Pain of a Different Sort

EMQ » September–December 2023 » Volume 59 Issue 4

Multivitamins are counted before distributing them to a patients at a mobile medical clinic. Photo courtesy of IMB.

Summary: Pairing foreign healthcare clinics with indigenous gospel and disciple-making efforts may have unintended consequences. They may heal pain on one front but cause it on another.

By Jean Johnson

During my sixteen years as a missionary in Cambodia, I participated in a couple of short-term medical clinics and observed many. I would be the first to say that seeing a person in pain who is made well by the medicine and care I bring is fulfilling. And if that is all I am after, then it is also praiseworthy.

But what if there is more to the situation than meets the eye? What if our short-term medical clinics in partnership with churches in cross-cultural settings heal pain on one front, but cause pain on another?

Short-term Gain for Long-Term Pain

Let me share an example from South Asia. A visiting short-term, medical-mission team paired up with a group of near-culture missionaries and a local church to host a pop-up medical clinic. Over 1 week, nearly 100 people were seen by visiting doctors and nurses from America. Most of those people were treated with medications, vaccinations, and vitamins. Each patient received a presentation of the gospel and was prayed for as they ended their turn in the makeshift clinic.

Upon departing the region, the visiting team provided the near-culture missionaries and church leaders the names of people they should visit because of their favorable responses to the gospel presentations. Upon arriving home, this medical mission team celebrated the many short-term gains of their work with their home church.

Meanwhile, the near culture missionaries and local church leaders experienced long-term pain – not of the medical sort, but of the gospel and discipleship sort. For example, some people complained that they didn’t seem to receive the same treatment as others, even when it wasn’t warranted. Others asked questions like, “How can we get ahold of those syringes that sucked out the bad air and spirits from us?” They’d clearly interpreted their experience with Western medicine based on their animistic beliefs.

When the near culture missionaries and local leaders visited people, they thought were new believers, they were asked questions like, “Why have you forsaken our traditions to chase after foreign gods?” It became clear that coupling free medical help with a request to respond to the gospel nearly always resulted in a “yes” in a culture that doesn’t want others to lose face.

A few people came to church, but left when they realized there was no ongoing help or handouts. And when local disciples tried a similar approach to sharing the gospel with a clinic using their local resources, it paled in comparison to what the foreigners provided. This caused the community to look down on them and made them feel inferior. 

So why would near-culture missionaries and local church leaders continue to host teams if there are so many unintended consequences? Why not initiate models that work in their context? They said, “We depend on the financial support that comes our way through these teams.”

Assuming, Activating, and Attracting Church Poverty

We observe three types of behaviors correlating to what we will call church poverty:

  1. Assuming church poverty is perceiving people and churches in a cross-cultural context as lacking and needy based on our own values, church experiences, and economic standards of living.
  2. Activating church poverty is stimulating a sense of poverty by raising people’s perception of what they think they need to function and succeed as a church, which leads to comparative poverty. Comparative poverty is when people feel that they can only be successful if they have what others have, and thus focus on seeking out sponsors rather than recognizing their own value and mobilizing themselves.
  3. Attracting church poverty is giving to, aiding, and funding churches in a way that causes the recipients to view their poverty as an asset – that they are better off not developing themselves in certain areas so they can depend on others.[i]

The medical team from abroad assumed that the local disciples of Jesus were underdeveloped and lacked ideas and methods to share the gospel-as-word and gospel-as-deed within their own communities. So they brought their expertise and tools of the trade with them, which activated a mentality that the local disciples’ approaches and resources were insufficient. The fringe benefits of hosting teams attracted a poverty mentality. In other words, downplaying their own strengths proved more lucrative than developing ideas and efforts that were locally driven, initiated, resourced, etc. 

Additionally, surrounding churches that heard about or observed the medical clinics started down the path of comparative poverty. They said to themselves, “If we had rich foreigners working with us; we would be successful.” And the biggest tragedy is when the Hindus and Muslims in this region observe the unintended consequences of this church poverty and thus move further away from the gospel.

G.P.V. Somaratna sheds light on this condition: “In Sri Lanka, Christians are being viewed as vultures nurtured on foreign funds and driven to hunt for the poor mortal souls of the gullible and poverty-stricken non-Christian.”[ii] Additionally, J.R. Meydan and Ramsay Harris reveal that “Muslims assume that the principal methods Christian missionaries intentionally use to lure Muslims away from Islam and to Western Christian culture is by buying them off with gifts and money, often under the guise of relief and development.” [iii]

Triggering these reactions to the gospel becomes counterproductive to the whole reason for medical teams partnering with local Christians. This all adds up to a pain of a different sort – not of the medical sort, but of the gospel and discipleship sort. 

Assume, Activate, and Attract Dignity

“It’s not the monkey on top that makes a tree fall, but it’s the work and effort of numerous small insects and ants,” explains an African proverb. Disciples and churches in the so-called developing world may seem small and incompetent from our position way high on top of the tree, but many ants that work together can fell a tree.

Donald McGavran is known for saying, “In every apple, there is an orchard.” Instead of importing models that are not reproducible, we could serve as catalysts by asking, “If you put your minds and actions together, what could you accomplish?” This serves as an assume dignity mindset.

In this case, the belief starts with us – the belief that every group of people has around them everything they need to obey Jesus Christ in their God-given setting. If we assume local ingenuity and capacity, rather than neediness among a people, we will treat them as significant partakers in their God’s kingdom work in their own Jerusalem and Judea. If we treat them with such respect, we will activate dignity and attract dignity.

Ponder the Pain

By now you might be asking, “What are you saying? Should we forgo pairing foreign medical teams with local disciples and churches in other countries?” I can’t make that decision for others. But I invite you to ponder a pain of a different sort – long-term pain that affects local gospel and disciple-making efforts. Are short-term gains worth the long-term pain that negatively affect local reproducibility and multiplication of disciples?

Jean Johnson ( is the author of We Are Not the Hero: A Missionary’s Guide for Sharing Christ, Not a Culture of Dependency. She has over 35 years of vocational cross-cultural ministry experience including 16 years of service in Cambodia. Jean is the director of Five Stones Global ( Five Stones Global provides missionaries with the coaching, training, and practical tools needed to multiply disciples organically among their host communities – utilizing biblical and reproducible models.

[i] Jean Johnson, Standing On Our Own Feet Workbook: How to Encourage Indigenous Churches to Operate from a Place of Dignity and Sustainability in Global Mission (Maitland, FL: Xulon Press, 2018), 32.

[ii] G. P. V. Somaratna, “Buddhist Perceptions of the Christian Use of Funds in Sri Lanka,” Complexities of Money and Missions in Asia, ed. Paul DeNeui (Pasadena, CA: William Carey Library, 2012), 9.

[iii] J. R. Meydan and Ramsay Harris, “Are We Nourishing or Choking Young Plants with Funds?” From Seed to Fruit ed. Dudley Woodberry, (Pasadena, CA: William Carey Library, 2011), 231.

EMQ, Volume 59, Issue 4. Copyright © 2023 by Missio Nexus. All rights reserved. Not to be reproduced or copied in any form without written permission from Missio Nexus. Email: