CHRIST'S mission charge to the twelve, recorded in Matthew 10:1-8,* constitutes the clearest Biblical in junction for the church to conduct medical missions. The first purpose of the charge (verse 7) was to proclaim the message, "The kingdom of heaven is at hand." This remains our primary task.
The second purpose (verse 8) was to "heal the sick." The word used for sickness is the word commonly used to refer to those who are ill with diseases. There is no enlargement on how the diseases were to be cured.
The third purpose (verse 8) was to "raise the dead." Jesus raised the dead and gave His disciples authority to do the same. This is a rather stunning injunction. Although there is no New Testament record of anyone being raised from the dead by the disciples before the ascension of Jesus, Peter and Paul are reported in The Acts of the Apostles as having raised the dead.
The fourth purpose (verse 8) was to cleanse the lepers. We have here a simple extension of the charge to heal the sick. Why lepers were mentioned as a special category is not entirely clear to us today.
The fifth purpose (verse 8) was to "cast out demons." Luke 9:1 adds that the disciples were given power and authority over demons, and in chapter 10:17 we are told that the seventy returned jubilant, saying, "The devils are subject unto us through thy name" (K.J.V.). Demon possession is clearly distinguished in the New Testament from ordinary illness.
The injunctions to raise the dead and cast out demons are rather shocking to the modern world. We do not quite know what to make of them. Passages such as this serve to remind us of the world view projected in the New Testament that seems to be strangely different from our rational scientific concepts.
It seems necessary for us to approach these injunctions with extreme caution lest we allow our own ways of conceptualizing reality to create a mental outlook that is inhospitable to the mes sage of the injunctions. I have often found myself wishing that those who approach this "burning bush" in the New Testament would be more cautious lest they dismiss it from seriousness too lightly and betray what it means.
The missionary, and especially the medical missionary, is often confronted with questions that arise from the gulf that lies between our own scientific rational views of reality and the sacral spiritual world of the New Testament. In his homeland he is confronted with the intellectual difficulties that arise from the skepticism of a secular society. In the mission field he may become aware that church members seem to be vaguely conscious that missionaries' views regarding healing, the casting out of demons, and the raising of the dead seem to be different from what they read in the Gospels. They want to know what it is that gives the missionary such shortsighted vision and creates his half-blindness to the most obvious relationships between spiritual forces and physical states. The missionary himself may come to sense that perhaps he holds a somewhat truncated view of reality.
As we consider these injunctions "raise the dead, . . . cast out demons" the present-day disciples of Christ can not at the very least fail to be moved with a certain helplessness. For all our knowledge and expertise there is a woeful lack of what Luke calls "power and authority" over the evasive and yet seemingly pervasive, dark, demonic forces of reality. Our inability to perform what the Master frankly charged and empowered the disciples to do ought to constantly remind us of our personal and spiritual limitations and of the parameters of our really rather impressive achievements in the healing arts.
Modern Medical Missions and the Charge to the Twelve
Modern medical missions appeared on the scene late, and then only slowly. Most mission societies had been at work for a hundred and fifty years before they began medical missionary work. In several cases it was purely accidental that they did. The survival rate of missionaries in some areas was shockingly low, and a number of societies sent out doctors as medical officers to look after the health of the corps of missionaries.
In some cases such doctors were specifically reminded that they were not being sent out as missionaries; neither were they ordained for the task. The task of mission was generally understood as the saving of souls, not the healing of bodies. It was only after the establishment of the Edinburgh Medical Missionary Society in 1841, for the purpose of sponsoring the education of such missionaries, that the concept of medical missions began to gain ground. And then it did so slowly.
The first American organization to sponsor medical missionary work was the International Medical Missionary Society, founded by Dr. Dowkont, in New York, in 1881, which significantly influenced J. H. Kellogg. But even then, and in spite of the already demonstrated success of medical work as a means of opening doors and creating acceptance, there was widespread opposition to the idea of medical missions. Medical work just did not seem to be the proper task of mission. The latter was often conceived as the purely spiritual task of the salvation of souls and the establishment of a spiritual community. To use funds for secular medical work, even if it was a successful method, was held to be almost a betrayal of trust.
Those who retained a vision of the relationship of the gospel of healing to the gospel of salvation needed some way to legitimize their concern. They found the justification they needed even a positive commission in the charge to the twelve.
A century after the founding of medical missionary work it is quite clear that things are not as they once were. Indeed, many voices announce confidently that medical missions, as we have known them, particularly mission hospitals, are in a closing-out stage. Some write of the end of an era. Operating costs have become prohibitive. The old entering-wedge assumption of medical missions is not now as clear as it once was; recruitment of medical personnel becomes increasingly difficult; national governments are extending their control over health services, taking over hospitals and providing services the missions cannot hope to equal.
As a result of these changes many voluntary agencies are discontinuing their hospital work and transferring them to state agencies. Some institutions are simply being abandoned.
One is, of course, interested in the justification for this change in policy and practice. The Lord's charge to the twelve was invoked as a commission to engage in medical work one hundred years ago. Now, however, there is a tendency to reinterpret the charge. "As can be seen from the context," it is argued, "the charge consists of a series of instructions to the twelve regarding their immediate tasks and is not applicable to us in our time." In other quarters the mandate for mission is based not so much on Biblical in junction as upon the action of God in history; and if this line of thought is followed, it is relatively easy to justify the change in policy.
Adventists and Medical Missions
We, of course, are more concerned about the Adventist Church and its mission, the theological grounding of its medical work, and its adjustment to the changing situation of medical missions. The Adventist Church was seriously interested in the relationship between the gospel and health before it began to take the foreign-mission task seriously. When it did embark on its task of worldwide mission, views regarding healthful living were so tightly interwoven with concerns regarding the sanctified life that medical work was axiomatically a part of the program.
There was, therefore, no necessity to appeal to the charge to the twelve to justify the involvement of funds and personnel in medical work. In one interesting passage Ellen White links together the charges to the twelve and the seventy with the missionary commission of the resurrected Lord in one grand and many-faceted gospel commission, which is valid "to the end of time" (Counsels to Parents and Teachers, pp. 465, 466). But the charge by itself has not been the basis of our health work. Rather, it is the capstone that gathers to a focal point a widely based way of thinking about man, his relationship to God, and his task of discipleship.
There is, in fact, a well-grounded theological basis for medical mission in Adventist thinking, even though it may not have been systematically developed. The commonly prevailing Hellenistic body-soul dichotomy was rejected by early Adventist believers in favor of a more Hebraic holistic view of man. Whatever one may wish to say about early Adventist discussions regarding the incarnation and the nature of Jesus Christ, no charge of docetism can be made against those who molded the church's Christology. Full humanity was affirmed, if not overaffirmed. And there is a realism about Adventist eschatology that, if any thing, makes it more liable to charges of physical literalism than of spiritualized otherworldliness.
This theological orientation provided a natural base for the guidance given by Ellen White on the relation ship of body and mind in salvation and for the lessons of healthful living taught by other Adventist church lead ers. The message of health has been a fundamental part of the plan of salvation, as understood by Adventists, from the early days of the church. The health message was not only a doctrine and way of life; it became a preferred method of evangelism and of mission. The healing ministry of the church is almost as essential a part of the gospel as is the forgiveness of sins indeed, they are united in the process of sanctification.
With the passing of the years our beliefs regarding the relationship of mind and body and of religion to health have received wide-ranging medical support; and, if anything, our conviction regarding these concerns is now deeper than in the past. Along with the growth of corroboration and conviction there has developed a maze of complex problems regarding the operation of our medical institutions.
We are sent "to proclaim the kingdom" and "to heal," and on both fronts--- or should we say, the common front linking these two moments in gospel witness--issues have arisen that seem to imply that there is a constant need to re-evaluate and modify our approach if we are to remain true to our task of discipleship.
In all likelihood we are now entering a transition stage in medical missions. The style of medical work that has been practiced during the past one hundred years by the mission agencies may be ending. Along with the recognition of this fact and its implications for the Adventist Church there must certainly be the affirmation that the church has a continued responsibility for the health and healing of mankind.
As we consider the future of our medical work, perhaps programs more in harmony with our intrinsic under standing of the gospel of health will be considered. From the beginning Adventists have been concerned with the interrelationship of health and spirituality. Our emphasis has been on dealing with the whole being of the person, and to a lesser extent with the person as a person in the community.
Responding to Current Problems
A first emphasis could properly lie in reflection on the spiritual basis of health and healing, about its place in Christian belief in relationship to God's plan of salvation. A concept of health that is merely that of restored balance or recovery from illness has no answer to the problem of human guilt, death, or the threat of meaninglessness. Health in the Christian understanding is a continuous and victorious encounter with the powers that deny the goodness of God. It is the experience in this life of what lies beyond death. It is a sign of God's victory.
Maybe spiritual reflection would lead us to institutional, organizational, professional, and personal repentance about schedules, priorities in finance, personnel, and time, so that we might participate more fully in the community in which healing takes place. It would seem that unless the Christian involved in medical work is prepared to seek for ways of going beyond medicine in dealing with those with whom he comes in contact, of going beyond the clinical-hospital situation, and beyond the professional-client relationship, there can be little that is distinctively Christian about the institutional and personal practice involved.
Our second emphasis can be crystallized in the term community medicine a comprehensive approach that centers, not on the individual and his disease in a hospital setting, but on the community and its health. The term conjures up ideas regarding water sup plies and diet and causes and etiology of disease, but these are merely the rudiments. Can these concerns be grounded in the gospel and receive practical expression in the life of the Christian community?
A third emphasis grows out of this and might perhaps be best described in a term that has come to have particular meaning in the "developing nations" ---intermediate technology. Such systems utilize corps of intermediately trained functionaries to perform various civic and social services. This calls for different styles of community-health-educational programs, preferably utilizing church members.
This may not sound particularly attractive to medical professionals, because, like theologians, most medical professionals prefer to educate a class of professionals like themselves. Both tend to fall short in training lay people, and this is precisely what inter mediate technology calls for. Encouraging new openings and signs of change in this direction are evident. Where hospital work and community health education are mutually supportive, results have been fruitful; and, where possible, maybe this is the ideal for which the church should strive.
Perhaps the local community of faith can become more involved in the process of healing. By its prayer, by the love with which it surrounds each per son, by the practical acts that express its concern, and by the opportunities it offers for participation in Christ's mission, the congregation should be an important agent of healing in each place. To its "intermediate technology" it can add the sanctified means of healing---the ministry of the Word, the sacraments, prayer, and the acceptance and support of the Christian community.
A fourth emphasis might be the restructuring of existing programs. In the days ahead, it will require much prayerful thought, much study, and constant reacquaintance with the principles given us by God, if we are to minister to the needs of all people. It will not be easy to avoid slanting our ministry toward one group and prejudicing an other against our message. It may be difficult for some to keep our legitimate message clean and clear of politics and expedient compromise.
In the charge to the twelve the commission to preach and heal is followed closely by the admonition: "Freely ye have received, freely give" (K.J.V.). The juxtaposition of these injunctions has not gone unnoticed. The "freely give" passage appears to be the most referred to section of the charge in the Ellen G. White writings. "Freely ye have received" is not quite true of medical education today, and it costs much to render medical assistance. But this does not forestall the frequent use of the "freely give" phrase against the church and its medical work in the Third World. There are no easy solutions to this problem.
Fifth, possibly there will arise the opportunities for cooperative endeavor with the medical ministries of national governments. Even as such governments are extending their authority over hospitals previously operated by voluntary agencies, many are critically short of medical personnel and expertise. Possibly teams of specialists can render valuable services and open up avenues of approach.
More Flexible Medical Services
And finally, in developing countries perhaps we need to think in terms of simpler, more extended, and more flexible medical services. There may be proportionately fewer large medical institutions and more attention to the training of lay people in healing. Possibly the church will pay more attention to the provision of simple facilities (which may refer patients to larger institutions) through which health and healing may be brought to total communities, and in which there may be more reliance upon both the Christian community and the spiritual dimensions of healing.
Christ's charge is to us no less than to the disciples, no less today than in the era of great medical mission institutions. Maybe the church needs the painful changes that circumstances are forcing upon it and stands to gain from the evaluative processes they engender. What is done probably needs to take as much cognizance of basic principles of the Adventist health message as of present realities. By starting again with first principles it may be possible for the church to bring about changes in its program of medical missions that give clear expression, in both theory and practice, to its understanding of the relationship between health and salvation.
* Texts are from the Revised Standard Version unless otherwise indicated.