Made in God’s Image: Doctors without Borders

Preacher: Emily Gill
Date: August 5, 2018

Scripture: Mark 5:25-34


What is the image of God when faced with injustices in our personal encounters? When people with abundant privilege, choice and power, meet someone who suffers because they have fewer or no choices, and the difference is because of random qualities we receive at birth: gender, race, and culture?


The woman in Mark’s passage, who is likely not much older than I am, resonates with my experiences in West Africa working for Doctors without Borders, otherwise known as MSF (medecins sans frontières). I can relate to her, as a woman with a common medical condition, but her suffering was exacerbated by lack of choices. She likely had the common medical condition of ‘Menorrhagia’: excessive, prolonged monthly bleeds. I encounter this frequently in my family medicine clinics and even with the choices of Western medicine, the suffering involves fatigue, interference with intimate relations, usually infertility, and requires additional daily hygiene practices. All of these sufferings would be compounded for a woman in the 1st century, a woman with few choices and little power.


Then, she encounters Jesus. Her healing came from the empowerment obtained through her bold move in actively touching Jesus. He did not actively heal her. It was she who took action. Someone who was suffering, audaciously and courageously took some of Jesus’ power to address her own suffering.


And, Jesus’ response is what I have pondered this week:


Taking something from someone how has more power than you is risky. As we just heard, she was trembling with fear as to how he might respond. But, Jesus responded with the pride of a parent or teacher seeing their child or student be bold, making a choice, and being empowered. A selfless parent or teacher who delights in sharing their privileges with their child, because this indicates their student is going to be ok, is going to thrive.


The Gospel story speaks of Jesus’ healing, good, power. But when I encountered suffering in West Africa, I struggled with my birthright privilege of abundant choice, and felt conflicted about the imbalance of power in my favor. Privilege is defined as "a special right or advantage, granted or available only to a particular person or group". Privilege creates an imbalance of power between those with the advantages, and those without.


I was born with more privilege than most, as a daughter of white, many-generational Americans who are successful baby-boomers. Even my gender was no disadvantage in the early 1990s California where gender and sexuality were fluid topics at my high-school. It’s unsurprising I volunteered for MSF, an organization guided by the principle of aiding those in distress, those who suffer. Humanitarian aid work is about people with the privilege of choices encountering those who suffer because of little or no choice. The excellent Nigerian author Chimamanda Ngozi Adiche writes about how gross world inequities economically and politically disenfranchise people and what that feels like: disempowering choicelessness.


This is the suffering I am focusing on today, the suffering caused explicitly because of the disadvantages of inequity . .. which underpinned the suffering I saw in West Africa. Where is God in this incredible injustice?


In 2007, I was working in a children’s clinic where malnutrition was the focus because of the recent civil war in Ivory Coast. Some children were not responding to treatment, and we then suspected that the war had also spread the life-threatening HIV/AIDS.


I met many women, like me, who were also made in the image of God, but they had got the short-end of the power-stick and I had the longer-end.


I got to know these children and their mothers through daily morning meetings in the clinic. Despite the vast differences in our existences, we shared small moments of daily connection.


The mum on the front of your worship order had a sense of humor and a confidence that meant she had little reserve in connecting with me, even though I was a foreigner: she was happy to comment on the outfit I was wearing, chide me if I was late, or pat my knee. She laughed when her son peed on my lap, and explained it was good luck and handed me a cloth to soak up the pee. This contrasted with others, more inclined to apologize and rush to take the child away from me, suggesting they thought I minded. I loved her willingness to share a bit of herself and her humor with me, and I think she sensed this.


Indeed, because this boy was not getting better quickly, I got to know him and his mother better than the others: I learned she was the 3 rd wife of a farmer, that she was really worried about all the time she was with us, because she wasn’t pulling her weight in the fields, along with the other wives, and worried about the consequence of this on her and her only child. However, she was desperately torn because her son, about 2 years old, had never spoken or even crawled yet. S he got looks from the other wives and people in her village. Her village required taking a bus and several hours walking to get to . . . and so she rarely had the income for this voyage. The suffering of this existence, with so little choice was profound. And remember, she was 1 of dozens.


Then, there was the power and privilege of my knowledge, gained through my abundant privilege: I knew this child was not getting better because he probably had HIV. And this means his mum, the woman I was getting to know, probably had it too. A choice was needed: Should the test be done to prove whether or not this mother and child, and by default a family, had HIV/AIDS?


I attempted what I’d been trained to do: a conversation about ‘informed consent’.


I asked her whether we could perform a test for HIV on her and her child. But, did she understand? . . . I was having this conversation with a woman who’d likely never been asked for her permission to do anything, much like the woman in the Gospel reading. And now, the first time she’s being asked for permission, it is about whether to find out if she has something horrible? That she might be ostracized for?


To make matters more challenging, World Health Organization's guidelines in 2007 stipulated I should not offer this choice to diagnose HIV if I couldn’t provide definitive anti-retroviral treatment, which I couldn’t. We had access to preliminary treatments. The alternative was to start these preliminary treatments without knowing whether the child had HIV. Effectively, to treat on a presumed diagnosis, and not have the difficult conversation.


I pray that God was in that room with me, when I asked this woman whether she consented to an HIV test or not. With all that conflict of ethics, I struggled with the complexities of choice I had from my privileged knowledge, and met with women who’d never had choice, and delivered news of even more suffering . . . in a strange, well-intentioned foreign way, I told myself I was offering a choice of knowledge.


I still do not know what the ‘right’ thing was to do. I know we finally settled on an approach to manage children whom we eventually diagnosed with HIV, despite the hurdles of getting definitive treatment. I had the joy in seeing several children, including the little boy I described before, change in weeks from weak, quiet, immobile forms curled in their mother’s laps to rambunctious toddlers, not dissimilar to my own. You can see his cheeky smile, wearing my hat on the front of the worship order. But, I still struggle with what happened in my conversations with those women in that room.


My only way to reconcile this experience is to have faith that God was there. That was, perhaps, the rawest images of God I will have the honor of experiencing. As a doctor, I take an oath to first do no harm. I am not sure I succeeded. Their suffering was abundantly clear. My white skinned privilege could be seen a mile away. Where was God for her, in that moment of receiving that bad news?


I was blessed to feel deep compassion. I hope that for the women, in that moment of suffering with me, they experienced some relief through the compassion. Perhaps there was relief in the knowing why their child was not improving; in sharing this revelation with a foreigner who had information to offer that might provide choices; perhaps, relief in sharing this event with someone who was not part of the social network where HIV stigma prevailed. We began what medical treatment we could, including educating the woman on avenues to pursue when we left, to access ongoing treatment. I pray that my role did not increase their suffering in the future.


I wish my story was one of a clear transfer of the power of my privileges being taken from me, to cure the suffering of others as with the story of Jesus and the woman with menorrhagia. But, of course, I am not Jesus as none of us are. I can but hope, that somehow, like the Gospel story, I was a vehicle of power. That through no action of my own, the women received some form of empowerment from me. How I pray this occurred.


I have previously understood this Gospel story to be one of the power of Faith-healing. I’ve enjoyed the additional perspective of the passage portraying God’s delight in power being shared. In a fitting analogy, Kent pointed out that when blood is donated, the blood donor quickly replenishes their own supply, while their donated blood delivers the power of healing to others. Spiritual and healing power are limitless. We lose nothing when we share that kind of power with others.


God’s power is limitless. It is our human traits that lock power up as privilege for some and not others. When we encounter the injustices that surround us every day, perhaps we can consider what power we have through the privileges we acquired at birth, and rejoice in sharing this to empower others and so expand overall power, to all of us as children of God.


So, please take stock of the privileges you have, and consider what power you have that can empower someone else. Perhaps this is through volunteer work, or social justice work, or financial donations, or perhaps, teaching a skill to someone voluntarily, or using your consumer power to buy ethically produced products. Then, as Jesus taught us, rejoice when your power empowers someone else. That is when God’s power is truly expanding.