January/February 2007

Learning About International Mission Work

Health Improvement Can Start with Community Development

01-07tanzania Photo

The children of Ebenezer Parish, a Lutheran parish in northern Tanzania, welcome the group hosted by the Catholic Consortium for International Health Care.

While relationships between U.S. health care providers and third-world areas in need of health improvement often grow slowly, the rewards — for those who provide help as well as those who receive it — can be great. This is one of the lessons learned by Catholic Health Initiatives leaders and other health care professionals who recently made a trip, hosted by the Catholic Consortium for International Health Care, to the African country of Tanzania. Catholic Health Initiatives is a member of the consortium, which hosts an annual trip to an international mission site led by one of its members. The fall of 2006 brought Catholic Health Initiatives’ turn to lead the trip. On behalf of Catholic Health Initiatives, John Tolmie, president and chief executive officer of St. Joseph Medical Center, Towson, Md., and Paul Neumann, Esq., senior vice president of legal services and general counsel for Catholic Health Initiatives, led a group to the Karatu District of northern Tanzania. Neumann also represented Global Health Initiatives, the organization created by Catholic Health Initiatives to help extend its mission beyond the borders of the U.S. The group included Phyllis Hughes, RSM, DrPH, a member of the Catholic Health Initiatives Board of Stewardship Trustees and manager of the Health-HIV/AIDS Unit of Catholic Relief Services; Michael Rowan, chief operating officer of Catholic Health Initiatives; and representatives from Catholic Healthcare West, San Francisco, Calif., and Henry Ford Health System, Detroit, Mich. This mud hut is a typical dwelling in the villages of the Karatu District. Eye-Opening Experience “With the help of international grants from the Mission and Ministry Fund, St. Joseph in Towson has been doing international mission work in the Karatu District for more than five years. This is the longest tenure of the projects under the auspices of Global Health Initiatives,” said Neumann. “Both John and I had been to Tanzania before, and we knew that we would be able to show the group a full range of health facilities, from larger hospitals in urban areas to small clinics and health projects that serve remote villages. With such a diversity of settings and facilities, we knew that the group would see a wide range of possibilities for international mission work.” Perhaps the most eye-opening experience for the group was to see the absence of basic health necessities in many of northern Tanzania’s rural villages. “The people who live in and around these villages are primarily subsistence farmers,” said Neumann. “Many of them have only mud huts to live in, open latrines and no running water. Flies, mosquitoes and the lack of clean water contribute to the spread of diseases like cholera and malaria. The people have few financial resources, and many can’t afford to pay for any health care that might be available. Our group was able to see all of this and understand one of the important lessons learned by St. Joseph Medical Center’s mission teams — it may not be possible to come in and help a local hospital build its capacity to provide health care without first helping the surrounding community obtain the basic resources of good health.” Generally, health care facilities in the Karatu District need lots of help,” said Sister Phyllis. “However, while the local hospitals need assistance, the greater need was to find out why people were coming to the hospitals. St. Joseph realized that they needed to go into the villages to do preventive work: to figure out why people were coming to Karatu’s health care facilities with malaria and cholera, and why they were so malnourished. It was very interesting to learn how St. Joseph started out to address health issues, but soon branched off into community development work.”

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The group gathers with the administrators of Karatu Lutheran Hospital. From left: John Tolmie, president and chief executive officer, St. Joseph Medical Center; John Kulle, treasurer, Karatu Lutheran Hospital; Marilyn Hubbard, corporate vice president of community partnership, Henry Ford Health System; Dr. Asantaeli Makyao, physician in charge, Karatu Lutheran Hospital; Michael Rowan, chief operating officer, Catholic Health Initiatives; Susan Whitten, vice president of business development and operational development, Catholic Healthcare West; Paul Neumann, Esq., senior vice president of legal services and general counsel, Catholic Health Initiatives; Dr. Gwendlolyn Graddy-Dansby, medical director, Henry Ford Health System; Michael Whitten, representative of Catholic Healthcare West; and Phyllis Hughes, RSM, DrPH, manager, Health-HIV/AIDS Unit, Catholic Relief Services.

Community Outreach St. Joseph and its collaborators in Tanzania — which include Mercy Regional Medical Center, Durango, Colo., and the local Catholic and Lutheran dioceses — have worked on projects such as implementing water purification systems; creating a system of covered latrines; distributing mosquito netting for beds; and even providing families with goats and cows to establish a reliable food supply and a means of income. “It’s a parallel to the type of community health work we do in the U.S., but in the Karatu District the needs are so much more basic,” said Neumann. “Communities in the U.S. are in need of health services, but they are usually not in need of clean water or covered toilets.” “It was wonderful and very impressive to see what St. Joseph and its collaborators have been able to accomplish through sustained effort,” said Sister Phyllis. “John Tolmie has provided consistent, hands-on leadership of this international mission effort and has been very effective at making connections with local leaders and other groups that do mission work in the area.” Sister Phyllis noted that Catholic Relief Services’ manager in Tanzania was able to join the group and see the programs supported by St. Joseph, which may lead to future collaboration. Tolmie emphasizes that Tanzanians are not looking for handouts, but for helping hands. “The ability to assist the villagers in helping themselves is very rewarding. St. Joseph Medical Center has developed many friendships, which is the richest gift we could ever be given for our assistance,” he said. Bedpans are simply washed and left out to dry in the sun. Building Trust While U.S. health care providers may envision replicating their own models of care overseas, this is probably not practical, according to Neumann. “Our group learned how important it is to visit a site even before sending supplies and equipment,” he said. “You need to talk to the local health providers and any others who are already there to do mission work to find out what resources are present. For example, is there a reliable supply of electricity? If not, sophisticated medical equipment won’t do much good. “Mission teams can also encounter skepticism on the part of the people they want to help,” he added. “They may doubt that you can really deliver what you promise. It takes time to build trust.” New Linkages As a result of the trip to Tanzania, Global Health Initiatives is considering new approaches to the organization’s efforts to link Catholic Health Initiatives hospitals with “sister” hospitals overseas. “We believe that direct, hospital-to-hospital relationships are not the only way to help improve health in third-world areas,” said Neumann. “It may also be very effective for our hospitals to work with religious congregations that already have community health improvement projects in place in developing nations. This is something the board of Global Health Initiatives will research in the coming months.” Other international mission projects supported by Global Health Initiatives and international grants from Catholic Health Initiatives’ Mission and Ministry Fund include:
  • An effort by Mercy Medical Center, Nampa, Idaho, to establish health clinics in Accra, Ghana.
  • A partnership between Comboni Clinic in Guatemala and TriHealth, Cincinnati, Ohio.
  • A partnership between St. Mary-Corwin Medical Center, Pueblo, Colo., and Providence Hospital, Gonaives, Haiti.
  • A sister-to-sister relationship between St. Anthony Hospitals, Denver, Colo., and Bach Mai Hospital, Hanoi, Vietnam.
  • A partnership between Mercy Medical Center, Roseburg, Ore., and St. Damians Hospital, Orlu, Nigeria.
  • A sister-to-sister relationship between St. Jude Hospital, St. Lucia, West Indies, and Holy Rosary Medical Center, Ontario, Ore.
For more information about Global Health Initiatives and its international mission projects, visit www.globalhealthinitiatives.org.