Missions, Humanitarianism, and the Evolution of Modern Global Surgery.

Modern global surgery, which aims to provide improved and equitable surgical care worldwide, is a product of centuries of international care initiatives, some borne out of religious traditions, dating back to the first millennium. The first hospitals (xenodochia) were established in the 4th and 5th centuries CE by the early Christian church. Early "missions," a term introduced by Jesuit Christians in the 16th century to refer to the institutionalized expansion of faith, included medical care. Formalized Muslim humanitarian medical care was marked by organizations like the Aga Khan Foundation and the Islamic Association of North America in the 20th century. Secular medical humanitarian programs developed in the 19th century, notably with the creation of the International Committee of the Red Cross (1863) and the League of Nations Health Organization (1920) (which later became the World Health Organization [1946]). World War II catalyzed another proliferation of nongovernmental organizations, epitomized by the quintessential humanitarian health provider, Médecins Sans Frontières (1971). "Global health" as an academic endeavor encompassing education, service, and research began as an outgrowth of departments of tropical medicine and international health. The American College of Surgeons brought a surgical focus to global health beginning in the 1980s. Providing medical care in distant countries has a long tradition that parallels broad themes in history: faith, imperialism, humanitarianism, education, and service. Surgery as a focus of academic global health is a recent development that continues to gain traction.

COVID-19 and African American Religious Institutions.

Religious institutions have historically been an essential resource in African American communities and can serve as indispensable partners during a public health crisis. The purpose of this perspective is to establish African American churches, mosques, and temples as essential for an immediate, comprehensive, and sustained response to the elevated risk for and spread of COVID-19 among African Americans.

The Development of a Surgical Mission in the Peruvian Amazon: A 15-Year Expedition.

Musculoskeletal disorders and injuries represent a substantial proportion of the global burden of disease. This burden is particularly prevalent in low and middle-income countries that already have insufficient health-care resources. The purpose of this paper is to highlight the vision, the history, the implementation, and the challenges in establishing an orthopaedic surgical mission in a developing nation to help address the epidemic of musculoskeletal trauma.Scalpel At The Cross (SATC) is a nonprofit Christian orthopaedic surgical mission organization that sends teams of 10 to 20 members to Pucallpa, Peru, a rural town in the Amazon, to evaluate patients with musculoskeletal conditions, many that require surgery. The organization employs 4 full-time staff members and has included over 400 medical volunteers in 32 surgical campaigns since 2005. SATC has provided approximately 8.1 million U.S. dollars in total medical care, while investing approximately 2.2 million U.S. dollars in implementation and overhead.Given the projected increase in trauma in low and middle-income countries, the SATC model may be increasingly relevant as a possible blueprint for other medical professionals to take on similar endeavors. This paper also highlights the importance of continued research into the effectiveness of various organizational models to advance surgical services in these countries.

Partnering with African American Churches to Create a Community Coalition for Mental Health.

Community partnered participatory research (CPPR) emphasizes community engagement, respect, and empowerment as guiding principles to promote mental health equity. This article describes the "Vision" stage of a CPPR-informed model to implement evidence-based practices for depression in two African American churches in Harlem, New York. Essential parts of the Vision include engagement of stakeholders and collaborative planning. The engagement process increased awareness about the project via a community-focused mental health symposium. The collaborative planning stage resulted in creating a multi-disciplinary Community Coalition for Mental Health, establishing the Coalition's values, agreeing to change the initial chosen study intervention from Interpersonal Counseling to Mental Health First Aid, and developing a website to disseminate the group's work. Key lessons learned from our partnered process are: 1) support from the lead pastor is crucial; 2) balancing community and academic interests can be challenging; 3) icebreaker activities foster relationships and reinforce CPPR principles; 4) multiple communication channels can enhance community participation; and, 5) should organize data in ways that make them easier to interpret.

Building Effective Medical Missions with Servant Leadership Skills.

Nurses are naturally drawn to service opportunities, such as short-term medical missions (STMM), which hold great potential to benefit health. But STMMs have been criticized as potentially being culturally insensitive, leading to dependency, inadvertently causing harm, or being unsustainable. Utilizing servant leadership skills, nurses can effectively build community, vision, and sustainability into STMM projects.

Predictors and Extent of Institutional Trust in Government, Banks, the Media and Religious Organisations: Evidence from Cross-Sectional Surveys in Six Asia-Pacific Countries.

BACKGROUND: Building or maintaining institutional trust is of central importance in democratic societies since negative experiences (potentially leading to mistrust) with government or other institutions may have a much more profound effect than positive experiences (potentially maintaining trust). Healthy democracy relies on more than simply trusting the national government of the time, and is mediated through other symbols of institutional power, such as the legal system, banks, the media and religious organisations. This paper focuses on institutional trust-the level and predictors of trust in some of the major institutions in society, namely politics, the media, banks, the legal system and religious organisations. We present analyses from a consolidated dataset containing data from six countries in the Asia Pacific region-Australia, Hong Kong, Japan, South Korea, Taiwan and Thailand. METHODS: Cross-sectional surveys were undertaken in each country in 2009-10, with an overall sample of 6331. Analyses of differences in overall levels of institutional trust between countries were undertaken using Chi square analyses. Multivariate binomial logistic regression analysis was undertaken to identify socio-demographic predictors of trust in each country. RESULTS: Religious institutions, banks and the judicial system had the highest overall trust across all countries (70%, 70% and 67% respectively), followed by newspapers and TV (59% and 58%) and then political leaders (43%). The range of levels of higher trust between countries differed from 43% for banks (range 49% in Australia to 92% in Thailand) to 59% for newspapers (28% in Australia to 87% in Japan). Across all countries, except for Australia, trust in political leaders had the lowest scores, particularly in Japan and South Korea (25% in both countries). In Thailand, people expressed the most trust in religious organisations (94%), banks (92%) and in their judicial/legal system (89%). In Hong Kong, people expressed the highest level of trust in their judicial/legal system (89%), followed by religious organisations (75%) and banks (77%). Australian respondents reported the least amount of trust in TV/media (24%) and press/newspapers (28%). South Korea put the least trust in their political leaders (25%), their legal system (43%) and religious organisations (45%). The key predictors of lower trust in institutions across all countries were males, people under 44 years and people unsatisfied with the health and standard of living. CONCLUSION: We interpreted our data using Fukuyama's theory of 'high/low trust' societies. The levels of institutional trust in each society did not conform to our hypothesis, with Thailand exhibiting the highest trust (predicted to be medium level), Hong Kong and Japan exhibiting medium trust (predicted to be low and high respectively) and Australia and South Korea exhibiting low trust (predicted to be high and medium respectively). Taiwan was the only country where the actual and predicted trust was the same, namely low trust. Given the fact that these predictors crossed national boundaries and institutional types, further research and policy should focus specifically on improving trust within these groups in order that they can be empowered to play a more central role in democratic vitality.

Dirección por misiones: del «qué» al «para qué» / Management by missions: from «what» to «why»

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Management by missions in the healthcare sector / La dirección por misiones en el sector sanitario

This article discusses the importance of the mission statement in the healthcare sector. It's also argued that only formal declaration of the mission it's insufficient to the appropriate professional coordination of doctors, nurses and managers. It's proposed a systematic approach to facilitate the introduction of the mission within the systems of the organization, what is called «Management by missions.» It promotes horizontal and vertical integration between doctors, nurses and managers. Criteria that ensure this integration are specified (AU)

En este artículo se aborda la importancia de la declaración de la misión en instituciones del sector sanitario; también se constata la insuficiencia de esta declaración formal para la adecuada coordinación profesional de médicos, enfermeros y gestores. Se propone un abordaje sistemático que facilite la introducción de la misión en los sistemas de la organización, lo que se denomina «Dirección por misiones». Se explicita como esto promueve la integración horizontal y vertical entre médicos, enfermeros y gestores. Se especifican los criterios que garantizan esa integración (AU)

The effect of the National Health Insurance Scheme (NHIS) on health service delivery in mission facilities in Ghana: a retrospective study.

BACKGROUND: In 2004, Ghana began implementation of a National Health Insurance Scheme (NHIS) to minimize out-of-pocket expenditure at the point of use of service. The implementation of the scheme was accompanied by increased access and use of health care services. Evidence suggests most health facilities are faced with management challenges in the delivery of services. The study aimed to assess the effect of the introduction of the NHIS on health service delivery in mission health facilities in Ghana. We conceptualised the effect of NHIS on facilities using service delivery indicators such as outpatient and inpatient turn out, estimation of general service readiness, revenue and expenditure, claims processing and availability of essential medicines. We collected data from 38 mission facilities, grouped into the three ecological zones; southern, middle and northern. Structured questionnaires and exit interviews were used to collect data for the periods 2003 and 2010. The data was analysed in SPSS and MS Excel. RESULTS: The facilities displayed high readiness to deliver services. There were significant increases in outpatient and inpatient attendance, revenue, expenditure and improved access to medicines. Generally, facilities reported increased readiness to deliver services. However, challenging issues around high rates of non-reimbursement of NHIS claims due to errors in claims processing, lack of feedback regarding errors, and lack of clarity on claims reporting procedures were reported. CONCLUSION: The implementation of the NHIS saw improvement and expansion of services resulting in benefits to the facilities as well as constraints. The constraints could be minimized if claims processing is improved at the facility level and delays in reimbursements also reduced.

Immigration detention and faith-based organizations.

Immigration detention is a hot contemporary issue in the United States, with over 33,000 individuals held in detention facilities daily and reports of poor conditions and human rights abuses. Building on a growing body of theory exploring the role of faith-based organizations (FBOs) in social services provision, and seeking to address a gap in the literature concerning services provided to immigrants in detention, this qualitative study explored the responses of FBOs to immigration detainees. Twenty in-depth interviews with volunteers and staff members of FBOs as well as field notes from participant observation were analyzed using thematic coding techniques. Findings suggest that FBOs are active leaders in this area of social work practice and provide significant resources to isolated and vulnerable detained immigrants in a variety of ways. Simultaneously, they face challenges surrounding access and constricted activity. The study indicates that considerable scope exists for expanding and enhancing faith-based and other social work engagement in this crucial field.

Healing, healthcare, missions, the church.

Churches throughout history have modeled ministry on Jesus' life of reaching out, teaching, preaching, and healing. Kampala Baptist Church (KBC) in Uganda is one such church that works to care spiritually and physically for their community. Partnering with local healthcare providers and short- and long-term healthcare missionaries, the church is transforming lives. Read about KBC and explore healthcare missions ministry.

Building on a legacy for the era of population health.

The 2011 Joplin tornado was a catastrophic EF5 multiple-vortex tornado that struck Joplin, Missouri, late in the afternoon of Sunday, May 22, 2011. It was part of a larger, late-May tornado outbreak and reached a maximum width of nearly 1 mile (1.6 km) during its path through the city. Mercy St John's Hospital (which had recently joined Mercy Ministries) suffered a direct hit and was rendered nonuseable. A total of 183 patients and nearly 200 coworkers/staff members were evacuated from the building within the next 90 minutes. Triage centers were set up outside as hospitals of other areas opened their doors for St John's patients and community members who had been injured. The tornado in Joplin destroyed Mercy St John's Hospital. Given this future, why did Mercy Ministries choose to rebuild an acute care facility rather than merely an outpatient system? The organization considered current community needs and the needs of the future. They also remembered their mission and the legacy of their heritage.