“So, why are we going to Zambia, anyway?”

Philippians. 1:20

… it is my eager expectation and hope that I will not be at all ashamed, but that with full courage now as always Christ will be honored in my body, whether by life or by death.

Mukinge Hospital. 180 beds. Remote northwestern Zambia. 40,000 people. Three doctors.

My wife and I were scheduled to depart soon to spend a month working there when she asked me a good and penetrating question: “why are we going anyway?” Now, Nancy is not spiritually inferior, and this was not the first time we had done this type of thing. My wife has been my constant companion for almost 34 years, she is at least my equal, and has spent months in Haiti, Kenya, and the United States with me doing short term medical missions. Nancy just has a nice way of cutting through layers of pat, correct, expected answers and getting to the core.

I had to stop and ask myself, “why are we going to Zambia?” “What is my motivation?” “What do I hope to accomplish?” “What do I want God to do in me and through me?” Better yet, “what does God want to do in me and through me?” I had to think through carefully, before I departed, why I was actually going.

There are lots of wrong reasons to go on a short term mission trip. I could go out of pride, seeking the admiration of others or even myself. I could go out of duty or obligation, feeling that I should go or ought to go. I could go for the sake of friendships. I could go out of pity or compassion for those in need of a physician. I could go simply because I thought it might be a good idea. Some of these reasons to go are worthy, but none of these motivations is both worthy in an ultimate sense and sustainable. I did not want to go to Zambia for the wrong reason, and I asked God to give me the right motivation; if I was going for the wrong reason, I asked that God change me, or stop me. I did not want anything less than supernatural motivation, and I desired nothing less than supernatural results.

The right answers to these questions of motivation do not change. The primary, ultimate and lasting motivation for any missionary activity can be only the desire to see Jesus Christ glorified; this occurs as his greatness, his love, his mercy, his grace, his forgiveness, in sum, his entire character and attributes, are made known to others and they then come to love him and honor him. Anything short of the glory of God is an unworthy and unsustainable motivation in missionary work or life in general.* I needed to be sure this was what I was after, and I hope it was.

Being used by God as an instrument to proclaim the gospel of Jesus Christ was another right and related reason to go, and this was something I hoped to accomplish mainly by caring for sick (often dying), poor, helpless patients, and doing this in the name of Christ. Mukinge Hospital has an active chaplain service, and these chaplains share the gospel with their people in a way I could not because of language and cultural barriers. Over 300 have come to Christ in just over the past year through the ministry of Mukinge Hospital.

I also wanted to relieve the missionary doctors there, one of whom was an old friend (Stephen Letchford, MD). These full time missionary doctors are often overworked, tired, and in need of a little rest.

After wrestling with my motivations and reasons for going to Zambia, I had to admit that I had a hard time discerning my real reasons; I find that questions of motivation are often difficult for me to really answer with certainty. I finally simply asked God to use us in Zambia to bless himself and others, and to change us. I asked him to purify my motivations, to change them as needed, and, in spite of my limited self-knowledge, to accomplish what he wanted to accomplish. I believed I was obeying him, and asked him to make it clear as I went exactly why I was going. And, most important, I realized that what I needed was a deeper relationship with Jesus Christ; I asked God for that, and desired to cultivate it.

God began showing me why we were in Zambia almost from the moment we got off the plane.

Now in retrospect, I can see even more clearly why we went. God is still teaching me, but so far, here are a few of the reasons we went to Zambia, and a few of the lessons learned.

To glorify Jesus Christ. By our being there and rendering medical care in Jesus’ name to needy, poor, very ill patients, Jesus was honored and magnified. I do not mean that he was made any better or greater than he is; he is infinite, and I can add nothing to the infinite and eternal Son of God. I mean that he can use us to demonstrate his greatness and goodness to others; surprisingly, they can see him more clearly as they look at him through the lives of believers. When his goodness and greatness are openly proclaimed, he is honored, and as others come to love him and follow him, he is glorified. At Mukinge Hospital, physicians, nurses, and chaplains share with patients the gospel of Jesus Christ, and many come to him for rescue and salvation. When people are physically sick or near death, they are often open to considering questions about their spiritual sickness and deadness; Jesus Christ is the only answer to these questions.
To share the gospel with both believers and non-believers. God gave us the chance to speak and teach in ways that allowed us the directly or indirectly give out the good news about Jesus Christ.
To care for the medical needs of a very sick and impoverished group of people. God has a heart for the poor, needy, sick, wounded, disenfranchised, and helpless. It is a privilege to give medical care to people God cares about, and to do it in Jesus’ name. It is a privilege to help relieve suffering, to be an instrument of God’s healing, and to offer Jesus’ healing, kindness and gentleness to those in distress. Our patients often traveled many miles and days by any means necessary, in seek of medical care, hoping to find relief and healing. Jesus said that the sick need a physician, and these people were sick, in need of a doctor. I believe that I owe it to sick people in other parts of the world to share with them the medical gifts and training I have been given by God; I am under obligation to them.
To work in an ongoing medical ministry with continuity and staying power. It was important to me that, though I might only be there for a few weeks, the work and ministry done would outlast my presence there. The facts that the hospital and associated ministries have a more than a fifty year history, a solid reputation in the country, and plans for ongoing, continuous ministry all made my relatively small contributions more valuable since I was a part of something much bigger than myself.
To provide some needed and deserved relief to the career missionaries. While there, for a few weeks, my son-in-law (Daniel Claassen, M.D., husband of our daughter Esther) and I served as vacation relief for two missionary doctors, allowing them to have time for vacation and retreat. For two weeks, we, along with a surgeon, were the only physicians there, caring for 120-150 inpatients per day.
To encourage the missionaries and Zambian fellow-believers, and to receive their encouragement. God allowed us to have good relationships there with the missionaries and with Zambians, and we attempted to use these relationships to encourage them in word and action, as they encouraged us. The missionary staff welcomed us immediately, and we enjoyed good times with them. My wife led Bible studies for nursing students, we participated in the Christian Nursing Students’ worship times, we worked and worshiped side by side with the Zambians, and we made good friendships with several of them. We were impressed at the health of the Zambian church, and thanked God for the bright, godly young leaders we saw there.
To visit with one of our church missionary families while they in their element. Steve Letchford and his family are friends and members of our church in Augusta, Georgia. This trip gave me the opportunity to observe, in person, what their lives are like and the struggles they face every day. I hope we were able to especially understand and encourage them.
To remind me again of the sacrifices missionaries make. I appreciate more than ever that career missionaries of the cross lose their lives when they go to their posts; they give up everything for the privilege of taking the gospel to the world. It is costly. I should be more willing to sacrifice for Jesus Christ.
To allow me to suffer a little with other believers. Zambian believers suffer, and missionaries suffer. God allowed us to enter into their suffering on a small scale, and to share it with them. The Zambians suffer from extreme poverty, illness, and frequent brushes with death. I have been in practice for 25 years now, and I have seen much suffering and death. I am still (and hopefully always will be) deeply distressed and at times brought to tears by suffering, dying people. I saw many suffering patients at Mukinge, and I found myself identifying deeply with their pain. Missionaries suffer in many large and small ways, from being separated from their parents and children to giving up what they might have had here in the United States to constant exposure to disease and danger.
To learn a little humility. It is humbling and humiliating to watch one’s patients die because there is nothing else to be done for them; they are often gravely ill in the first place, but this is compounded by lack of resources and medications. It was not uncommon to lose several patients in a day; even now, I can hear the wailing of mourners for deceased patients. Many patients were admitted with AIDS or malnutrition underlying their pneumonia, tuberculosis, meningitis, or malaria; they were compromised from the beginning, and many did not survive.
To learn a little gratitude. I came away from Zambia very grateful for the life God has given me, for the place he has put me, for my family, church, practice, and country. I am blessed by God beyond my ability to thank him.
To be reminded of the importance of prayer for the worldwide spread of the gospel and for the missionaries who pour out their lives to spread it. The gospel will spread, grow, and bear fruit because it is the gospel of the grace of God. We have the privilege of praying that God will bring many to Jesus Christ, and we know beforehand that this is what he wants to do and will do. We have no doubt about his will in this matter, and we can be involved in this global initiative of God’s through prayer.
To change my perspective. This time in Zambia was used by God to uproot me, unsettle me, and to shake me up. I see again clearly that all I need is God through Jesus Christ, and he allowed me to find him again in a new a fresh way. God cultivated my relationship with Jesus Christ, and I needed this experience to draw me closer to him.
To make me a better physician. Practicing in a new place with new diseases and relatively little in resources makes one depend upon God more, gives new confidence in God and the skills he has given me, and yields sharper clinical skills. I am now a much better physician for my patients in America. Spending a month practicing medicine in a developing country is like an intensive continuing medical education course, close up and personal, no holds barred. I was challenged with the diagnostic possibilities, the need to be flexible and adaptable in treatment, and with the realization anew that we treat patients but God heals.
To serve Jesus as a family. God again gave Nancy and me the opportunity to serve God abroad with our family. Daniel and Esther Claassen (our son-in-law and daughter) preceded us to Zambia by one month, but then, we were able to work together for about a month. Daniel and I took care of the hospital inpatients, Esther worked in administration at the hospital, and Nancy and Esther helped lead Bible studies for the nursing students. It was a unique and meaningful opportunity to spend this time with our children as a team.
To see some medical miracles firsthand. I saw patients there who lived and walked out normal who I thought would die or at least show signs of serious long term disability. My first full day there, a two week old baby with overwhelming sepsis (serious bacterial infection) arrived on the pediatric ward. She was near death, and I thought she would die before we could even get an IV into her. Even here in America, she might have easily succumbed. She lived and 10 days later her mother took her home. We had two patients with advanced and very serious bacterial meningitis who surprised me by going home after 10 days of antibiotics. We had countless patients with malaria, many with cerebral malaria, who recovered and went home cured. These are patients who in the best of situations might easily have died. They are miraculous cures from the hand of God.
To give me renewed purpose. We went to Zambia realizing that it might not be safe, that it might be dangerous, that we might become ill there, or might even die there. We were only being realistic. (At the same time, is anything really completely safe? There, as here, anything can happen at any time; yet, ultimately, we are in a fundamental sense always totally safe as long as God is the one who holds us.) God impressed Philippians 1:20 on me several years ago, and then again, several months ago; it is my desire that Christ be honored and magnified in my body whether by life or by death. I arrived at Mukinge already somewhat ill, and two weeks later was extremely sick. I believe I was under Satanic assault that Saturday night. I remember clearly in the midst of the battle being able to say, by the grace of God, “blessed is the name of the Lord.” I asked God to help me and to heal me, and God got me through that night. I was able to work the next morning, but only barely. I stumbled (slowly) up the hill to the hospital, made rounds, did a spinal tap, and got everyone tucked in. After rounds, I went home and slept for four hours, feeling much better when I awoke. I believe that during that night’s struggle, God healed me in several ways and on multiple levels; it was so dramatic that I have difficulty explaining it in a way that makes it comprehensible. He gave my life back to me in more than a physical sense. He healed me physically, but, even more, he healed me spiritually, giving me a new verse in the following days to go with Philippians 1:20 as the other bookend around my life. That verse was Acts 20:24 where Paul says his life is of relatively little value to him (compared to the privilege of serving and knowing Christ), and that all he wants is to finish his course with joy, and to fulfill the ministry given to him by Jesus. This is what I want for the rest of my life. I want to finish my course for Jesus with joy, and to fulfill the ministry he has given me, specifically, to do. I know he wants me to honor him where I am, and wherever he places me. I want to see Jesus honored and glorified in my life, in my family, in my church, and in my practice. Jesus has given me new joy, freedom, peace, and purpose. Jesus Christ is all I need in life and in death.

So, why did I go to Zambia? I went to Zambia intending to give my life away for a short term medical mission, but I returned with Jesus more than giving my life back to me again.

Acts 20:24

But I do not account my life of any value nor as precious to myself, if only I may finish my course and the ministry that I received from the Lord Jesus, to testify to the gospel of the grace of God.

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* I owe this concept to Dr. John Piper, and discovered it while reading his book, Let the Nations Be Glad.

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Copyright, Jerry Miller, Jr., 2005. You are permitted and encouraged to reproduce and distribute this article as long as 1. it remains unaltered in wording, 2.there is no charge for the distribution, and 3. not more than 500 copies are made.

“So, why are we going to Zambia, anyway?”

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