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From Luke’s Journal June 2024  |  Vol.29 No.2  |  Christian Hospitality

“One Sabbath, when Jesus went to eat in the house of a prominent Pharisee, he was being carefully watched.…Then Jesus said to his host, “When you give a luncheon or dinner, do not invite your friends, your brothers or sisters, your relatives, or your rich neighbors; if you do, they may invite you back and so you will be repaid. But when you give a banquet, invite the poor, the crippled, the lame, the blind, and you will be blessed. Although they cannot repay you, you will be repaid at the resurrection of the righteous.” Luke 14:1, 12-14

In Luke 14 of the Bible, we read that Jesus was eating in the house of a prominent Pharisee during Sabbath. Jesus gives a directive to his prominent Pharisee host to invite people to his banquet who are not able to repay him, such as the poor, the disabled, the lame, and the blind. Although the two parables in Luke 14 are considered by some commentators as allegorical references to the inclusion of Gentiles and of God’s salvation plan, it emphasises Jesus’ hospitality to the poor and marginalised; and is a reminder for Christ’s followers of all eras to do likewise as a foretaste of the great eschatological feast. 

In Mark 12:28, Jesus was asked by a Pharisee “Of all the commandments, which is the most important?” In Mark 12:29-31, Jesus replied, “The most important is: ‘Love the Lord your God with all your heart and with all your soul and with all your mind and with all your strength.’ The second is this: ‘Love your neighbour as yourself’. There is no commandment greater than these.”

If we consider these verses together, it seems that if we want to be hospitable, we should “love our neighbours”. “Loving our neighbours” entails both extending hospitality to them and also inviting them to enter a love relationship with God. To love our neighbours as Jesus did means loving enemies and strangers as well.

As a healthcare professional who has worked in public oral health, I viewed my efforts to improve access to oral health and oral health services, as actions that stemmed from “loving my neighbours” and being hospitable to the poor and marginalised, just as Jesus did.

Access to health and health services are fundamental human rights. These rights are equally valid for oral healthcare since oral health is an integral part of general health.¹ Oral diseases are the most common noncommunicable diseases (NCD) in the world, affecting an estimated 3.5 billion individuals.¹ Oral diseases share some common risk factors and social determinants with other NCD, such as type 2 diabetes mellitus, ischaemic heart disease, etc.. Poor oral health has a significant and often underestimated impact on the health and well-being of individuals and communities. The effects of poor oral health manifest not only as pain and suffering ,but can impact negatively on child growth and development, quality of life and well-being, leading to missed opportunities, compromised productivity, and increasing the burden of disease and public health expenses. Despite health and oral health improvements over recent decades, inequalities and inequitable access to basic health and oral healthcare continue to persist.

Poverty-stricken individuals and communities, especially people of low-income nations, are left marginalised from the ‘hospitality’ of accessible and affordable oral healthcare. One of the oral healthcare systems that is foremost in developed countries is the treatment-orientated curative approach. This model of care, with all its shortcomings, has been duplicated in many marginalised communities to tackle oral health inequalities.  Forever treating away oral health problems is akin to emptying the ocean with a leaky spoon!

There is a need for those wanting to extend hospitality to low-income nations to refocus their priorities and efforts from a curative approach to prioritising health promotion. The World Health Organisation defines health promotion as “the process of enabling people [individuals and communities] to increase control over, and to improve their health”.² Health promotion is a “mediating strategy between people and their environment, combining personal choice and social responsibility for health to create a healthier future”.³

According to the Ottawa Charter for Health Promotion, the five broad actions of health promotion are: 
1. create supportive environments,
2. build healthy public policy,
3. strengthen community action,
4. develop personal skills, and
5. reorient health services.⁴ 

As such, advocacy is central to effective health promotion. The World Health Organisation describes advocacy for health as “a combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or programme”. ⁵

Equally important is a primary healthcare approach which many countries have adopted, adhering to the fundamental principles and goals of primary healthcare described in the Declaration of Alma Ata⁶:
1. health is a fundamental human right,
2. primary healthcare is essential,
3. address the root cause of health problems,
4. intersectoral cooperation,
5. community participation,
6. health promotion and prevention,
7. equitable and accessible care,
8. affordable and cost-effective care,
9. training of health workers, and
10. international cooperation.

As a Christian and a healthcare professional, I can’t help but ask, “How does God want Christian healthcare professionals to respond to these problems? What is the Biblical or Christian approach to healthcare? Is there a Biblical paradigm for improving oral health and access to oral healthcare?”

In my search for answers, I turned to the teachings of our Lord Jesus in the Bible.

Understanding the situation

In Matthew 9 and 10, we learn that the situation in Jesus’ days was probably very similar to the present situation in many low-resource countries. Crossing the Sea of Galilee, Immanuel, God with us, went to His own town, Capernaum. He lived and grew up with fellow Jews and understood their aspirations and their needs – physical, social, emotional, and spiritual. Jesus was the perfect example of a hospitable person while on earth: Jesus healed the paralysed, the blind, the dumb, and the chronically ill; offered spiritual healing (forgiveness and salvation) to sinners; befriended the marginalised; raised the dead; shared his meals; and also taught. Jesus embraced the whole person. Health was not the ‘mere absence of disease’.

To extend relevant hospitality as Christian healthcare professionals in the public health context, we must do as Jesus did: be familiar with our target population to understand their needs and concerns, and subsequently identify the problems and the strategies to address the problems.

Identifying the underlying problems

Jesus understood the full extent of the problems in his community. The needs and demands were huge. What was contributing to the huge need? What were the root causes of the problems? Why were these problems present?

Jesus knew the root cause. He came to earth to tackle the underlying cause of the problems, while addressing the obvious observable issues (the people’s needs, the issues contributing to the needs including the influencing factors such as the decision-makers). Recognising the issue compounding the problems, Jesus said, “The harvest is plentiful but the workers are few” (Matt 9:37).  At the same time, Jesus was compassionate, recognising that the people were “like sheep without a shepherd” (Matt 9:36). In the Parable of the Good Samaritan (Luke 10:25-37), Jesus taught about the importance of compassion, mercy and care and care for those in need, regardless of their ethnicity or social standing.

To address the root cause, Jesus taught the people, sharing His values and His perspectives. In caring for the people, Jesus empowered them with “a new and right spirit” (Psalm 51:10) and the opportunity to be “transformed by the renewal of the mind” (Romans 12:2) and of the heart (Ezekiel 36:26,27). Jesus did not extend help rashly. Jesus was never in haste to “fix the problems”. He knew the importance of understanding the community that He wanted to help and was clear about the context, their needs and demands, and the underlying root cause. Jesus was an advocate for the poor and needy, and spoke and acted against the unjust system and the hypocrisy of the religious elite.  Jesus knew that the root cause of injustice and unholiness was an issue of the heart (Mark 7:21-23) and that the remedy was to be born again with a new heart.  Jesus addressed the heart of an important decision maker,“a Pharisee, a man named Nicodemus who was a member of the Jewish ruling council.” (John 3:1).  Like Jesus, Christian healthcare workers must be willing to be effective advocates for change and to offer the gift and hope of being born again not only to decision makers but to all our neighbours.  When decision makers receive a spiritual heart transplant, streams of living and holy water will flow from their new hearts issuing forth equitable and accessible health policies which have the potential to sustain wholesome, healthy life in abundance for individuals and communities as prophesied in Ezekiel 47. By contrast, in the hope of “doing good”, we as Christian healthcare professionals often jump in with a “let’s fix it” attitude, without a full comprehension of the situation, and the need to address the root causes of health inequalities. Very often, in looking at the situation as “an opportunity to serve”, we are blinded to the real needs and to the most important.

Praying continuously

To ensure continual hospitality and strength to minister to the people around Him, what else did Jesus do while He was on earth?

Our Lord often went away to pray to His Father in Heaven, to share with His Father the concerns that weighted His heart, ask for help, and seek wisdom, guidance, and understanding, in line with the Father’s sovereign will. As Alfred Lord Tennyson wrote more than 150 years ago, “More things are wrought through prayer than the world dreams of”.

Likewise, as Christian healthcare professionals, we must pray.

Our God is a meticulous God. He does not give us a task to do that He has not planned. To seek God’s guidance and understand His will, we must maintain a close relationship with our Heavenly Father and “pray continuously” (1 Thess 5:17). We can be confident knowing that if God has provided the vision, then God will also provide the resources to implement the plan in a God-given process – one that brings people together and draws them to Him.

Planning strategically

Let us look closely at what Jesus did to implement God’s plan of action for the needs of the community (Matthew 10: 1-14 and Luke 10: 1-17: Jesus sending out the twelve and the seventy-two).

In these passages, we observe that Jesus did not operate out of one location or a purpose-built building. Instead, Jesus discipled ordinary people from the community. After training them, Jesus sent them back into the community, empowering and authorising His disciples to use their power, knowledge, and skills to minister within the community, including providing and receiving hospitality; teaching; and healing the physically, emotionally, and spiritually sick. Jesus and His disciples worked as a team amongst a specific target group (Matthew 10: 7) moving from community to community.

One of the most obvious and imminent care needs among low-resource countries is pain relief (including pain due to systemic conditions, oral diseases, psychological struggles, and physical or spiritual hunger). For the delivery of basic healthcare including pain relief, many countries utilise a primary healthcare system, employing primary healthcare workers (e.g. community health workers, paramedics, nurse practitioners, physician assistants, auxiliary health practitioners, etc.).  In low-resource countries such as Nepal, Cambodia, Tanzania, Peru, China, Laos and Peru, primary healthcare workers often live and work in rural villages as well as urban centres. Many primary healthcare workers are community members who are trained through short courses or apprenticeships. Their scope of practice usually includes health promotion and basic healthcare including basic oral care using evidence-based appropriate low-cost technology.^7,8 Other community members, such as schoolteachers, traditional birth attendants and parents, may also be trained to provide health education. Christian healthcare professionals and faith-based organisations working in resource limited countries should seek to make themselves redundant by training, equipping and mentoring local personnel to care for their own community.

Engaging the community

Although Jesus instructed His disciples very specifically not to accept payment for their services (Matthew 10: 8-10), the active participation of the community in other ways was desired (Matthew 10: 10-15).  The community was expected to extend hospitality to the disciples, house them, and feed them. If the community was not willing to be active participants or be involved, the disciples were to ‘shake the dust off their feet’ and move on. 

The participation of the community in all aspects of oral care, from the situational analysis, problem identification, needs assessment and setting of priorities, to the selection of programmes or interventions, financing, and evaluation, is necessary to ensure agency, acceptance, usage, and sustainability of programmes or services intended for the well-being of the local people.

Although aid may be initially required to change the circumstances of the community, an important objective of a Biblical approach to healthcare is to empower individuals and communities to be self-reliant and to depend on God, on the talents and gifts provided by God, and on community resources, rather than being perpetually dependent on foreign aid.

Evaluating for continual improvement

Filled with joy and encouraged by the results of their work in the community, the seventy-two disciples returned to Jesus and reported what they had witnessed (Luke 10:17). 

In community health and health promotion, feedback and evaluation will assist in the assessment of valued outcomes (what were the achievements) of interventions to promote health, and also to gain insights and knowledge concerning the processes (how the outcomes were achieved).  Evaluation will also assist in identifying the problems and challenges faced during the implementation of the programme, the strengths and weaknesses of the programme for future improvement, and aid in the justification of resources used for the implementation of programme activities.

Too often evaluation is left as the sole responsibility of the donor, or the development agency, or the providers of care. This limits the scope and value of any evaluation activity.  Since improving community health and health promotion involves the community in their own development, participatory evaluation involving members of the community is desirable and essential for the community to learn, adapt, and improve their control over the determinants of health. 

For oral health programmes based on the Biblical approach, the evaluation would not be complete unless the degree of change or transformation is measured in the areas of culture, faith, attitude towards Christians and the gospel, and quality of witness. For Christian oral health workers and development agencies, process evaluation may ask this relevant question: “Was care provided with a quality of love described in 1 Corinthians 13?  Were the oral care providers patient, kind, not envious, not boastful, not proud, not dishonouring, not self-seeking, not easily angered and kept no record of wrongs?”

Summary

Christian healthcare professionals can offer an alternative, more hospitable, care approach, one that is Biblically based. The Biblically-based approach to improving care and access to care in marginalised communities combines the principles and strategies of public health, health promotion and primary healthcare with the spiritual component. Let us not forget that it is through sin that diseases exist and persist in this world.  Through Jesus Christ and the fullness of the gospel, there is the opportunity for Christian healthcare professionals and faith-based health organisations to offer holistic healing and transformation by “loving our neighbours” and extending Christian hospitality to those living in low-resource countries of our world. As Christian healthcare professionals, we have God-given abilities to address the oral health and spiritual needs of those living in low-resource countries. May the Holy Spirit guide you in Kingdom building as you serve as God’s agents of change and transformation, starting small and thinking big.

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