Globalisation, Health Nursing and The Gospel

Written by Steve Fouch

Many of you would have noticed in 2005 the emphasis on global poverty and the attempts to get major world leaders to do something about it. Live 8, Make Poverty History, dramas by Richard Curtis, songs by Sting and swearing by Bob Geldoff. Somehow or another, at least over the summer months, global poverty became big news – it even featured surprisingly high in the General Election in May!

Well, here we are in 2006, and it would be easy to ask, what has happened? The answer – well not that much actually. But also, surprisingly more than in previous years. There is no end to global poverty in sight, yet more people are being treated for AIDS, TB and malaria than ever before. Millions are still dying in famines and in childbirth, but debt relief and aid to the poorest nations is increasing as never before. Small steps, but as the Chinese saying goes, “the journey of a thousand leagues starts with a single step”.

William Wilberforce fought for over thirty years to end slavery – but in the end he succeeded and changed the world as a result. We are in the midst of an even bigger struggle to change the world, and like Wilberforce, it is faith in Jesus and a strong grasp of scripture that is motivating many to lead this fight, but we have to be in it for the long haul – it won’t change overnight.

Nevertheless, one could well ask, “What has this got to do with me?” After all, we have problems enough to deal with here in the UK, and what can we do to make life any better for people on the other side of the world when we cannot do much about those in need on our own doorsteps?

Well, consider a few facts, coolly and objectively. The average woman in sub-Saharan Africa has a one in six chance of dying in childbirth. If you are a midwife, think about how many babies you have delivered; how may are still born or die shortly afterwards? How may of their mothers die? One in every six? I doubt it if you are working in the UK. While we are at it, in East Africa, on average 40% of the women turning up at antenatal clinics are HIV+. How may do you see here in Britain?

What are your chances of making it to adulthood? In the UK, pretty good – only 6 in a thousand children do not make it to five. In developing countries, the odds shrink rapidly; in Turkey it’s 35 in 1,000; while in Liberia 235 in 1,000 won’t live beyond their fifth birthday.

Add to this AIDS, which claims over three million lives a year, mostly in Africa and Asia, where between six and nine million people with an AIDS diagnosis have no access to treatment. Similar statistic can be quoted for TB and malaria.

Need I go on? We are privileged here in the West, we all know that. We have access to healthcare free at the point of delivery, which most of the world’s poor do not have. We have more food than we need to survive, so much so that overeating is one of our biggest health problems. But this does not tell us why as nurses and midwives practicing in Britain this is an issue to concern us.

Well, here are three reasons. Firstly, we are in globalised world. The panics caused by avian influenza and SARS in recent years illustrate how a health problem in one part of the world affects every part of the world. Poverty, war, famine, and disease -the four horsemen ride far and wide and pay no respect to national boundaries, even to our own doorsteps. TB is on the rise in schools and communities across Britain, as any public health nurse will tell you. Refugees are living amongst us, with their own needs- many of us see them regularly in our work. What horrors have they have lived through? What physical and mental health needs do we have to deal with regularly as a result of disasters in far-flung nations? These are matters to concern us all.

Secondly, our actions and choices affect other nations. The issues of international trade are complex, but in short, the poor cannot sell us their goods at a reasonable price so they can make a living, while we unload heavily subsidised goods on them, driving their own business to close down because they cannot compete. What we buy and how we buy it, affects others. Our lifestyles have far reaching consequences, more than we can discuss in one article!

Finally, and most importantly, we should care because God tells us to! Scripture urges us to respond to the needs of the poor. Jesus’ much misquoted saying “the poor will you will always have with you” is actually taken from Deuteronomy 15: 11 – the second half of which says “Therefore I command you saying ‘You shall freely open your hand to your brother, to your needy and poor in your land’”. The New Testament also exhorts us to care for the needs of our brothers in poverty (e.g. 1 John 3: 16 –18, James 2: 14 – 17). It could be argued that this does not relate to those in other nations, but to our near neighbours, but again we are exhorted to care for the whole Body of Christ (1 Corinthians 12: 20-26), and it is clear that a huge proportion of those suffering in Africa in particular are Christians. Furthermore, Jesus made a strong point that our neighbour was anyone in need, of any nation, tribe, creed or tongue (Luke 10: 25 – 37).

Yet at the same time, giving money, sending Christian health professionals and other forms of aid are not enough. Such aid helps in the short-term, but in the long-term it fosters dependency and feeds corruption. The Levitical Law encouraged generosity to the poor, but the aid given was to help that person be able to make his own living again. The laws required that debts be cancelled and land restored to its original owners on regular cycles, ensuring that the means of living were not concentrated in one set of hands for too long, and that people could feed and clothe themselves rather than depend indefinitely on the goodwill of their neighbours (Leviticus 25 & Deuteronomy 15).

There is then above all a call for us to pursue justice as believers. Poverty may be always with us, and some degree of inequality is inevitable, and not necessarily unjust, but the degree of extreme poverty and inequality in health that we see today is not acceptable, especially as so many of the causes are due to injustice. That is why we are exhorted to speak up for the poor, and encourage those in power to act justly on their behalf.

As nurses and midwives, what can we do? We have skills that can be used in many places [see the elective report from Elisabeth Sayers, and the article from John & Mair Pugh in this edition of CNM News for some examples]. We can make a positive contribution to the health of the poor. We can get informed and speak out. There are many great sources of information on health and poverty issues around the world – Tear Times is one good example. The Micah Challenge campaign (see www.micahchallenge.org) is another example – it encourages Christian to get informed and speak out on issue of global poverty from a Christian perspective.

At this year’s national conference [see Notice Board for details] I will be looking at these issues, and how we can respond in a Christ like manner as health professionals. In future editions of CNM News we will attempt to look at some of these issues in more depth and have some examples of ways you can get involved.

As we start a New Year, full of resolutions and plans let us stop for a moment and consider what God might be saying to us about what we can do to affect positively the lives and well being of millions around the globe.