Three Principles to Guide Us 

One of the challenges of work, positions or ministry roles is that they can easily become our identity, defining us and our lives. To prevent this, we should hold on to three key principles: 

1. It’s Not About Us – What we are involved in is ‘Missio Dei’ – God’s mission, not our own. Every job, role, position and opportunity are part of his mission. We are merely stewards of these responsibilities; they do not belong to us. It’s about God and his Kingdom, not about our roles or titles. 
2. It’s Given to Us for a Season – The Kingdom of God extends far beyond organisations, positions and roles. These are simply platforms or opportunities entrusted to us for a particular season. 
3. We are Expected to be ‘F.A.T.’ – We are called to be ‘Faithful, Available and Teachable’. At the same time, we need to be ‘Flexible, Agile and Transformable’, holding our roles and positions loosely. 

Chris Wright reminds us in his book on missions: “It is not about what I can do for God, but how I can be part of what God is doing in his world.”

Three Perspectives to Hold on to 

1. We are Just One Link in the Chain – We are part of a continuum, connected to those who came before us and those who will follow. Our role is to faithfully receive what has been handed down and pass it forward. 
2. None of Us are Indispensable – While we are uniquely chosen by God, his Kingdom does not depend on any one individual. Our responsibility is to be faithful in our appointed time. We are neither messiahs nor martyrs, so we should avoid falling into the “Messiah/Martyr syndrome” by clinging too tightly to roles. 
3. We Must Prepare to Exit from Day One – Realistically, we should begin preparing for our departure the moment we step into a role. This means identifying and nurturing potential successors. 

In ‘The Last Battle’, the final book of The Chronicles of Narnia, C.S. Lewis closes with this thought: “All their life in this world and all their adventures had only been the cover and the title page: now at last they were beginning Chapter One of the Great Story which no one on earth has read: which goes on forever: in which every chapter is better than the one before.” This reminds us to take a long-term perspective on life and leadership transitions. 

Three Practices to Consider

If these are the principles and perspectives, how should we function in our roles? Beyond simply getting things done, here are three key practices for transitioning well when the time comes: 

1. Plan Succession Early – Do not wait until the last minute or the final year. Always be on the lookout for individuals who can be developed for the role. 
2. Define the Required Qualities – Be clear on the skills, experience and character traits needed for the role. That way, when the time comes, you have already laid the groundwork for a smooth transition. 
3. Create Opportunities to Mentor and Take Risks – Invest in potential successors by delegating responsibilities under supervision as early as possible. Be willing to take risks in leadership development. 

Peter Drucker, the well-known leadership coach, once said: “People who do not take risks generally make about two big mistakes a year. People who take risks generally make about two big mistakes a year.” 

This highlights the importance of taking calculated risks in leadership. Just as God took a risk on us, we must do the same for others. 

A 2021 McKinsey article¹ views succession planning as leadership development, emphasising the need for organisations to become “leadership factories” that cultivate individuals to develop these key characteristics:

• Positive Energy & Personal Balance – Developing and protecting the mind, body and spirit. 
• Servant Leadership – Focusing on making the team and others successful. 
• Continuous Learning & Humility – Leaders should not fear taking risks. 
• Grit & Resilience – Remaining steadfast in the face of disruption. 
• Levity – Using humour appropriately, even in serious situations. 
• Stewardship – Seeing oneself as a temporary custodian of an organisation or team. 

The Importance of Preparation

As you go through transition seasons, three preparations are important.

1. Prepare Yourself – Our hearts can be deceptive. Power, positions and roles can define us and become our source of identity and security. Guard your heart and be prepared to let go when the time comes. 
2. Prepare Those Around You – Listen to your team, though you may not always follow their suggestions. Teams often resist transitions because they value stability. However, your responsibility is to be faithful to your calling, even when it requires stepping away. 
3. Prepare Your Successor – If you have identified the next leader, equip them well. Establish open, transparent and effective processes for a seamless handover. 

David Lancefield² identifies four common traps leaders fall into during transitions:

• The Lingering Trap – Struggling to step away. A helpful reminder: “Give up and come in – Give up and go on.” 
• The Adrenaline Trap – Seeking validation through constant activity and success. An advice to remember: “Transition slowly, take time to reflect, and settle into the role well.” 
• The Judgment Trap – Relying too much on past experiences rather than adapting. A Guidance: “Manage change with continuity – Do not hover over or hold on to the past.” 
• The Dogma Trap – Imposing rigid structures that may not fit a new context. An Encouragement: “Keep learning and growing.” 

Do not transition out of restlessness but in the “Fullness of Time” – not because you seek change, but because it is time to move forward. After moving on, live with “Attached Detachment” – stay committed to the vision but detached from the role itself. Guard against “separation anxiety” that can affect your personal journey. 

To live this way, consider Jesus, who modelled it perfectly. Pray, seek wisdom, and draw strength from God and your community of friends and family. 

1. https://www.mckinsey.com/capabilities/strategy-and-corporate-finance/our-insights/the-art-of-21st-century-leadership-from-succession-planning-to-building-a-leadership-factory
2. https://hbr.org/2024/09/4-traps-to-avoid-as-you-transition-into-a-leadership-role

One of the mega national projects in ancient Israel is the rebuilding of the destroyed wall of Jerusalem under the leadership of Nehemiah. What is remarkable about this project, which perhaps is rare in our time, is the participation of almost all sectors of the society in the work. People from across the nation from all sort of backgrounds joined hands in completing the work.

What inspired people to get involved?

• Importance and significance of the project.

For the Jewish people, the wall of Jerusalem was both a symbol of protection and dignity. Its destruction therefore brought disgrace. Once the wall was rebuilt, the people would no longer be in disgrace. That’s a good reason to be involved! People love to take part in projects that bring them dignity and improve their life.  

• Presence of a strong and visionary leader.

Nehemiah’s strong leadership and heart for Israel’s identity as a nation were key in the success of the project. People rally around a strong, visionary and loving leader who cares for the welfare of all people. (Nehemiah 2:10)

Who were the people involved?

Nehemiah 3 gives a detailed account of the people involved. Seven sectors of society were involved in rebuilding the wall. Such a national project needed the involvement and participation of all.

1. Individuals:

2. Families:

• Jedaiah the son of Harumaph made repairs in front of his house (Neh. 3:10)
• Shallum son of Hallohesh and his daughters made repairs (Neh. 3:12)
• Benjamin and Hasshub made repairs opposite their house (Neh. 3:23)
• Azariah the son of Maaseiah made repairs beside his house (Neh. 3:23)
• Zadok the son of Immer made repairs in front of his house (Neh. 3:29)
• Meshullam son of Berekiah made repairs opposite his living quarters (Neh. 3:30)

5. Politicians:

• Shallum the son of Col-Hozeh, ruler of the district of Mizpah (Neh. 3:15)
• Malchijah the son of Rechab, ruler of the district of Beth Hakkerem (Neh. 3:14)
• Nehemiah son of Azbuk, ruler of a half-district of Beth Zur (Neh. 3:16)
• Hashabiah ruler of half the district of Keilah (Neh. 3:17)
• Binnui son of Henadad, ruler of the other half-district of Keilah (Neh. 3:18)
• Ezer son of Joshua, ruler of Mizpah (Neh. 3:19)

Isn’t that interesting? Can we imagine a high priest putting aside his priestly robes and getting his hands dirty? How many of our professionals, businessmen and politicians are taking part in God’s work and ministry?

The missing sector

Their nobles did not put their shoulders to the work of their Lord. (Neh. 3:5)

What might have led the nobles to leave the work of this great national project to others? The text does not say, but perhaps it was attitudes such as:

• Pride
• Not knowing the importance and significance of the project
• Not wanting to spend energy, time and money
• No heart for Israel’s national identity
• Not wanting to get their hands dirty

Lessons from this project

1. A leader with a God-given vision is key in any successful project.

 When a godly and visionary leader like Nehemiah is in place, the rest is history.

2. We all have different gifts to bring to a project.

Seven different groups of people with all their gifts, talents, resources and positions of influence took part. God is waiting for all to build his kingdom.

3. A group of nobles did not take part.

This was written to teach us today (Romans 15:4) so that we are not surprised when people do not have the same passion for a project that we do. The good news is that God’s work is not dependent on ‘nobles of Tekoa’ to be done. God will use humble and available people.

4. Attitude towards the work.

Zabbai zealously repaired the other section. (Neh. 3:20)

In such a busy project with a multitude of people working, how can one discern who does his work with passion and who is apathetic? Only God knows our hearts! God is looking for people like Zabbai who do his work with zeal.

5. No limit in God’s work.

The men of Tekoa repaired another section. (Neh. 3:27)

People say, ‘I have completed the section/role assigned to me.’ But the men of Tekoa went an extra mile and repaired ‘another section’ after finishing their section. In God’s kingdom, there is always ‘another section’ waiting for us to build.

6. Birth position does not matter as far as God’s work is concerned.

Hanun, the sixth son of Zalaph repaired another section. (Neh. 3:30)

Hanun being the ‘sixth son’ is probably the youngest in the family like David who was rebuked for coming to the battle frontlines (1 Samuel 17:28). But God is ready to use any last born available. Where are Hanun’s elder brothers?

7. The project was successfully completed.

The wall was completed… in fifty-two days. (Neh. 6:15)

Any project that has God’s hand on it will never fail. In spite of the enormous challenges Nehemiah faced with opposing enemies (Neh. 2:19 & 4:7), people refusing to be involved (Neh. 3:5), and workers getting exhausted and tired (Neh. 4:10), the work went on to completion. Isn’t that encouraging?

Lord, help us to take part in building your kingdom.

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

‘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  

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.

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

Sadly, the ever-increasing specialism we see in the medical world furthers the concept of fixing the part, making it harder to see the whole, especially if we work in isolation rather than in a team. In this Covid era, where fortunately the need for and benefit of compassionate care has been emphasized both in the medical world and public media, our care and support for each other has become even more vital in underpinning our care of the patient.

This was expressed recently in Dame Claire Marx’s candid and refreshing resignation letter as Chair of the UK General Medical Council, which we reproduce here in part.

Dear Colleagues,

I wanted to write to you all to let you know that I am stepping down from the GMC, having recently been diagnosed with pancreatic cancer.

Since receiving this news, I’ve been reminded once again of the importance and power of kindness in everything we do as doctors.

Compassionate leadership has been a cause I’ve championed throughout my career, from my early days as a surgeon, to my position as Chair of the GMC. Now, as a patient, I’ve appreciated that kindness from my medical team and found its impact to be profound.

As doctors, the interactions we have with our patients are a crucial part of the medical care we provide. Our empathy and professionalism shape a patient’s experience almost as much as our diagnostic ability or surgical skills, and they shape our own experiences as clinicians.

As an orthopaedic surgeon, I was often in the fortunate position of being able to ‘fix’ my patients. Performing a hip replacement and knowing how much it would improve someone’s quality of life is immensely satisfying.

But receiving my diagnosis reinforced for me that neat outcomes aren’t the norm in most areas of medicine. Many doctors carry this weight, but kind words can soften the blow of bad news, and empathy and understanding undoubtedly ease the burden. There is no greater comfort than human connection.

The events of the last year and a half have meant many doctors have been dealing with unimaginably sad situations. Facing them has required great fortitude.

In those dark moments, it is the support of our colleagues that pulls us back up. Being able to laugh and cry together, to share our experiences and lean on one another provides the courage to keep going. In a profession that rises or falls on the strength of our teams, dignity and respect for each other is indispensable. So, in addition to compassion for our patients, we must show respect and kindness for colleagues.

Perhaps then, in areas of the world where medical citadels were once resistant to prioritising care and compassion, we will now find open doors that PRIME as an organisation is able to walk through. As well as sadness then, is this also a time of greater opportunity to bring God’s Kingdom into the medical world?

Dr Robert Sadler is Chair of PRIME Management Team. This article is republished from their website by kind permission.

The meaning of being literate has expanded to include other types of literacy like ‘computer literacy’. Johannes Gutenberg, the father of modern printing brought the greatest revolution to human civilisation. Some cultures have embraced reading and writing for centuries. Each year, hundreds and thousands of books are written and read in the Western world, a phenomenon rarely observed in other cultures. Availability of electronic books today has made carrying of books lighter and easier which is a further encouragement.

Factors affecting reading and writing

Many factors have invaded people’s reading and writing habit and worn it out. Top of the list is TV which has diverted people’s attention away from books. Today people prefer watching a TV program to reading a book. Cultural and family background is another factor that affects the way people relate to books. Political crisis in many countries also adversely affects reading and writing.

Why then is reading and writing important? There are many reasons.

The importance of writing

First, writing communicates to a wider audience. Ideas and thoughts printed in books and articles travel far and wide and benefit many people. Giving a lecture in a university hall, for instance, only reaches the student and academic community unless it is televised or put online.

Second, writing helps us leave a good legacy. I am reading President John F Kennedy’s book ‘Profiles in Courage’ written before I was born. Writing is one legacy that keeps people speaking after this life like Abel who ‘though he is dead, still speaks’ (Hebrews 11:4). The Psalmist talks of telling the ‘next generations’ (Psalm 78:3,4). The Lord told the Apostle John: ‘Write what you have seen, what is now and what will take place later’ (Revelation 1:19). God similarly told the prophet Jeremiah: ‘Take a scroll and write on it all the words I have spoken to you concerning Israel… from the time I began speaking to you till now.’ (Jeremiah 36:1,2). God wants all life experiences – past, present and future – written and left for future generations to benefit from!

Third, writing is important for record keeping and history’s sake. Written history and well-kept archives are important for researchers and history. Mordecai’s story for instance was discovered and became an important and integral part of the Bible all because it was written and kept (Esther 2:21-23).

Fourth, writing sharpens writing skills. Putting down something in writing where we know other people will be reading it makes us think twice about the content, language, grammar and information flow. This strengthens writing skills. ‘Wake up! Strengthen what remains and is about to die.’ (Revelation 3:2)

The importance of reading

Reading, on the other hand, has many advantages but I want to emphasise three.

First, reading widens our knowledge and world. A friend of books has a broader world and general knowledge than one who is far from books. People often seem to accumulate knowledge only of their field of study but that is myopic as life is bigger than that. The first century Athenians were known to be hungry for new knowledge of any subject (Acts 17:21). If they lived today, they would be searching all websites for information! Reading deepens understanding and insight (Job 34:34,35).

Secondly, reading facilitates and bridges cultural dialogue. The first contact I had with the English people and their culture was through English literature like ‘Oliver Twist’ and ‘Great Expectations’. Literature, books and movies facilitate dialogue and bridge cultures. People who are exposed to other cultures are open-minded and get along with people from other racial and cultural backgrounds better than those who are not.

Third, reading enables learning from others’ style of writing. For those who aspire to be writers, reading others’ writings sharpens writing skills. When reading a book, one can see how the writer attracts his reader’s interest to read and like what he is trying to communicate. Napoleon Hill says, ‘The leading writer must add to their own stock of knowledge by appropriating the thoughts and ideas of others through personal contacts and by reading.’ (Master Key to Riches, p118).

The importance of libraries

A society with writers and people who love books is characterised by the presence of public libraries.

Are libraries important? If so, do governments plan and prioritise them? Napoleon Hill writes, ‘The Public libraries offer a great array of organised knowledge on every subject. The successful person makes it their business and responsibility to read books and acquire important knowledge which comes from the experiences of others who have gone before.’ (Ibid, p114).

Eleanor Roosevelt equally shed light on the importance of libraries: ’There are so many places that have no libraries and that have no way of getting books. What the libraries mean to the nation is obvious to all of us. I do not think that many people know how many states have large areas, particularly rural areas, where we cannot get books.’ Eleanor is concerned about the availability of books in rural areas let alone in capital cities!

Though not everyone is a writer, my humble opinion is that all should be able to enjoy reading as a general hobby. People should appreciate books as custodians of organised knowledge. Charles Lamb said: ‘I feel more like saying The Grace before a good book than before meat.’

Alex Bolek is ICMDA Regional Secretary for East Africa

In this short post, I reflect on some lessons from nations that seem to have done well, in supporting their church-run and other mission institutions. These reflections are based on stories I have heard from some of the founders of national hospital associations and trying to draw some principles from these stories.

This is in no way comprehensive and complete but is written in the hope that some of the issues raised might stimulate more questions and ongoing reflections within ICMDA and its member organisations. I have not given many references as we do not yet have data to prove all that is written. So, these might look anecdotal and nebulous, but I hope will be the start of asking further questions on these assumptions or observations.

Many southern continent nations have had large numbers of MHs started by international mission agencies (IMAs). Most of them started in late 19^th century or early 20^th century. This was during the large cross-cultural missionary movement of those decades.

Most nations currently are facing or have already faced reduction in the numbers of such institutions, expect for a few well-run ones. These exceptions do well due to specific teams or support systems. But in the midst of such a global decline, there are signs that in some regions or nations, there is still life and energy. What are some of the reasons for such ongoing life and energy, what are some of those systems, processes and directions that make these locations different?

I want to look at six themes or directions that might have contributed to such a difference.

1. National Hospital Associations

Nations that have seem to do well are those who have been able to build and strengthen National Hospital Associations which are owned and led by national leaders.

We see such examples in South Asia and some African nations. In these nations, IMAs recognised the need of moving from focusing on running their institutions to playing a facilitatory role. Some IMAs even gave up their institutions to national organisations for a greater purpose of building and strengthening national hospital associations. There are stories of missionaries who gave up their positions and roles and travelled all over the nation to encourage mission institutions to come together and support the formation of National Hospital Associations and support the national ownership and running of such associations.

RW, a well settled CT surgeon in the most prestigious institution in the nation, gave up his position, travelled all over the nation where he was a missionary, to understand the context that was emerging in MHs. He met with the church leadership of that nation and challenged them to form a health care association that would run and manage the potentially closing MHs.

2. Christian Medical and Dental Associations

Many of these nations did not have a strong Christian Medical or Dental fellowship or organisation, at the time when hospital associations were formed. Where there were strong CMDAs or CMFs or where such groups were established alongside, and where the CMDAs or CMFs and hospital associations have held hands to support each other and grow together the MHs have done well. This was very evident again in South Asia and some other African nations.

FG, a professor of surgery and a missionary, took five years leave and travelled across the nation he had come to adopt as his own, challenging national young doctors to form a new CMDA for the nation.

3. Handing over control to health professionals

In many contexts and locations, the institutionalised church that did not have the know-how of running complex medical institutions, ended up managing these institutions not too well. But where the church and mission agencies gave control to trained healthcare and management professionals to run MHs, institutions seem to have done better. These people were those who can strategise and plan to take institutions forward.

4. Leadership development

Where proactive leadership development was a focus, national hospital associations have done well. Where senior and second line leadership has been built intentionally, there is still a cadre of leaders who provide leadership from the front. In some nations IMAs focused on this as their strategy of transition. Some nations like India were privileged to have IMAs who built Christian Medical colleges which played a major role in leadership development. In other nations national CMDAs or CMFs have proactively focused on leadership development, and built a cadre of trained professionals who are willing to take the leadership of institutions.

HS, a missionary family practitioner, in a MH, spent one year, traveling to all the medical schools and major towns and cities, meeting with young consultants and faculty, challenging them to move into MHs and take responsibility for these institutions. He gave up his position and role to focus on the bigger picture of the nation.  

5. Ongoing mentoring

Supporting and motivating these young leaders and journeying with them is key if these leaders must take institutions forward. Where ongoing mentoring support is provided to these leaders who have taken up responsibility and such systems and process have been set up, MHs seem to have done well.

6. Good governance

Studies have shown that in addition to HR, the other factors that influence MH sustainability are Governance and Hospital Management systems, (finance, material, human resources, quality statutory etc). David Stevens has addressed this well in his webinar. Those institutions that are doing well are those where such issues have been proactively addressed.  

The way forward

There will be many other issues like professional training and financial support. But one thing that stands out in all these contexts that are well doing are that there was a proactive and engaged leadership. COVID-19 had taught us that in locations where such leadership exists, institutions engage effectively.

How can we understand some of these issues better? What other factors are important? How can we start supporting MHs in nations where ICMDA has its presence?

Responses and reflections from the ICMDA family are invited.

Santhosh Mathew is ICMDA Head of Training and South Asia Regional Secretary