The Problem
The scale of Africa’s health crisis is daunting.
- Life expectancy is usually less than 50 years of age
- More than 1 out of 10 children die before the age of 5
- On average, there is only one surgeon for every quarter of a million people
- AIDS often affects 10-20% or more of the adult population
- Tuberculosis has spiraled out of control
- There is a critical shortage of health personnel. In Malawi, for example, there are over 7400 HIV-infected individuals for every trained physician.
Many of these statistics are familiar; so much so that they have been taken for granted and no longer surprise us.
The African church health sector has, for many decades, been quietly worked to alleviate the suffering and to reverse these trends. This sector provides a third or more of all health care services in Africa (see chart) and are typically located in rural, underserved areas. Mission hospitals are often the only safe place to obtain surgery or a C-section. The faith-based sector has played a critical role in the scale-up of HIV care and treatment. And these institutions train doctors, physician assistants, nurses and community health workers within a functioning and accountable structure. The reputation of mission health facilities is such that sick clients will travel long distances and pass by other hospitals in order to obtain quality, compassionate care.
Historically, Christian hospitals were staffed by free labor in the form of medical missionaries. These missionaries provided a connection back to concerned friends and donors in the West. Missions and churches raised a significant amount of the funds required to sustain and expand operations.
With the decline in the number of medical missionaries, many dedicated African professionals have stepped up to continue the work. But these committed workers do not have access and connections to the same level of funding. In general, Christian hospitals are expected to be more and more on their own.
Researchers from the World Bank, after studying health institutions in Uganda and finding that faith-based institutions outperformed governmental ones, concluded that “working for God matters.” A study funded by the Gates Foundation documented the wide range of effective health work conducted by faith-based institutions on the continent. These investigators determined that significant external resources are required to rebuild deteriorating infrastructure, support clinical services for the poor, and expand training programs at Christian hospitals (see the Gates-funded report here http://www.arhap.uct.ac.za/publications.php).
Given the scale of the health problems facing Africa, more support is required so that these effective, quality institutions can fully reach their communities.
“There was an ongoing and pervasive problem of declining external resources for REs [religious entities]. Whereas in the past faith-based hospitals were supported by international partners, they were now expected to be more self-reliant and this was very difficult in a context of a very poor national congregational base.”(Schmid et al.)
Sources:
Pan-African Academy of Christian Surgeons (www.paacs.net)
Samb et al. New England Journal of Medicine 2007 Dec 13;357(24):2510-4
Schmid B, Thomas E, Olivier J and Cochrane JR. "The Contribution of Religious Entities to Health in Sub-Saharan Africa", Report for the Bill and Melinda Gates Foundation, (Cape Town: African Religious Health Assets Programme, October 2008). http://www.arhap.uct.ac.za/publications.php
UNAIDS (download the latest report at the following URL:
http://www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive/2009/default.asp)
USAID. Working with faith-based organisations to strengthen human resources for health. The Capacity Project. 2007. www.capacityproject.org.
World Health Organization (www.who.int and search country profiles)