The state of mission hospitals in India- as I see it

I have added ‘as I see it’ to act as a clear declaration that I am very inexperienced, both as a doctor and in years, and have had very little exposure in such hospitals. Little, but significant. My views come from neither statistical data nor hard evidence, but simply the emotional and genuine sentiments from my close friends whose view I can trust and identify with. My objective is not to put down any organisations or people, or even dispel any enthusiasm towards mission hospitals; but rather for people to see clearly that there is a much larger problem than a simple lack of doctors that threaten health care in rural India. And to quote my aunt who is a PhD in old testament: “the institutionalization of the church in India is seeing the church sinking into an alarming condition where there seems to be no vision or sense of purpose that corresponds to the dictates of the gospel.” Which is heavily showing in the hospitals managed by them.

Sorry to start on such a gloomy note 😊 perhaps my views are highly biased, perhaps they will turnaround completely in a few years, or maybe this needs to be said so that it can reach the corner of someone’s mind and initiate whispers of change. So, with a collaboration of experiences from different corners of India; here goes the good, the bad, and the ugly…

The Good-

The concept of mission hospitals brought an air of inspiration for a lot of us. The idea that like-minded doctors work tirelessly towards a common goal of doing what God intended for them despite the existence of a comfortable, well reciprocated life in the private sector made us want to strive to acquire that sort of passion. Cause we had seen in; face to face during our small exposure trips. There are hospitals where Doctors; even if they have to work everyday from 8- 10 are happy to do it because they have each other, and a community that they have grown to love and serve. Where in the middle of nowhere; excitement, laughter and memories are created evaporating any longing for a city life. Where everyone from the director to the sweeper is treated equally. In fact where everyone works the same amount regardless of your degree. There are places where consultants alternate calls with the junior doctor. Where learning is an active lifestyle; be it clinical skills, to ultrasounds, to life lessons and lessons about God. Where work is a passion and not a sacrifice. Yes there are such hospitals! Where nurses work beyond their duty hours, and good patient care is the emphasis. Junior doctors get to learn more than they ever expected, some are doing independent C- sections. With the increase in learning, they get an equal amount of trust to manage patients which only makes them work harder. A significant point to note is that in most of these hospitals, the burden of patients and their inability to afford higher centers is felt and is met with compliance and compassion. As in the whole hospital feels it, making way for a wholesome treatment and a united front. Good company is what makes it worthwhile. Some have prayer partners who go on prayer walks, or cook food (for the first time) together; basically they get to spend quality time with each other. Some are able to see legends of Indian missions at work, and learn far more than medicine and get the inspiration they need to push forward. There are even hospitals where there is open sharing of the gospel, despite repeated persecution. These are places where lives are shared, lives are saved, and lives are born again.

The Bad-

From all my conversations, the most common element I hear (and have experienced) is loneliness. The extreme of which is having an average of 3 patients a week, duty hours of 9am- 12pm, and literally nothing to do (too isolated to get an internet connection) and no one to talk to. And that’s bad, people can go crazy! Perhaps its hitting us hard cause we’re fresh out of an unbelievable college life, but its dawned on us that no one should be put through this extreme, and loneliness is not something people should get used to. You would be surprised to know how lonely one can feel even in a hospital surrounded by people. You know how I talked about having a like-minded community? What if that didn’t exist, and in place is a “let’s just do our job and go home” environment? It can put even the best of us down, and makes you look once again for a hint of motivation to serve. It’s really hard to work with the attitude you intended to have when all around you everyone seems to follow a different agenda. For lots of us, coupled with this loneliness is a severe lack of spiritual nourishment. Perhaps gone are the days when a Christian mission hospital would mean having fellowship and worship together, and abiding by Christian values. There are places where the hospital exists solely because it once HAD a vision, and where great things used to happen, where there WAS a big demand. I once heard a great man of God and doctor say: “mission hospitals whose purpose is to only exist for the sake of existing have definitely lost their purpose”. These are places where the administration is least supportive, and only look at numbers and finance. There are places where there are no senior consultants, sometimes no other junior doctors and where the staff are less than competent. It’s a startling discovery when you realize that being a mission hospital doesn’t mean you need to care for the poor, or have any sort of spiritual support system. In some places the consultants don’t work after 5pm, and the hospital functions as a referral center. So we’re left with no one to talk to, no one to pray with, no job satisfaction, no source of learning, and sadly a declining motivation.

The Ugly-

I think this best describes the fact that people have used the title of a mission hospital for personal gain, in a variety of ways. A particular story that comes to mind is when a junior doctor was asked to give a lesser dose of oxytocin so as to deliberately prolong labour leading to a probable C- section! It’s sad to hear of such things, and I who started out having the most optimism for mission hospitals am heart broken. There are places where the doctors hardly work 15 days a month, whilst portraying a different picture to everyone else. These are places where there was no effort to bring about a community in the first place, where doctors who had joined were treated badly and were driven to leave owing to the fact that the person wanted to be their own boss. Where the administration is least bothered and give a below par pay to really qualified nurses. Where it seems as if the hospital were to close down, no one would care! I don’t know the statistics but there has been a dramatic decline in the functioning of mission hospitals over the last 25 years, revealing a poor administration as a major cause. Mind you, most of these were managed by church bodies. A junior doctor was told to admit everyone who comes because they need more income. Really poor patients are sent away, and you can see the desperation and hope in their eyes turn to sadness and despair. A man I highly admire once said to me that he charges the minimum possible for procedures and treatment and even with that his hospital is able to make enough profit. Just imagine how much profit everyone else is making. There are places where drugs are sold at 4 times the actual price. Recently I’ve heard of honest, passionate, strong willed Christian doctors feel a sense of defeat and injustice, leading to them moving out in search of a place where they could attain the freedom of doing good. Naïve young doctors like us are left wondering where this is going lead; is that it for the future of mission hospitals? Where good cannot be done even if you tried. A quote from one of my friends: “We can be happy here only if we stop caring about what’s happening around us.” 

What makes me more upset is that the churches have done nothing, and have shown no intent on doing anything to improve the situation, despite repeated promises earlier on when we were even more naïve. There is no structure in place to ensure the sacredness of the vision and mission of these hospitals. Nor is there an attempt to maintain sources of spiritual food. It’s like these hospitals are telling us: why do you want to serve the poor? Work for an income and be happy. The painful fact is, that people just don’t care.

Would it be so bad, or take so much effort to just pray together, and reaffirm our commitment to use our abilities for God’s work? Hospitals like what I depicted earlier exist, I’ve seen them; and my friends work in them right now. It really doesn’t take much to make that happen, all we need to do is put aside our own agendas and simply build a community together. A community of friends, family; sharing our joys and pain with each other, enabling us to become better people with a heart to serve the people suffering around us…To have meals together, and enjoy a movie now and then. Or simply to just talk about things other than work.  A batch of us left to do good and decrease suffering in this world, but have realized the world is a mean place, and working in a mission hospital needn’t offer any solace. The best of us have lost heart, and are in a process to revive it by looking at others who are in better places, recognizing that all is not lost. We thought the hardships of mission life would be electricity and water shortages, or busy emergencies and endless days with hardly any sleep. But none of us expected this. These are definitely experiences we will one day be thankful for, for it has showed us early-on the hypocrisy that exists; and to not judge a book by its cover. Lots of us have turned to God, for that is what we do when we are left with nothing.  

I seek change. With the future of sponsorship looking bleak and the way certain hospitals are right now, people won’t be looking to go back unless they have an obligation; and this spells disaster.

Eric Williams.