Coming and Going and Being Sent: Thuma mina (Send me)

In the early morning hours, these words from a psalmist of old are striking, “I know that the Lord secures justice for the poor and upholds the cause of the needy. Surely the righteous will praise your name and the upright will live before you.” Those are the last two verses of psalm 140, penned by David. I find them striking.

An application of that text also resonates deeply. For those two weeks that we were in the presence of ten African students from six African countries deeply penetrated my soul. The course was an upper division elective.  They were either third year counselling and psychology students, or they were second year students. The syllabus was daunting. They would have to read a lot, ponder a lot, learn a lot, and apply a lot. 

Here is what the syllabus said:  This elective in the psychology and counselling track is designed to orient students in the discipline of medical family therapy and its potential applications in their countries of origin. Consideration will be given to the cultural context from which she and he comes. Theory and practice of working collaborative healthcare settings with individuals, couples, and families in which illnesses are assessed and treated.

Here were the course objectives: 
 

1.         Students will learn and articulate the biopsychosocial/spiritual model
2.         Students will learn principles and practices of medical family therapy as a
            discipline with application to her or his country of origin
3.         Students will acquire basic information relative to illness and family
4.         Students will practice engagement with medical personnel in primary care clinics
5.         Students will develop a preliminary model for working in the country of origin
6.         Students will maintain an annotated bibliography for daily readings that include
            engagement questions and applications
7.         Students will learn the art of constructing both a genogram and an ecomap

The human part is that these ten students were prepared for this course. They could write well and speak English well. They had a clear vision for returning to Malawi or Zimbabwe or Tanzania or South Africa or Swaziland or Zambia and serve God and the people of their homeland.

They know intimately the impact of trauma on their lives and the lives of their families. They know well the impact of HIV/AIDS, or TB, or cancer, or any number of other health conditions.

They had just never put all of these things together, things such as “how does a trained therapist conceptualize and engage a person and a family in which illness is pervasive,” or “how does one work to alleviate pain and suffering in the marginalized who have socially unacceptable illnesses,” or “how can serving those with health problems be service to God,” or “how does illness or disease come to be the central organizing principle in families,” or “if we could develop one, what would an internship or a clinic look like that had both behavioral health and a focus on illness of its patients,” or “how could a ministry in the church create a focus on behavioral health and medical needs of the people in its community.”

By reflecting on those questions, learning theory and practice of medical family therapy, role-playing curb-side consults or “friendly handoffs,” and a myriad of other things that occur in collaborative care clinics, they caught the vision for what could happen in their homelands. It was riveting to see how they grasped the ideas and practiced, and how they reflected upon applications in her or his country of origin.

On Monday of this week an internship that captures these principles and practices started at a clinic not far from the campus. Dr. Bob Whitaker, long-time medical missionary in Nigeria and now medical missionary in Swaziland, had agreed to work with Lynn Rhodes and one of my students to develop an integrated care focus. May God's grace shine upon that effort.

Justice and righteousness have a lot to do with the motivation to learn and apply those things.  A theology of shalom, justice, and righteousness undergirded the class. Shalom had been broken in the garden. The breakup in families and the breakdown in health of family members and community members were signs of that violation of shalom. Bringing ones’ self into the mix of pain and suffering, just as Jesus emptied himself as He entered our world, is a meaningful attempt to re-create shalom insofar as we can re-create it in this broken world, and as we point to the ultimate healing when the Lord comes again to claim His own.

Yes, I believe God cares for the mistreated and those for whom justice has not come. I believe my job and the jobs of my students is to bring about justice and righteousness insofar as we are able. We validate stories and we convince people that they are worthy as we engage, listen, and validate.

That can happen in communities from which my students come in Africa.