How and Where Is Missionary Member Care Done?
Short & Simple Summary
The short answer is almost anywhere and in an ever increasing variety of ways. In Bible times member care was done by traveling to where the missionary was (or the missionary traveling “home”) and talking face-to-face or through a letter, or through a combination of the two. Today changes in technology, especially during the last half century, have opened many more ways through which missionary member care can be provided nearly instantly. Here are the topics covered in the chapter.
In the Bible
Since Bible times
Communication
Transportation: Cargo, currency, and people
Telehealth
Telepsychology
If you want more detail and links to other sources, read on.
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The “how” and the “where” of missionary member care must be considered together because they are so interrelated. Until recent years, the options available for both of these were far more limited than they are today. With the technology available today, especially that related to communication and transportation, people serving in missionary member care have a broad range of possibilities. We will begin with member care options in Bible times and then go on to those available today.
In the Bible
Consider the how and when of missionary member care of Paul. “I was glad when Stephanas, Fortunatus and Achaicus arrived, because they have supplied what was lacking from you….The churches in the province of Asia send you greetings. Aquila and Priscilla greet you warmly in the Lord, and so does the church that meets at their house” (1 Corinthians 16:17-19). The Corinthian church had sent the three men to personally provide missionary member care to Paul, and he sent a written reply back with them.
Also consider how headquarters in Jerusalem communicated their decision on an important issue to people on the field. “Then the apostles and elders, with the whole church, decided to choose some of their own men and send them to Antioch with Paul and Barnabas…. With them they sent the following letter:…The men were sent off and went down to Antioch, where they gathered the church together and delivered the letter. The people read it and were glad for its encouraging message” (Acts 15:22-31).
Note that there were three means of communicating and delivering member care.
· Face-to-face talking, such as Stephanas, Paul, and the others who went with them
· Writing a letter, such as 1 Corinthians or the decision of people at headquarters
· Sending someone to deliver and orally explain the letter or the decision
Since Bible times
Little had changed relative to transportation and communication when William Carey, the “father of modern missions,” and his family left England to go as missionaries to India near the end of the 18th century. They sailed on a ship for nearly five months without stopping even for supplies. To request an item from headquarters back in England took months as ships carried the letter back. Then to receive the aid from the home office took additional months as ships sailed to India again.
However, within a century major changes began to take place. By the end of the 19th century the steam engine had been invented and developed to the place where ships were no longer subject to the whim of the winds and the sea. Locomotives could rapidly transport both people and goods across continents. In addition, the telephone and telegraph had been developed to the point that communication not only across continents, but across oceans was possible.
Finally, by the end of the 20th century airline travel had made it possible for a person to be half way around the world in a single day. The digital revolution had made it possible to communicate electronically with people around the world, free of charge, 24 hours a day, seven days a week. Offerings could be taken for special needs and instantly transferred to where they were needed nearly anywhere in the world. Today member care has the potential of being instantly available anywhere in the world at any time. Here are some of the possibilities that have implications for member care.
Communication
Technological developments made it as easy, as fast, and as costly to communicate with someone on the other side of the world as to call someone across the street.
· Mail. Both surface mail and airmail take original documents from place to place. Postal systems and airmail have made some mail more reliable, more secure, and faster than it was when William Carey went in the 18th century. Mailed documents include only words on paper.
· Telephone and fax. Telephone conversations include audible conversations so that some nonverbal cues are available, and the telephone makes instant replies possible; however, no written documents are available unless they are sent by fax.
· Email. Email is “free” and fast for those who have computers, tablets, or “smart phones,” and it includes written documents. However, messages may sit in the receiver’s inbox for hours or days, so “conversations” may take a rather long time.
· Instant Messaging. IM is also free and fast for those who have computers and internet access, and it includes a written “transcript” of the conversation. Since it is a conversation done in real time, it requires that the two people involved be at their computers during that entire time. It does not include many nonverbal cues.
· Skype. Skype is also free and fast for those who have computers, tablets, or “smart phones” and internet access. In addition to the audio, it includes video (if both people have good connections) so that both can get more nonverbal cues as well as seeing something of the other’s “environment.” In addition, “group” conversations can be arranged with people from different countries included in the conversations.
· New things yet to be invented. Half a century ago, before the digital revolution, many of the things described above were science fiction; today they are reality. Who knows what else will be invented that will have implications for member care?
This new technology provides many more options for how missionary member care is done and many more options for where it is done. No longer do the missionary and the member care provider even have to be on the same continent. Of course, issues raised are the time it takes, the expense it costs, and how “personal or impersonal” it is. It also raises legal and ethical issues discussed in a later chapter. Finally, the seriousness of the problem must be considered. For example, if a missionary is suicidal, being there in person is much better than talking on the phone. Fortunately, other technology makes it possible for a person to get anywhere in the world in about a day—or contact someone in the host country in minutes.
Transportation: Cargo, currency, and people
Technological developments have made it possible to get people, cash, and objects to the other side of the world in a single day or even less if necessary; however, it may be very costly. However, if the missionaries can wait a week, all of those can be accomplished at a much lower cost for shipping.
When missionaries need a part for equipment, it can often be ordered and shipped directly by air to the host country. If the object they need is at headquarters, it can be shipped by air to be delivered the next day—at a price, and at a lower cost if they can wait a few days.
When missionaries need personal care, member care providers can be in the host countries within 24 hours if airlines have space. We can fly from our airport 20 minutes from home and be 12 time zones away in 25 hours, and we do not live near a hub.
When missionaries need currency, the home office can usually wire it to them in a matter of hours if it is a large amount. If they need smaller amounts of cash, the home office can place it in their bank account in their passport country, and the missionary can get it in local currency through an ATM right in their host country as soon as the deposit is credited to their account.
What a difference between that and Bible times when Paul needed encouragement and the offering was taken for him. But it took weeks or months for Stephanas or Titus to get to him when the offering was sent by the Corinthian church.
Telehealth
Telehealth (or Telemedicine) is the general name given to the rise in providing care for people from a distance, which is now possible. It is widely used for medical consultations and for providing medical care for people who are at a distance from health care providers, such as those living in rural areas. The following link gives a good overview of the whole field with many links to specific areas of telemedicine http://en.wikipedia.org/wiki/Telemedicine. The following article is more limited, but it does include preventive medicine as well http://en.wikipedia.org/wiki/Telehealth. The U.S. Department of Health and Human Services has much information about telehelath at http://www.hrsa.gov/ruralhealth/about/telehealth/. Be sure to click on the “Telehealth Toolbox” on that page for an excellent overview of telehealth.
Telehealth includes all areas of medicine, including telepsychiatry. One can add the prefix “tele” to virtually any field in the mental health area, type it into a search engine and come up a list of links to websites about that area. This includes counseling, psychology, psychotherapy, pastoral counseling, etc. Readers can make that kind of search for their own discipline. Because I am a psychologist, here are some links that I have found relative to telepsychology.
Telepsychology
The American Psychological Association (APA) sends their monthly publication, Monitor on Psychology, to all members of APA. Here is one relevant item from the Monitor on Psychology during each of the last four years.
· “Telepsychology is in the rise” http://www.apa.org/monitor/2010/03/telepsychology.aspx
· “A new emphasis on telehealth: How can psychologists stay ahead of the curve—and keep patients safe?” http://www.apa.org/monitor/2011/06/telehealth.aspx
· “More states reimburse for telehealth services” http://www.apa.org/monitor/2012/07-08/telehealth.aspx
· “Phone therapy works for mild to moderate disorders, study suggests” http://www.apa.org/monitor/2013/01/phone-therapy.aspx
In addition, on July 27, 2012 the APA released a draft document “Guidelines for the practice of Telepsychology” for public comment. A copy of this 18-page document is available at.
In addition to professional standards, missionary member care providers need to be aware of the laws of their own state and country and the laws of the states and countries in which the missionaries serve. I live in Kentucky, and the laws about “Telehealth and Telepsychology” are available at
http://www.lrc.ky.gov/kar/201/026/310.htm. It is the providers’ responsibility to find the laws under which they work (usually easy) and the laws where the missionaries live (usually more difficult).
Finally, there are many other sources that pertain to several mental health disciplines. For example there is a 60-page article, “Telepsychology & Telehealth: Counselling Conducted in a Technology Environment,” published in Counselling, Psychotherapy, and Health at
http://www.mentalhealthacademy.com.au/journal_archive/cph0817.pdf . Also, “Resources & Updates for Psychotherapists, Counselors, Marriage & Family Therapists, Social Workers, Psychiatrists and Other Mental Health Professionals” are available at http://www.zurinstitute.com/telehealthresources.html.
This new technology provides new possibilities for providing missionary member care. However, it also produces new pitfalls which we must be careful to avoid.
Note to the reader: If you have suggestions about other things that would better answer this chapter’s question, please email those to me at ron@missionarycare.com. In that email please tell me three things: (1) what you believe needs to be included, (2) links to relevant websites if available, and (3) how it better answers the question “How and where is missionary member care done?” I plan to periodically update and expand the book with these suggestions.