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Note #7677 from PCUSA NEWS to PRESBYNEWS:

Poor prognosis
03211
April 30, 2003

Poor prognosis

Mission of medical foundation is healing the have-nots

by John Filiatreau

COLUMBUS, OH - The theme of the 2003 conference of the Medical Benevolence
Foundation (MBF) was "Healing Ministries in a Changing World," but many of
the speakers and workshops focused on ways the world hasn't changed:
	
* Every day, 3,000 children die of malaria, a disease that can be cured for
$1.50. 
	
* In many African countries, life expectancy is less than 40 years - barely
half what it is in the United States and Western Europe. 
	
* Worldwide, 1.2 billion people struggle to survive on less than $1 a day. 
	
* Eleven million people die of preventable diseases every year.
	
* Physicians in many countries do surgery with blades made out of tin cans,
and depend on hand-crank respirators to help patients breathe.

MBF, in partnership with the Worldwide Ministries Division of the
Presbyterian Church (USA), and with the support of countless mission-minded
PC(USA) congregations, swims against that tide: promoting community health
around the world; fighting the "diseases of poverty" - malaria, tuberculosis
and HIV/AIDS; training medical personnel; operating dozens of hospitals and
clinics; and shipping surplus medical equipment and supplies to the parts of
the world where they are most desperately needed.
	
And spreading far and wide the good news of the gospel of Jesus Christ, not
through words but through loving action.
	
"We hope to give the kind of care Jesus gave," said Richard Harding, MD, a
longtime PC(USA) medical missionary in Nepal.
	
Harding, a featured speaker at the April 25-26 conference, also confessed to
feeling the kind of anger one imagines Jesus might have felt about needless
human suffering and social injustice.
	
The immediate brunt of Harding's anger was E. Anne Peterson, MD, a government
official who came to the conference to assure participants that the Bush
administration's embrace of "faith-based initiatives" is the start of "a new
day" in global public health.
	
"We now have a president who really does care about international
development," said Peterson, a former missionary (in Kenya and Zimbabwe) who
now serves as assistant administrator of the Bureau for Global Health in the
U.S. Agency for International Development (USAID). "And he really understands
that disease impacts international development."
	
One indication of change, Peterson said, is a new interest in what she called
"the 'abstinence and be faithful' message" about the prevention of AIDS.
	
Referring to the "ABCs" of prevention - A for abstinence, B for being
faithful, C for condom use - Peterson said the strategy has been applied in
most instances as "a little A, a little B and a great deal of C," even though
the most successful programs (notably the one created by the government of
Uganda) have relied more significantly on A and B and behavior change
promoted largely through religious organizations.
	
"Africa is not lost," she insisted, partly because such programs can be
effective.
	
USAID has long been among the sources of the very imbalance Peterson regrets.
 According to a pamphlet distributed during the conference, Mohamed Abdullah,
the chairman of Kenya's National AIDS Council, once said that his country
received $10 million in U.S. aid, "but it had to be only condoms."
	
"We had two options: to accept all the US $10 million worth of condoms, or
refuse," Abdullah said. "If it was our choice, we would have spread this help
to other forms of prevention as well, and particularly advocacy for behavior
change."
	
Peterson admitted that her own campaign to change the bureau hasn't been
entirely successful. In the rapidly changing international health arena, she
said, private organizations such as the Bill and Melinda Gates Foundation
"can move faster" than the government can.
	
"I can recognize the problem (quickly), but I can't respond," she said. "I
can't turn my system that quickly." Peterson also acknowledged that her
efforts to streamline the red tape and paperwork necessary to get government
funding has largely failed.
	
And despite her advocacy, she said, the conservative administration refuses
to support family planning programs - even though the health benefits are
clear: When women space births 36 months apart, infant mortality declines by
20 percent, and maternal deaths decline as well. She noted that one-third of
all pregnancies today are unplanned - and that 1 billion women worldwide are
entering their childbearing years.
	
Peterson said the administration's new policy merely acknowledges that "the
faith-based community stays long after the government ends."
	
Harding, who worked as a United Ministry missionary in Nepal for 22 years,
said advances in global health - e.g., decreases in childhood mortality and
progress against such devastating diseases as measles and polio - "were not
done by USAID, and not by government-supported things, but by missionaries." 
	
He groused that "billions" in U.S. aid has gone to corrupt foreign
governments and to U.S. aid employees "who live in very, very lovely houses
and have very, very large expense accounts, and so forth."
	
"I've been angry for a lot of years," he said apologetically.
	
Peterson conceded that the government is "doing too little." She said recent
polls have found that most Americans believe at least 15 percent of the U.S.
budget goes for foreign aid - while the real figure is one-tenth of 1
percent.
	
The PC(USA) has been a key supporter of a campaign to pressure the United
States to devote at least seven-tenths of 1 percent of its budget to support
for international health and development projects, especially those related
to AIDS in Africa. (Some Scandinavian nations give 4 percent or more.) The
"0.7 Initiative" expects no less of Presbyterian individuals and
congregations. To meet that standard, a person who makes $50,000 a year would
have to contribute $350 a year.
	
That $350 would go a long way: The cost of one vaccination for a childhood
disease is 25 cents; of one day of hospitalization, $3; of one day of
operation of a village health clinic, $15; of cataract surgery that could
restore someone's sight, $20; for the training of one nurse, $250.
	
On April 29, Bush asked Congress to pass a $15 billion legislative package to
fight AIDS in Africa.
	
"We can turn our eyes away in resignation and despair," he said, "or we can
take decisive, historic action to turn the tide against this disease and give
the hope of life to millions who need our help now."
	
MBF officials held workshops on opportunities in long- and short-term mission
service; planning overseas trips to PC(USA) missions; and getting
congregations and youth groups involved in medical missions through the
foundation.
	
The approximately 100 participants in the conference - missionaries,
ministers, members, mavens and MBF staffers - also heard from the Rev.
Fletcher Matandika, who directs a program of community-based care for AIDS
orphans in Malawi; Jack Guy Lafontante, MD, medical director of St. Croix
Hospital in Leogane, Haiti, a 120-bed primary-care hospital that also
sponsors a network of 120 village health workers; David G. Addiss, MD, an
epidemiologist at the Centers for Disease Control and Prevention in Atlanta,
GA, who treats elephantiasis victims in a project in Haiti sponsored by
Presbyterian Women; and Douglas Jackson, MD, director of Project C.U.R.E.,
which collects U.S. surplus medical supplies and ships it overseas.

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