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August 22, 2005

When it comes to health care, a battle between heaven and hell is unfolding across the globe. On one side, there's compassion for the poor who are sick -- on the other, the market and money drive the healing industry. One of the earliest advocates of physical wellness, Jesus, must have seen the issue as important; healing the sick was the first job assigned to the team-in-training that he mobilized.

It's a lesson not lost on Dr. Nelson Jesudasan. His surname name literally means "Jesus Devotee," and he's a good case study for a crisis that is ripping the heart out of care for the poor.

Dr. Jesudasan has been using Canadian dollars and his faith to stay viable in serving impoverished blind patients in south India. As director and chief ophthalmologist at Joseph Eye Hospital in Tiruchirapalli, in the state of Tamil Nadu, he's just finished spending more than $2-million in Canadian donations to equip his centre. More than $1-million came from one Toronto-area philanthropist, the rest from the wallets of ordinary Canadians. Both gifts came through the Canadian offices of the Christian Blind Mission, the world's largest care provider for the disabled poor, and Dr. Jesudasan's project is one of their projects in creating viable "centres of excellence."

But something's happening to their model of mission care today. In India alone, hundreds of mission hospitals are closing because they've not had the leadership of a Dr. Jesudasan, nor partnership from a donating agency.

India today is a medical-care factory with at least two million Indian doctors and nurses serving more than 18,000 private hospitals. Health tourism is booming, growing by 100,000 clients a year. Media reports estimate that a mitral valve surgery that would cost $200,000 (U.S.) in the United States can be done for less than $7,000 in India. If you have the money, there's no limit to your access.

But unregulated private health care has gouged hope for any equity, and government health care seems to be in critical condition. It covers only 17 per cent of all India's health expenditure, and the local paper in Dr. Jesudasan's city of Tiruchirapalli reports that tens of millions of Indians are too poor to go see a doctor. The Hindu News says at least 21 per cent of the population is no longer seeking any medical treatment because of cost restrictions, and "ill-equipped and crumbling government hospitals."
Dr. Jesudasan's response to the crisis in his field, eye care, was to retool his 70-year-old mission hospital for "extreme competitiveness," and to operate with a "take from the rich to pay for the poor" sustainability plan. Canada's $2-million contribution enabled the hospital to move from 6,700 sight-restoring surgeries a year to 28,000; to build wards for the poor -- and to buy equipment that would attract paying clientele whose fees would, in turn, support surgery for those unable to pay (UN statistics report 35 per cent of India's people live on less than $1 day.)

Ruthless entrepreneurs who profit from health care dislike this model. Some working near the Joseph Eye Hospital even threatened Dr. Jesudasan with death as he carried out his plan to help the poor.
Given such ferocious economic and social pressures, it's easy to see why more than half the mission hospitals created in India by Protestant agencies no longer exist. Dr. Jesudasan believes the Protestant church community is "practising euthanasia on its hospitals and because it's killing its hospitals, it is also euthanizing the poor and elderly." The most conservative estimates from India's Christian Medical Association say at least 400 of 700 mission hospitals have closed. Many of the remainder are ailing. This is a remarkable loss of investment when you consider that in the 1940s, mission agencies and India's tiny Christian population supplied one-fifth of all the hospital beds in India and created the state's best medical schools.

Each developing nation has tragic evidence to show how once-productive and cherished mission hospitals for the poor have been wiped out by hostile governments, changing patterns in North American donations, and indigenous church leadership fraught with deficient management skills.
As Canadians fight to guard our own universal health care, we'd be wise to observe how even in the most dire of circumstances, models of care can survive amid forces of greed. This is just as Canada's founder of medicare, Baptist preacher Rev. Tommy Douglas, warned: "You're never going to step out of the front door into the Kingdom of God. What you're going to do is slowly and painfully change society until it has more of the values that emanate from the teachings of Jesus or from the other great religious leaders."

Christianity is abandoning a core mission if it continues to neglect health care for the poor. Our generation has the greatest ability in history to communicate across the global village; the question is, what are we doing with it?

Every country has its glimmers of hope. India's Catholic church has a vigilant force of nuns managing 750 hospitals. Calcutta Mercy Hospital (created by Canadian missionaries Mark and Huldah Buntain) serves 100,000 patients a year, and expatriate doctors are using connections here to address the inequities in their home countries. Regina neonatologist Dr. Abraham Ninan spends up to six months a year away from his Canadian job to help 20 mission hospitals in northern India become centres that thrive under Emmanuel Hospital Association.

We all know of agencies out there that can make a difference. But we stand in a new age of accountability and it should change how we spend the resources we enjoy. It's high time that we reaffirmed our tradition of investment in medical care for the poor, both in India and in Canada. It's high time we follow the steps of Jesus who reached with compassion and said, "Be healed."
Lorna Dueck is the executive producer of Context with Lorna Dueck TV, a spiritual view of news and current events seen Sundays on Global TV, CTS, NOW, and Salt and Light TV.

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