THE CLERGYMAN, a traditional community leader in many countries, is in a unique position to be a health-education leader. His educational preparation in communication skills, and the respect with which he is usually held in the community, make him a natural leader of people. Coupled with this is the deep commitment to service in areas often unappealing to others. His source of funding is from private, voluntary sources, so he does not represent an additional financial burden to public-health budgets. Ministries of health in developing countries, as well as those in which public health is more advanced, can benefit by tapping this type of community leader as a resource in health education.
Traditionally, the clergy have been held responsible for the spiritual welfare of their constituents. Today, in the view of many, man cannot be divided into spiritual, physical, mental, and social components. He must be dealt with as a whole being. Thus, a clergyman who expands his interest to the physical and mental welfare of his parishioners is following the lead of the physician who does not divorce the emotional needs of his patient from the physical manifestations, or the school teacher who includes an emphasis on physical and health education in his curriculum. Indeed, Christian clergymen have the example of Christ, who spent more time in healing than in preaching.
With additional preparation, specifically in two areas necessary to function in health education, the clergyman can become an effective force in community health education. A working knowledge of health-behavior concepts, and of basic-health content, will enable the clergyman to expand his role.
Such additional preparation can be gained in several ways. A beginning can be made through individual self-study of health literature, by reading such journals as Family Health1 or Life and Health.2 Some church groups publish health information regularly for their ministry. Clergymen may need some direction as to which sources of information are reputable in the health field, but advice in this area is quickly obtainable from others in the health-care professions and professional organizations, such as the local medical or dental societies.
Staff development conferences, utilizing health-education specialists from university or government agencies, can be arranged by religious leaders for the clergy in a given geographic area. Ex tension courses and off-campus teaching programs are already in existence, and can be enlarged to meet the demand.3
Clergymen can choose the route of obtaining an additional professional degree, that of the Master of Science in Public Health. This degree, designed by Loma Linda University School of Public Health to meet the needs of clergymen who lack a full undergraduate science background, is balanced equally be tween the health-behavior change and health-content components against a background of public-health science. A full complement of skills peculiar to the health-education specialist, including program-planning and evaluation skills and the ability to plan research, are included in this year-long program.
Individuals prepared in this manner are ready to return to their former profession, that of full-time clergymen, with the skills and knowledge to become community health-education leaders as well. Such individuals, while serving their churches, may also serve the communities in which their churches are located. Their own parishioners are among the first to be health-educated, then the service is expanded to other parts of the community as part of the church's outreach program. Churches have long rendered other services to the community, by operating early childhood education centers, welfare centers, hospitals, and clinics. Why should they not also be sources for community health education?
In Many Countries
From Tanzania to the Philippines clergymen are demonstrating the effectiveness of such health-education leadership. Pastor John Monge, chaplain and health educator at the Guam Seventh-day Adventist clinic, recently initiated a series of health lectures on the island of Saipan. He spent one entire week of counseling and lecturing at the Catholic high school of about 200 students. His main emphasis, at the re quest of high school leaders, was in the area of alcohol and drug dependency. In addition, a workshop on alcohol and drug dependency was held with about fifty teachers, public-health officers, and government workers in attendance.4 Pastor Monge completed his M.S.P.H. degree at Loma Linda University in 1975. He has been invited now by the district offices of education to speak at the annual teachers' convention in April, 1977, which is attended by all of the teacher-representatives of the is lands in the trust territory.
By commonly used measurements of success in their church-related activities, twenty-six ministers who participated in a health-education extension course in Davao City, Philippines, in 1970 were recently compared to 230 other Seventh-day Adventist Filipino ministers who did not attend the course.
Wilbur K. Nelson, in an unpublished Dr.P.H. dissertation at the University of California (Los Angeles), reports that three years after the training program the experimental group showed greater involvement in community-health activities than did their peers and were more productive than the control group. 5
In the same study Nelson also records the case study of the experience of a Filipino Roman Catholic priest serving a parish of about 60,000. With only a minimal amount of professional consultation in health-education methods and materials, the priest organized and implemented an extensive survey of rural health needs. Based upon the survey findings, the parish was organized for health education and health promotion.
Nearly a decade ago Loma Linda University personnel on loan to Heri Hospital, in Tanzania, set up a one-year training course for Seventh-day Adventist ministers. They came from many countries in East Africa, and re turned to their pastorates able to effectively combine health education with their other ministerial duties. Two years ago, the headquarters of the pro gram was moved to Arusha, Tanzania. More than sixty have been graduated from this program, and its success is testified to by the continued financial support of the church organization in that country.
A large-scale village health program is being developed in Pakistan, with the financial assistance of the West German Republic. In this program ministerial students will be trained as paramedics at the bachelor's degree level in college. Their preparation will include basic health-education classes, social service for referral purposes, and screening programs in the area of preventive medicine. In addition, they will be prepared to give simple treatments and prescribe common medications, as allowed by the government for people trained at this level. The Pakistani health officials feel that a person thus prepared can take care of 80 per cent of the health complaints of the local villager. Currently, three Pakistani clergymen are studying at Loma Linda University at the Master's level and will return to Pakistan to teach in this pro gram.
The United States Too
In the United States, community leadership has taken three major forms: (1) organization of, and working with, other health professionals to carry out health evaluation and educational programs; (2) cooperation with health agencies and public schools in a variety of health-education efforts; and (3) utilizing the church as a center for community health education.
Pastor Ron Ruskjer, of Lansing, Michigan, is illustrative of the first two categories. In the year since he completed his M.S.P.H. degree he has set up a LIFELINE risk-evaluation program in which a preventive-care team of seven medical doctors, two doctors of osteopathy, six dentists, twelve registered nurses, one dietitian, one physical therapist, one respiratory therapist, one attorney, one physiologist, and six pastors cooperated to perform tests and give counsel in preventing the major cause of death in the United States, coronary heart disease. In addition, he has taught classes in health at Lansing's community college and at Michigan State University. Cable television programs on nutrition were prepared and aired for World Food Day, which led to a request he is now filling for a whole series on health entitled "LIFELINE Presents.
In Elmhurst, Illinois, a suburban community of fifty thousand, Robert Hirst, who pastors a church of 156 members, has made his church a center for health education. In the three years since beginning his pastorate there, the risk-evaluation team he organized has screened more than two thousand individuals, most of whom have also at tended individual counseling sessions and follow-up classes in such areas of health education as weight control, exercise and physical fitness, and dietary control and prevention of heart disease.
Developing a small church into such a community resource calls for community organization skills, a facet that many clergymen already possess and which can be enhanced by graduate work in a school of public health. Pastor Hirst illustrates just such a combination—a warm, friendly man with natural leadership capabilities, sharpened and focused by his M.S.P.H. degree and several years of experience in community health-education leadership.
Clergymen are natural community leaders. When communities and countries recognize their potential and offer them encouragement and additional meaningful professional preparation, they will meet the emerging challenges in health education.
Notes:
1 Publication (monthly) of the American Medical Association.
2 Publication of the Review and Herald Publishing Association, Washington, D.C. 20012.
3 Loma Linda University School of Health conducts off-campus programs for ministers in Canada, the Northwest, and southern regions of the United States.
4 Far Eastern Division Outlook, April, 1976, p. 11.
5 Wilbur K. Nelson, "Effectiveness of Health Education Professional Preparation for Selected Religious Workers." Unpublished Dr.P.H. dissertation, University of Southern California (Los Angeles), 1976, p. viii.
