who said, it is not the strongest of the species that survives, nor the most intelligent; it is the one most adaptable to change.

If we need to live as salt and light in this world, we need to cultivate some mindsets and lifestyles. Daniel and his friends in Babylon are a good case study to reflect on. Faced with a new normal they did a few things. They did not shy away from embracing the changes around them. They learnt the new language, immersed themselves in the new context and culture and lived lives of influence. They built their knowledge and expertise in new ways of engaging and excelled themselves in the spheres of engagement. They built their lives with a long-term perspective, Daniel serving three empires and four emperors over 70 years. But they held on to the core values and their faith as foundations. They supported each other, as they faced challenging contexts and situations.

A changing context of the world and new normal emerging around us, is a call for us to live such lives. Return and renew our commitment to the core foundations of our faith and values that should undergird our lives. At the same time, accept and embrace change and excel in new ways of engaging. We need to live our lives with a long-term life perspective – a long obedience in the same direction. Rooted in our relationship to God we need to build our dependence on the faith community that we are part of, to support and be supported in our journeys. Remember, God is still on the throne and in control. Such people and communities will continue to be salt and light in a world that is changing and losing its saltiness and light.

Mathew Santhosh Thomas is ICMDA Regional Secretary for South Asia

Published in Campus Link, UESI India bi-monthly magazine, Jan-Feb 2022, Volume 24, No.1. Home – Campus Link (campuslinklive.org), Republished with permission.

End of year and cross-over into a new year are exciting and joyful times in all cultures around the world. Two things come to mind at the end of year: reflection and thanksgiving.

The end of the year is first a time for reflection, when we can turn our minds back to the beginning of the year, ponder and scan through the months, and see how God’s grace has carried us through.

Reflection on God’s care through the year leads us to thank God for:

• blessing us and our families with good health, food, protection, finances, friendships, the communion of believers and spiritual nourishment
• blessing our ministry, businesses and the work of our hands
• seeing us through difficult and challenging times
• giving us peaceful times in our nations

We always have a lot to thank God for. As we count our blessings one by one, we lay a stone of thanksgiving, ‘Ebenezer’, and say, ‘Thus far the Lord has helped us.’

But crossing over to a new year also brings uncertainties as we don’t know what lies ahead. It is often a pleasant time of the year, a time of excitement. It was, for instance, an exciting moment for the people of Israel when they were told: ‘Get ready for in three days you will cross the Jordan to go in and possess the land’ (Joshua 1:11). We don’t know for sure what the future holds but we know the LORD who holds the future and who goes ahead of us to the new year to fight our battles and arrange things before us (Deuteronomy 1:30-33).

Samuel’s annual stations and circuit

The Bible text above gives us a glimpse and insight into how the prophet Samuel served his people and managed his year.

First, Samuel served with dedication ‘all the days of his life’ and with the right motives that his people know God and that God alone be exalted and glorified.  As we come to the end of the year, it is time to stop and ask ourselves: What has been my level of dedication in ministry? What were my motives as I served?

Second, the prophet Samuel had the following four important work stations which we can all learn from as we cross to start the new year.

Bethel

Samuel starts his year from Bethel. Bethel is the awesome place of God’s presence, a place of dreams, the place of a ladder connecting to heaven, a place of blessings and great promises, the House of God and the gate of heaven! (Genesis 28:10-17). What a great place to start the year from! Start in God’s awesome presence!

Gilgal

The next station is Gilgal. Gilgal is the place of circumcision, the place where the manna stopped and people ate from the produce of the land for the first time, a place of celebration of the Passover (Joshua 5:1-12). Both painful (circumcision and stopping of the manna) and enjoyable (celebrating the Passover) things happened in Gilgal. Gilgal might not be a place we like but it is an important station in our life and ministry. God at times allows us to go through Gilgal, through both painful and enjoyable times. In Gilgal, we might need to consider cutting out (circumcising) some activities and readjust to changes in funding and limited budgets. Gilgal is a place of refinement and re-alignment of goals, activities and budgets.

Mizpah

After Bethel and Gilgal, comes Mizpah. Mizpah is where the ark of the covenant was received back, prayers and sacrifices were offered, a stone of thanksgiving ‘Ebenezer’ was laid, battles were fought and lands were recovered. It is where Samuel judged Israel.  Mizpah is operations centre. It is a great place but not the starting point. The mistake we all make at times is starting the year from Mizpah (operations) rather than from Bethel (God’s presence), a reason we fail.

Ramah

Samuel’s final station is his home town Ramah where he built an altar. Ramah is where we reconnect and have communion with God before starting over again in Bethel. As we come to the end of the year, we need to return home to our base, Ramah, and build an altar before we cross to the new year. Bethel and Ramah are next to each other in the circuit.

Have a blessed end of year and cross-over to 2022!

Alex Bolek is ICMDA Africa Coordinator and East Africa Regional Secretary