Supporting traumatised mission workers

pastoralMany people in the mission world are exposed to significant levels of suffering.  Whether it’s walking past vast numbers of the destitute on the streets of Asian megacities, watching people die of diseases that could be cured in the west, or supporting the millions of people worldwide living in refugee camps, mission workers witness a lot of suffering.  Sometimes it’s a passive experience which can be part of life in their field of ministry, or sometimes an active one as they devote themselves to providing relief.

Others of us experience suffering ourselves, perhaps through the car accidents which are all-too-frequent in the sort of places we work, robbery, kidnap, assault, or natural disaster.  We may experience broken relationships, spiritual abuse within toxic agencies, or exploitation by those we are aiming to serve.

Such exposure to suffering can have a variety of impacts.  It can lead to compassion fatigue, with people becoming uncaring as they steel themselves to withstand the suffering around them.  It can lead to burnout as they strive compassionately to personally meet the needs of everyone they come across.  And it can, in extreme circumstances, lead to severe theological doubts or even a loss of faith as people struggle to come to terms with the presence of suffering in a world created by a loving God.  Not to mention conditions like Post-Traumatic Stress Disorder.

How do mission workers suffering from such trauma find relief for it?

  • They need to get away. People working in traumatic contexts should withdraw regularly for rest and healthcare, to make sure they stay well enough to do their jobs.  In the process they’ll need to feel helped not to feel guilty for leaving those who need their help.  By withdrawing to recharge their batteries, they will in the long run be able to be help more people.  Fortunately there is a growing number of retreat centres worldwide where mission workers can get a break and, if they want, also find debriefing.
  • They need to engage spiritually with the situation. Where is God to be found in this mess?  What is God saying to them?  How is the Holy Spirit empowering them to do their ministry?
  • They need to have a proper debrief. It’s important with people engaging with trauma that they don’t merely have a brief chat with a colleague, but meet with professionals as part of a process of unpacking their emotions.  Ministries like ARREST, Healthlink360, Interhealth, and Le Rucher specialise in providing such focussed support.
  • They need a supporting church that can care for them when they come “home” for a break, by providing hospitality, love and support, and an opportunity for them to talk if they want to, while respecting the fact that they may want to keep silent and think things through in their minds rather than verbalising everything. They need to feel involved without having lots to do, as they will need space to work through what is going on inside them.
  • They need to be accepted for who they are at this moment. One of the big challenges for mission workers with doubts about their faith is that there are few people they can talk to honestly.  They are frightened to tell their agency that they are constantly tearful and feel guilty of their relative wealth and security for fear of not being allowed to go back.  They fear they will lose the support of their church if they say that after what they’ve seen, they can’t believe in a God of love any more.  An accepting, non-judgmental environment in which mission workers can express such doubts can go a long way towards their healing, though sadly what we hear most from mission workers is that they have nobody who understands.

In order to prevent the build-up of stress in a mission worker to an unhealthy state, they should have a good understanding of a theology of suffering, recognise their own physical responses to stress so that they can take appropriate action, and have supportive relationships where it is safe to talk openly about the challenges they face.

Far too many mission workers are invalided out of the field because they weren’t properly supported and cared for… by church, by agency, and by themselves.

Malaria

Image courtesy of Gabor Bibor on www.freeimages.com

A new malaria vaccine – the first in history – has passed its trials recently, so we thought it might be a good idea to bring you all up to speed on it.  Malaria is a significant global public health issue, claiming over 600,000 lives a year, mostly children in sub-Saharan Africa, so anything that can make a dent in those statistics is a welcome development.

The new vaccine, RTS,S (also known as Mosquirix)  is produced by GlaxoSmithKline, with $200m of funding from the Bill and Melinda Gates Foundation, and is the culmination of a sixty year search for the Holy Grail of tropical medicine.  Because malaria is such a varied disease, it is notoriously hard to fight, but RTS,S works by introducing one protein from the parasite into the human immune system so that it will respond more rapidly to an infection.  In Phase III trials in seven African countries in children and infants it was found to significantly reduce the incidence of malaria for up to 18 months.  You can read the GlaxoSmithKlein press release here.

Malaria zones (source: Rpyal Perth Hospital)

Malaria regions (source: Royal Perth Hospital)

GSK hope to get the vaccine to market by 2016, and plan to sell it at a price which will cover the cost of production plus 5%, with profits being ploughed back in to product development.  It remains to be seen, of course, whether the cost will be low enough to be affordable to many countries which desperately need it.

As well as this prophylactic, there are also well-established preventatives such as malarone, a relatively expensive but highly effective prophylactic , and doxycycline, a mild antibiotic noted for its lack of serious side effects other than reducing tolerance to sunlight, which makes it problematic in the tropics.  Many adult prophylactics are not recommended for children, particularly Lariam, which has been linked to vivid nightmares, anxiety, depression and mood swings.  For more information visit the Interhealth website, but you should always seek bespoke medical advice from your GP or other medical adviser before taking anything to prevent or treat malaria, especially as strains of malaria differ across the world.

Effective prevention

Effective prevention

Of course, the best way to prevent malaria is not to get bitten by a mosquito in the first place.  Sleeping under impregnated mosquito nets, fitting mesh to windows, and keeping skin covered, particularly around sunset, are suitable barrier methods.  Having an electric fly killer also works, as does regular spraying of rooms with insect killer, though take care not to be in the room for a little while afterwards.  Burning mosquito coils and wearing insect repellent are less dangerous ways of deterring mosquitos.  There is also evidence that eating garlic works, or maybe that’s just wishful thinking!

One of the most effective ways of making sure that mosquitos are eliminated from your environment is to ensure that there is no standing water near your home.  That’s not easy during the rainy season, but mosquitos don’t travel far from their place of birth – some studies say as little as 100 metres.  If you can’t eliminate the water, introduce fish to it to eat the mosquito larvae, or add a small amount of paraffin to it to reduce the surface tension of the water which means the eggs fall through and drown.

Another method is to eliminate the mosquito’s food source – nectar and other plant sugars.  Many of us plant lawns or flower beds round our homes or offices to make them look nice, but that’s just building a mozzie diner.  Contrary to popular belief, mosquitos don’t feed on blood; the females use it for reproduction.  So by replacing your lovely green lawn and flower beds with gravel, you starve the mozzies.  If you must have the greenery, spray it regularly with an insecticide.

Sensible precautions could save thousands of lives a year.  But so could RTS,S.  And the best thing is that all of us who have moaned about our MS Windows over the years have indirectly contributed to its development.  Eat your hearts out, MAC users!

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Postscript

In a recent development, a new test for malaria has been discovered, which promises to be much more accurate than the current standard slide test.  For more information visit http://allafrica.com/stories/201312311173.html